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Oliveira DS, Ponfick M, Braun DI, Osswald M, Sierotowicz M, Chatterjee S, Weber D, Eskofier B, Castellini C, Farina D, Kinfe TM, Del Vecchio A. A direct spinal cord-computer interface enables the control of the paralysed hand in spinal cord injury. Brain 2024; 147:3583-3595. [PMID: 38501612 DOI: 10.1093/brain/awae088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 01/24/2024] [Accepted: 03/05/2024] [Indexed: 03/20/2024] Open
Abstract
Paralysis of the muscles controlling the hand dramatically limits the quality of life for individuals living with spinal cord injury (SCI). Here, with a non-invasive neural interface, we demonstrate that eight motor complete SCI individuals (C5-C6) are still able to task-modulate in real-time the activity of populations of spinal motor neurons with residual neural pathways. In all SCI participants tested, we identified groups of motor units under voluntary control that encoded various hand movements. The motor unit discharges were mapped into more than 10 degrees of freedom, ranging from grasping to individual hand-digit flexion and extension. We then mapped the neural dynamics into a real-time controlled virtual hand. The SCI participants were able to match the cue hand posture by proportionally controlling four degrees of freedom (opening and closing the hand and index flexion/extension). These results demonstrate that wearable muscle sensors provide access to spared motor neurons that are fully under voluntary control in complete cervical SCI individuals. This non-invasive neural interface allows the investigation of motor neuron changes after the injury and has the potential to promote movement restoration when integrated with assistive devices.
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Affiliation(s)
- Daniela Souza Oliveira
- Department Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91052 Erlangen, Germany
| | - Matthias Ponfick
- Querschnittzentrum Rummelsberg, Krankenhaus Rummelsberg GmbH, 90592 Schwarzenbruck, Germany
| | - Dominik I Braun
- Department Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91052 Erlangen, Germany
| | - Marius Osswald
- Department Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91052 Erlangen, Germany
| | - Marek Sierotowicz
- Department Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91052 Erlangen, Germany
- Institute of Robotics and Mechatronics, German Aerospace Center (DLR), 82234 Oberpfaffenhofen, Germany
| | - Satyaki Chatterjee
- Department Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91052 Erlangen, Germany
| | - Douglas Weber
- Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, PA 15213, USA
- Neuroscience Institute, Carnegie Mellon University, Pittsburgh, PA 15213, USA
| | - Bjoern Eskofier
- Department Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91052 Erlangen, Germany
- Translational Digital Health Group, Institute of AI for Health, Helmholtz Zentrum München-German Research Center for Environmental Health, 85764 Neuherberg, Germany
| | - Claudio Castellini
- Department Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91052 Erlangen, Germany
- Institute of Robotics and Mechatronics, German Aerospace Center (DLR), 82234 Oberpfaffenhofen, Germany
| | - Dario Farina
- Department of Bioengineering, Imperial College London, London, SW7 2AZ, UK
| | - Thomas Mehari Kinfe
- Department Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91052 Erlangen, Germany
- Division of Functional Neurosurgery and Stereotaxy, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Alessandro Del Vecchio
- Department Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91052 Erlangen, Germany
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He X, Sun W, Song R, Xu W. Wavelet Coherence Analysis of Post-Stroke Intermuscular Coupling Modulated by Myoelectric-Controlled Interfaces. Bioengineering (Basel) 2024; 11:802. [PMID: 39199760 PMCID: PMC11351678 DOI: 10.3390/bioengineering11080802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2024] [Revised: 08/01/2024] [Accepted: 08/06/2024] [Indexed: 09/01/2024] Open
Abstract
Intermuscular coupling reflects the corticospinal interaction associated with the control of muscles. Nevertheless, the deterioration of intermuscular coupling caused by stroke has not received much attention. The purpose of this study was to investigate the effect of myoelectric-controlled interface (MCI) dimensionality on the intermuscular coupling after stroke. In total, ten age-matched controls and eight stroke patients were recruited and executed elbow tracking tasks within 1D or 2D MCI. Movement performance was quantified using the root mean square error (RMSE). Wavelet coherence was used to analyze the intermuscular coupling in alpha band (8-12 Hz) and beta band (15-35 Hz). The results found that smaller RMSE of antagonist muscles was observed in both groups within 2D MCI compared to 1D MCI. The alpha-band wavelet coherence was significantly lower in the patients compared to the controls during elbow extension. Furthermore, a decreased alpha-band and beta-band wavelet coherence was observed in the controls and stroke patients, as the dimensionality of MCI increased. These results may suggest that stroke-related neural impairments deteriorate the motor performance and intermuscular coordination pattern, and, further, that MCI holds promise as a novel effective tool for rehabilitation through the direct modulation of muscle activation pattern.
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Affiliation(s)
- Xinyi He
- School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen 518107, China; (X.H.); (W.S.)
| | - Wenbo Sun
- School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen 518107, China; (X.H.); (W.S.)
| | - Rong Song
- School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen 518107, China; (X.H.); (W.S.)
- Shenzhen Research Institute of Sun Yat-sen University, Shenzhen 518107, China
| | - Weiling Xu
- School of Information Science and Technology, Zhongkai University of Agriculture and Engineering, Guangzhou 510408, China
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Borhanazad M, van Wijk BC, Buizer AI, Kerkman JN, Bekius A, Dominici N, Daffertshofer A. Lateralized modulation of cortical beta power during human gait is related to arm swing. iScience 2024; 27:110301. [PMID: 39055930 PMCID: PMC11269954 DOI: 10.1016/j.isci.2024.110301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 05/15/2024] [Accepted: 06/14/2024] [Indexed: 07/28/2024] Open
Abstract
Human gait is a complex behavior requiring dynamic control of upper and lower extremities that is accompanied by cortical activity in multiple brain areas. We investigated the contribution of beta (15-30 Hz) and gamma (30-50 Hz) band electroencephalography (EEG) activity during specific phases of the gait cycle, comparing treadmill walking with and without arm swing. Modulations of spectral power in the beta band during early double support and swing phases source-localized to the sensorimotor cortex ipsilateral, but not contralateral, to the leading leg. The lateralization disappeared in the condition with constrained arms, together with an increase of activity in bilateral supplementary motor areas. By contrast, gamma band modulations that localized to the presumed leg area of sensorimotor cortex around the heel-strike events were unaffected by arm movement. Our findings demonstrate that arm swing is accompanied by considerable cortical activation that should not be neglected in gait-related neuroimaging studies.
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Affiliation(s)
- Marzieh Borhanazad
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam 1081 BT, the Netherlands
- Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands
- Institute for Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Bernadette C.M. van Wijk
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam 1081 BT, the Netherlands
- Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands
- Institute for Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Department of Neurology, Amsterdam UMC Location University of Amsterdam, Amsterdam 1105 AZ, the Netherlands
| | - Annemieke I. Buizer
- Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands
- Department of Rehabilitation Medicine, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam 1081 HZ, the Netherlands
| | - Jennifer N. Kerkman
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam 1081 BT, the Netherlands
- Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands
- Institute for Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Annike Bekius
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam 1081 BT, the Netherlands
- Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands
- Institute for Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Centre, Utrecht University, Utrecht 3584 CG, the Netherlands
| | - Nadia Dominici
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam 1081 BT, the Netherlands
- Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands
- Institute for Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Andreas Daffertshofer
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam 1081 BT, the Netherlands
- Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands
- Institute for Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Chung RS, Martin del Campo Vera R, Sundaram S, Cavaleri J, Gilbert ZD, Leonor A, Shao X, Zhang S, Kammen A, Mason X, Heck C, Liu CY, Kellis SS, Lee B. Beta-band power modulation in the human amygdala differentiates between go/no-go responses in an arm-reaching task. J Neural Eng 2024; 21:046019. [PMID: 38959877 PMCID: PMC11369913 DOI: 10.1088/1741-2552/ad5ebe] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 04/22/2024] [Accepted: 07/03/2024] [Indexed: 07/05/2024]
Abstract
Objective. Traditionally known for its involvement in emotional processing, the amygdala's involvement in motor control remains relatively unexplored, with sparse investigations into the neural mechanisms governing amygdaloid motor movement and inhibition. This study aimed to characterize the amygdaloid beta-band (13-30 Hz) power between 'Go' and 'No-go' trials of an arm-reaching task.Approach. Ten participants with drug-resistant epilepsy implanted with stereoelectroencephalographic (SEEG) electrodes in the amygdala were enrolled in this study. SEEG data was recorded throughout discrete phases of a direct reach Go/No-go task, during which participants reached a touchscreen monitor or withheld movement based on a colored cue. Multitaper power analysis along with Wilcoxon signed-rank and Yates-correctedZtests were used to assess significant modulations of beta power between the Response and fixation (baseline) phases in the 'Go' and 'No-go' conditions.Main results. In the 'Go' condition, nine out of the ten participants showed a significant decrease in relative beta-band power during the Response phase (p⩽ 0.0499). In the 'No-go' condition, eight out of the ten participants presented a statistically significant increase in relative beta-band power during the response phase (p⩽ 0.0494). Four out of the eight participants with electrodes in the contralateral hemisphere and seven out of the eight participants with electrodes in the ipsilateral hemisphere presented significant modulation in beta-band power in both the 'Go' and 'No-go' conditions. At the group level, no significant differences were found between the contralateral and ipsilateral sides or between genders.Significance.This study reports beta-band power modulation in the human amygdala during voluntary movement in the setting of motor execution and inhibition. This finding supplements prior research in various brain regions associating beta-band power with motor control. The distinct beta-power modulation observed between these response conditions suggests involvement of amygdaloid oscillations in differentiating between motor inhibition and execution.
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Affiliation(s)
- Ryan S Chung
- Department of Neurological Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States of America
| | - Roberto Martin del Campo Vera
- Department of Neurological Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States of America
| | - Shivani Sundaram
- Department of Neurological Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States of America
| | - Jonathon Cavaleri
- Department of Neurological Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States of America
| | - Zachary D Gilbert
- Department of Neurological Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States of America
| | - Andrea Leonor
- Department of Neurological Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States of America
| | - Xiecheng Shao
- Department of Neurological Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States of America
- Viterbi School of Engineering, University of Southern California, Los Angeles, CA, United States of America
| | - Selena Zhang
- Viterbi School of Engineering, University of Southern California, Los Angeles, CA, United States of America
| | - Alexandra Kammen
- Department of Neurological Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States of America
| | - Xenos Mason
- Department of Neurological Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States of America
- USC Neurorestoration Center, Keck School of Medicine of USC, Los Angeles, CA, United States of America
- Department of Neurology, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States of America
- Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States of America
| | - Christi Heck
- USC Neurorestoration Center, Keck School of Medicine of USC, Los Angeles, CA, United States of America
- Department of Neurology, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States of America
- Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States of America
| | - Charles Y Liu
- Department of Neurological Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States of America
- USC Neurorestoration Center, Keck School of Medicine of USC, Los Angeles, CA, United States of America
- Department of Neurology, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States of America
- Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States of America
- Viterbi School of Engineering, University of Southern California, Los Angeles, CA, United States of America
| | - Spencer S Kellis
- Department of Neurological Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States of America
- USC Neurorestoration Center, Keck School of Medicine of USC, Los Angeles, CA, United States of America
- Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States of America
| | - Brian Lee
- Department of Neurological Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States of America
- USC Neurorestoration Center, Keck School of Medicine of USC, Los Angeles, CA, United States of America
- Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States of America
- Viterbi School of Engineering, University of Southern California, Los Angeles, CA, United States of America
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5
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Dash D, Teplansky K, Ferrari P, Babajani-Feremi A, Calley CS, Heitzman D, Austin SG, Wang J. Automatic detection of ALS from single-trial MEG signals during speech tasks: a pilot study. Front Psychol 2024; 15:1114811. [PMID: 38903475 PMCID: PMC11188989 DOI: 10.3389/fpsyg.2024.1114811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 05/24/2024] [Indexed: 06/22/2024] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is an idiopathic, fatal, and fast-progressive neurodegenerative disease characterized by the degeneration of motor neurons. ALS patients often experience an initial misdiagnosis or a diagnostic delay due to the current unavailability of an efficient biomarker. Since impaired speech is typical in ALS, we hypothesized that functional differences between healthy and ALS participants during speech tasks can be explained by cortical pattern changes, thereby leading to the identification of a neural biomarker for ALS. In this pilot study, we collected magnetoencephalography (MEG) recordings from three early-diagnosed patients with ALS and three healthy controls during imagined (covert) and overt speech tasks. First, we computed sensor correlations, which showed greater correlations for speakers with ALS than healthy controls. Second, we compared the power of the MEG signals in canonical bands between the two groups, which showed greater dissimilarity in the beta band for ALS participants. Third, we assessed differences in functional connectivity, which showed greater beta band connectivity for ALS than healthy controls. Finally, we performed single-trial classification, which resulted in highest performance with beta band features (∼ 98%). These findings were consistent across trials, phrases, and participants for both imagined and overt speech tasks. Our preliminary results indicate that speech-evoked beta oscillations could be a potential neural biomarker for diagnosing ALS. To our knowledge, this is the first demonstration of the detection of ALS from single-trial neural signals.
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Affiliation(s)
- Debadatta Dash
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, TX, United States
| | - Kristin Teplansky
- Department of Speech, Language, and Hearing Sciences, University of Texas at Austin, Austin, TX, United States
| | - Paul Ferrari
- Helen DeVos Children’s Hospital, Corewell Health, Grand Rapids, MI, United States
| | | | - Clifford S. Calley
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, TX, United States
| | | | - Sara G. Austin
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, TX, United States
| | - Jun Wang
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, TX, United States
- Department of Speech, Language, and Hearing Sciences, University of Texas at Austin, Austin, TX, United States
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6
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Baumgartner NW, Hill JP, Bhatnagar S, Roos R, Soliven B, Rezania K, Issa NP. Added load increases the peak frequency of intermuscular coherence. J Electromyogr Kinesiol 2024; 76:102881. [PMID: 38574588 PMCID: PMC11111328 DOI: 10.1016/j.jelekin.2024.102881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 02/15/2024] [Accepted: 03/30/2024] [Indexed: 04/06/2024] Open
Abstract
Cortical motor neuron activity appears to drive lower motor neurons through two distinct frequency bands: the β range (15-30 Hz) during weak muscle contractions and γ range (30-50 Hz) during strong contractions. It is unknown whether the frequency of cortical drive shifts continuously or abruptly between the β and γ frequency bands as contraction strength changes. Intermuscular coherence (IMC) between synergistic arm muscles was used to assess how the frequency of common neuronal drive shifts with increasing contraction strength. Muscle activity was recorded by surface electromyography (EMG) from the biceps and brachioradialis in nine healthy adults performing 30-second isometric holds with added loads. IMC was calculated across the two muscle groups during the isometric contraction. Significant IMC was present in the 20 to 50 Hz range with all loads. Repeated measures ANOVA show the peak frequency of IMC increased significantly when load was added, from a peak of 32.7 Hz with no added load, to 35.3 Hz, 35.7 Hz, and 36.3 Hz with three-, five-, and ten-pound loads respectively. An increase in IMC frequency occurs in response to added load, suggesting that cortical drive functions over a range of frequencies as a function of an isometric contraction against load.
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Affiliation(s)
- Nicholas W Baumgartner
- Department of Neurology, University of Chicago, 5841 S. Maryland Ave, Chicago, IL 60637, USA
| | - Jacquelyn P Hill
- Department of Neurology, University of Chicago, 5841 S. Maryland Ave, Chicago, IL 60637, USA
| | - Shail Bhatnagar
- Department of Neurology, University of Chicago, 5841 S. Maryland Ave, Chicago, IL 60637, USA
| | - Raymond Roos
- Department of Neurology, University of Chicago, 5841 S. Maryland Ave, Chicago, IL 60637, USA
| | - Betty Soliven
- Department of Neurology, University of Chicago, 5841 S. Maryland Ave, Chicago, IL 60637, USA
| | - Kourosh Rezania
- Department of Neurology, University of Chicago, 5841 S. Maryland Ave, Chicago, IL 60637, USA
| | - Naoum P Issa
- Department of Neurology, University of Chicago, 5841 S. Maryland Ave, Chicago, IL 60637, USA.
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Issa NP, Aydin S, Polley E, Carberry N, Garret MA, Smith S, Habib AA, Baumgartner NW, Soliven B, Rezania K. Intermuscular coherence as an early biomarker for amyotrophic lateral sclerosis: The protocol for a prospective, multicenter study. PLoS One 2024; 19:e0303053. [PMID: 38776297 PMCID: PMC11111088 DOI: 10.1371/journal.pone.0303053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 04/18/2024] [Indexed: 05/24/2024] Open
Abstract
OBJECTIVE To describe the protocol of a prospective study to test the validity of intermuscular coherence (IMC) as a diagnostic tool and biomarker of upper motor neuron degeneration in amyotrophic lateral sclerosis (ALS). METHODS This is a multicenter, prospective study. IMC of muscle pairs in the upper and lower limbs is gathered in ∼650 subjects across three groups using surface electrodes and conventional electromyography (EMG) machines. The following subjects will be tested: 1) neurotypical controls; 2) patients with symptomatology suggestive for early ALS but not meeting probable or definite ALS by Awaji Criteria; 3) patients with a known ALS mimic. The recruitment period is between 3/31/2021 and 12/31/2025. Written consent will be sought from the subject or the subject's legally authorized representative during enrollment. RESULTS The endpoints of this study include: 1) whether adding IMC to the Awaji ALS criteria improve its sensitivity in early ALS and can allow for diagnosis earlier; 2) constructing a database of IMC across different ages, genders, and ethnicities. SIGNIFICANCE This study may validate a new inexpensive, painless, and widely available tool for the diagnosis of ALS.
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Affiliation(s)
- Naoum P. Issa
- University of Chicago Medical Center, Chicago, IL, United States of America
| | - Serdar Aydin
- University of Chicago Medical Center, Chicago, IL, United States of America
| | - Eric Polley
- University of Chicago Medical Center, Chicago, IL, United States of America
| | - Nathan Carberry
- University of Miami, Coral Gables, FL, United States of America
| | - Mark A. Garret
- Massachusetts General Hospital, Boston, MA, United States of America
| | - Sean Smith
- Washington University, St. Louis, MO, United States of America
| | - Ali A. Habib
- University of California, Irvine, Irvine, CA, United States of America
| | | | - Betty Soliven
- University of Chicago Medical Center, Chicago, IL, United States of America
| | - Kourosh Rezania
- University of Chicago Medical Center, Chicago, IL, United States of America
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8
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Rong P, Heidrick L, Pattee GL. A multimodal approach to automated hierarchical assessment of bulbar involvement in amyotrophic lateral sclerosis. Front Neurol 2024; 15:1396002. [PMID: 38836001 PMCID: PMC11148322 DOI: 10.3389/fneur.2024.1396002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 05/01/2024] [Indexed: 06/06/2024] Open
Abstract
Introduction As a hallmark feature of amyotrophic lateral sclerosis (ALS), bulbar involvement leads to progressive declines of speech and swallowing functions, significantly impacting social, emotional, and physical health, and quality of life. Standard clinical tools for bulbar assessment focus primarily on clinical symptoms and functional outcomes. However, ALS is known to have a long, clinically silent prodromal stage characterized by complex subclinical changes at various levels of the bulbar motor system. These changes accumulate over time and eventually culminate in clinical symptoms and functional declines. Detection of these subclinical changes is critical, both for mechanistic understanding of bulbar neuromuscular pathology and for optimal clinical management of bulbar dysfunction in ALS. To this end, we developed a novel multimodal measurement tool based on two clinically readily available, noninvasive instruments-facial surface electromyography (sEMG) and acoustic techniques-to hierarchically assess seven constructs of bulbar/speech motor control at the neuromuscular and acoustic levels. These constructs, including prosody, pause, functional connectivity, amplitude, rhythm, complexity, and regularity, are both mechanically and clinically relevant to bulbar involvement. Methods Using a custom-developed, fully automated data analytic algorithm, a variety of features were extracted from the sEMG and acoustic recordings of a speech task performed by 13 individuals with ALS and 10 neurologically healthy controls. These features were then factorized into 10 composite outcome measures using confirmatory factor analysis. Statistical and machine learning techniques were applied to these composite outcome measures to evaluate their reliability (internal consistency), validity (concurrent and construct), and efficacy for early detection and progress monitoring of bulbar involvement in ALS. Results The composite outcome measures were demonstrated to (1) be internally consistent and structurally valid in measuring the targeted constructs; (2) hold concurrent validity with the existing clinical and functional criteria for bulbar assessment; and (3) outperform the outcome measures obtained from each constituent modality in differentiating individuals with ALS from healthy controls. Moreover, the composite outcome measures combined demonstrated high efficacy for detecting subclinical changes in the targeted constructs, both during the prodromal stage and during the transition from prodromal to symptomatic stages. Discussion The findings provided compelling initial evidence for the utility of the multimodal measurement tool for improving early detection and progress monitoring of bulbar involvement in ALS, which have important implications in facilitating timely access to and delivery of optimal clinical care of bulbar dysfunction.
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Affiliation(s)
- Panying Rong
- Department of Speech-Language-Hearing: Sciences and Disorders, University of Kansas, Lawrence, KS, United States
| | - Lindsey Heidrick
- Department of Hearing and Speech, University of Kansas Medical Center, Kansas City, KS, United States
| | - Gary L Pattee
- Neurology Associate P.C., Lincoln, NE, United States
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9
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Lemon R. The Corticospinal System and Amyotrophic Lateral Sclerosis: IFCN handbook chapter. Clin Neurophysiol 2024; 160:56-67. [PMID: 38401191 DOI: 10.1016/j.clinph.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 12/23/2023] [Accepted: 02/03/2024] [Indexed: 02/26/2024]
Abstract
Corticospinal neurons located in motor areas of the cerebral neocortex project corticospinal axons which synapse with the spinal network; a parallel corticobulbar system projects to the cranial motor network and to brainstem motor pathways. The primate corticospinal system has a widespread cortical origin and an extensive range of different fibre diameters, including thick, fast-conducting axons. Direct cortico-motoneuronal (CM) projections from the motor cortex to arm and hand alpha motoneurons are a recent evolutionary feature, that is well developed in dexterous primates and particularly in humans. Many of these projections originate from the caudal subdivision of area 4 ('new' M1: primary motor cortex). They arise from corticospinal neurons of varied soma size, including those with fast- and relatively slow-conducting axons. This CM system has been shown to be involved in the control of skilled movements, carried out with fractionation of the distal extremities and at low force levels. During movement, corticospinal neurons are activated quite differently from 'lower' motoneurons, and there is no simple or fixed functional relationship between a so-called 'upper' motoneuron and its target lower motoneuron. There are key differences in the organisation and function of the corticospinal and CM system in primates versus non-primates, such as rodents. These differences need to be recognized when making the choice of animal model for understanding disorders such as amyotrophic lateral sclerosis (ALS). In this neurodegenerative brain disease there is a selective loss of fast-conducting corticospinal axons, and their synaptic connections, and this is reflected in responses to non-invasive cortical stimuli and measures of cortico-muscular coherence. The loss of CM connections influencing distal limb muscles results in a differential loss of muscle strength or 'split-hand' phenotype. Importantly, there is also a unique impairment in the coordination of skilled hand tasks that require fractionation of digit movement. Scores on validated tests of skilled hand function could be used to assess disease progression.
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Affiliation(s)
- Roger Lemon
- Department of Clinical and Movement Sciences, Queen Square Institute of Neurology, UCL, London WC1N 3BG, UK.
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10
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Issa NP, Aydin S, Bhatnagar S, Baumgartner NW, Hill J, Aluri S, Valentic CS, Polley E, Gomez CM, Rezania K. Intermuscular Coherence in Spinocerebellar Ataxias 3 and 6: a Preliminary Study. CEREBELLUM (LONDON, ENGLAND) 2024; 23:601-608. [PMID: 37428409 PMCID: PMC10776817 DOI: 10.1007/s12311-023-01585-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/03/2023] [Indexed: 07/11/2023]
Abstract
Spinocerebellar ataxias (SCAs) are familial neurodegenerative diseases involving the cerebellum and spinocerebellar tracts. While there is variable involvement of corticospinal tracts (CST), dorsal root ganglia, and motor neurons in SCA3, SCA6 is characterized by a pure, late-onset ataxia. Abnormal intermuscular coherence in the beta-gamma frequency range (IMCβγ) implies a lack of integrity of CST or the afferent input from the acting muscles. We test the hypothesis that IMCβγ has the potential to be a biomarker of disease activity in SCA3 but not SCA6. Intermuscular coherence between biceps brachii and brachioradialis muscles was measured from surface EMG waveforms in SCA3 (N = 16) and SCA6 (N = 20) patients and in neurotypical subjects (N = 23). IMC peak frequencies were present in the β range in SCA patients and in the γ range in neurotypical subjects. The difference between IMC amplitudes in the γ and β ranges was significant when comparing neurotypical control subjects to SCA3 (p < 0.01) and SCA6 (p = 0.01) patients. IMCβγ amplitude was smaller in SCA3 patients compared to neurotypical subjects (p < 0.05), but not different between SCA3 and SCA6 patients or between SCA6 and neurotypical subjects. IMC metrics can differentiate SCA patients from normal controls.
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Affiliation(s)
- Naoum P Issa
- Department of Neurology, University of Chicago, 5841 S. Maryland Ave., MC2030, Chicago, IL, 60637, USA.
| | - Serdar Aydin
- Department of Neurology, University of Chicago, 5841 S. Maryland Ave., MC2030, Chicago, IL, 60637, USA
| | - Shail Bhatnagar
- Department of Neurology, University of Chicago, 5841 S. Maryland Ave., MC2030, Chicago, IL, 60637, USA
| | | | - Jacquelyn Hill
- Department of Neurology, University of Chicago, 5841 S. Maryland Ave., MC2030, Chicago, IL, 60637, USA
| | - Sravya Aluri
- Department of Neurology, University of Chicago, 5841 S. Maryland Ave., MC2030, Chicago, IL, 60637, USA
| | | | - Eric Polley
- Department of Neurology, University of Chicago, 5841 S. Maryland Ave., MC2030, Chicago, IL, 60637, USA
| | - Christopher M Gomez
- Department of Neurology, University of Chicago, 5841 S. Maryland Ave., MC2030, Chicago, IL, 60637, USA
| | - Kourosh Rezania
- Department of Neurology, University of Chicago, 5841 S. Maryland Ave., MC2030, Chicago, IL, 60637, USA
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11
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Xiong Q, Wan J, Liu Y, Wu X, Jiang S, Xiao N, Hou W. Reduced corticospinal drive to antagonist muscles of upper and lower limbs during hands-and-knees crawling in infants with cerebral palsy: Evidence from intermuscular EMG-EMG coherence. Behav Brain Res 2024; 457:114718. [PMID: 37858871 DOI: 10.1016/j.bbr.2023.114718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 10/02/2023] [Accepted: 10/16/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND There is growing interest in understanding the central control of hands-and-knees crawling, especially as a significant motor developmental milestone for early assessment of motor dysfunction in infants with cerebral palsy (CP) who have not yet acquired walking ability. In particular, CP is known to be associated with walking dysfunctions caused by early damage and incomplete maturation of the corticospinal tract. However, the extent of damage to the corticospinal connections during crawling in infants with CP has not been fully clarified. Therefore, this study aimed to investigate the disparities in intermuscular EMG-EMG coherence, which serve as indicators of corticospinal drives to antagonist muscles in the upper and lower limbs during crawling, between infants with and without CP. METHODS This study involved 15 infants diagnosed with CP and 20 typically developing (TD) infants. Surface EMG recordings were obtained from two pairs of antagonist muscles in the upper limbs (triceps brachii (TB) and biceps brachii (BB)) and lower limbs (quadriceps femoris (QF) and hamstrings (HS)), while the infants performed hands-and-knees crawling at their self-selected velocity. Intermuscular EMG-EMG coherence was computed in two frequency bands, the beta band (15-30 Hz) and gamma band (30-60 Hz), which indicate corticospinal drive. Additionally, spatiotemporal parameters, including crawling velocity, cadence, duration, and the percentage of stance phase time, were calculated for comparison. Spearman rank correlations were conducted to assess the relationship between EMG-EMG coherence and crawling spatiotemporal parameters. RESULTS Infants with CP exhibited significantly reduced crawling velocity, decreased cadence, longer cycle duration, and a higher percentage of stance phase time compared to TD infants. Furthermore, CP infants demonstrated decreased coherence in the beta and gamma frequency bands (indicators of corticospinal drive) in both upper and lower limb muscles. Regarding limb-related differences in the beta and gamma coherence, significant disparities were found between upper and lower limb muscles in TD infants (p < 0.05), but not in infants with CP (p > 0.05). Additionally, significant correlations between coherence metrics and crawling spatiotemporal parameters were identified in the TD group (p < 0.05), while such correlations were not evident in the CP group. CONCLUSIONS Our findings suggest that the corticospinal drive may functionally influence the central control of antagonist muscles in the limbs during typical infant crawling. This functional role could be impaired by neurological conditions such as cerebral palsy. The neurophysiological markers of corticospinal drive, specifically intermuscular EMG-EMG coherence during crawling in infants with cerebral palsy, could potentially serve as a tool to assess developmental response to therapy.
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Affiliation(s)
- Qiliang Xiong
- Department of Biomedical Engineering, Nanchang Hangkong University, Jiangxi, China; Department of Bioengineering, Chongqing University, Chongqing, China.
| | - Jinliang Wan
- Department of Biomedical Engineering, Nanchang Hangkong University, Jiangxi, China
| | - Yuan Liu
- Department of Rehabilitation, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaoying Wu
- Department of Bioengineering, Chongqing University, Chongqing, China
| | - Shaofeng Jiang
- Department of Biomedical Engineering, Nanchang Hangkong University, Jiangxi, China
| | - Nong Xiao
- Department of Rehabilitation, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Wensheng Hou
- Department of Bioengineering, Chongqing University, Chongqing, China
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12
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Oliveira Santos M, Swash M, de Carvalho M. Current challenges in primary lateral sclerosis diagnosis. Expert Rev Neurother 2024; 24:45-53. [PMID: 38093670 DOI: 10.1080/14737175.2023.2295010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 12/11/2023] [Indexed: 01/09/2024]
Abstract
INTRODUCTION Primary lateral sclerosis (PLS) is a rare, adult-onset and slowly progressive motor neuron disorder whose clinical core is characterized by upper motor neuron (UMN) dysfunction. Its formal diagnosis is clinically based and disease duration-dependent. Differentiating PLS from other disorders involving UMN can be challenging, particularly in the early stages. AREAS COVERED Our review covers and discusses different aspects of the PLS field, including the diagnostic criteria and its limitations, its differential diagnosis and their major pitfalls, and the actual role of neurophysiology, neuroimaging, genetics, and molecular biomarkers. Symptomatic treatment of the different manifestations is also addressed. The authors searched MEDLINE and Scopus. They also searched the reference lists of articles identified by our search strategy and reviewed and selected those deemed relevant. They selected papers and studies based on the quality of the report, significance of the findings, and on the author's critical appraise and expertise. EXPERT OPINION It is important to investigate novel molecular biomarkers and plan multicenter clinical trials for PLS. However, this will require a large international project to recruit enough patients, particularly given the diagnostic uncertainty of the current clinical criteria. A better understanding of PLS pathophysiology is crucial for designing disease-targeted therapies.
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Affiliation(s)
- Miguel Oliveira Santos
- Institute of Physiology, Instituto de Medicina Molecular João Lobo Antunes, Centro de Estudos Egas Moniz, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Department of Neurosciences and Mental Health, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte, Lisbon, Portugal
| | - Michael Swash
- Institute of Physiology, Instituto de Medicina Molecular João Lobo Antunes, Centro de Estudos Egas Moniz, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Departments of Neurology and Neuroscience, Barts and the London School of Medicine, Queen Mary University of London, London, UK
| | - Mamede de Carvalho
- Institute of Physiology, Instituto de Medicina Molecular João Lobo Antunes, Centro de Estudos Egas Moniz, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Department of Neurosciences and Mental Health, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte, Lisbon, Portugal
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13
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Wen L, Watanabe T, Iwamoto Y, Ishii Y, Miyoshi F, Shiraishi K, Date S, Siu KC, Kirimoto H, Takahashi M. Intramuscular and intermuscular coherence analysis while obstacle crossing during treadmill gait. Somatosens Mot Res 2023:1-11. [PMID: 38145411 DOI: 10.1080/08990220.2023.2296516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 11/30/2023] [Indexed: 12/26/2023]
Abstract
PURPOSE This study aimed to identify the contribution of the common synaptic drives to motor units during obstacle avoidance, using coherence analysis between a-pair electromyography (EMG) signals (EMG-EMG coherence). MATERIALS AND METHODS Fourteen healthy volunteers walked on a treadmill with and without obstacle avoidance. During obstacle gait, subjects were instructed to step over an obstacle with their right leg while walking that would randomly and unpredictably appear. Surface EMG signals were recorded from the following muscles of the right leg: the proximal and distal ends of tibialis anterior (TAp and TAd), biceps femoris (BF), semitendinosus (ST), lateral gastrocnemius (LG), and medial gastrocnemius (MG). Beta-band (13-30 Hz) EMG-EMG coherence was analysed. RESULTS Beta-band EMG-EMG coherence of TAp-TAd during swing phase and BF-ST during pre and initial swing phase when stepping over an obstacle were significantly higher compared to normal gait (both p < 0.05). Beta-band EMG-EMG coherence of TAp-TAd, BF-ST, and LG-MG during stance phase were not significantly different between the two gait conditions (all p > 0.05). CONCLUSIONS The present findings suggest increased common synaptic drives to motor units in ankle dorsiflexor and knee flexor muscles during obstacle avoidance. It also may reflect an increased cortical contribution to modify the gait patterns to avoid an obstacle.
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Affiliation(s)
- Lin Wen
- Department of Biomechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tatsunori Watanabe
- Department of Sensorimotor Neuroscience, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Department of Health Sciences, Aomori University of Health and Welfare, Aomori, Japan
| | - Yoshitaka Iwamoto
- Department of Biomechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yosuke Ishii
- Department of Biomechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Fumiya Miyoshi
- Department of Biomechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kanako Shiraishi
- Department of Biomechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shota Date
- Department of Analysis and Control of Upper Extremity Function, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Ka-Chun Siu
- Physical Therapy Education, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, USA
| | - Hikari Kirimoto
- Department of Sensorimotor Neuroscience, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Makoto Takahashi
- Department of Biomechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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14
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Shiba T, Mizuta N, Hasui N, Kominami Y, Nakatani T, Taguchi J, Morioka S. Effect of bihemispheric transcranial direct current stimulation on distal upper limb function and corticospinal tract excitability in a patient with subacute stroke: a case study. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1250579. [PMID: 37732289 PMCID: PMC10507690 DOI: 10.3389/fresc.2023.1250579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 08/21/2023] [Indexed: 09/22/2023]
Abstract
Introduction Activation of the unaffected hemisphere contributes to motor function recovery post stroke in patients with severe upper limb motor paralysis. Transcranial direct current stimulation (tDCS) has been used in stroke rehabilitation to increase the excitability of motor-related areas. tDCS has been reported to improve upper limb motor function; nonetheless, its effects on corticospinal tract excitability and muscle activity patterns during upper limb exercise remain unclear. Additionally, it is unclear whether simultaneously applied bihemispheric tDCS is more effective than anodal tDCS, which stimulates only one hemisphere. This study examined the effects of bihemispheric tDCS training on corticospinal tract excitability and muscle activity patterns during upper limb movements in a patient with subacute stroke. Methods In this single-case retrospective study, the Fugl-Meyer Assessment, Box and Block Test, electromyography, and intermuscular coherence measurement were performed. Intermuscular coherence was calculated at 15-30 Hz, which reflects corticospinal tract excitability. Results The results indicated that bihemispheric tDCS improved the Fugl-Meyer Assessment, Box and Block Test, co-contraction, and intermuscular coherence results, as compared with anodal tDCS. Discussion: These results reveal that upper limb training with bihemispheric tDCS improves corticospinal tract excitability and muscle activity patterns in patients with subacute stroke.
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Affiliation(s)
- Takahiro Shiba
- Department of Therapy, Takarazuka Rehabilitation Hospital, Medical Corporation SHOWAKAI, Hyogo, Japan
| | - Naomichi Mizuta
- Department of Rehabilitation, Faculty of Health Sciences, Nihon Fukushi University, Aichi, Japan
- Neurorehabilitation Research Center, Kio University, Nara, Japan
| | - Naruhito Hasui
- Department of Therapy, Takarazuka Rehabilitation Hospital, Medical Corporation SHOWAKAI, Hyogo, Japan
- Department of Neurorehabilitation, Graduate School of Health Sciences, Kio University, Nara, Japan
| | - Yohei Kominami
- Department of Therapy, Takarazuka Rehabilitation Hospital, Medical Corporation SHOWAKAI, Hyogo, Japan
| | - Tomoki Nakatani
- Department of Therapy, Takarazuka Rehabilitation Hospital, Medical Corporation SHOWAKAI, Hyogo, Japan
| | - Junji Taguchi
- Department of Therapy, Takarazuka Rehabilitation Hospital, Medical Corporation SHOWAKAI, Hyogo, Japan
| | - Shu Morioka
- Neurorehabilitation Research Center, Kio University, Nara, Japan
- Department of Neurorehabilitation, Graduate School of Health Sciences, Kio University, Nara, Japan
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15
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Ko NH, Laine CM, Valero-Cuevas FJ. Task-dependent alteration of beta-band intermuscular coherence is associated with ipsilateral corticospinal tract excitability. Front Sports Act Living 2023; 5:1177004. [PMID: 37576608 PMCID: PMC10416639 DOI: 10.3389/fspor.2023.1177004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 07/18/2023] [Indexed: 08/15/2023] Open
Abstract
Beta-band (15-30 Hz) synchronization between the EMG signals of active limb muscles can serve as a non-invasive assay of corticospinal tract integrity. Tasks engaging a single limb often primarily utilize one corticospinal pathway, although bilateral neural circuits can participate in goal-directed actions involving multi-muscle coordination and utilization of feedback. Suboptimal utilization of such circuits after CNS injury can result in unintended mirror movements and activation of pathological synergies. Accordingly, it is important to understand how the actions of one limb (e.g., a less-affected limb after strokes) influence the opposite corticospinal pathway for the rehabilitation target. Certain unimanual actions decrease the excitability of the "unengaged" corticospinal tract, presumably to prevent mirror movement, but there is no direct way to predict the extent to which this will occur. In this study, we tested the hypothesis that task-dependent changes in beta-band drives to muscles of one hand will inversely correlate with changes in the opposite corticospinal tract excitability. Ten participants completed spring pinching tasks known to induce differential 15-30 Hz drive to muscles. During compressions, transcranial magnetic stimulation single pulses to the ipsilateral M1 were delivered to generate motor-evoked potentials in the unengaged hand. The task-induced changes in ipsilateral corticospinal excitability were inversely correlated with associated changes in EMG-EMG coherence of the task hand. These results demonstrate a novel connection between intermuscular coherence and the excitability of the "unengaged" corticospinal tract and provide a springboard for further mechanistic studies of unimanual tasks of varying difficulty and their effects on neural pathways relevant to rehabilitation.
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Affiliation(s)
- Na-hyeon Ko
- Department of Physical Therapy, California State University, Fresno, CA, United States
| | - Christopher M. Laine
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, United States
| | - Francisco J. Valero-Cuevas
- Brain Body Dynamics Lab, Division of Biokinesiology and Physical Therapy, Department of Biomedical Engineering, University of Southern California, Los Angeles, CA, United States
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16
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Seo G, Houston M, Portilla M, Fang F, Park JH, Lee H, Li S, Park HS, Zhang Y, Roh J. Expanding the repertoire of intermuscular coordination patterns and modulating intermuscular connectivity in stroke-affected upper extremity through electromyogram-guided training: a pilot study. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2023; 2023:1-4. [PMID: 38083684 DOI: 10.1109/embc40787.2023.10341085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Abnormal intermuscular coordination is a major stroke-induced functional motor impairment in the upper extremity (UE). Previous studies have computationally identified the abnormalities in the intermuscular coordination in the stroke-affected UE and their negative impacts on motor outputs. Therefore, targeting the aberrant muscle synergies has the potential as an effective approach for stroke rehabilitation. Recently, we verified the modifiability of the naturally expressed muscle synergies of young able-bodied adults in UE through an electromyographic (EMG) signal-guided exercise protocol. This study tested if an EMG-guided exercise will induce new muscle synergies, alter the associated intermuscular connectivity, and improve UE motor outcome in stroke-affected UE with moderate-to-severe motor impairment. The study used the six-week isometric EMG signal-guided exercise protocol that focused on independently activating two specific muscles, the biceps and brachioradialis, to develop new muscle activation groups. The study found that both the stroke and age-matched, able-bodied groups were able to develop new muscle coordination patterns through the exercise while habitual muscle activation was still available, which led to improvements in the motor control of the trained arm. In addition, the results provided preliminary evidence of increased intermuscular connectivity between targeted muscles in the beta-band frequencies for stroke patients after training, suggesting a modulation of the common neural drive. These findings suggest that our isometric exercise protocol has the potential to improve stroke survivors' performance of UE in their activities in daily lives (ADLs) and, ultimately, their quality of life through expanding their repertoire of intermuscular coordination.Clinical Relevance- This study shows the feasibility of expanding the intermuscular coordination pattern in stroke-affected UE through an isometric EMG-guided exercise which positively affects task performance and intermuscular connectivity.
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17
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Zipser-Mohammadzada F, Scheffers MF, Conway BA, Halliday DM, Zipser CM, Curt A, Schubert M. Intramuscular coherence enables robust assessment of modulated supra-spinal input in human gait: an inter-dependence study of visual task and walking speed. Exp Brain Res 2023; 241:1675-1689. [PMID: 37199775 DOI: 10.1007/s00221-023-06635-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 05/11/2023] [Indexed: 05/19/2023]
Abstract
Intramuscular high-frequency coherence is increased during visually guided treadmill walking as a consequence of increased supra-spinal input. The influence of walking speed on intramuscular coherence and its inter-trial reproducibility need to be established before adoption as a functional gait assessment tool in clinical settings. Here, fifteen healthy controls performed a normal and a target walking task on a treadmill at various speeds (0.3 m/s, 0.5 m/s, 0.9 m/s, and preferred) during two sessions. Intramuscular coherence was calculated between two surface EMG recordings sites of the Tibialis anterior muscle during the swing phase of walking. The results were averaged across low-frequency (5-14 Hz) and high-frequency (15-55 Hz) bands. The effect of speed, task, and time on mean coherence was assessed using three-way repeated measures ANOVA. Reliability and agreement were calculated with the intra-class correlation coefficient and Bland-Altman method, respectively. Intramuscular coherence during target walking was significantly higher than during normal walking across all walking speeds in the high-frequency band as obtained by the three-way repeated measures ANOVA. Interaction effects between task and speed were found for the low- and high-frequency bands, suggesting that task-dependent differences increase at higher walking speeds. Reliability of intramuscular coherence was moderate to excellent for most normal and target walking tasks in all frequency bands. This study confirms previous reports of increased intramuscular coherence during target walking, while providing first evidence for reproducibility and robustness of this measure as a requirement to investigate supra-spinal input.Trial registration Registry number/ClinicalTrials.gov Identifier: NCT03343132, date of registration 2017/11/17.
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Affiliation(s)
| | - Marjelle Fredie Scheffers
- Department of Neurophysiology, Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland
- Faculty of Medicine, Utrecht University, Utrecht, The Netherlands
| | - Bernard A Conway
- Biomedical Engineering, University of Strathclyde, Glasgow, G4 0NW, UK
| | - David M Halliday
- School of Physics, Engineering and Technology, University of York, York, YO10 5DD, UK
- York Biomedical Research Institute, University of York, York, UK
| | - Carl Moritz Zipser
- Department of Neurophysiology, Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland
| | - Armin Curt
- Department of Neurophysiology, Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland
| | - Martin Schubert
- Department of Neurophysiology, Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland
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18
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Yamanaka E, Horiuchi Y, Nojima I. EMG-EMG coherence during voluntary control of human standing tasks: a systematic scoping review. Front Neurosci 2023; 17:1145751. [PMID: 37250422 PMCID: PMC10215561 DOI: 10.3389/fnins.2023.1145751] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 04/24/2023] [Indexed: 05/31/2023] Open
Abstract
Background Intra- or inter-muscular (EMG-EMG) coherence is a simple and non-invasive method for estimating central nervous system control during human standing tasks. Although this research area has developed, no systematic literature review has been conducted. Objectives We aimed to map the current literature on EMG-EMG coherence during various standing tasks to identify the research gaps and summarize previous studies comparing EMG-EMG coherence between healthy young and elderly adults. Methods Electronic databases (PubMed, Cochrane Library, and CINAHL) were searched for articles published from inception to December 2021. We incorporated studies that analyzed EMG-EMG coherence of the postural muscles in various standing tasks. Results Finally, 25 articles fulfilled the inclusion criteria and involved 509 participants. Most participants were healthy young adults, while only one study included participants with medical conditions. There was some evidence that EMG-EMG coherence could identify differences in standing control between healthy young and elderly adults, although the methodology was highly heterogeneous. Conclusion The present review indicates that EMG-EMG coherence may help elucidate changes in standing control with age. In future studies, this method should be used in participants with central nervous system disorders to understand better the characteristics of standing balance disabilities.
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Affiliation(s)
- Eiji Yamanaka
- Division of Physical Therapy, Shinshu University School of Health Sciences, Nagano, Japan
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan
| | - Yuki Horiuchi
- Division of Physical Therapy, Shinshu University School of Health Sciences, Nagano, Japan
| | - Ippei Nojima
- Division of Physical Therapy, Shinshu University School of Health Sciences, Nagano, Japan
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19
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Issa NP, Aydin S, Bhatnagar S, Baumgartner NW, Hill J, Aluri S, Valentic CS, Gomez CM, Rezania K. Intermuscular coherence in spinocerebellar ataxias 3 and 6: a preliminary study. RESEARCH SQUARE 2023:rs.3.rs-2782070. [PMID: 37131794 PMCID: PMC10153384 DOI: 10.21203/rs.3.rs-2782070/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Objective : Spinocerebellar ataxias (SCAs) are familial neurodegenerative diseases involving the cerebellum and spinocerebellar tracts. While there is variable involvement of corticospinal tracts (CST), dorsal root ganglia, and motor neurons in SCA3, SCA6 is characterized by a pure, late-onset ataxia. Abnormal intermuscular coherence in the beta-gamma frequency range (IMCbg) implies lack of integrity of CST or the afferent input from the acting muscles. We test the hypothesis that IMCbg has the potential to be a biomarker of disease activity in SCA3 but not SCA6. Methods: Intermuscular coherence between biceps and brachioradialis muscles was measured from surface EMG waveforms in SCA3 (N=16) and SCA6 (N=20) patients, and in neurotypical subjects (N=23). Results: IMC peak frequencies were present in the b range in SCA patients and in the g range in neurotypical subjects. The difference between IMC amplitudes in the g and b ranges was significant when comparing neurotypical control subjects to SCA3 (p < 0.01) and SCA6 (p = 0.01) patients. IMCbg amplitude was smaller in SCA3 patients compared to neurotypical subjects (p<0.05), but not different between SCA3 and SCA6 patients or between SCA6 and neurotypical subjects. Conclusion/significance: IMC metrics can differentiate SCA patients from normal controls.
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20
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Antunes M, Folgado D, Barandas M, Carreiro A, Quintão C, de Carvalho M, Gamboa H. A morphology-based feature set for automated Amyotrophic Lateral Sclerosis diagnosis on surface electromyography. Biomed Signal Process Control 2023. [DOI: 10.1016/j.bspc.2022.104011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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21
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Younger DS. Spinal cord motor disorders. HANDBOOK OF CLINICAL NEUROLOGY 2023; 196:3-42. [PMID: 37620076 DOI: 10.1016/b978-0-323-98817-9.00007-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
Spinal cord diseases are frequently devastating due to the precipitous and often permanently debilitating nature of the deficits. Spastic or flaccid paraparesis accompanied by dermatomal and myotomal signatures complementary to the incurred deficits facilitates localization of the insult within the cord. However, laboratory studies often employing disease-specific serology, neuroradiology, neurophysiology, and cerebrospinal fluid analysis aid in the etiologic diagnosis. While many spinal cord diseases are reversible and treatable, especially when recognized early, more than ever, neuroscientists are being called to investigate endogenous mechanisms of neural plasticity. This chapter is a review of the embryology, neuroanatomy, clinical localization, evaluation, and management of adult and childhood spinal cord motor disorders.
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Affiliation(s)
- David S Younger
- Department of Clinical Medicine and Neuroscience, CUNY School of Medicine, New York, NY, United States; Department of Medicine, Section of Internal Medicine and Neurology, White Plains Hospital, White Plains, NY, United States.
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22
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Charalambous CC, Hadjipapas A. Is there frequency-specificity in the motor control of walking? The putative differential role of alpha and beta oscillations. Front Syst Neurosci 2022; 16:922841. [PMID: 36387306 PMCID: PMC9650482 DOI: 10.3389/fnsys.2022.922841] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 10/14/2022] [Indexed: 11/04/2023] Open
Abstract
Alpha and beta oscillations have been assessed thoroughly during walking due to their potential role as proxies of the corticoreticulospinal tract (CReST) and corticospinal tract (CST), respectively. Given that damage to a descending tract after stroke can cause walking deficits, detailed knowledge of how these oscillations mechanistically contribute to walking could be utilized in strategies for post-stroke locomotor recovery. In this review, the goal was to summarize, synthesize, and discuss the existing evidence on the potential differential role of these oscillations on the motor descending drive, the effect of transcranial alternate current stimulation (tACS) on neurotypical and post-stroke walking, and to discuss remaining gaps in knowledge, future directions, and methodological considerations. Electrophysiological studies of corticomuscular, intermuscular, and intramuscular coherence during walking clearly demonstrate that beta oscillations are predominantly present in the dorsiflexors during the swing phase and may be absent post-stroke. The role of alpha oscillations, however, has not been pinpointed as clearly. We concluded that both animal and human studies should focus on the electrophysiological characterization of alpha oscillations and their potential role to the CReST. Another approach in elucidating the role of these oscillations is to modulate them and then quantify the impact on walking behavior. This is possible through tACS, whose beneficial effect on walking behavior (including boosting of beta oscillations in intramuscular coherence) has been recently demonstrated in both neurotypical adults and stroke patients. However, these studies still do not allow for specific roles of alpha and beta oscillations to be delineated because the tACS frequency used was much lower (i.e., individualized calculated gait frequency was used). Thus, we identify a main gap in the literature, which is tACS studies actually stimulating at alpha and beta frequencies during walking. Overall, we conclude that for beta oscillations there is a clear connection to descending drive in the corticospinal tract. The precise relationship between alpha oscillations and CReST remains elusive due to the gaps in the literature identified here. However, better understanding the role of alpha (and beta) oscillations in the motor control of walking can be used to progress and develop rehabilitation strategies for promoting locomotor recovery.
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Affiliation(s)
- Charalambos C. Charalambous
- Department of Basic and Clinical Sciences, Medical School, University of Nicosia, Nicosia, Cyprus
- Center for Neuroscience and Integrative Brain Research (CENIBRE), Medical School, University of Nicosia, Nicosia, Cyprus
| | - Avgis Hadjipapas
- Department of Basic and Clinical Sciences, Medical School, University of Nicosia, Nicosia, Cyprus
- Center for Neuroscience and Integrative Brain Research (CENIBRE), Medical School, University of Nicosia, Nicosia, Cyprus
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23
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Rong P, Hansen O, Heidrick L. Relationship between rate-elicited changes in muscular-kinematic control strategies and acoustic performance in individuals with ALS-A multimodal investigation. JOURNAL OF COMMUNICATION DISORDERS 2022; 99:106253. [PMID: 36007484 DOI: 10.1016/j.jcomdis.2022.106253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 08/08/2022] [Accepted: 08/09/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION As a key control variable, duration has been long suspected to mediate the organization of speech motor control strategies, which has management implications for neuromotor speech disorders. This study aimed to experimentally delineate the role of duration in organizing speech motor control in neurologically healthy and impaired speakers using a voluntary speaking rate manipulation paradigm. METHODS Thirteen individuals with amyotrophic lateral sclerosis (ALS) and 10 healthy controls performed a sentence reading task three times, first at their habitual rate, then at a slower rate. A multimodal approach combining surface electromyography, kinematic, and acoustic technologies was used to record jaw muscle activities, jaw kinematics, and speech acoustics. Six muscular-kinematic features were extracted and factor-analyzed to characterize the organization of the mandibular control hierarchy. Five acoustic features were extracted, measuring the spectrotemporal properties of the diphthong /ɑɪ/ and the plosives /t/ and /k/. RESULTS The muscular-kinematic features converged into two interpretable latent factors, reflecting the level and cohesiveness/flexibility of mandibular control, respectively. Voluntary rate reduction led to a trend toward (1) finer, less cohesive, and more flexible mandibular control, and (2) increased range and decreased transition slope of the diphthong formants, across neurologically healthy and impaired groups. Differential correlations were found between the rate-elicited changes in mandibular control and acoustic performance for neurologically healthy and impaired speakers. CONCLUSIONS The results provided empirical evidence for the long-suspected but previously unsubstantiated role of duration in (re)organizing speech motor control strategies. The rate-elicited reorganization of muscular-kinematic control contributed to the acoustic performance of healthy speakers, in ways consistent with theoretical predictions. Such contributions were less consistent in impaired speakers, implying the complex nature of speaking rate reduction in ALS, possibly reflecting an interplay of disease-related constraints and volitional duration control. This information may help to stratify and identify candidates for the rate manipulation therapy.
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Affiliation(s)
- Panying Rong
- Department of Speech-Language-Hearing: Sciences & Disorders, University of Kansas, Lawrence KS, USA.
| | - Olivia Hansen
- Department of Speech-Language-Hearing: Sciences & Disorders, University of Kansas, Lawrence KS, USA; Department of Hearing & Speech, University of Kansas Medical Center, Kansas City, KS, USA
| | - Lindsey Heidrick
- Department of Hearing & Speech, University of Kansas Medical Center, Kansas City, KS, USA
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Zipser-Mohammadzada F, Conway BA, Halliday DM, Zipser CM, Easthope CA, Curt A, Schubert M. Intramuscular coherence during challenging walking in incomplete spinal cord injury: Reduced high-frequency coherence reflects impaired supra-spinal control. Front Hum Neurosci 2022; 16:927704. [PMID: 35992941 PMCID: PMC9387543 DOI: 10.3389/fnhum.2022.927704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 07/15/2022] [Indexed: 11/30/2022] Open
Abstract
Individuals regaining reliable day-to-day walking function after incomplete spinal cord injury (iSCI) report persisting unsteadiness when confronted with walking challenges. However, quantifiable measures of walking capacity lack the sensitivity to reveal underlying impairments of supra-spinal locomotor control. This study investigates the relationship between intramuscular coherence and corticospinal dynamic balance control during a visually guided Target walking treadmill task. In thirteen individuals with iSCI and 24 controls, intramuscular coherence and cumulant densities were estimated from pairs of Tibialis anterior surface EMG recordings during normal treadmill walking and a Target walking task. The approximate center of mass was calculated from pelvis markers. Spearman rank correlations were performed to evaluate the relationship between intramuscular coherence, clinical parameters, and center of mass parameters. In controls, we found that the Target walking task results in increased high-frequency (21–44 Hz) intramuscular coherence, which negatively related to changes in the center of mass movement, whereas this modulation was largely reduced in individuals with iSCI. The impaired modulation of high-frequency intramuscular coherence during the Target walking task correlated with neurophysiological and functional readouts, such as motor-evoked potential amplitude and outdoor mobility score, as well as center of mass trajectory length. The Target walking effect, the difference between Target and Normal walking intramuscular coherence, was significantly higher in controls than in individuals with iSCI [F(1.0,35.0) = 13.042, p < 0.001]. Intramuscular coherence obtained during challenging walking in individuals with iSCI may provide information on corticospinal gait control. The relationships between biomechanics, clinical scores, and neurophysiology suggest that intramuscular coherence assessed during challenging tasks may be meaningful for understanding impaired supra-spinal control in individuals with iSCI.
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Affiliation(s)
- Freschta Zipser-Mohammadzada
- Spinal Cord Injury Center, Department of Neurophysiology, Balgrist University Hospital, Zurich, Switzerland
- *Correspondence: Freschta Zipser-Mohammadzada,
| | - Bernard A. Conway
- Department of Biomedical Engineering, University of Strathclyde, Glasgow, United Kingdom
| | - David M. Halliday
- Department of Electronic Engineering, University of York, York, United Kingdom
- York Biomedical Research Institute, University of York, York, United Kingdom
| | - Carl Moritz Zipser
- Spinal Cord Injury Center, Department of Neurophysiology, Balgrist University Hospital, Zurich, Switzerland
| | - Chris A. Easthope
- Spinal Cord Injury Center, Department of Neurophysiology, Balgrist University Hospital, Zurich, Switzerland
- Cereneo Foundation, Center for Interdisciplinary Research, Vitznau, Switzerland
| | - Armin Curt
- Spinal Cord Injury Center, Department of Neurophysiology, Balgrist University Hospital, Zurich, Switzerland
| | - Martin Schubert
- Spinal Cord Injury Center, Department of Neurophysiology, Balgrist University Hospital, Zurich, Switzerland
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25
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O'Keeffe R, Shirazi SY, Bilaloglu S, Jahed S, Bighamian R, Raghavan P, Atashzar SF. Nonlinear functional muscle network based on information theory tracks sensorimotor integration post stroke. Sci Rep 2022; 12:13029. [PMID: 35906239 PMCID: PMC9338017 DOI: 10.1038/s41598-022-16483-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 07/11/2022] [Indexed: 11/28/2022] Open
Abstract
Sensory information is critical for motor coordination. However, understanding sensorimotor integration is complicated, especially in individuals with impairment due to injury to the central nervous system. This research presents a novel functional biomarker, based on a nonlinear network graph of muscle connectivity, called InfoMuNet, to quantify the role of sensory information on motor performance. Thirty-two individuals with post-stroke hemiparesis performed a grasp-and-lift task, while their muscle activity from 8 muscles in each arm was measured using surface electromyography. Subjects performed the task with their affected hand before and after sensory exposure to the task performed with the less-affected hand. For the first time, this work shows that InfoMuNet robustly quantifies changes in functional muscle connectivity in the affected hand after exposure to sensory information from the less-affected side. > 90% of the subjects conformed with the improvement resulting from this sensory exposure. InfoMuNet also shows high sensitivity to tactile, kinesthetic, and visual input alterations at the subject level, highlighting its potential use in precision rehabilitation interventions.
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Affiliation(s)
- Rory O'Keeffe
- Department of Electrical and Computer Engineering, New York University, New York, NY, USA
| | - Seyed Yahya Shirazi
- Department of Electrical and Computer Engineering, New York University, New York, NY, USA
| | - Seda Bilaloglu
- Department of Medicine, New York University Langone Health, New York, NY, USA
| | - Shayan Jahed
- Department of Electrical and Computer Engineering, New York University, New York, NY, USA
| | - Ramin Bighamian
- Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, United States Food and Drug Administration, Silver Spring, MD, USA
| | - Preeti Raghavan
- Departments of Physical Medicine and Rehabilitation and Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - S Farokh Atashzar
- Department of Electrical and Computer Engineering, New York University, New York, NY, USA.
- Department of Mechanical and Aerospace Engineering, New York University, New York, NY, USA.
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26
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De Oliveira HM, Silsby M, Jaiser SR, Lai HM, Pavey N, Kiernan MC, Williams TL, Vucic S, Baker MR. Electrodiagnostic findings in facial onset sensory motor neuronopathy (FOSMN). Clin Neurophysiol 2022; 140:228-238. [DOI: 10.1016/j.clinph.2022.04.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 04/13/2022] [Accepted: 04/25/2022] [Indexed: 01/08/2023]
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27
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Effects of Transcranial Direct Current Electrical Stimulation over the Supplementary Motor Area Combined with Walking on the Intramuscular Coherence of the Tibialis Anterior in a Subacute Post-Stroke Patient: A Single-Case Study. Brain Sci 2022; 12:brainsci12050540. [PMID: 35624929 PMCID: PMC9139188 DOI: 10.3390/brainsci12050540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 04/13/2022] [Accepted: 04/19/2022] [Indexed: 02/04/2023] Open
Abstract
Motor recovery is related to the corticospinal tract (CST) lesion in post-stroke patients. The CST originating from the supplementary motor area (SMA) affects the recovery of impaired motor function. We confirmed the effects of transcranial direct current stimulation (tDCS) over the SMA combined with walk training on CST excitability. This study involved a stroke patient with severe sensorimotor deficits and a retrospective AB design. Walk training was conducted only in phase A. Phase B consisted of anodal tDCS (1.5 mA) combined with walk training. Walking speed, stride time variability (STV; reflecting gait stability), and beta-band intramuscular coherence—derived from the paired tibialis anterior on the paretic side (reflecting CST excitability)—were measured. STV quantified the coefficient of variation in stride time using accelerometers. Intramuscular coherence during the early stance phase noticeably increased in phase B compared with phase A. Intramuscular coherence in both the stance and swing phases was reduced at follow-up. Walking speed showed no change, while STV was noticeably decreased in phase B compared with phase A. These results suggest that tDCS over the SMA during walking improves gait stability by enhancing CST excitability in the early stance phase.
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28
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Ohtsuka H, Nakajima T, Komiyama T, Suzuki S, Irie S, Ariyasu R. Execution of natural manipulation in the air enhances the beta-rhythm intermuscular coherences of the human arm depending on muscle pairs. J Neurophysiol 2022; 127:946-957. [PMID: 35294314 DOI: 10.1152/jn.00421.2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Natural manipulation tasks in air consist of two kinematic components: a grasping component, with activation of the hand muscles, and a lifting component, with activation of the proximal muscles. However, it remains unclear whether the synchronized motor commands to the hand/proximal arm muscles are divergently controlled during the task. Therefore, we examined how intermuscular coherence was modulated depending on the muscle combinations during grip and lift (G&L) tasks. Electromyograms (EMGs) were recorded from the biceps brachii (BB), triceps brachii (TB), flexor digitorum superficialis (FDS), and extensor digitorum communis (EDC) muscles. The participants were required to maintain G&L tasks involving a small cubical box with the thumb and index and middle fingers. Consequently, we found that the beta-rhythm coherence (15-35 Hz) in BB-TB, BB-FDS, and TB-EDC pairs during G&L was significantly larger than that during the isolated task with cocontraction of the two target muscles but not BB-EDC, TB-FDS, and FDS-EDC (task and muscle pair specificities). These increases in beta-rhythm coherence were also observed in intramuscular EMG recordings. Furthermore, the results from the execution of several mimic G&L tasks revealed that the separated task-related motor signals and combinations between the motor signals/sensations of the fingertips or object load had minor contributions to the increase in the coherence. These results suggest that during G&L the central nervous system regulates synchronous drive onto motoneurons depending on the muscle pairs and that the multiple combination effect of the sensations of touch/object load and motor signals in the task promotes the synchrony of these pairs.NEW & NOTEWORTHY Natural manipulation in air consists of two kinematic components: grasping, with activation of hand muscles, and lifting, with activation of proximal muscles. We show that during the maintenance of object manipulation in air the central nervous system regulates the synchronous drive onto human motoneuron pools depending on the hand/proximal muscle pairs and that the multiple combination effect of the sensations of touch/object load and motor signals in the task promotes the synchrony of these pairs.
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Affiliation(s)
- Hiroyuki Ohtsuka
- Department of Integrative Physiology, Kyorin University School of Medicine, Mitaka City, Tokyo, Japan.,Department of Physical Therapy, Showa University School of Nursing and Rehabilitation Sciences, Yokohama City, Kanagawa, Japan
| | - Tsuyoshi Nakajima
- Department of Integrative Physiology, Kyorin University School of Medicine, Mitaka City, Tokyo, Japan
| | - Tomoyoshi Komiyama
- Division of Health and Sports Sciences, Faculty of Education, Chiba University, Chiba City, Chiba, Japan.,Division of Health and Sports Education, The United Graduate School of Education, Tokyo Gakugei University, Koganei City, Tokyo, Japan
| | - Shinya Suzuki
- Department of Integrative Physiology, Kyorin University School of Medicine, Mitaka City, Tokyo, Japan
| | - Shun Irie
- Department of Integrative Physiology, Kyorin University School of Medicine, Mitaka City, Tokyo, Japan
| | - Ryohei Ariyasu
- Department of Integrative Physiology, Kyorin University School of Medicine, Mitaka City, Tokyo, Japan
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29
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Effects of Transcranial Direct Current Stimulation of Bilateral Supplementary Motor Area on the Lower Limb Motor Function in a Stroke Patient with Severe Motor Paralysis: A Case Study. Brain Sci 2022; 12:brainsci12040452. [PMID: 35447983 PMCID: PMC9029581 DOI: 10.3390/brainsci12040452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 03/23/2022] [Accepted: 03/26/2022] [Indexed: 02/04/2023] Open
Abstract
In patients with severe motor paralysis, increasing the excitability of the supplementary motor area (SMA) in the non-injured hemisphere contributes to the recovery of lower limb motor function. However, the contribution of transcranial direct current stimulation (tDCS) over the SMA of the non-injured hemisphere in the recovery of lower limb motor function is unclear. This study aimed to examine the effects of tDCS on bilateral hemispheric SMA combined with assisted gait training. A post-stroke patient with severe motor paralysis participated in a retrospective AB design. Assisted gait training was performed only in period A and tDCS to the SMA of the bilateral hemisphere combined with assisted gait training (bi-tDCS) was performed in period B. Additionally, three conditions were performed for 20 min each in the intervals between the two periods: (1) assisted gait training only, (2) assisted gait training combined with tDCS to the SMA of the injured hemisphere, and (3) bi-tDCS. Measurements were muscle activity and beta-band intermuscular coherence (reflecting corticospinal tract excitability) of the vastus medialis muscle. The bi-tDCS immediately and longitudinally increased muscle activity and intermuscular coherence. We consider that bi-tDCS may be effective in recovering lower limb motor function in a patient with severe motor paralysis.
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30
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Liu H, Gao Y, Huang W, Li R, Houston M, Benoit JS, Roh J, Zhang Y. Inter-muscular coherence and functional coordination in the human upper extremity after stroke. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2022; 19:4506-4525. [PMID: 35430825 DOI: 10.3934/mbe.2022208] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Muscle coordination and motor function of stroke patients are weakened by stroke-related motor impairments. Our earlier studies have determined alterations in inter-muscular coordination patterns (muscle synergies). However, the functional connectivity of these synergistically paired or unpaired muscles is still unclear in stroke patients. The goal of this study is to quantify the alterations of inter-muscular coherence (IMC) among upper extremity muscles that have been shown to be synergistically or non-synergistically activated in stroke survivors. In a three-dimensional isometric force matching task, surface EMG signals are collected from 6 age-matched, neurologically intact healthy subjects and 10 stroke patients, while the target force space is divided into 8 subspaces. According to the results of muscle synergy identification with non-negative matrix factorization algorithm, muscle pairs are classified as synergistic and non-synergistic. In both control and stroke groups, IMC is then calculated for all available muscle pairs. The results show that synergistic muscle pairs have higher coherence in both groups. Furthermore, anterior and middle deltoids, identified as synergistic muscles in both groups, exhibited significantly weaker IMC at alpha band in stroke patients. The anterior and posterior deltoids, identified as synergistic muscles only in stroke patients, revealed significantly higher IMC in stroke group at low gamma band. On the contrary, anterior deltoid and pectoralis major, identified as synergistic muscles in control group only, revealed significantly higher IMC in control group in alpha band. The results of muscle synergy and IMC analyses provide congruent and complementary information for investigating the mechanism that underlies post-stroke motor recovery.
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Affiliation(s)
- Hongming Liu
- Zhuoyue Honors College, Hangzhou Dianzi University, Hangzhou 310018, China
- College of Automation, Hangzhou Dianzi University, Hangzhou 310018, China
| | - Yunyuan Gao
- College of Automation, Hangzhou Dianzi University, Hangzhou 310018, China
- Key labortory of Brain Machine Collaborative Intelligence of Zhejiang Province, Hangzhou 311247, China
| | - Wei Huang
- College of Automation, Hangzhou Dianzi University, Hangzhou 310018, China
| | - Rihui Li
- Department of Biomedical Engineering, University of Houston, Houston 75835, United States
| | - Michael Houston
- Department of Biomedical Engineering, University of Houston, Houston 75835, United States
| | - Julia S Benoit
- Texas Institute for Measurement Evaluation and Statistics, University of Houston, Houston 75835, United States
| | - Jinsook Roh
- Department of Biomedical Engineering, University of Houston, Houston 75835, United States
| | - Yingchun Zhang
- Department of Biomedical Engineering, University of Houston, Houston 75835, United States
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31
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Simoneau M, Pialasse JP, Mercier P, Blouin JS. Adolescents with idiopathic scoliosis show decreased intermuscular coherence in lumbar paraspinal muscles: a new pathophysiological perspective. Clin Neurophysiol 2022; 138:38-51. [DOI: 10.1016/j.clinph.2022.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 02/18/2022] [Accepted: 03/02/2022] [Indexed: 11/03/2022]
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32
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Rong P, Pattee GL. A multidimensional facial surface EMG analysis for objective assessment of bulbar involvement in amyotrophic lateral sclerosis. Clin Neurophysiol 2022; 135:74-84. [DOI: 10.1016/j.clinph.2021.11.074] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 11/01/2021] [Accepted: 11/07/2021] [Indexed: 11/03/2022]
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Time-dependent directional intermuscular coherence analysis reveals that forward and backward arm swing equally drive the upper leg muscles during gait initiation. Gait Posture 2022; 92:290-293. [PMID: 34896841 DOI: 10.1016/j.gaitpost.2021.11.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 07/30/2021] [Accepted: 11/24/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Human bipedal gait benefits from arm swing, as it drives and shapes lower limb muscle activity in healthy participants as well as patients suffering from neurological impairment. Also during gait initiation, arm swing instructions were found to facilitate leg muscle recruitment. RESEARCH QUESTION The aim of the present study is to exploit the directional decomposition of coherence to examine to what extent forward and backward arm swing contribute to leg muscle recruitment during gait initiation. METHODS Ambulant electromyography (EMG) from shoulder muscles (deltoideus anterior and posterior) and upper leg muscles (biceps femoris and rectus femoris) was analysed during gait initiation in nineteen healthy participants (median age of 67 ± 12 (IQR) years). To assess to what extent either deltoideus anterior or posterior muscles were able to drive upper leg muscle activity during distinct stages of the gait initiation process, time dependent intermuscular coherence was decomposed into directional components based on their time lag (i.e. forward, reverse and zero-lag). RESULTS Coherence from the forward directed components, representing shoulder muscle signals leading leg muscle signals, revealed that deltoideus anterior (i.e. forward arm swing) and deltoideus posterior (i.e. backward arm swing) equally drive upper leg muscle activity during the gait initiation process. SIGNIFICANCE The presently demonstrated time dependent directional intermuscular coherence analysis could be of use for future studies examining directional coupling between muscles or brain areas relative to certain gait (or other time) events. In the present study, this analysis provided neural underpinning that both forward and backward arm swing can provide neuronal support for leg muscle recruitment during gait initiation and can therefore both serve as an effective gait rehabilitation method in patients with gait initiation difficulties.
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34
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Zaback M, Adkin AL, Chua R, Timothy Inglis J, Carpenter MG. Facilitation and habituation of cortical and subcortical control of standing balance following repeated exposure to a height-related postural threat. Neuroscience 2022; 487:8-25. [DOI: 10.1016/j.neuroscience.2022.01.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 12/23/2021] [Accepted: 01/17/2022] [Indexed: 01/21/2023]
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35
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Weersink JB, de Jong BM, Maurits NM. Neural coupling between upper and lower limb muscles in Parkinsonian gait. Clin Neurophysiol 2021; 134:65-72. [PMID: 34979292 DOI: 10.1016/j.clinph.2021.11.072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 11/08/2021] [Accepted: 11/22/2021] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To explore to what extent neuronal coupling between upper and lower limb muscles during gait is preserved or affected in patients with Parkinson's Disease (PD). METHODS Electromyography recordings were obtained from the bilateral deltoideus anterior and bilateral rectus femoris and biceps femoris muscles during overground gait in 20 healthy participants (median age 69 years) and 20 PD patients (median age 68.5 years). PD patients were able to walk independently (Hoehn and Yahr scale: Stage 2-3), had an equally distributed symptom laterality (6 left side, 7 both sides and 7 right side) and no cognitive problems or tremor dominant PD. Time-dependent directional intermuscular coherence analysis was employed to compare the neural coupling between upper and lower limb muscles between healthy participants and PD patients in three different directions: zero-lag (i.e. common driver), forward (i.e. shoulders driving the legs) and reverse component (i.e. legs driving the shoulders). RESULTS Compared to healthy participants, PD patients exhibited (i) reduced intermuscular zero-lag coherence in the beta/gamma frequency band during end-of-stance and (ii) enhanced forward as well as reverse directed coherence in the alpha and beta/gamma frequency bands around toe-off. CONCLUSIONS PD patients had a reduced common cortical drive to upper and lower limb muscles during gait, possibly contributing to disturbed interlimb coordination. Enhanced bidirectional coupling between upper and lower limb muscles on subcortical and transcortical levels in PD patients suggests a mechanism of compensation. SIGNIFICANCE These findings provide support for the facilitating effect of arm swing instructions in PD gait.
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Affiliation(s)
- Joyce B Weersink
- University of Groningen, University Medical Center Groningen, Department of Neurology, Hanzeplein 1, POB 30.001, Groningen, the Netherlands
| | - Bauke M de Jong
- University of Groningen, University Medical Center Groningen, Department of Neurology, Hanzeplein 1, POB 30.001, Groningen, the Netherlands
| | - Natasha M Maurits
- University of Groningen, University Medical Center Groningen, Department of Neurology, Hanzeplein 1, POB 30.001, Groningen, the Netherlands.
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36
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Nakagawa K, Kadono N, Shimoda T, Mitsuhara T, Tanaka E, Yuge L. Intramuscular Coherence of the Lower Flexor Muscles during Robotic Ankle-Assisted Gait. J Mot Behav 2021; 54:344-353. [PMID: 34558390 DOI: 10.1080/00222895.2021.1965527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
A close-fitting assisted walking device (RE-Gait) designed to assist ankle movements might be a novel approach for acquiring the forefoot rocker function in the gait cycle. The purpose of the present study was to investigate the effects of using RE-Gait by evaluating the intramuscular coherence (IMC) of the two parts of the tibialis anterior muscles (TA), which could indicate whether a common synaptic drive is present. Seventeen healthy volunteers walked on a treadmill at a comfortable speed before, during, and immediately after 15-minute RE-Gait intervention. After RE-Gait intervention, IMC of the two parts of the TA muscles in the beta frequency band in the initial swing phase was significantly enhanced during RE-Gait intervention. In addition, IMCs in the beta and low-gamma frequency bands were significantly correlated with the enhancement ratio of the step length. These results suggest that robotic ankle plantar flexion and dorsiflexion assistance in the initial swing phase may be effective for improving gait function with enhancement of the functioning of the sensorimotor loop.
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Affiliation(s)
- Kei Nakagawa
- Division of Bio-Environmental Adaptation Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Naoto Kadono
- Division of Bio-Environmental Adaptation Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | | | - Takafumi Mitsuhara
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Eiichiro Tanaka
- Graduate School of Information, Production and Systems, Faculty of Science and Engineering, Waseda University, Kita-Kyushu, Japan
| | - Louis Yuge
- Division of Bio-Environmental Adaptation Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.,Space Bio-Laboratories Co., Ltd, Hiroshima, Japan
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Zokaei N, Quinn AJ, Hu MT, Husain M, van Ede F, Nobre AC. Reduced cortico-muscular beta coupling in Parkinson's disease predicts motor impairment. Brain Commun 2021; 3:fcab179. [PMID: 34514395 PMCID: PMC8421699 DOI: 10.1093/braincomms/fcab179] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 05/15/2021] [Accepted: 05/28/2021] [Indexed: 11/16/2022] Open
Abstract
Long-range communication through the motor system is thought to be facilitated by phase coupling between neural activity in the 15–30 Hz beta range. During periods of sustained muscle contraction (grip), such coupling is manifest between motor cortex and the contralateral forearm muscles—measured as the cortico-muscular coherence. We examined alterations in cortico-muscular coherence in individuals with Parkinson’s disease, while equating grip strength between individuals with Parkinson’s disease (off their medication) and healthy control participants. We show a marked reduction in beta cortico-muscular coherence in the Parkinson’s disease group, even though the grip strength was comparable between the two groups. Moreover, the reduced cortico-muscular coherence was related to motor symptoms, so that individuals with lower cortico-muscular coherence also displayed worse motor symptoms. These findings highlight the cortico-muscular coherence as a simple, effective and clinically relevant neural marker of Parkinson’s disease pathology, with the potential to aid monitoring of disease progression and the efficacy of novel treatments for Parkinson’s disease.
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Affiliation(s)
- Nahid Zokaei
- Oxford Centre for Human Brain Activity (OHBA), Wellcome Centre for Integrative Neuroimaging, Department of Psychiatry, University of Oxford, Oxford OX3 7JX, UK
| | - Andrew J Quinn
- Oxford Centre for Human Brain Activity (OHBA), Wellcome Centre for Integrative Neuroimaging, Department of Psychiatry, University of Oxford, Oxford OX3 7JX, UK
| | - Michele T Hu
- Department of Neurology, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford OX3 9DU, UK
| | - Masud Husain
- Department of Experimental Psychology, University of Oxford, Oxford OX2 6GG, UK
| | - Freek van Ede
- Oxford Centre for Human Brain Activity (OHBA), Wellcome Centre for Integrative Neuroimaging, Department of Psychiatry, University of Oxford, Oxford OX3 7JX, UK
| | - Anna Christina Nobre
- Oxford Centre for Human Brain Activity (OHBA), Wellcome Centre for Integrative Neuroimaging, Department of Psychiatry, University of Oxford, Oxford OX3 7JX, UK
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Eisen A, Lemon R. The motor deficit of ALS reflects failure to generate muscle synergies for complex motor tasks, not just muscle strength. Neurosci Lett 2021; 762:136171. [PMID: 34391870 DOI: 10.1016/j.neulet.2021.136171] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/09/2021] [Accepted: 08/10/2021] [Indexed: 11/17/2022]
Abstract
Customarily the motor deficits that develop in ALS are considered in terms of muscle weakness. Functional rating scales used to assess ALS in terms of functional decline do not measure the deficits when performing complex motor tasks, that make up the human skilled motor repertoire, best exemplified by tasks requiring skilled hand and finger movement. This repertoire depends primarily upon the strength of direct corticomotoneuronal (CM) connectivity from primary motor cortex to the motor units subserving skilled movements. Our review prompts the question: if accumulating evidence suggests involvement of the CM system in the early stages of ALS, what kinds of motor deficit might be expected to result, and is current methodology able to identify such deficits? We point out that the CM system is organized not in "commands" to individual muscles, but rather encodes the building blocks of complex and intricate movements, which depend upon synergy between not only the prime mover muscles, but other muscles that stabilize the limb during skilled movement. Our knowledge of the functional organization of the CM system has come both from invasive studies in non-human primates and from advanced imaging and neurophysiological techniques in humans, some of which are now being applied in ALS. CM pathology in ALS has consequences not only for muscle strength, but importantly in the failure to generate complex motor tasks, often involving elaborate muscle synergies. Our aim is to encourage innovative methodology specifically directed to assessing complex motor tasks, failure of which is likely a very early clinical deficit in ALS.
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Affiliation(s)
- Andrew Eisen
- Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, Canada.
| | - Roger Lemon
- Department of Clinical and Motor Neurosciences, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK.
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Rong P. A Novel Hierarchical Framework for Measuring the Complexity and Irregularity of Multimodal Speech Signals and Its Application in the Assessment of Speech Impairment in Amyotrophic Lateral Sclerosis. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:2996-3014. [PMID: 34293265 DOI: 10.1044/2021_jslhr-20-00743] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose The purposes of this study are to develop a novel multimodal framework for measuring variability at the muscular, kinematic, and acoustic levels of the motor speech hierarchy and evaluate the utility of this framework in detecting speech impairment in amyotrophic lateral sclerosis (ALS). Method The myoelectric activities of three bilateral jaw muscle pairs (masseter, anterior temporalis, and anterior belly of digastric), jaw kinematics, and speech acoustics were recorded in 13 individuals with ALS and 10 neurologically healthy controls during sentence reading. Thirteen novel measures (six muscular, three kinematic, four acoustic), which characterized two different but interrelated aspects of variability-complexity and irregularity-were derived using linear and nonlinear methods. Exploratory factor analysis was applied to identify the latent factors underlying these measures. Based on the latent factors, three supervised classifiers-support vector machine (SVM), random forest (RF), and logistic regression (Logit)-were used to differentiate between the speech samples for patients and controls. Results Four interpretable latent factors were identified, representing the complexity of jaw kinematics, the irregularity of jaw antagonists functioning, the irregularity of jaw agonists functioning, and the irregularity of subband acoustic signals, respectively. Based on these latent factors, the speech samples for patients and controls were classified with high accuracy (> 96% for SVM and RF; 88.64% for Logit), outperforming the unimodal measures. Two factors showed significant between-groups differences, as characterized by decreased complexity of jaw kinematics and increased irregularity of jaw antagonists functioning in patients versus controls. Conclusions Decreased complexity of jaw kinematics presumably reflects impaired fine control of jaw movement, while increased irregularity of jaw antagonists functioning could be attributed to reduced synchronization of motor unit firing in ALS. The findings provide preliminary evidence for the utility of the multimodal framework as a novel quantitative assessment tool for detecting speech impairment in ALS and (potentially) in other neuromotor disorders.
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Affiliation(s)
- Panying Rong
- Department of Speech-Language-Hearing: Sciences & Disorders, University of Kansas, Lawrence
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Tian N, Chen Y, Sun W, Liu H, Wang X, Yan T, Song R. Investigating the Stroke- and Aging-Related Changes in Global and Instantaneous Intermuscular Coupling Using Cross-Fuzzy Entropy. IEEE Trans Neural Syst Rehabil Eng 2021; 29:1573-1582. [PMID: 34329167 DOI: 10.1109/tnsre.2021.3101615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Intermuscular coupling is essential in the coordination of agonist and antagonist muscles. However, its dynamic characteristics are not fully understood, especially the alterations of intermuscular coupling induced by stroke and aging. This study aimed to investigate the aging- and stroke-related changes in the global and instantaneous intermuscular coupling between agonist and antagonist muscles. In the experiment, 8 patients after stroke, 18 healthy young subjects and 10 healthy middle-aged subjects were recruited and instructed to finish the elbow flexion and extension tasks. Cross-fuzzy entropy (C-FuzzyEn) and instantaneous C-FuzzyEn ( [Formula: see text]-FuzzyEn) based on a sliding window were used to analyze the global and instantaneous intermuscular coupling, respectively. Instantaneous FuzzyEn ( i -FuzzyEn) based on a sliding window was also applied to investigate the dynamic complexity of the EMG segment. Pearson correlation analysis revealed that i -FuzzyEn values were negatively correlated with [Formula: see text]-FuzzyEn values in most cases, which implied that there was a positive correlation between EMG complexity and intermuscular coupling. The C-FuzzyEn values between agonist and antagonist muscles increased significantly in both tasks of the patients after stroke than those of the healthy subjects (p < 0.05), which might be due to the decrease in intermuscular coupling induced by the damage of the corticospinal pathways after stroke. The combined application of C-FuzzyEn, [Formula: see text]-FuzzyEn and i -FuzzyEn provides a more comprehensive understanding of the global and instantaneous intermuscular coupling.
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Quintão C, Vigário R, Santos MM, Gomes AL, de Carvalho M, Pinto S, Gamboa H. Surface electromyography for testing motor dysfunction in amyotrophic lateral sclerosis. Neurophysiol Clin 2021; 51:454-465. [PMID: 34172377 DOI: 10.1016/j.neucli.2021.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 06/01/2021] [Accepted: 06/01/2021] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVES To investigate the use of a set of dynamical features, extracted from surface electromyography, to study upper motor neuron (UMN) degeneration in amyotrophic lateral sclerosis (ALS). METHODS We acquired surface EMG signals from the upper limb muscles of 13 ALS patients and 20 control subjects and classified them according to a novel set of muscle activity features, describing the temporal and frequency dynamic behavior of the signals, as well as measures of its complexity. Using a battery of classification approaches, we searched for the most discriminating combination of those features, as well as a suitable strategy to identify ALS. RESULTS We observed significant differences between ALS patients and controls, in particular when considering features highlighting differences between forearm and hand recordings, for which classification accuracies of up to 94% were achieved. The most robust discriminations were achieved using features based on detrended fluctuation analysis and peak frequency, and classifiers such as decision trees, random forest and Adaboost. CONCLUSION The current work shows that it is possible to achieve good identification of UMN changes in ALS by taking into consideration the dynamical behavior of surface electromyographic (sEMG) data.
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Affiliation(s)
- Carla Quintão
- Laboratory for Instrumentation, Biomedical Engineering and Radiation Physics, NOVA University of Lisbon, 2829-516 Caparica, Portugal; Department of Physics, Nova School of Science and Technology, 2829-516 Caparica, Portugal.
| | - Ricardo Vigário
- Laboratory for Instrumentation, Biomedical Engineering and Radiation Physics, NOVA University of Lisbon, 2829-516 Caparica, Portugal; Department of Physics, Nova School of Science and Technology, 2829-516 Caparica, Portugal
| | - Maria Marta Santos
- Department of Physics, Nova School of Science and Technology, 2829-516 Caparica, Portugal
| | - Ana Luísa Gomes
- PLUX - Wireless Biosignals, Avenida 5 de Outubro 70, 1050-059 Lisboa, Portugal
| | - Mamede de Carvalho
- Faculdade de Medicina, Instituto de Medicina Molecular, Universidade de Lisboa, 1179-056 Lisboa, Portugal
| | - Susana Pinto
- Faculdade de Medicina, Instituto de Medicina Molecular, Universidade de Lisboa, 1179-056 Lisboa, Portugal
| | - Hugo Gamboa
- Laboratory for Instrumentation, Biomedical Engineering and Radiation Physics, NOVA University of Lisbon, 2829-516 Caparica, Portugal; Department of Physics, Nova School of Science and Technology, 2829-516 Caparica, Portugal
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Ibáñez J, Del Vecchio A, Rothwell JC, Baker SN, Farina D. Only the Fastest Corticospinal Fibers Contribute to β Corticomuscular Coherence. J Neurosci 2021; 41:4867-4879. [PMID: 33893222 PMCID: PMC8260170 DOI: 10.1523/jneurosci.2908-20.2021] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 02/04/2021] [Accepted: 03/15/2021] [Indexed: 01/09/2023] Open
Abstract
Human corticospinal transmission is commonly studied using brain stimulation. However, this approach is biased to activity in the fastest conducting axons. It is unclear whether conclusions obtained in this context are representative of volitional activity in mild-to-moderate contractions. An alternative to overcome this limitation may be to study the corticospinal transmission of endogenously generated brain activity. Here, we investigate in humans (N = 19; of either sex), the transmission speeds of cortical β rhythms (∼20 Hz) traveling to arm (first dorsal interosseous) and leg (tibialis anterior; TA) muscles during tonic mild contractions. For this purpose, we propose two improvements for the estimation of corticomuscular β transmission delays. First, we show that the cumulant density (cross-covariance) is more accurate than the commonly-used directed coherence to estimate transmission delays in bidirectional systems transmitting band-limited signals. Second, we show that when spiking motor unit activity is used instead of interference electromyography, corticomuscular transmission delay estimates are unaffected by the shapes of the motor unit action potentials (MUAPs). Applying these improvements, we show that descending corticomuscular β transmission is only 1-2 ms slower than expected from the fastest corticospinal pathways. In the last part of our work, we show results from simulations using estimated distributions of the conduction velocities for descending axons projecting to lower motoneurons (from macaque histologic measurements) to suggest two scenarios that can explain fast corticomuscular transmission: either only the fastest corticospinal axons selectively transmit β activity, or else the entire pool does. The implications of these two scenarios for our understanding of corticomuscular interactions are discussed.SIGNIFICANCE STATEMENT We present and validate an improved methodology to measure the delay in the transmission of cortical β activity to tonically-active muscles. The estimated corticomuscular β transmission delays obtained with this approach are remarkably similar to those expected from transmission in the fastest corticospinal axons. A simulation of β transmission along a pool of corticospinal axons using an estimated distribution of fiber diameters suggests two possible mechanisms by which fast corticomuscular transmission is achieved: either a very small fraction of the fastest descending axons transmits β activity to the muscles or, alternatively, the entire population does and natural cancellation of slow channels occurs because of the distribution of axon diameters in the corticospinal tract.
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Affiliation(s)
- J Ibáñez
- Department of Bioengineering, Imperial College London, London SW7 2AZ, United Kingdom
- Department of Clinical and Movement Disorders, Institute of Neurology, University College London, London WC1N 3BG, United Kingdom
| | - A Del Vecchio
- Department Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander University, Erlangen-Nürnberg, Erlangen 91052, Germany
| | - J C Rothwell
- Department of Clinical and Movement Disorders, Institute of Neurology, University College London, London WC1N 3BG, United Kingdom
| | - S N Baker
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne NE2 4HH, United Kingdom
| | - D Farina
- Department of Bioengineering, Imperial College London, London SW7 2AZ, United Kingdom
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Walker S. Evidence of resistance training-induced neural adaptation in older adults. Exp Gerontol 2021; 151:111408. [PMID: 34022275 DOI: 10.1016/j.exger.2021.111408] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 05/04/2021] [Accepted: 05/17/2021] [Indexed: 11/25/2022]
Abstract
The deleterious effects of aging on force production are observable from the age of 40 upwards, depending on the measure. Neural mechanisms contributing to maximum force production and rate of force development have been suggested as descending drive from supraspinal centers, spinal motoneuron excitability, and corticospinal inhibition of descending drive; all of which influence motor unit recruitment and/or firing rate. Resistance-trained Master athletes offer a good source of information regarding the inevitable effects of aging despite the countermeasure of systematic resistance-training. However, most evidence of neural adaptation is derived from longitudinal intervention studies in previously untrained (i.e. resistance-training naïve) older adults. There is good evidence for the effect of resistance-training on the end-point of neural activation, i.e. motor unit behavior, but little to no data on the generation of descending drive from e.g. transcranial magnetic stimulation or cortical imaging studies in older adults. This, along with tracking master athletes over several years, would provide valuable information and could be the focus of future research.
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Affiliation(s)
- Simon Walker
- NeuroMuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Finland.
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44
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Houston M, Li X, Zhou P, Li S, Roh J, Zhang Y. Alterations in Muscle Networks in the Upper Extremity of Chronic Stroke Survivors. IEEE Trans Neural Syst Rehabil Eng 2021; 29:1026-1034. [PMID: 33900919 DOI: 10.1109/tnsre.2021.3075907] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Muscle networks describe the functional connectivity between muscles quantified through the decomposition of intermuscular coherence (IMC) to identify shared frequencies at which certain muscles are co-modulated by common neural input. Efforts have been devoted to characterizing muscle networks in healthy subjects but stroke-linked alterations to muscle networks remain unexplored. Muscle networks were assessed for eight key upper extremity muscles during isometric force generation in stroke survivors with mild, moderate, and severe impairment and compared against healthy controls to identify stroke-specificalterations in muscle connectivity. Coherence matrices were decomposed using non-negative matrix factorization. The variance accounted for thresholding was then assessed to identify the number of muscle networks. Results showed that the number of muscle networks decreased in stroke survivors compared to age-matched healthy controls (four networks in the healthy control group) as the severity of post-stroke motor impairment increased (three in the mild- and two in the moderate- and severe-strokegroups). Statistically significant reductions of IMC in the synergistic deltoid muscles in the alpha-band in stroke patients versus healthy controls ( p < 0.05) were identified. This study represents the first effort, to the best of our knowledge, to assess stroke-linked alterations in functional intermuscular connectivity using muscle network analysis. The findings revealed a pattern of alterations to muscle networks in stroke survivors compared to healthy controls, as a result of the loss of brain function associated with the stroke. These alterations in muscle networks reflected underlying pathophysiology. These findings can help better understand the motor impairment and motor control in stroke and may advance rehabilitation efforts for stroke by identifying the impaired neuromuscular coordination among multiple muscles in the frequency domain.
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Weersink JB, de Jong BM, Halliday DM, Maurits NM. Intermuscular coherence analysis in older adults reveals that gait-related arm swing drives lower limb muscles via subcortical and cortical pathways. J Physiol 2021; 599:2283-2298. [PMID: 33687081 PMCID: PMC8252748 DOI: 10.1113/jp281094] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 02/26/2021] [Indexed: 12/11/2022] Open
Abstract
KEY POINTS Gait-related arm swing in humans supports efficient lower limb muscle activation, indicating a neural coupling between the upper and lower limbs during gait. Intermuscular coherence analyses of gait-related electromyography from upper and lower limbs in 20 healthy participants identified significant coherence in alpha and beta/gamma bands indicating that upper and lower limbs share common subcortical and cortical drivers that coordinate the rhythmic four-limb gait pattern. Additional directed connectivity analyses revealed that upper limb muscles drive and shape lower limb muscle activity during gait via subcortical and cortical pathways and to a lesser extent vice versa. The results provide a neural underpinning that arm swing may serve as an effective rehabilitation therapy concerning impaired gait in neurological diseases. ABSTRACT Human gait benefits from arm swing, as it enhances efficient lower limb muscle activation in healthy participants as well as patients suffering from neurological impairment. The underlying neuronal mechanisms of such coupling between upper and lower limbs remain poorly understood. The aim of the present study was to examine this coupling by intermuscular coherence analysis during gait. Additionally, directed connectivity analysis of this coupling enabled assessment of whether gait-related arm swing indeed drives lower limb muscles. To that end, electromyography recordings were obtained from four lower limb muscles and two upper limb muscles bilaterally, during gait, of 20 healthy participants (mean (SD) age 67 (6.8) years). Intermuscular coherence analysis revealed functional coupling between upper and lower limb muscles in the alpha and beta/gamma band during muscle specific periods of the gait cycle. These effects in the alpha and beta/gamma bands indicate involvement of subcortical and cortical sources, respectively, that commonly drive the rhythmic four-limb gait pattern in an efficiently coordinated fashion. Directed connectivity analysis revealed that upper limb muscles drive and shape lower limb muscle activity during gait via subcortical and cortical pathways and to a lesser extent vice versa. This indicates that gait-related arm swing reflects the recruitment of neuronal support for optimizing the cyclic movement pattern of the lower limbs. These findings thus provide a neural underpinning for arm swing to potentially serve as an effective rehabilitation therapy concerning impaired gait in neurological diseases.
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Affiliation(s)
- Joyce B Weersink
- Department of Neurology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, POB 30.001, Groningen, The Netherlands
| | - Bauke M de Jong
- Department of Neurology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, POB 30.001, Groningen, The Netherlands
| | - David M Halliday
- Department of Electronic Engineering & York Biomedical Research Institute, University of York, York, YO10 5DD, UK
| | - Natasha M Maurits
- Department of Neurology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, POB 30.001, Groningen, The Netherlands
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Calabrò RS, Billeri L, Ciappina F, Balletta T, Porcari B, Cannavò A, Pignolo L, Manuli A, Naro A. Toward improving functional recovery in spinal cord injury using robotics: a pilot study focusing on ankle rehabilitation. Expert Rev Med Devices 2021; 19:83-95. [PMID: 33616471 DOI: 10.1080/17434440.2021.1894125] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background: Conventional physical therapy interventions are strongly recommended to improve ambulation potential and upright mobility in persons with incomplete spinal cord injury (iSCI). Ankle rehabilitation plays a significant role, as it aims to stem drop foot consequences.Research question: This pilot study aimed to assess the neurophysiological underpinnings of robot-aided ankle rehabilitation (using a platform robot) compared to conventional physiotherapy and its efficacy in improving gait performance and balance in persons with iSCI.Methods: Ten individuals with subacute/chronic iSCI (six males and four females, 39 ± 13 years, time since injury 8 ± 4 months, ASIA impairment scale grade C-D) were provided with one-month intensive training for robot-aided ankle rehabilitation (24 sessions, 1 h daily, six times a week). Clinical (10-Meter Walk Test (10MWT), 6-Minute Walk Test (6MWT), and Timed Up and Go test (TUG)), and electrophysiological aftereffects (surface-EMG from tibialis anterior and medial gastrocnemius muscles to estimate muscle activation patterns; and corticomuscular coherence-CMC-to assess functional synchronization between sensorimotor cortex and muscles, i.e. the functional integrity of corticospinal output) were assessed at baseline (PRE) and after the trial completion (POST). The experimental group (EG) data were compared with those coming from a retrospective control group (CG; n = 10) matched for clinical-demographic characteristics, who previously underwent conventional ankle rehabilitation.Results: the EG achieved a greater improvement in balance and gait as compared to the CG (TUG EG from 70 ± 18 to 45 ± 15 s, p = 0.002; CG from 68 ± 21 to 48 ± 18 s, p = 0.01; group-comparison p = 0.001; 10MWT EG from 0.43 ± 0.11 to 0.51 ± 0.09 m/s, p = 0.006; CG from 0.4 ± 0.13 to 0.45 ± 0.12, p = 0.01; group-comparison p = 0.006; 6 MWT EG from 231 ± 13 to 274 ± 15 m, p < 0.001; CG from 236 ± 13 to 262 ± 15 m, p = 0.003; group-comparison p = 0.01). Furthermore, the EG showed a retraining of muscle activation (an increase within proper movements, with a reduction of co-contractions) and CMC (beta frequency increase within proper movements, i.e. in a framework of preserved motor coordination). The improvements in CMC, gait, balance, and muscle activation were not correlated with each other.Conclusions: Robot-aided ankle rehabilitation improved gait performance by selectively ameliorating CMC, muscle activation patterns, and, lastly, gait balance and speed. Despite CMC, gait, balance, and muscle activation were not correlated, this pilot study suggests that robot-aided ankle rehabilitation may favor a better communication between above-SCI and below-SCI structures. This communication improvement may depend on a more synchronized corticospinal output (as per CMC increase) and a better responsiveness of below-SCI motorneurons to corticospinal output (as per specific and ankle movement focused muscle activation increases at the surface EMG), thus favoring greater recruitment of spinal motor units and, ultimately, improving muscle activation pattern and strength.Significance: Adopting robot-aided ankle rehabilitation protocols for persons with iSCI in the subacute/chronic phase may allow achieving a clinically significant improvement in gait performance.
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Affiliation(s)
| | - Luana Billeri
- IRCCS Centro Neurolesi Bonino Pulejo, Messina, Italy
| | | | - Tina Balletta
- IRCCS Centro Neurolesi Bonino Pulejo, Messina, Italy
| | - Bruno Porcari
- IRCCS Centro Neurolesi Bonino Pulejo, Messina, Italy
| | | | | | | | - Antonino Naro
- IRCCS Centro Neurolesi Bonino Pulejo, Messina, Italy
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de Carvalho M, Kiernan MC, Pullman SL, Rezania K, Turner MR, Simmons Z. Neurophysiological features of primary lateral sclerosis. Amyotroph Lateral Scler Frontotemporal Degener 2021; 21:11-17. [DOI: 10.1080/21678421.2020.1837174] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Mamede de Carvalho
- Instituto de Fisiologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Department of Neurosciences and Mental Health, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte, Lisbon, Portugal
| | - Matthew C. Kiernan
- Brain and Mind Centre, University of Sydney, and Department of Neurology, Royal Prince Alfred Hospital, Sydney, Australia
| | - Seth L Pullman
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Kourosh Rezania
- Department of Neurology, The University of Chicago, Chicago, IL, USA
| | - MR Turner
- Department of Clinical Neurology, University of Oxford, John Radcliffe Hospital, Oxford, UK, and
| | - Zachary Simmons
- Department of Neurology, Pennsylvania State University, Hershey, PA, US
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Wavelet coherence analysis of muscle coupling during reaching movement in stroke. Comput Biol Med 2021; 131:104263. [PMID: 33636422 DOI: 10.1016/j.compbiomed.2021.104263] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 02/06/2021] [Accepted: 02/06/2021] [Indexed: 11/22/2022]
Abstract
Agonist-antagonist coordination is essential to ensure the accuracy and stability of voluntary movement, which can be presented by time-varying coupling between agonist-antagonist electromyographic (EMG) signals. To discover the stroke-induced neurological change in paretic muscles, the wavelet coherence is firstly compared with coherence by simulated data and is utilized to represent the time-varying coupling of experimental data during elbow-tracking tasks. The simulation in this study demonstrates that the wavelet coherence is superior to coherence in the detection of short-time coupling between simulated signals. In addition, the experiment in this study is designed to explore the coupling between agonist-antagonist activations during the dynamic process. In the experiment, 10 post-stroke patients and 10 age-matched adults serving as controls were recruited and asked to perform elbow sinusoidal trajectory tracking tasks. Both the elbow angle and EMG signals of biceps and triceps were recorded simultaneously. Experimental results showed that wavelet coherence could represent the time-varying coupling between two EMG signals in the time-frequency domain, and its dynamic character was appropriate in the dynamic process to discover the functional coupling. According to the time and frequency analysis, the lower functional coupling in the post-stroke group and the obvious wavelet coherence difference between the two groups in the lower frequency range suggested a possible hypothesis mechanism that the weakening of coupling between agonist-antagonist muscles in the affected sides might in fact be stroke-induced damage in the direct corticospinal pathways.
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Rong P, Pattee GL. A potential upper motor neuron measure of bulbar involvement in amyotrophic lateral sclerosis using jaw muscle coherence. Amyotroph Lateral Scler Frontotemporal Degener 2021; 22:368-379. [PMID: 33522298 DOI: 10.1080/21678421.2021.1874993] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To identify a novel, quantitative bulbar measure in amyotrophic lateral sclerosis (ALS) based on jaw muscle coherence. Methods: The myoelectric activities of masseter, anterior temporalis, and anterior belly of digastric were recorded bilaterally during a speech task in 12 individuals with ALS and 10 neurologically healthy controls, using surface electromyography. Coherence and directed coherence were calculated for all muscle pairs. The muscle pairs showing significant coherence and directed coherence in the beta-band (15-35 Hz) were identified and their mean beta-band coherence were (1) correlated with the kinematic (i.e. jaw acceleration time) and functional speech (i.e. speaking rate) measures that have been previously identified to be affected by bulbar ALS, across all participants, and (2) evaluated in terms of their efficacy in differentiating individuals with ALS from healthy controls. Results: Beta-band coherence was in general reduced in ALS relative to healthy controls, with the antagonistic and homologous muscle pairs being more affected than the agonistic pairs. Among all muscle pairs, the coherence between masseter and digastric (1) showed the strongest correlations with jaw acceleration time and speaking rate, and (2) differentiated individuals with ALS from healthy controls with the highest sensitivity (i.e. 0.92) and specificity (i.e. 0.90). Conclusions: Reduced beta-band coherence between masseter and digastric in ALS reflects weakened neural linkage between these muscles resulting from the disrupted cortical drive to the bulbar musculature. These findings provide preliminary evidence for jaw muscle coherence as a novel, quantitative measure of corticobulbar involvement, designed to improve bulbar assessment in ALS.
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Affiliation(s)
- Panying Rong
- Department of Speech-Language-Hearing: Sciences and Disorders, University of Kansas, Lawrence, KS, USA
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Gennaro F, de Bruin ED. A pilot study assessing reliability and age-related differences in corticomuscular and intramuscular coherence in ankle dorsiflexors during walking. Physiol Rep 2021; 8:e14378. [PMID: 32109345 PMCID: PMC7048377 DOI: 10.14814/phy2.14378] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 01/29/2020] [Accepted: 02/01/2020] [Indexed: 12/11/2022] Open
Abstract
Corticomuscular (CMC) and intramuscular (intraMC) coherence represent measures of corticospinal interaction. Both CMC and intraMC can be assessed during human locomotion tasks, for example, while walking. Corticospinal control of gait can deteriorate during the aging process and CMC and intraMC may represent an important monitoring means. However, it is unclear whether such assessments represent a reliable tool when performed during walking in an ecologically valid scenario and whether age‐related differences may occur. Wireless surface electroencephalography and electromyography were employed in a pilot study with young and old adults during overground walking in two separate sessions. CMC and intraMC analyses were performed in the gathered beta and lower gamma frequencies (i.e., 13–40 Hz). Significant log‐transformed coherence area was tested for intersessions test–retest reliability by determining intraclass correlation coefficient (ICC), yielding to low reliability in CMC in both younger and older adults. intraMC exclusively showed low reliability in the older adults, whereas intraMC in the younger adults revealed similar values as previously reported: test–retest reliability [ICC (95% CI): 0.44 (−0.23, 0.87); SEM: 0.46; MDC: 1.28; MDC%: 103; Hedge's g (95% CI): 0.54 (−0.13, 1.57)]. Significant differences between the age groups were observed in intraMC by either comparing the two groups with the first test [Hedge's g (95% CI): 1.55 (0.85, 2.15); p‐value: .006] or with the retest data [Hedge's g (95% CI): 2.24 (0.73, 3.70); p‐value: .005]. Notwithstanding the small sample size investigated, intraMC seems a moderately reliable assessment in younger adults. The further development and use of this measure in practical settings to infer corticospinal interaction in human locomotion in clinical practice is warranted and should help to refine the analysis. This necessitates involving larger sample sizes as well as including a wider number of lower limb muscles. Moreover, further research seems warranted by the observed differences in modulation mechanisms of corticospinal control of gait as ascertained by intraMC between the age groups.
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Affiliation(s)
- Federico Gennaro
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Eling D de Bruin
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland.,Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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