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Kitchen NM, Dexheimer B, Yuk J, Maenza C, Ruelos PR, Kim T, Sainburg RL. The complementary dominance hypothesis: a model for remediating the 'good' hand in stroke survivors. J Physiol 2024. [PMID: 38733166 DOI: 10.1113/jp285561] [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: 02/03/2024] [Accepted: 04/25/2024] [Indexed: 05/13/2024] Open
Abstract
The complementary dominance hypothesis is a novel model of motor lateralization substantiated by decades of research examining interlimb differences in the control of upper extremity movements in neurotypical adults and hemisphere-specific motor deficits in stroke survivors. In contrast to earlier ideas that attribute handedness to the specialization of one hemisphere, our model proposes complementary motor control specializations in each hemisphere. The dominant hemisphere mediates optimal control of limb dynamics as required for smooth and efficient movements, whereas the non-dominant hemisphere mediates impedance control, important for countering unexpected mechanical conditions and achieving steady-state limb positions. Importantly, this model proposes that each hemisphere contributes its specialization to both arms (though with greater influence from either arm's contralateral hemisphere) and thus predicts that lesions to one hemisphere should produce hemisphere-specific motor deficits in not only the contralesional arm, but also the ipsilesional arm of stroke survivors - a powerful prediction now supported by a growing body of evidence. Such ipsilesional arm motor deficits vary with contralesional arm impairment, and thus individuals with little to no functional use of the contralesional arm experience both the greatest impairments in the ipsilesional arm, as well as the greatest reliance on it to serve as the main or sole manipulator for activities of daily living. Accordingly, we have proposed and tested a novel intervention that reduces hemisphere-specific ipsilesional arm deficits and thereby improves functional independence in stroke survivors with severe contralesional impairment.
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Affiliation(s)
- Nick M Kitchen
- Department of Neurology, College of Medicine, Pennsylvania State University, Hershey, Pennsylvania, USA
- Department of Kinesiology, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Brooke Dexheimer
- Department of Occupational Therapy, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Jisung Yuk
- Department of Kinesiology, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Candice Maenza
- Department of Neurology, College of Medicine, Pennsylvania State University, Hershey, Pennsylvania, USA
| | - Paul R Ruelos
- Department of Kinesiology, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Taewon Kim
- Department of Kinesiology, Pennsylvania State University, University Park, Pennsylvania, USA
- Department of Physical Medicine and Rehabilitation, College of Medicine, Pennsylvania State University, Hershey, Pennsylvania, USA
- Huck Institute of the Life Sciences, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Robert L Sainburg
- Department of Neurology, College of Medicine, Pennsylvania State University, Hershey, Pennsylvania, USA
- Department of Kinesiology, Pennsylvania State University, University Park, Pennsylvania, USA
- Huck Institute of the Life Sciences, Pennsylvania State University, University Park, Pennsylvania, USA
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2
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Sekiguchi Y, Owaki D, Honda K, Izumi SI, Ebihara S. Differences in kinetic factors affecting gait speed between lesion sides in patients with stroke. Front Bioeng Biotechnol 2024; 12:1240339. [PMID: 38567085 PMCID: PMC10985198 DOI: 10.3389/fbioe.2024.1240339] [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: 06/14/2023] [Accepted: 03/06/2024] [Indexed: 04/04/2024] Open
Abstract
The differences in kinetic mechanisms of decreased gait speed across brain lesion sides have not been elucidated, including the arrangement of motor modules reflected by kinetic interjoint coordination. The purpose of this study was to elucidate the differences in the kinetic factors of slow gait speed in patients with stroke on the lesion sides. A three-dimensional motion analysis system was employed to assess joint moment in the lower limb and representative gait parameters in 32 patients with right hemisphere brain damage (RHD) and 38 patients with left hemisphere brain damage (LHD) following stroke as well as 20 healthy controls. Motor module composition and timing were determined using principal component analysis based on the three joint moments in the lower limb in the stance phase, which were the variances accounted for principal components (PCs) and the peak timing in the time series of PCs. A stepwise multiple linear regression analysis was performed to identify the most significant joint moment and PC-associated parameter in explaining gait speed. A negligible difference was observed in age, weight, height, and gait speed among patients with RHD and LHD and controls. The following factors contributed to gait speed: in patients with RHD, larger ankle plantarflexion moment on the paretic (p = 0.001) and nonparetic (p = 0.002) sides and ankle dorsiflexion moment on the nonparetic side (p = 0.004); in patients with LHD, larger ankle plantarflexion moment (p < 0.001) and delayed peak timing of the first PC (p = 0.012) on the paretic side as well as ankle dorsiflexion moment on the nonparetic side (p < 0.001); in the controls, delayed peak timing of the first PC (p = 0.002) on the right side and larger ankle dorsiflexion moment (p = 0.001) as well as larger hip flexion moment on the left side (p = 0.023). The findings suggest that the kinetic mechanisms of gait speed may differ among patients with RHD following patients with stroke with LHD, and controls.
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Affiliation(s)
- Yusuke Sekiguchi
- Department of Physical Medicine and Rehabilitation, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Dai Owaki
- Department of Robotics, Graduate School of Engineering, Tohoku University, Sendai, Japan
| | - Keita Honda
- Department of Physical Medicine and Rehabilitation, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Shin-Ichi Izumi
- Department of Physical Medicine and Rehabilitation, Graduate School of Medicine, Tohoku University, Sendai, Japan
- Department of Physical Medicine and Rehabilitation, Graduate School of Biomedical Engineering, Tohoku University, Sendai, Japan
| | - Satoru Ebihara
- Department of Internal Medicine & Rehabilitation Science, Disability Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan
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3
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Torell F, Franklin S, Franklin DW, Dimitriou M. Goal-directed modulation of stretch reflex gains is reduced in the non-dominant upper limb. Eur J Neurosci 2023; 58:3981-4001. [PMID: 37727025 DOI: 10.1111/ejn.16148] [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: 03/07/2023] [Revised: 08/08/2023] [Accepted: 08/31/2023] [Indexed: 09/21/2023]
Abstract
Most individuals experience their dominant arm as being more dexterous than the non-dominant arm, but the neural mechanisms underlying this asymmetry in motor behaviour are unclear. Using a delayed-reach task, we have recently demonstrated strong goal-directed tuning of stretch reflex gains in the dominant upper limb of human participants. Here, we used an equivalent experimental paradigm to address the neural mechanisms that underlie the preparation for reaching movements with the non-dominant upper limb. There were consistent effects of load, preparatory delay duration and target direction on the long latency stretch reflex. However, by comparing stretch reflex responses in the non-dominant arm with those previously documented in the dominant arm, we demonstrate that goal-directed tuning of short and long latency stretch reflexes is markedly weaker in the non-dominant limb. The results indicate that the motor performance asymmetries across the two upper limbs are partly due to the more sophisticated control of reflexive stiffness in the dominant limb, likely facilitated by the superior goal-directed control of muscle spindle receptors. Our findings therefore suggest that fusimotor control may play a role in determining performance of complex motor behaviours and support existing proposals that the dominant arm is better supplied than the non-dominant arm for executing more complex tasks, such as trajectory control.
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Affiliation(s)
- Frida Torell
- Physiology Section, Department of Integrative Medical Biology, Umeå University, Umeå, Sweden
| | - Sae Franklin
- Neuromuscular Diagnostics, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - David W Franklin
- Neuromuscular Diagnostics, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
- Munich Institute of Robotics and Machine Intelligence (MIRMI), Technical University of Munich, Munich, Germany
- Munich Data Science Institute (MDSI), Technical University of Munich, Munich, Germany
| | - Michael Dimitriou
- Physiology Section, Department of Integrative Medical Biology, Umeå University, Umeå, Sweden
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4
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Park K, Ritsma BR, Dukelow SP, Scott SH. A robot-based interception task to quantify upper limb impairments in proprioceptive and visual feedback after stroke. J Neuroeng Rehabil 2023; 20:137. [PMID: 37821970 PMCID: PMC10568927 DOI: 10.1186/s12984-023-01262-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 10/06/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND A key motor skill is the ability to rapidly interact with our dynamic environment. Humans can generate goal-directed motor actions in response to sensory stimulus within ~ 60-200ms. This ability can be impaired after stroke, but most clinical tools lack any measures of rapid feedback processing. Reaching tasks have been used as a framework to quantify impairments in generating motor corrections for individuals with stroke. However, reaching may be inadequate as an assessment tool as repeated reaching can be fatiguing for individuals with stroke. Further, reaching requires many trials to be completed including trials with and without disturbances, and thus, exacerbate fatigue. Here, we describe a novel robotic task to quantify rapid feedback processing in healthy controls and compare this performance with individuals with stroke to (more) efficiently identify impairments in rapid feedback processing. METHODS We assessed a cohort of healthy controls (n = 135) and individuals with stroke (n = 40; Mean 41 days from stroke) in the Fast Feedback Interception Task (FFIT) using the Kinarm Exoskeleton robot. Participants were instructed to intercept a circular white target moving towards them with their hand represented as a virtual paddle. On some trials, the arm could be physically perturbed, the target or paddle could abruptly change location, or the target could change colour requiring the individual to now avoid the target. RESULTS Most participants with stroke were impaired in reaction time (85%) and end-point accuracy (83%) in at least one of the task conditions, most commonly with target or paddle shifts. Of note, this impairment was also evident in most individuals with stroke when performing the task using their unaffected arm (75%). Comparison with upper limb clinical measures identified moderate correlations with the FFIT. CONCLUSION The FFIT was able to identify a high proportion of individuals with stroke as impaired in rapid feedback processing using either the affected or unaffected arms. The task allows many different types of feedback responses to be efficiently assessed in a short amount of time.
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Affiliation(s)
- Kayne Park
- Centre for Neuroscience Studies, Queen's University, Botterell Hall, 18 Stuart St, Kingston, ON, K7L 3N6, Canada.
| | - Benjamin R Ritsma
- Department of Physical Medicine and Rehabilitation, Queen's University, Kingston, ON, Canada
- Providence Care Hospital, Queen's University, Kingston, ON, Canada
| | - Sean P Dukelow
- Department of Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Stephen H Scott
- Centre for Neuroscience Studies, Queen's University, Botterell Hall, 18 Stuart St, Kingston, ON, K7L 3N6, Canada
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
- Department of Medicine, Queen's University, Kingston, ON, Canada
- Providence Care Hospital, Queen's University, Kingston, ON, Canada
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5
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Monfredini CFP, Coelho DB, Marcori AJ, Teixeira LA. Control of interjoint coordination in the performance of manual circular movements can explain lateral specialization. Hum Mov Sci 2023; 90:103102. [PMID: 37236120 DOI: 10.1016/j.humov.2023.103102] [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: 03/06/2023] [Revised: 05/19/2023] [Accepted: 05/20/2023] [Indexed: 05/28/2023]
Abstract
Between-arm performance asymmetry can be seen in different arm movements requiring specific interjoint coordination to generate the desired hand trajectory. In the current investigation, we assessed between-arm asymmetry of shoulder-elbow coordination and its stability in the performance of circular movements. Participants were 16 healthy right-handed university students. The task consisted of performing cyclic circular movements with either the dominant right arm or the nondominant left arm at movement frequencies ranging from 40% of maximum to maximum frequency in steps of 15%. Kinematic analysis of shoulder and elbow motions was performed through an optoelectronic system in the three-dimensional space. Results showed that as movement frequency increased circularity of left arm movements diminished, taking an elliptical shape, becoming significantly different from the right arm at higher movement frequencies. Shoulder-elbow coordination was found to be asymmetric between the two arms across movement frequencies, with lower shoulder-elbow angle coefficients and higher relative phase for the left compared to the right arm. Results also revealed greater variability of left arm movements in all variables assessed, an outcome observed from low to high movement frequencies. From these findings, we propose that specialization of the left cerebral hemisphere for motor control resides in its higher capacity to generate appropriate and stable interjoint coordination leading to the planned hand trajectory.
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Affiliation(s)
| | - Daniel Boari Coelho
- University of São Paulo, Human Motor Systems Laboratory, São Paulo, Brazil; Biomedical Engineering, Federal University of ABC, São Paulo, Brazil.
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6
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Steinbach MJ, Campbell RW, DeVore BB, Harrison DW. Laterality in Parkinson's disease: A neuropsychological review. APPLIED NEUROPSYCHOLOGY. ADULT 2023; 30:126-140. [PMID: 33844619 DOI: 10.1080/23279095.2021.1907392] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Laterality of motor symptom onset in Parkinson's disease is both well-known and under-appreciated. Treatment of disorders that have asymmetric pathological features, such as stroke and epilepsy, demonstrate the importance of incorporating hemispheric lateralization and specialization into therapy and care planning. These practices could theoretically extend to Parkinson's disease, providing increased diagnostic accuracy and improved treatment outcomes. Additionally, while motor symptoms have generally received the majority of attention, non-motor features (e.g., autonomic dysfunction) also decrease quality of life and are influenced by asymmetrical neurodegeneration. Due to the laterality of cognitive and behavioral processes in the two brain hemispheres, analysis of hemibody side of onset can potentially give insight into expected symptom profile of the patient and allow for increased predictive accuracy of disease progression and outcome, thus opening the door to personalized and improved therapy in treating Parkinson's disease patients. This review discusses motor and non-motor symptoms (namely autonomic, sensory, emotional, and cognitive dysfunction) of Parkinson's disease in respect to hemispheric lateralization from a theoretical perspective in hopes of providing a framework for future research and personalized treatment.
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7
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Brain Asymmetry and Its Effects on Gait Strategies in Hemiplegic Patients: New Rehabilitative Conceptions. Brain Sci 2022; 12:brainsci12060798. [PMID: 35741683 PMCID: PMC9220897 DOI: 10.3390/brainsci12060798] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 06/08/2022] [Accepted: 06/17/2022] [Indexed: 11/16/2022] Open
Abstract
Brain asymmetry is connected with motor performance, suggesting that hemiparetic patients have different gait patterns depending on the side of the lesion. This retrospective cohort study aims to further investigate the difference between right and left hemiplegia in order to assess whether the injured side can influence the patient’s clinical characteristics concerning gait, thus providing insights for new personalized rehabilitation strategies. The data from 33 stroke patients (17 with left and 16 with right hemiplegia) were retrospectively compared with each other and with a control group composed of 20 unaffected age-matched individuals. The 3D gait analysis was used to assess kinematic data and spatio-temporal parameters. Compared to left hemiplegic patients, right hemiplegic patients showed worse spatio-temporal parameters (p < 0.05) and better kinematic parameters (p < 0.05). Both pathological groups were characterized by abnormal gait parameters in comparison with the control group (p < 0.05). These findings show an association between the side of the lesion—right or left—and the different stroke patients’ gait patterns: left hemiplegic patients show better spatio-temporal parameters, whereas right hemiplegic patients show better segmentary motor performances. Therefore, further studies may develop and assess new personalized rehabilitation strategies considering the injured hemisphere and brain asymmetry.
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8
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Maenza C, Sainburg RL, Varghese R, Dexheimer B, Demers M, Bishop L, Jayasinghe SAL, Wagstaff DA, Winstein C. Ipsilesional arm training in severe stroke to improve functional independence (IPSI): phase II protocol. BMC Neurol 2022; 22:141. [PMID: 35413856 PMCID: PMC9002228 DOI: 10.1186/s12883-022-02643-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 03/16/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We previously characterized hemisphere-specific motor control deficits in the ipsilesional, less-impaired arm of unilaterally lesioned stroke survivors. Our preliminary data indicate these deficits are substantial and functionally limiting in patients with severe paresis. METHODS We have designed an intervention ("IPSI") to remediate the hemisphere-specific deficits in the ipsilesional arm, using a virtual-reality platform, followed by manipulation training with a variety of real objects, designed to facilitate generalization and transfer to functional behaviors encountered in the natural environment. This is a 2-site (primary site - Penn State College of Medicine, secondary site - University of Southern California), two-group randomized intervention with an experimental group, which receives unilateral training of the ipsilesional arm throughout 3 one-hour sessions per week for 5 weeks, through our Virtual Reality and Manipulation Training (VRMT) protocol. Our control group receives a conventional intervention on the contralesional arm, 3 one-hour sessions per week for 5 weeks, guided by recently released practice guidelines for upper limb rehabilitation in adult stroke. The study aims to include a total of 120 stroke survivors (60 per group) whose stroke was in the territory of the middle cerebral artery (MCA) resulting in severe upper-extremity motor impairments. Outcome measures (Primary: Jebsen-Taylor Hand Function Test, Fugl-Meyer Assessment, Abilhand, Barthel Index) are assessed at five evaluation points: Baseline 1, Baseline 2, immediate post-intervention (primary endpoint), and 3-weeks (short-term retention) and 6-months post-intervention (long-term retention). We hypothesize that both groups will improve performance of the targeted arm, but that the ipsilesional arm remediation group will show greater improvements in functional independence. DISCUSSION The results of this study are expected to inform upper limb evaluation and treatment to consider ipsilesional arm function, as part of a comprehensive physical rehabilitation strategy that includes evaluation and remediation of both arms. TRIAL REGISTRATION This study is registered with ClinicalTrials.gov (Registration ID: NCT03634397 ; date of registration: 08/16/2018).
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Affiliation(s)
- Candice Maenza
- Department of Neurology, Pennsylvania State University College of Medicine, 500 University Drive, Hershey, PA, 17033, USA. .,Department of Kinesiology, Pennsylvania State University, 27 Rec Hall, University Park, PA, 16802, USA.
| | - Robert L Sainburg
- Department of Neurology, Pennsylvania State University College of Medicine, 500 University Drive, Hershey, PA, 17033, USA.,Department of Kinesiology, Pennsylvania State University, 27 Rec Hall, University Park, PA, 16802, USA
| | - Rini Varghese
- Division of Biokinesiology and Physical Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
| | - Brooke Dexheimer
- Department of Kinesiology, Pennsylvania State University, 27 Rec Hall, University Park, PA, 16802, USA
| | - Marika Demers
- Division of Biokinesiology and Physical Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
| | - Lauri Bishop
- Division of Biokinesiology and Physical Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
| | - Shanie A L Jayasinghe
- Department of Neurology, Pennsylvania State University College of Medicine, 500 University Drive, Hershey, PA, 17033, USA
| | - David A Wagstaff
- Department of Human Development and Family Studies, Pennsylvania State University, 102 HHD Building, University Park, PA, 16802, USA
| | - Carolee Winstein
- Division of Biokinesiology and Physical Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA.,Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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9
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Golub VM, Reddy DS. Contusion brain damage in mice for modelling of post-traumatic epilepsy with contralateral hippocampus sclerosis: Comprehensive and longitudinal characterization of spontaneous seizures, neuropathology, and neuropsychiatric comorbidities. Exp Neurol 2021; 348:113946. [PMID: 34896334 DOI: 10.1016/j.expneurol.2021.113946] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 11/12/2021] [Accepted: 12/04/2021] [Indexed: 02/03/2023]
Abstract
Traumatic brain injury (TBI) is a leading cause of acquired epilepsy referred to as post-traumatic epilepsy (PTE), characterized by spontaneous recurrent seizures (SRS) that start in the months or years following TBI. There is a critical need to develop small animal models for advancing the neurotherapeutics of PTE, which accounts for 20% of all acquired epilepsy cases. Despite many previous attempts, there are few PTE models with demonstrated consistency or longitudinal incidence of SRS, a critical feature for creating models for investigation of novel therapeutics for preventing PTE. Over the past few years, we have made in-depth updates and several advances to our mouse model of TBI in which SRS consistently occurs upon 24/7 monitoring for 4 months. Here, we show that an advanced cortical contusion damage in mice elicits a chronic state of PTE with SRS and robust epileptiform activity, along with cognitive comorbidities. We observed SRS in 33% and 87% of moderate and severe injury cohorts, respectively. Though incidence was higher in the severe cohort, moderate injury elicited a robust epileptogenesis. Progressive neuronal damage, neurodegeneration, and inflammation signals were evident in many brain regions; comorbid behavior and cognitive deficits were observed for up to 4-months. SRS onset was correlated with the inception of interneuron loss after TBI. Contralateral hippocampal sclerosis was unique and well correlated with SRS, confirming a potential network basis for epileptogenesis. Collectively, this mouse model exhibits a number of hallmark TBI sequelae reminiscent of human PTE. This model provides a vital tool for probing molecular pathological mechanisms and therapeutic interventions for post-traumatic epileptogenesis. SIGNIFICANCE STATEMENT: TBI is a leading cause of post-traumatic epilepsy (PTE). Despite many attempts to create PTE in animals, success has been limited due to a lack of consistent spontaneous "epileptic" seizures after TBI. We present a comprehensive phenotype of PTE after contusion brain injury in mice, which exhibits robust spontaneous seizures along with neuronal loss, inflammation, and cognitive dysfunction. Our broad profiling of a TBI mouse reveals features of progressive, long-lasting epileptic activity, unique contralateral hippocampal sclerosis, and comorbid mood and memory deficits. The PTE mouse shows a striking consistency in recapitulating major pathological sequelae of human PTE. This mouse model will be helpful in assessing mechanisms and interventions for TBI-induced epilepsy and mood dysfunction.
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Affiliation(s)
- Victoria M Golub
- Department of Neuroscience and Experimental Therapeutics, College of Medicine, Texas A&M University Health Science Center, Bryan, TX, USA
| | - Doodipala Samba Reddy
- Department of Neuroscience and Experimental Therapeutics, College of Medicine, Texas A&M University Health Science Center, Bryan, TX, USA.
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10
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Aerobic Exercise After Left-Sided Stroke Improves Gait Speed and Endurance: A Prospective Cohort Study. Am J Phys Med Rehabil 2021; 100:576-583. [PMID: 32932358 DOI: 10.1097/phm.0000000000001596] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of the study was to investigate the effects of aerobic exercise on individuals who have had a stroke and showed baseline scores lower than the standard scores for the 6-min and 10-meter walk tests. DESIGN Individuals were assigned to groups according to gait performance, defined by the standard values in the 6-min and 10-meter walk tests (standard baseline score and lower baseline score), and brain injury side. Aerobic exercise, 30 mins per day, 2 times a week, for a total of 12 wks. The 6-min and 10-meter walk tests in five assessments: initial, after 4, 8, 12 wks, and 4 wks of follow-up, analyzed by multivariate analysis, with P value of less than 0.05. RESULTS The 6-min walk test data showed an increase in endurance for lower baseline score and left-brain injury, during assessments 4, and follow-up, compared with standard baseline score (F4,84 = 14.64). Lower baseline score showed endurance increase for assessments 2, 3, 4, and follow-up compared with assessment 1 (F4,84 = 7.70). The 10-meter walk test data showed an increase in speed for lower baseline score and left-brain injury, during assessments 3, 4, and follow-up, compared with assessment 1, 4, and follow-up, compared with assessment 2 (F4,84 = 5.33). CONCLUSIONS Aerobic exercise increases gait endurance and speed in individuals who have had a stroke, with left-brain injury, and lower baseline score in the 6-min and 10-meter walk tests.
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11
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Maenza C, Wagstaff DA, Varghese R, Winstein C, Good DC, Sainburg RL. Remedial Training of the Less-Impaired Arm in Chronic Stroke Survivors With Moderate to Severe Upper-Extremity Paresis Improves Functional Independence: A Pilot Study. Front Hum Neurosci 2021; 15:645714. [PMID: 33776672 PMCID: PMC7994265 DOI: 10.3389/fnhum.2021.645714] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 02/23/2021] [Indexed: 01/22/2023] Open
Abstract
The ipsilesional arm of stroke patients often has functionally limiting deficits in motor control and dexterity that depend on the side of the brain that is lesioned and that increase with the severity of paretic arm impairment. However, remediation of the ipsilesional arm has yet to be integrated into the usual standard of care for upper limb rehabilitation in stroke, largely due to a lack of translational research examining the effects of ipsilesional-arm intervention. We now ask whether ipsilesional-arm training, tailored to the hemisphere-specific nature of ipsilesional-arm motor deficits in participants with moderate to severe contralesional paresis, improves ipsilesional arm performance and generalizes to improve functional independence. We assessed the effects of this intervention on ipsilesional arm unilateral performance [Jebsen–Taylor Hand Function Test (JHFT)], ipsilesional grip strength, contralesional arm impairment level [Fugl–Meyer Assessment (FM)], and functional independence [Functional independence measure (FIM)] (N = 13). Intervention occurred over a 3 week period for 1.5 h/session, three times each week. All sessions included virtual reality tasks that targeted the specific motor control deficits associated with either left or right hemisphere damage, followed by graded dexterity training in real-world tasks. We also exposed participants to 3 weeks of sham training to control for the non-specific effects of therapy visits and interactions. We conducted five test-sessions: two pre-tests and three post-tests. Our results indicate substantial improvements in the less-impaired arm performance, without detriment to the paretic arm that transferred to improved functional independence in all three posttests, indicating durability of training effects for at least 3 weeks. We provide evidence for establishing the basis of a rehabilitation approach that includes evaluation and remediation of the ipsilesional arm in moderately to severely impaired stroke survivors. This study was originally a crossover design; however, we were unable to complete the second arm of the study due to the COVID-19 pandemic. We report the results from the first arm of the planned design as a longitudinal study.
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Affiliation(s)
- Candice Maenza
- Department of Neurology, Pennsylvania State University College of Medicine, Hershey, PA, United States.,Department of Kinesiology, Pennsylvania State University, State College, PA, United States
| | - David A Wagstaff
- Department of Human Development and Family Studies, Pennsylvania State University, State College, PA, United States
| | - Rini Varghese
- Department of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, United States
| | - Carolee Winstein
- Department of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, United States
| | - David C Good
- Department of Neurology, Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Robert L Sainburg
- Department of Neurology, Pennsylvania State University College of Medicine, Hershey, PA, United States.,Department of Kinesiology, Pennsylvania State University, State College, PA, United States
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12
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Synergistic Activation Patterns of Hand Muscles in Left-and Right-Hand Dominant Individuals. J Hum Kinet 2021; 76:89-100. [PMID: 33603927 PMCID: PMC7877284 DOI: 10.2478/hukin-2021-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Handedness has been associated with behavioral asymmetries between limbs that suggest specialized function of dominant and non-dominant hand. Whether patterns of muscle co-activation, representing muscle synergies, also differ between the limbs remains an open question. Previous investigations of proximal upper limb muscle synergies have reported little evidence of limb asymmetry; however, whether the same is true of the distal upper limb and hand remains unknown. This study compared forearm and hand muscle synergies between the dominant and non-dominant limb of left-handed and right-handed participants. Participants formed their hands into the postures of the American Sign Language (ASL) alphabet, while EMG was recorded from hand and forearm muscles. Muscle synergies were extracted for each limb individually by applying non-negative-matrix-factorization (NMF). Extracted synergies were compared between limbs for each individual, and between individuals to assess within and across participant differences. Results indicate no difference between the limbs for individuals, but differences in limb synergies at the population level. Left limb synergies were found to be more similar than right limb synergies across left- and right-handed individuals. Synergies of the left hand of left dominant individuals were found to have greater population level similarity than the other limbs tested. Results are interpreted with respect to known differences in the neuroanatomy and neurophysiology of proximal and distal upper limb motor control. Implications for skill training in sports requiring dexterous control of the hand are discussed.
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13
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Rahimi M, Swann Z, Honeycutt CF. Does exposure to startle impact voluntary reaching movements in individuals with severe-to-moderate stroke? Exp Brain Res 2021; 239:745-753. [PMID: 33392695 PMCID: PMC7943527 DOI: 10.1007/s00221-020-06005-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 12/04/2020] [Indexed: 12/26/2022]
Abstract
When movements of individuals with stroke (iwS) are elicited by startling acoustic stimulus (SAS), reaching movements are faster, further, and directed away from the body. However, these startle-evoked movements also elicit task-inappropriate flexor activity, raising concerns that chronic exposure to startle might also induce heightened flexor activity during voluntarily elicited movement. The objective of this study is to evaluate the impact of startle exposure on voluntary movements during point-to-point reaching in individuals with moderate and severe stroke. We hypothesize that startle exposure will increase task-inappropriate activity in flexor muscles, which will be associated with worse voluntarily initiated reaching performance (e.g. decreased distance, displacement, and final accuracy). Eleven individuals with moderate-to-severe stroke (UEFM = 8–41/66 and MAS = 0–4/4) performed voluntary point-to-point reaching with 1/3 of trials elicited by an SAS. We used electromyography to measure activity in brachioradialis (BR), biceps (BIC), triceps lateral head (TRI), pectoralis (PEC), anterior deltoid (AD), and posterior deltoid (PD). Conversely to our hypothesis, exposure to startle did not increase abnormal flexion but rather antagonist activity in the elbow flexors and shoulder horizontal adductors decreased, suggesting that abnormal flexor/extensor co-contraction was reduced. This reduction of flexion led to increased reaching distance (18.2% farther), movement onset (8.6% faster), and final accuracy (16.1% more accurate) by the end of the session. This study offers the first evidence that exposure to startle in iwS does not negatively impact voluntary movement; moreover, exposure may improve volitionally activated reaching movements by decreasing abnormal flexion activity.
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Affiliation(s)
- Marziye Rahimi
- Ira A. Fulton Schools of Engineering, Arizona State University, 699 S Mill Ave, Tempe, AZ, 85281, USA. .,Arizona State University, Mailcode 9709, 611 E Orange St, Tempe, AZ, 85281, USA.
| | - Zoe Swann
- School of Life Sciences, Arizona State University, 427 E Tyler Mall, Tempe, AZ, 85281, USA
| | - Claire F Honeycutt
- School of Biological and Health Science Engineering, Arizona State University, 501 E Tyler Mall, Tempe, AZ, 85287, USA
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14
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Schaffer JE, Maenza C, Good DC, Przybyla A, Sainburg RL. Left hemisphere damage produces deficits in predictive control of bilateral coordination. Exp Brain Res 2020; 238:2733-2744. [PMID: 32970199 PMCID: PMC10704921 DOI: 10.1007/s00221-020-05928-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 08/24/2020] [Indexed: 10/23/2022]
Abstract
Previous research has demonstrated hemisphere-specific motor deficits in ipsilesional and contralesional unimanual movements in patients with hemiparetic stroke due to MCA infarct. Due to the importance of bilateral motor actions on activities of daily living, we now examine how bilateral coordination may be differentially affected by right or left hemisphere stroke. To avoid the caveat of simply adding unimanual deficits in assessing bimanual coordination, we designed a unique task that requires spatiotemporal coordination features that do not exist in unimanual movements. Participants with unilateral left (LHD) or right hemisphere damage (RHD) and age-matched controls moved a virtual rectangle (bar) from a midline start position to a midline target. Movement along the long axis of the bar was redundant to the task, such that the bar remained in the center of and parallel to an imaginary line connecting each hand. Thus, to maintain midline position of the bar, movements of one hand closer to or further away from the bar midline required simultaneous, but oppositely directed displacements with the other hand. Our findings indicate that left (LHD), but not right (RHD) hemisphere-damaged patients showed poor interlimb coordination, reflected by significantly lower correlations between displacements of each hand along the bar axis. These left hemisphere-specific deficits were only apparent prior to peak velocity, likely reflecting predictive control of interlimb coordination. In contrast, the RHD group bilateral coordination was not significantly different than that of the control group. We conclude that predictive mechanisms that govern bilateral coordination are dependent on left hemisphere mechanisms. These findings indicate that assessment and training in cooperative bimanual tasks should be considered as part of an intervention framework for post-stroke physical rehabilitation.
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Affiliation(s)
- Jacob E Schaffer
- Department of Kinesiology, The Pennsylvania State University, 27 Recreation Building, University Park, PA, 16802, USA.
| | - Candice Maenza
- Department of Neurology, Penn State Milton S. Hershey College of Medicine, Hershey, USA
| | - David C Good
- Department of Neurology, Penn State Milton S. Hershey College of Medicine, Hershey, USA
| | - Andrzej Przybyla
- Department of Physical Therapy, University of North Georgia, Dahlonega, USA
| | - Robert L Sainburg
- Department of Kinesiology, The Pennsylvania State University, 27 Recreation Building, University Park, PA, 16802, USA
- Department of Neurology, Penn State Milton S. Hershey College of Medicine, Hershey, USA
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15
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Yadav G, Mutha PK. Symmetric interlimb transfer of newly acquired skilled movements. J Neurophysiol 2020; 124:1364-1376. [PMID: 32902352 DOI: 10.1152/jn.00777.2019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
In this study, we aimed to examine features of interlimb generalization or "transfer" of newly acquired motor skills, with a broader goal of better understanding the mechanisms mediating skill learning. Right-handed participants (n = 36) learned a motor task that required them to make very rapid but accurate reaches to one of eight randomly presented targets, thus bettering the typical speed-accuracy tradeoff. Subjects were divided into an "RL" group that first trained with the right arm and was then tested on the left and an "LR" group that trained with the left arm and was subsequently tested on the right. We found significant interlimb transfer in both groups. Remarkably, we also observed that participants learned faster with their left arm compared with the right. We hypothesized that this could be due to a previously suggested left arm/right hemisphere advantage for movements under variable task conditions. To corroborate this, we recruited two additional groups of participants (n = 22) that practiced the same task under a single target condition. This removal of task level variability eliminated learning rate differences between the arms, yet interlimb transfer remained robust and symmetric, as in the first experiment. Additionally, the strategy used to reduce errors during learning, albeit heterogeneous across subjects particularly in our second experiment, was adopted by the untrained arm. These findings may be best explained as the outcome of the operation of cognitive strategies during the early stages of motor skill learning.NEW & NOTEWORTHY How newly acquired motor skills generalize across effectors is not well understood. Here, we show that newly learned skilled actions transfer symmetrically across the arms and that task-level variability influences learning rate but not transfer magnitude or direction. Interestingly, strategies developed during learning with one arm transfer to the untrained arm. This likely reflects the outcome of learning driven by cognitive mechanisms during the initial stages of motor skill acquisition.
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Affiliation(s)
- Goldy Yadav
- Center for Cognitive and Brain Sciences, Indian Institute of Technology Gandhinagar, Gujarat, India
| | - Pratik K Mutha
- Center for Cognitive and Brain Sciences, Indian Institute of Technology Gandhinagar, Gujarat, India.,Department of Biological Engineering, Indian Institute of Technology Gandhinagar, Gujarat, India
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16
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Tafuro A, Vallesi A, Ambrosini E. Cognitive brakes in interference resolution: A mouse-tracking and EEG co-registration study. Cortex 2020; 133:188-200. [PMID: 33128914 DOI: 10.1016/j.cortex.2020.09.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 07/20/2020] [Accepted: 09/17/2020] [Indexed: 01/10/2023]
Abstract
Cognitive control is particularly challenged when it is necessary to resolve interference and correct our behavior on-the-fly. To do this, it is necessary to inhibit the ongoing wrong action and reprogram a new motor plan as appropriate for the current task. This ability requires a complex interaction between cognitive and motor control. Here, we aimed at shedding light on this interplay. To do this, we administered a spatial version of the Stroop task comprising blocks with different Proportion Congruency (PC) manipulations (i.e., manipulating the percentage of congruent trials at 25%, 50% or 75%), to elicit different cognitive control demands. Moreover, we used two techniques with high-temporal resolution, as we simultaneously recorded EEG and mouse trajectories, that can be considered the real-time kinematic correlates of the ongoing cognitive processing. Specifically, we analyzed the Event Related Potentials (ERPs) locked to the peak deceleration time, which marks the suppression of ongoing erroneous trajectories, and we estimated their neural sources. We found three PC-dependent ERP components engaging distinct neural regions, which showed a reduction of the Stroop effect for low-PC blocks. By using a novel co-registration of mouse-trajectories and EEG, we suggest that the observed components may reflect different mechanisms engaged by reactive cognitive control to resolve the interference, including the suppression of an ongoing but no longer appropriate response, the selection of the new motor plan and its actual updating.
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Affiliation(s)
- Alessandra Tafuro
- Department of Neuroscience, University of Padua, Padua, Italy; Perception and Awareness (PandA) Laboratory, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Antonino Vallesi
- Department of Neuroscience & Padova Neuroscience Center, University of Padua, Padua, Italy; Brain Imaging and Neural Dynamics Research Group, IRCCS, San Camillo Hospital, Venice, Italy
| | - Ettore Ambrosini
- Department of Neuroscience & Padova Neuroscience Center, University of Padua, Padua, Italy; Department of General Psychology, University of Padua, Padua, Italy.
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17
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Burns MK, Stika J, Patel V, Pei D, Nataraj R, Vinjamuri R. Lateralization and Model Transference in a Bilateral Cursor Task .. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2020:3240-3243. [PMID: 33018695 DOI: 10.1109/embc44109.2020.9176496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Post-stroke rehabilitation, occupational and physical therapy, and training for use of assistive prosthetics leverages our current understanding of bilateral motor control to better train individuals. In this study, we examine upper limb lateralization and model transference using a bimanual joystick cursor task with orthogonal controls. Two groups of healthy subjects are recruited into a 2-session study spaced seven days apart. One group uses their left and right hands to control cursor position and rotation respectively, while the other uses their right and left hands. The groups switch control methods in the second session, and a rotational perturbation is applied to the positional controls in the latter half of each session. We find agreement with current lateralization theories when comparing robustness to feedforward perturbations in feedback and feedforward measures. We find no evidence of a transferable model after seven days, and evidence that the brain does not synchronize task completion between the hands.
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18
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Labaune O, Deroche T, Teulier C, Berret B. Vigor of reaching, walking, and gazing movements: on the consistency of interindividual differences. J Neurophysiol 2019; 123:234-242. [PMID: 31774359 DOI: 10.1152/jn.00344.2019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Movement vigor is an important feature of motor control that is thought to originate from cortico-basal ganglia circuits and processes shared with decision-making, such as temporal reward discounting. Accordingly, vigor may be related to one's relationship with time, which may, in turn, reflect a general trait-like feature of individuality. While significant interindividual differences of vigor have been typically reported for isolated motor tasks, little is known about the consistency of such differences across tasks and movement effectors. Here, we assessed interindividual consistency of vigor across reaching (both dominant and nondominant arm), walking, and gazing movements of various distances within the same group of 20 participants. Given distinct neural pathways and biomechanical specificities of each movement modality, a significant consistency would corroborate the trait-like aspect of vigor. Vigor scores for dominant and nondominant arm movements were found to be highly correlated across individuals. Vigor scores of reaching and walking were also significantly correlated across individuals, indicating that people who reach faster than others also tend to walk faster. At last, vigor scores of saccades were uncorrelated with those of reaching and walking, reaffirming that the vigor of stimulus-elicited eye saccades is distinct. These findings highlight the trait-like aspect of vigor for reaching movements with either arms and, to a lesser extent, walking.NEW & NOTEWORTHY Robust interindividual differences of movement vigor have been reported for arm reaching and saccades. Beyond biomechanics, personality trait-like characteristics have been proposed to account for those differences. Here, we examined for the first time the consistency of interindividual differences of vigor during dominant/nondominant arm reaching, walking, and gazing to assess the trait-like aspect of vigor. We found a significant consistency of vigor within our group of individuals for all tested tasks/effectors except saccades.
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Affiliation(s)
- Ombeline Labaune
- Complexité, innovation, activités motrices et sportives (CIAMS), Université Paris Sud, Université Paris-Saclay, Orsay, France.,CIAMS, Université d'Orléans, Orléans, France
| | - Thomas Deroche
- Complexité, innovation, activités motrices et sportives (CIAMS), Université Paris Sud, Université Paris-Saclay, Orsay, France.,CIAMS, Université d'Orléans, Orléans, France
| | - Caroline Teulier
- Complexité, innovation, activités motrices et sportives (CIAMS), Université Paris Sud, Université Paris-Saclay, Orsay, France.,CIAMS, Université d'Orléans, Orléans, France
| | - Bastien Berret
- Complexité, innovation, activités motrices et sportives (CIAMS), Université Paris Sud, Université Paris-Saclay, Orsay, France.,CIAMS, Université d'Orléans, Orléans, France.,Institut Universitaire de France, Paris, France
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19
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Swanson CW, Fling BW. Associations between Turning Characteristics and Corticospinal Inhibition in Young and Older Adults. Neuroscience 2019; 425:59-67. [PMID: 31765624 DOI: 10.1016/j.neuroscience.2019.10.051] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 10/23/2019] [Accepted: 10/30/2019] [Indexed: 01/12/2023]
Abstract
The effects of aging are multifaceted including deleterious changes to the structure and function of the nervous system which often results in reduced mobility and quality of life. Turning while walking (dynamic) and in-place (stable) are ubiquitous aspects of mobility and have substantial consequences if performed poorly. Further, turning is thought to require higher cortical control compared to bouts of straight-ahead walking. This study sought to understand how relative amounts of corticospinal inhibition as measured by transcranial magnetic stimulation and the cortical silent period within the primary motor cortices are associated with various turning characteristics in neurotypical young (YA) and older adults (OA). In the current study, OA had reduced peak turn velocity and increased turn duration for both dynamic and stable turns. Further, OA demonstrated significantly reduced corticospinal inhibition within the right motor cortex. Finally, all associations between corticospinal inhibition and turning performance were specific to the right hemisphere, reflecting that those OA who maintained high levels of inhibition performed turning similar to their younger counterparts. These results compliment the right hemisphere model of aging and lateralization specification of cortically regulated temporal measures of dynamic movement. While additional investigations are required, these pilot findings provide an additional understanding as to the neural control of dynamic movements.
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Affiliation(s)
- Clayton W Swanson
- Department of Health & Exercise Science, Colorado State University, Fort Collins, CO, USA
| | - Brett W Fling
- Department of Health & Exercise Science, Colorado State University, Fort Collins, CO, USA; Molecular, Cellular, and Integrative Neuroscience Program, Colorado State University, Fort Collins, CO, USA.
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20
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Bundy DT, Leuthardt EC. The Cortical Physiology of Ipsilateral Limb Movements. Trends Neurosci 2019; 42:825-839. [PMID: 31514976 PMCID: PMC6825896 DOI: 10.1016/j.tins.2019.08.008] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 07/25/2019] [Accepted: 08/16/2019] [Indexed: 12/19/2022]
Abstract
Whereas voluntary movements have long been understood to derive primarily from the cortical hemisphere contralateral to a moving limb, substantial cortical activations also occur in the same-sided, or ipsilateral, cortical hemisphere. These ipsilateral motor activations have recently been shown to be useful to decode specific movement features. Furthermore, in contrast to the classical understanding that unilateral limb movements are solely driven by the contralateral hemisphere, it appears that the ipsilateral hemisphere plays an active and specific role in the planning and execution of voluntary movements. Here we review the movement-related activations observed in the ipsilateral cortical hemisphere, interpret this evidence in light of the potential roles of the ipsilateral hemisphere in the planning and execution of movements, and describe the implications for clinical populations.
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Affiliation(s)
- David T Bundy
- Department of Rehabilitation Medicine, University of Kansas Medical Center, Kansas City, KS, USA; Department of Biomedical Engineering, Washington University, St. Louis, MO, USA
| | - Eric C Leuthardt
- Department of Biomedical Engineering, Washington University, St. Louis, MO, USA; Department of Neurological Surgery, Washington University, St. Louis, MO, USA; Center of Innovation in Neuroscience and Technology, Washington University, St. Louis, MO, USA.
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21
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Maenza C, Good DC, Winstein CJ, Wagstaff DA, Sainburg RL. Functional Deficits in the Less-Impaired Arm of Stroke Survivors Depend on Hemisphere of Damage and Extent of Paretic Arm Impairment. Neurorehabil Neural Repair 2019; 34:39-50. [PMID: 31538852 DOI: 10.1177/1545968319875951] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background. Previous research has detailed the hemisphere dependence and specific kinematic deficits observed for the less-affected arm of patients with unilateral stroke. Objective. We now examine whether functional motor deficits in the less-affected arm, measured by standardized clinical measures of motor function, also depend on the hemisphere that was damaged and on the severity of contralesional impairment. Methods. We recruited 48 left-hemisphere-damaged (LHD) participants, 62 right-hemisphere-damaged participants, and 54 age-matched control participants. Measures of motor function included the following: (1) Jebsen-Taylor Hand Function Test (JHFT), (2) Grooved Pegboard Test (GPT), and (3) grip strength. We measured the extent of contralesional arm impairment with the upper-extremity component of the Fugl-Meyer (UEFM) assessment of motor impairment. Results. Ipsilesional limb functional performance deficits (JHFT) varied with both the damaged hemisphere and severity of contralesional arm impairment, with the most severe deficits expressed in LHD participants with severe contralesional impairment (UEFM). GPT and grip strength varied with severity of contralesional impairment but not with hemisphere. Conclusions. Stroke survivors with the most severe paretic arm impairment, who must rely on their ipsilesional arm for performing daily activities, have the greatest motor deficit in the less-affected arm. We recommend remediation of this arm to improve functional independence in this group of stroke patients.
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Affiliation(s)
- Candice Maenza
- The Pennsylvania State University, University Park, PA, USA
- Pennsylvania State College of Medicine, Hershey, PA, USA
| | - David C Good
- Pennsylvania State College of Medicine, Hershey, PA, USA
| | | | | | - Robert L Sainburg
- The Pennsylvania State University, University Park, PA, USA
- Pennsylvania State College of Medicine, Hershey, PA, USA
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22
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Bindawas SM, Mawajdeh HM, Vennu VS, Alhaidary HM. Functional recovery differences after stroke rehabilitation in patients with uni- or bilateral hemiparesis. ACTA ACUST UNITED AC 2019; 22:186-191. [PMID: 28678212 PMCID: PMC5946362 DOI: 10.17712/nsj.2017.3.20170010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To examine the functional recovery differences after stroke rehabilitation in patients with uni- or bilateral hemiparesis. METHODS In this retrospective study, we included data from the medical record of all 383 patients with uni- or bilateral hemiparesis after stroke who were admitted to King Fahad Medical City-Rehabilitation Hospital between 2008 and 2014 in Riyadh, Kingdom of Saudi Arabia. According to the site of hemiparesis, we classified patients into 3 groups: right hemiparesis (n=208), left hemiparesis (n=157), and bilateral hemipareses (n=18). The patients (n=49) who did not have either site of hemiparesis were excluded. The Functional Independence Measures (FIM) instrument was used to assess the score at admission and discharge. A post hoc test was conducted to examine the functional recovery differences between groups. Multiple regression analyses were used to confirm the findings. RESULTS Amongst the three groups, there were significant (p<0.05) differences in the total-FIM score as well as motor- and cognitive-FIM sub-scores between admission and discharge of stroke rehabilitation. The differences were significantly greater in the bilateral hemipareses group than in either unilateral hemiparesis group. Multiple regression analyses also confirmed that the site of hemiparesis significantly (p<0.05) differs in the total-FIM score as well as motor-FIM and cognitive-FIM sub-scores. CONCLUSION Our results demonstrate that differences in functional recovery after stroke rehabilitation may be influenced by the site of hemiparesis after stroke.
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Affiliation(s)
- Saad M Bindawas
- Department of Rehabilitation Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail:
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23
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Abstract
OBJECTIVES To investigate whether the relationship between arm use and motor impairment post-stroke is influenced by the hemisphere of damage. METHODS Right-handed patients with unilateral left hemisphere damage (LHD) or right (RHD) (n=58; 28 LHD, 30 RHD) were recruited for this study. The Arm Motor Ability Test and Functional Impact Assessment were used to derive arm use patterns. The Fugl-Meyer motor assessment scale was used to quantify the level of motor impairment. RESULTS A significant interaction between patient group and impairment level was observed for contralesional, but not ipsilesional arm use. For lower impairment levels, contralesional (right arm for LHD and left arm for RHD) arm use was greater in LHD than RHD patients. In contrast, for greater levels of impairment, there were no arm use differences between the two patient groups. CONCLUSIONS When motor impairment is significant, it overrides potential effects of stroke laterality on the patterns of arm use. However, a robust influence of hemisphere of damage on the patterns of arm use is evident at lower impairment levels. This may be attributed to previously described arm preference effects. These findings suggest adoption of distinct strategies for rehabilitation following left versus right hemisphere damage in right-handers, at least when the impairment is moderate to low. (JINS, 2019, 25, 470-478).
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24
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Lodha N, Patel P, Casamento-Moran A, Gauger K, Christou EA. Endpoint accuracy of goal-directed ankle movements correlates to over-ground walking in stroke. Clin Neurophysiol 2019; 130:1008-1016. [PMID: 31005051 DOI: 10.1016/j.clinph.2019.03.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 02/22/2019] [Accepted: 03/22/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Goal-directed movements are essential for voluntary motor control. The inability to execute precise goal-directed movements after stroke can impair the ability to perform voluntary functions, learn new skills, and hinder rehabilitation. However, little is known about how the accuracy of single-joint, goal-directed ankle movements relates to multi-joint, lower limb function in stroke. Here, we determined the impact of stroke on the accuracy of goal-directed ankle movements and its relation to over-ground walking. METHODS Stroke (N = 28) and control (N = 28) participants performed (1) goal-directed ankle dorsiflexion movements to accurately match 9 degrees in 180 ms and (2) over-ground walking. During goal-directed ankle movements, we measured the endpoint error, position error, time error and the activation of the agonist and antagonist muscles. During over-ground walking, we measured the walking speed, paretic stride length, and cadence. RESULTS The stroke group demonstrated increased endpoint error than the controls. Increased endpoint error was associated with increased co-activation between agonist-antagonist muscles. Endpoint error was a significant predictor of walking speed and paretic stride length in stroke. CONCLUSIONS Impaired accuracy of goal-directed, ankle movements is correlated to over-ground walking in stroke. SIGNIFICANCE Quantifying accuracy of goal-directed ankle movements may provide insights into walking function post-stroke.
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Affiliation(s)
- Neha Lodha
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA.
| | - Prakruti Patel
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA
| | | | - Katlyn Gauger
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
| | - Evangelos A Christou
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
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25
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Coelho DB, Fernandes CA, Martinelli AR, Teixeira LA. Right in Comparison to Left Cerebral Hemisphere Damage by Stroke Induces Poorer Muscular Responses to Stance Perturbation Regardless of Visual Information. J Stroke Cerebrovasc Dis 2019; 28:954-962. [PMID: 30630757 DOI: 10.1016/j.jstrokecerebrovasdis.2018.12.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 11/22/2018] [Accepted: 12/14/2018] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Fast and scaled muscular activation is required to recover body balance following an external perturbation. An issue open to investigation is the extent to which the cerebral hemisphere lesioned by stroke leads to asymmetric deficits in postural reactive responses. In this experiment, we aimed to compare muscular responses to unanticipated stance perturbations between individuals who suffered unilateral stroke either to the right or to the left cerebral hemisphere. METHODS Stance perturbations were produced by releasing a load attached to the participant's trunk, inducing fast forward body oscillation. Electromyography was recorded from the gastrocnemius medialis and biceps femoris muscles. Muscular activation from age-matched healthy individuals was taken as reference. RESULTS Analysis indicated that damage to the right hemisphere induced delayed activation onset, and lower rate and magnitude of activation of the proximal and distal muscles of the paretic leg. Those deficits were associated with stronger activation of the nonparetic leg. Comparisons between left hemisphere damage and controls showed deficits limited to activation of the biceps femoris of the paretic leg. Manipulation of visual information led to no significant effects on muscular responses. CONCLUSIONS These results suggest that right cerebral hemisphere damage by stroke leads to more severe deficits in the generation of reactive muscular responses to stance perturbation than damage to the left cerebral hemisphere regardless of visual information.
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Affiliation(s)
- Daniel Boari Coelho
- Human Motor Systems Laboratory, School of Physical Education and Sport, University of São Paulo, SP, Brazil; Biomedical Engineering, Federal University of ABC, São Bernardo do Campo, SP, Brazil.
| | - Corina Aparecida Fernandes
- Human Motor Systems Laboratory, School of Physical Education and Sport, University of São Paulo, SP, Brazil
| | | | - Luis Augusto Teixeira
- Human Motor Systems Laboratory, School of Physical Education and Sport, University of São Paulo, SP, Brazil
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26
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Unilateral, 3D Arm Movement Kinematics Are Encoded in Ipsilateral Human Cortex. J Neurosci 2018; 38:10042-10056. [PMID: 30301759 PMCID: PMC6246886 DOI: 10.1523/jneurosci.0015-18.2018] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 08/02/2018] [Accepted: 09/10/2018] [Indexed: 11/21/2022] Open
Abstract
There is increasing evidence that the hemisphere ipsilateral to a moving limb plays a role in planning and executing movements. However, the exact relationship between cortical activity and ipsilateral limb movements is uncertain. We sought to determine whether 3D arm movement kinematics (speed, velocity, and position) could be decoded from cortical signals recorded from the hemisphere ipsilateral to the moving limb. By having invasively monitored patients perform unilateral reaches with each arm, we also compared the encoding of contralateral and ipsilateral limb kinematics from a single cortical hemisphere. In four motor-intact human patients (three male, one female) implanted with electrocorticography electrodes for localization of their epileptic foci, we decoded 3D movement kinematics of both arms with accuracies above chance. Surprisingly, the spatial and spectral encoding of contralateral and ipsilateral limb kinematics was similar, enabling cross-prediction of kinematics between arms. These results clarify our understanding that the ipsilateral hemisphere robustly contributes to motor execution and supports that the information of complex movements is more bihemispherically represented in humans than has been previously understood.SIGNIFICANCE STATEMENT Although limb movements are traditionally understood to be driven by the cortical hemisphere contralateral to a moving limb, movement-related neural activity has also been found in the ipsilateral hemisphere. This study provides the first demonstration that 3D arm movement kinematics can be decoded from human electrocorticographic signals ipsilateral to the moving limb. Surprisingly, the spatial and spectral encoding of contralateral and ipsilateral limb kinematics was similar. The finding that specific kinematics are encoded in the ipsilateral hemisphere demonstrates that the ipsilateral hemisphere contributes to the execution of unilateral limb movements, improving our understanding of motor control. Additionally, the bihemisheric representation of voluntary movements has implications for the development of neuroprosthetic systems for reaching and for neurorehabilitation strategies following cortical injuries.
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Anderson C, Rajamani K, Pardo V, Adamo DE. Asymmetries in force matching are related to side of stroke in right-handed individuals. Neurosci Lett 2018; 683:144-149. [PMID: 30055254 DOI: 10.1016/j.neulet.2018.07.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 07/17/2018] [Accepted: 07/21/2018] [Indexed: 12/20/2022]
Abstract
Asymmetries in grasp force matching extend beyond quantifying a single measure of maximum grip strength and advance our application of side-specific treatment interventions. A cross sectional study design investigated grasp-force matching performance in right-handed individuals with a stroke and age-matched healthy controls. A visual representation of the 20% Maximum Voluntary Contraction (MVC) was matched in three conditions in the absence of visual feedback with the same (Ipsilateral Remembered - IR) or opposite hand (Concurrent - CC and Contralateral Remembered - CR). Greater overall relative error (RE) was found in contralateral compared to ipsilateral matching tasks. In the CR condition, post hoc analysis revealed significant differences between control and right hemisphere damage (RHD) group (95% CI [16.41-88.59]; p < 0.01) as well as left hemisphere damage (LHD) group and RHD (95% CI [23.4-95.09]; p < 0.01). Right hand matching relative error was 2.49 times larger in the RHD compared to the LHD group. Within the RHD group, matching errors were greater for the right than left hand in both contralateral conditions (95% CI [34.25-101.07]; p < 0.001). Individuals with RHD showed greater asymmetries in contralateral matching tasks compared to LHD and controls. More specifically, the RHD group had the greatest difficulty matching tasks with their right (non-paretic) than left (paretic) hand. In order to elucidate this asymmetry in the clinic the use of complementary grasp measures may be considered.
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Affiliation(s)
- Charlie Anderson
- Department of Physical Therapy, College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, United States.
| | - Kumar Rajamani
- Department of Medicine, University Health Center, Wayne State University, United States.
| | - Victoria Pardo
- Department of Physical Therapy, College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, United States.
| | - Diane E Adamo
- Department of Physical Therapy, College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, United States; Institute of Gerontology, Detroit, MI, United States.
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Right Hemisphere Contributions to Bilateral Force Control in Chronic Stroke: A Preliminary Report. J Stroke Cerebrovasc Dis 2018; 27:3218-3223. [PMID: 30093198 DOI: 10.1016/j.jstrokecerebrovasdis.2018.07.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 07/05/2018] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Bilateral motor control deficits poststroke may be lateralized by hemisphere damage. This preliminary study investigated bilateral force control between left and right hemisphere-damaged groups at baseline and after coupled bilateral movement training with neuromuscular stimulation. METHODS Stroke participants (8 left hemisphere and 6 right hemisphere cerebrovascular accidents) performed a bilateral isometric force control task at 3 submaximal force levels (5%, 25%, and 50% of maximum voluntary contraction [MVC]) before and after training. Force accuracy, force variability, and interlimb force coordination were analyzed in 3-way mixed design ANOVAs (2 × 2 × 3; Group × Test Session × Force Level) with repeated measures on test session and force level. RESULTS The findings indicated that force accuracy and variability at 50% of MVC in the right hemisphere-damaged group were more impaired than lower targeted force levels at baseline, and the impairment at the highest target level was improved after coupled bilateral movement training. However, these patterns were not observed in the left hemisphere-damaged group. CONCLUSIONS Current findings support a proposition that the right hemisphere presumably contributes to controlling bilateral force production.
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Woytowicz EJ, Westlake KP, Whitall J, Sainburg RL. Handedness results from complementary hemispheric dominance, not global hemispheric dominance: evidence from mechanically coupled bilateral movements. J Neurophysiol 2018; 120:729-740. [PMID: 29742023 PMCID: PMC7132323 DOI: 10.1152/jn.00878.2017] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 04/13/2018] [Accepted: 05/06/2018] [Indexed: 11/22/2022] Open
Abstract
Two contrasting views of handedness can be described as 1) complementary dominance, in which each hemisphere is specialized for different aspects of motor control, and 2) global dominance, in which the hemisphere contralateral to the dominant arm is specialized for all aspects of motor control. The present study sought to determine which motor lateralization hypothesis best predicts motor performance during common bilateral task of stabilizing an object (e.g., bread) with one hand while applying forces to the object (e.g., slicing) using the other hand. We designed an experimental equivalent of this task, performed in a virtual environment with the unseen arms supported by frictionless air-sleds. The hands were connected by a spring, and the task was to maintain the position of one hand while moving the other hand to a target. Thus the reaching hand was required to take account of the spring load to make smooth and accurate trajectories, while the stabilizer hand was required to impede the spring load to keep a constant position. Right-handed subjects performed two task sessions (right-hand reach and left-hand stabilize; left-hand reach and right-hand stabilize) with the order of the sessions counterbalanced between groups. Our results indicate a hand by task-component interaction such that the right hand showed straighter reaching performance whereas the left hand showed more stable holding performance. These findings provide support for the complementary dominance hypothesis and suggest that the specializations of each cerebral hemisphere for impedance and dynamic control mechanisms are expressed during bilateral interactive tasks. NEW & NOTEWORTHY We provide evidence for interlimb differences in bilateral coordination of reaching and stabilizing functions, demonstrating an advantage for the dominant and nondominant arms for distinct features of control. These results provide the first evidence for complementary specializations of each limb-hemisphere system for different aspects of control within the context of a complementary bilateral task.
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Affiliation(s)
- Elizabeth J Woytowicz
- Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine , Baltimore, Maryland
| | - Kelly P Westlake
- Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine , Baltimore, Maryland
| | - Jill Whitall
- Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine , Baltimore, Maryland
- Department of Health Sciences, University of Southampton , Southampton , United Kingdom
| | - Robert L Sainburg
- Department of Kinesiology, Penn State University , University Park, Pennsylvania
- Department of Neurology, Penn State Milton S. Hershey Medical Center and College of Medicine , Hershey, Pennsylvania
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Iandolo R, Bellini A, Saiote C, Marre I, Bommarito G, Oesingmann N, Fleysher L, Mancardi GL, Casadio M, Inglese M. Neural correlates of lower limbs proprioception: An fMRI study of foot position matching. Hum Brain Mapp 2018; 39:1929-1944. [PMID: 29359521 PMCID: PMC6866268 DOI: 10.1002/hbm.23972] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 12/20/2017] [Accepted: 01/07/2018] [Indexed: 12/13/2022] Open
Abstract
Little is known about the neural correlates of lower limbs position sense, despite the impact that proprioceptive deficits have on everyday life activities, such as posture and gait control. We used fMRI to investigate in 30 healthy right-handed and right-footed subjects the regional distribution of brain activity during position matching tasks performed with the right dominant and the left nondominant foot. Along with the brain activation, we assessed the performance during both ipsilateral and contralateral matching tasks. Subjects had lower errors when matching was performed by the left nondominant foot. The fMRI analysis suggested that the significant regions responsible for position sense are in the right parietal and frontal cortex, providing a first characterization of the neural correlates of foot position matching.
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Affiliation(s)
- Riccardo Iandolo
- Department of Robotics, Brain and Cognitive Science (RBCS)Italian Institute of TechnologyGenoaItaly
- Department of Informatics, Bioengineering, Robotics and Systems Engineering (DIBRIS)University of GenoaGenoaItaly
| | - Alessandro Bellini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI)University of Genoa and IRCCS AOU San Martino‐ISTGenoaItaly
| | - Catarina Saiote
- Department of NeurologyMount Sinai School of MedicineNew YorkNew York
- Department of PsychiatryMount Sinai School of MedicineNew YorkNew York
| | - Ilaria Marre
- Department of Informatics, Bioengineering, Robotics and Systems Engineering (DIBRIS)University of GenoaGenoaItaly
| | - Giulia Bommarito
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI)University of Genoa and IRCCS AOU San Martino‐ISTGenoaItaly
| | - Niels Oesingmann
- Department of RadiologyMount Sinai School of MedicineNew YorkNew York
- UK Biobank StockportCheshireSK3 0SAUnited Kingdom
| | - Lazar Fleysher
- Department of NeurologyMount Sinai School of MedicineNew YorkNew York
| | - Giovanni Luigi Mancardi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI)University of Genoa and IRCCS AOU San Martino‐ISTGenoaItaly
| | - Maura Casadio
- Department of Robotics, Brain and Cognitive Science (RBCS)Italian Institute of TechnologyGenoaItaly
- Department of Informatics, Bioengineering, Robotics and Systems Engineering (DIBRIS)University of GenoaGenoaItaly
| | - Matilde Inglese
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI)University of Genoa and IRCCS AOU San Martino‐ISTGenoaItaly
- Department of NeurologyMount Sinai School of MedicineNew YorkNew York
- Department of RadiologyMount Sinai School of MedicineNew YorkNew York
- Department of NeuroscienceMount Sinai School of MedicineNew YorkNew York
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Maidan I, Nieuwhof F, Bernad-Elazari H, Bloem BR, Giladi N, Hausdorff JM, Claassen JAHR, Mirelman A. Evidence for Differential Effects of 2 Forms of Exercise on Prefrontal Plasticity During Walking in Parkinson's Disease. Neurorehabil Neural Repair 2018; 32:200-208. [PMID: 29546797 DOI: 10.1177/1545968318763750] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND In a randomized control trial conducted in patients with Parkinson's disease, a treadmill training program combined with virtual reality that targeted motor and cognitive aspects of safe ambulation led to fewer falls, compared with treadmill training alone. OBJECTIVE To investigate if the 2 types of training differentially affected prefrontal activation and if this might explain differences in fall rates after the intervention. METHODS Sixty-four patients with Parkinson's disease were randomized into the treadmill training arm (n = 34, mean age 73.1 ± 1.1 years, 64% men, disease duration 9.7 ± 1.0 years) or treadmill training with virtual reality arm (n = 30, mean age 70.1 ± 1.3 years, 71% men, disease duration 8.9 ± 1.1 years). Prefrontal activation during usual, dual-task, and obstacle negotiation walking was assessed before and after 6 weeks of training, using a functional near-infrared spectroscopy system. RESULTS Treadmill training with and without virtual reality reduced prefrontal activation during walking ( P < .001), with specific interactions related to training arm ( P = .01), lateralization ( P = .05), and walking condition ( P = .001). For example, among the subjects who trained with treadmill training alone, prefrontal activation during dual-task walking and obstacle negotiation increased after training, while in the combined training arm, activation decreased. CONCLUSIONS Prefrontal activation during usual and during more challenging walking conditions can be altered in response to 2 different types of training. The addition of a cognitive training component to a treadmill exercise program apparently modifies the effects of the training on the magnitude and lateralization of prefrontal activation and on falls, extending the understanding of the plasticity of the brain in PD.
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Affiliation(s)
- Inbal Maidan
- 1 Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,2 Tel Aviv University, Tel Aviv, Israel
| | - Freek Nieuwhof
- 3 Radboud University, Nijmegen, Netherlands.,4 Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Bastiaan R Bloem
- 3 Radboud University, Nijmegen, Netherlands.,4 Radboud University Medical Center, Nijmegen, Netherlands
| | - Nir Giladi
- 1 Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,2 Tel Aviv University, Tel Aviv, Israel
| | - Jeffrey M Hausdorff
- 1 Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,2 Tel Aviv University, Tel Aviv, Israel.,5 Rush University Medical Center, Chicago, IL, USA
| | - Jurgen A H R Claassen
- 3 Radboud University, Nijmegen, Netherlands.,4 Radboud University Medical Center, Nijmegen, Netherlands
| | - Anat Mirelman
- 1 Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,2 Tel Aviv University, Tel Aviv, Israel
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32
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Right cerebral hemisphere specialization for quiet and perturbed body balance control: Evidence from unilateral stroke. Hum Mov Sci 2018; 57:374-387. [DOI: 10.1016/j.humov.2017.09.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 09/27/2017] [Accepted: 09/29/2017] [Indexed: 01/11/2023]
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33
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Rizzo JR, Hosseini M, Wong EA, Mackey WE, Fung JK, Ahdoot E, Rucker JC, Raghavan P, Landy MS, Hudson TE. The Intersection between Ocular and Manual Motor Control: Eye-Hand Coordination in Acquired Brain Injury. Front Neurol 2017; 8:227. [PMID: 28620341 PMCID: PMC5451505 DOI: 10.3389/fneur.2017.00227] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 05/11/2017] [Indexed: 11/13/2022] Open
Abstract
Acute and chronic disease processes that lead to cerebral injury can often be clinically challenging diagnostically, prognostically, and therapeutically. Neurodegenerative processes are one such elusive diagnostic group, given their often diffuse and indolent nature, creating difficulties in pinpointing specific structural abnormalities that relate to functional limitations. A number of studies in recent years have focused on eye-hand coordination (EHC) in the setting of acquired brain injury (ABI), highlighting the important set of interconnected functions of the eye and hand and their relevance in neurological conditions. These experiments, which have concentrated on focal lesion-based models, have significantly improved our understanding of neurophysiology and underscored the sensitivity of biomarkers in acute and chronic neurological disease processes, especially when such biomarkers are combined synergistically. To better understand EHC and its connection with ABI, there is a need to clarify its definition and to delineate its neuroanatomical and computational underpinnings. Successful EHC relies on the complex feedback- and prediction-mediated relationship between the visual, ocular motor, and manual motor systems and takes advantage of finely orchestrated synergies between these systems in both the spatial and temporal domains. Interactions of this type are representative of functional sensorimotor control, and their disruption constitutes one of the most frequent deficits secondary to brain injury. The present review describes the visually mediated planning and control of eye movements, hand movements, and their coordination, with a particular focus on deficits that occur following neurovascular, neurotraumatic, and neurodegenerative conditions. Following this review, we also discuss potential future research directions, highlighting objective EHC as a sensitive biomarker complement within acute and chronic neurological disease processes.
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Affiliation(s)
- John-Ross Rizzo
- Department of Rehabilitation Medicine, New York University Langone Medical Center, New York, NY, United States.,Department of Neurology, New York University Langone Medical Center, New York, NY, United States
| | - Maryam Hosseini
- Department of Rehabilitation Medicine, New York University Langone Medical Center, New York, NY, United States
| | - Eric A Wong
- Department of Rehabilitation Medicine, New York University Langone Medical Center, New York, NY, United States
| | - Wayne E Mackey
- Department of Psychology and Center for Neural Science, New York University, New York, NY, United States
| | - James K Fung
- Department of Rehabilitation Medicine, New York University Langone Medical Center, New York, NY, United States
| | - Edmond Ahdoot
- Department of Rehabilitation Medicine, New York University Langone Medical Center, New York, NY, United States
| | - Janet C Rucker
- Department of Neurology, New York University Langone Medical Center, New York, NY, United States.,Department of Ophthalmology, New York University Langone Medical Center, New York, NY, United States
| | - Preeti Raghavan
- Department of Rehabilitation Medicine, New York University Langone Medical Center, New York, NY, United States
| | - Michael S Landy
- Department of Psychology and Center for Neural Science, New York University, New York, NY, United States
| | - Todd E Hudson
- Department of Rehabilitation Medicine, New York University Langone Medical Center, New York, NY, United States.,Department of Neurology, New York University Langone Medical Center, New York, NY, United States
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Gulde P, Hermsdörfer J. Both hands at work: the effect of aging on upper-limb kinematics in a multi-step activity of daily living. Exp Brain Res 2017; 235:1337-1348. [PMID: 28210758 DOI: 10.1007/s00221-017-4897-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 01/28/2017] [Indexed: 01/23/2023]
Abstract
The kinematic performance of basic motor tasks shows a clear decrease with advancing age. This study examined if the rules known from such tasks can be generalized to activities of daily living. We examined the end-effector kinematics of 13 young and 13 elderly participants in the multi-step activity of daily living of tea-making. Furthermore, we analyzed bimanual behavior and hand dominance in the task using different conditions of execution. The elderly sample took substantially longer to complete the activity (almost 50%) with longer trajectories compared with the young sample. Models of multiple linear regression revealed that the longer trajectories prolonged the trial duration in both groups, and while movement speed influenced the trial duration of young participants, phases of inactivity negatively affected how long the activity took the elderly subjects. No differences were found regarding bimanual performance or hand dominance. We assume that in self-paced activities of daily living, the age-dependent differences in the kinematics are more likely to be based on the higher cognitive demands of the task rather than on pure motor capability. Furthermore, it seems that not all of the rules known from basic motor tasks can be generalized to activities of daily living.
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Affiliation(s)
- Philipp Gulde
- Department of Sport and Health Sciences, Institute of Movement Science, Technical University of Munich, Georg-Brauchle-Ring 60/62, Munich, Germany.
| | - Joachim Hermsdörfer
- Department of Sport and Health Sciences, Institute of Movement Science, Technical University of Munich, Georg-Brauchle-Ring 60/62, Munich, Germany
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Hammerbeck U, Yousif N, Hoad D, Greenwood R, Diedrichsen J, Rothwell JC. Chronic Stroke Survivors Improve Reaching Accuracy by Reducing Movement Variability at the Trained Movement Speed. Neurorehabil Neural Repair 2017; 31:499-508. [PMID: 28506150 DOI: 10.1177/1545968317693112] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Recovery from stroke is often said to have "plateaued" after 6 to 12 months. Yet training can still improve performance even in the chronic phase. Here we investigate the biomechanics of accuracy improvements during a reaching task and test whether they are affected by the speed at which movements are practiced. METHOD We trained 36 chronic stroke survivors (57.5 years, SD ± 11.5; 10 females) over 4 consecutive days to improve endpoint accuracy in an arm-reaching task (420 repetitions/day). Half of the group trained using fast movements and the other half slow movements. The trunk was constrained allowing only shoulder and elbow movement for task performance. RESULTS Before training, movements were variable, tended to undershoot the target, and terminated in contralateral workspace (flexion bias). Both groups improved movement accuracy by reducing trial-to-trial variability; however, change in endpoint bias (systematic error) was not significant. Improvements were greatest at the trained movement speed and generalized to other speeds in the fast training group. Small but significant improvements were observed in clinical measures in the fast training group. CONCLUSIONS The reduction in trial-to-trial variability without an alteration to endpoint bias suggests that improvements are achieved by better control over motor commands within the existing repertoire. Thus, 4 days' training allows stroke survivors to improve movements that they can already make. Whether new movement patterns can be acquired in the chronic phase will need to be tested in longer term studies. We recommend that training needs to be performed at slow and fast movement speeds to enhance generalization.
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Affiliation(s)
- Ulrike Hammerbeck
- 1 Institute of Neurology, UCL, London, UK.,2 University of Manchester, Manchester, UK
| | - Nada Yousif
- 3 University of Hertfordshire, Hertfordshire, UK
| | - Damon Hoad
- 1 Institute of Neurology, UCL, London, UK
| | - Richard Greenwood
- 1 Institute of Neurology, UCL, London, UK.,4 National Hospital for Neurology and Neurosurgery, London, UK
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Findlater SE, Dukelow SP. Upper Extremity Proprioception After Stroke: Bridging the Gap Between Neuroscience and Rehabilitation. J Mot Behav 2016; 49:27-34. [PMID: 27726645 DOI: 10.1080/00222895.2016.1219303] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Proprioception is an important aspect of function that is often impaired in the upper extremity following stroke. Unfortunately, neurorehabilitation has few evidence based treatment options for those with proprioceptive deficits. The authors consider potential reasons for this disparity. In doing so, typical assessments and proprioceptive intervention studies are discussed. Relevant evidence from the field of neuroscience is examined. Such evidence may be used to guide the development of targeted interventions for upper extremity proprioceptive deficits after stroke. As researchers become more aware of the impact of proprioceptive deficits on upper extremity motor performance after stroke, it is imperative to find successful rehabilitation interventions to target these deficits and ultimately improve daily function.
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Affiliation(s)
- Sonja E Findlater
- a Division of Physical Medicine and Rehabilitation, Department of Clinical Neurosciences , Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary , Calgary, Alberta , Canada
| | - Sean P Dukelow
- a Division of Physical Medicine and Rehabilitation, Department of Clinical Neurosciences , Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary , Calgary, Alberta , Canada
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Sainburg RL, Schaefer SY, Yadav V. Lateralized motor control processes determine asymmetry of interlimb transfer. Neuroscience 2016; 334:26-38. [PMID: 27491479 DOI: 10.1016/j.neuroscience.2016.07.043] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 07/25/2016] [Accepted: 07/26/2016] [Indexed: 02/02/2023]
Abstract
This experiment tested the hypothesis that interlimb transfer of motor performance depends on recruitment of motor control processes that are specialized to the hemisphere contralateral to the arm that is initially trained. Right-handed participants performed a single-joint task, in which reaches were targeted to 4 different distances. While the speed and accuracy was similar for both hands, the underlying control mechanisms used to vary movement speed with distance were systematically different between the arms: the amplitude of the initial acceleration profiles scaled greater with movement speed for the right-dominant arm, while the duration of the initial acceleration profile scaled greater with movement speed for the left-non-dominant arm. These two processes were previously shown to be differentially disrupted by left and right hemisphere damage, respectively. We now hypothesize that task practice with the right arm might reinforce left-hemisphere mechanisms that vary acceleration amplitude with distance, while practice with the left arm might reinforce right-hemisphere mechanisms that vary acceleration duration with distance. We thus predict that following right arm practice, the left arm should show increased contributions of acceleration amplitude to peak velocities, and following left arm practice, the right arm should show increased contributions of acceleration duration to peak velocities. Our findings support these predictions, indicating that asymmetry in interlimb transfer of motor performance, at least in the task used here, depends on recruitment of lateralized motor control processes.
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Affiliation(s)
- Robert L Sainburg
- The Pennsylvania State University, Department of Kinesiology, United States; Penn State College of Medicine, Department of Neurology, United States.
| | - Sydney Y Schaefer
- Arizona State University, School of Biological and Health Systems Engineering, United States
| | - Vivek Yadav
- Stony Brook University, Department of Mechanical Engineering, United States
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Archer DB, Misra G, Patten C, Coombes SA. Microstructural properties of premotor pathways predict visuomotor performance in chronic stroke. Hum Brain Mapp 2016; 37:2039-54. [PMID: 26920656 DOI: 10.1002/hbm.23155] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 01/26/2016] [Accepted: 02/14/2016] [Indexed: 12/19/2022] Open
Abstract
Microstructural properties of the corticospinal tract (CST) descending from the motor cortex predict strength and motor skill in the chronic phase after stroke. Much less is known about the relation between brain microstructure and visuomotor processing after stroke. In this study, individual's poststroke and age-matched controls performed a unimanual force task separately with each hand at three levels of visual gain. We collected diffusion MRI data and used probabilistic tractography algorithms to identify the primary and premotor CSTs. Fractional anisotropy (FA) within each tract was used to predict changes in force variability across different levels of visual gain. Our observations revealed that individuals poststroke reduced force variability with an increase in visual gain, performed the force task with greater variability as compared with controls across all gain levels, and had lower FA in the primary motor and premotor CSTs. Our results also demonstrated that the CST descending from the premotor cortex, rather than the primary motor cortex, best predicted force variability. Together, these findings demonstrate that the microstructural properties of the premotor CST predict visual gain-related changes in force variability in individuals poststroke. Hum Brain Mapp 37:2039-2054, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Derek B Archer
- Laboratory for Rehabilitation Neuroscience, Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida
| | - Gaurav Misra
- Laboratory for Rehabilitation Neuroscience, Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida
| | - Carolynn Patten
- Neural Control of Movement Lab, Department of Physical Therapy, University of Florida and Malcolm-Randall VA Medical Center, Gainesville, Florida
| | - Stephen A Coombes
- Laboratory for Rehabilitation Neuroscience, Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida
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Anticipation in Object Manipulation: Behavioral and Neural Correlates. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2016; 957:173-194. [DOI: 10.1007/978-3-319-47313-0_10] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Sainburg RL, Maenza C, Winstein C, Good D. Motor Lateralization Provides a Foundation for Predicting and Treating Non-paretic Arm Motor Deficits in Stroke. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2016; 957:257-272. [PMID: 28035570 DOI: 10.1007/978-3-319-47313-0_14] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Brain lateralization is a ubiquitous feature of neural organization across the vertebrate spectrum. We have developed a model of motor lateralization that attributes different motor control processes to each cerebral hemisphere. This bilateral hemispheric model of motor control has successfully predicted hemisphere-specific motor control and motor learning deficits in the ipsilesional, or non-paretic, arm of patients with unilateral stroke. We now show across large number and range of stroke patients that these motor performance deficits in the non-paretic arm of stroke patients vary with both the side of the lesion, as well as with the severity of contralesional impairment. This last point can be functionally devastating for patients with severe contralesional paresis because for these individuals, performance of upper extremity activities of daily living depends primarily and often exclusively on ipsilesional arm function. We present a pilot study focused on improving the speed and coordination of ipsilesional arm function in a convenience sample of three stroke patients with severe contralesional impairment. Over a three-week period, patients received a total of nine 1.5 h sessions of training that included intense practice of virtual reality and real-life tasks. Our results indicated substantial improvements in ipsilesional arm movement kinematics, functional performance, and that these improvements carried over to improve functional independence. In addition, the contralesional arm improved in our measure of contralesional impairment, which was likely due to improved participation in activities of daily living. We discuss of our findings for physical rehabilitation.
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Affiliation(s)
- Robert L Sainburg
- Department of Kinesiology, The Pennsylvania State University, 29 Rec Building, Biomechanics Laboratory, University Park, Pennsylvania, 16802, USA. .,Department of Neurology, Penn State Milton S. Hershey College of Medicine, Hershey, Pennsylvania, USA.
| | - Candice Maenza
- Department of Kinesiology, The Pennsylvania State University, 29 Rec Building, Biomechanics Laboratory, University Park, Pennsylvania, 16802, USA.,Department of Neurology, Penn State Milton S. Hershey College of Medicine, Hershey, Pennsylvania, USA
| | - Carolee Winstein
- Department of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, California, USA
| | - David Good
- Department of Neurology, Penn State Milton S. Hershey College of Medicine, Hershey, Pennsylvania, USA
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Rizzo JR, Hudson TE, Abdou A, Rashbaum IG, George AE, Raghavan P, Landy MS. Motor planning poststroke: impairment in vector-coded reach plans. Physiol Rep 2015; 3:3/12/e12650. [PMID: 26660558 PMCID: PMC4760446 DOI: 10.14814/phy2.12650] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Healthy individuals appear to use both vector‐coded reach plans that encode movements in terms of their desired direction and extent, and target‐coded reach plans that encode the desired endpoint position of the effector. We examined whether these vector and target reach‐planning codes are differentially affected after stroke. Participants with stroke and healthy controls made blocks of reaches that were grouped by target location (providing target‐specific practice) and by movement vector (providing vector‐specific practice). Reach accuracy was impaired in the more affected arm after stroke, but not distinguishable for target‐ versus vector‐grouped reaches. Reach velocity and acceleration were not only impaired in both the less and more affected arms poststroke, but also not distinguishable for target‐ versus vector‐grouped reaches. As previously reported in controls, target‐grouped reaches yielded isotropic (circular) error distributions and vector‐grouped reaches yielded error distributions elongated in the direction of the reach. In stroke, the pattern of variability was similar. However, the more affected arm showed less elongated error ellipses for vector‐grouped reaches compared to the less affected arm, particularly in individuals with right‐hemispheric stroke. The results suggest greater impairment to the vector‐coded movement‐planning system after stroke, and have implications for the development of personalized approaches to poststroke rehabilitation: Motor learning may be enhanced by practice that uses the preserved code or, conversely, by retraining the more impaired code to restore function.
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Affiliation(s)
- John-Ross Rizzo
- Rusk Rehabilitation, Langone Medical Center, New York University, New York, New York Department of Psychology and Center for Neural Science, New York University, New York, New York
| | - Todd E Hudson
- Department of Psychology and Center for Neural Science, New York University, New York, New York
| | - Andrew Abdou
- School of Medicine, University of Medicine and Dentistry of New Jersey, Newark, New Jersey
| | - Ira G Rashbaum
- Rusk Rehabilitation, Langone Medical Center, New York University, New York, New York
| | - Ajax E George
- Neuroradiology Section Department of Radiology, Langone Medical Center, New York University, New York, New York
| | - Preeti Raghavan
- Rusk Rehabilitation, Langone Medical Center, New York University, New York, New York
| | - Michael S Landy
- Department of Psychology and Center for Neural Science, New York University, New York, New York
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Gera G, Freitas SMSF, Scholz JP. Relationship of diminished interjoint coordination after stroke to hand path consistency. Exp Brain Res 2015; 234:741-51. [PMID: 26608514 DOI: 10.1007/s00221-015-4500-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 11/11/2015] [Indexed: 11/30/2022]
Abstract
Differences between 12 left-brain (LCVA, 65.4 ± 11.7 years old) and 10 right-brain (RCVA, 61 ± 12.1 years old) chronic stroke survivors and 10 age-matched control adults in coordinating specific joint motions of the arm to stabilize hand path when reaching to a central target were investigated in this study. The importance of coordinating joints to stabilize hand path was tested by comparing results from uncontrolled manifold (UCM) analysis performed on experimental data versus simulated data where the covariation (coordination) between particular joint motions was removed from the original data set. UCM analysis allowed estimation of the joint configuration variance magnitude that led to hand path variability (V ORT), where the extent of increase in V ORT after removing a joint's covariation indicated how well coordinated its motion actually was with those of the other joints. The more strongly coordinated a joint was with other joints, the greater effect removal of its covariance should have on indices of hand path stability. For the paretic arm of stroke survivors, simulated removal of a joint's covariation, mainly that of shoulder with elbow and wrist, led to less change in the magnitude of V ORT compared to the same arm of control subjects. These findings confirm a reduced ability of the motion of proximal joint from paretic arm to combine flexibly with motions of the distal joints to stabilize hand path.
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Affiliation(s)
- Geetanjali Gera
- Department of Neurology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR, 97239-3098, USA.
| | | | - John Peter Scholz
- Biomechanics and Movement Science Program, University of Delaware, Newark, DE, 19716, USA. .,Physical Therapy Department, University of Delaware, Newark, DE, 19716, USA.
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Relationships of Balance, Gait Performance, and Functional Outcome in Chronic Stroke Patients: A Comparison of Left and Right Lesions. BIOMED RESEARCH INTERNATIONAL 2015; 2015:716042. [PMID: 26583129 PMCID: PMC4637081 DOI: 10.1155/2015/716042] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 05/28/2015] [Accepted: 06/25/2015] [Indexed: 11/17/2022]
Abstract
Introduction. This study compared the balance by center of pressure (COP) and its relationship with gait parameters and functional independence in left (LH) and right (RH) chronic stroke patients. Methods. In this cross-sectional study, twenty-one hemiparetic stroke patients were assessed for Functional Independence Measure (FIM), balance with a force platform, and gait in the Motion Analysis Laboratory. Results. The amplitudes of the COP in the anteroposterior and mediolateral directions were similar in both groups. The anteroposterior direction was greater than the mediolateral direction. Only the temporal parameters showed any statistically significant differences. The LH showed a significant correlation between stride length, step length, and gait velocity with COP velocity sway for the healthy and paretic lower limbs. In both groups, the area of COP was significantly correlated with stride length. Motor FIM was significantly correlated with the COP in the LH group. Conclusion. There was no difference in the performance of balance, gait, and functional independence between groups. The correlation of the COP sway area with stride length in both groups can serve as a guideline in the rehabilitation of these patients where training the static balance may reflect the improvement of the stride length.
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Abstract
The target article (Smeets, Oostwoud Wijdenes, & Brenner, 2016) proposes that short latency responses to changes in target location during reaching reflect an unconscious, continuous, and incremental minimization of the distance between the hand and the target, which does not require detection of the change in target location. We, instead, propose that short-latency visuomotor responses invoke reflex- or startle-like mechanisms, an idea supported by evidence that such responses are both automatic and resistant to cognitive influences. In addition, the target article fails to address the biological underpinnings for the range of response latencies reported across the literature, including the circuits that might underlie the proposed sensorimotor loops. When considering the range of latencies reported in the literature, we propose that mechanisms grounded in neurophysiology should be more informative than the simple information processing perspective adopted by the target article.
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Quick foot placement adjustments during gait: direction matters. Exp Brain Res 2015; 233:3349-57. [DOI: 10.1007/s00221-015-4401-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Accepted: 07/31/2015] [Indexed: 11/26/2022]
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46
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Feedback control during voluntary motor actions. Curr Opin Neurobiol 2015; 33:85-94. [DOI: 10.1016/j.conb.2015.03.006] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 03/10/2015] [Accepted: 03/11/2015] [Indexed: 12/27/2022]
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Deficits of reach-to-grasp coordination following stroke: Comparison of instructed and natural movements. Neuropsychologia 2015; 77:1-9. [PMID: 26189872 DOI: 10.1016/j.neuropsychologia.2015.07.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 05/28/2015] [Accepted: 07/15/2015] [Indexed: 11/22/2022]
Abstract
The present work evaluates whether stroke-induced deficits of reach-to-grasp movements, established by typical laboratory paradigms, transfer unconditionally to more natural situations. Sixteen patients with a stroke to the motor-dominant left hemisphere and 16 age- and gender-matched healthy control subjects executed grasping movements with their left (ipsilesional, non-dominant) hand. All movements started in the same position, were aimed at the same object positioned in the same location, and were followed by forward displacement of that object along the same path. Twenty movements were performed as a repetitive, externally triggered task executed for their own sake (context L, as in typical laboratory tasks). Twenty movements were performed as part of a self-initiated action sequence aimed at winning a reward (context E, similar to many everyday situations). The kinematics and dynamics of the transport, grasp and manipulation component of each reach-to-grasp movement were quantified by 41 parameters. Analyses of variance yielded a significant effect of Context for 29 parameters, a significant effect of Group for 9 parameters (mostly related to the coupling of hand transport and grip aperture), and a significant interaction for 5 parameters (all related to the coupling of hand transport and grip aperture). The interaction reflected the fact that stroke patients' movement parameters were more abnormal in context E than in context L. Our data indicate that unilateral stroke degrades the grasp-transport coupling, and that stroke-related motor deficits may be more pronounced in a natural than in a laboratory context. Thus, for stroke patients, assessments and rehabilitation regimes should mainly use activities that are as natural as possible.
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Arm dominance affects feedforward strategy more than feedback sensitivity during a postural task. Exp Brain Res 2015; 233:2001-11. [PMID: 25850407 DOI: 10.1007/s00221-015-4271-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 03/31/2015] [Indexed: 10/23/2022]
Abstract
Handedness is a feature of human motor control that is still not fully understood. Recent work has demonstrated that the dominant and nondominant arm each excel at different behaviors and has proposed that this behavioral asymmetry arises from lateralization in the cerebral cortex: the dominant side specializes in predictive trajectory control, while the nondominant side is specialized for impedance control. Long-latency stretch reflexes are an automatic mechanism for regulating posture and have been shown to contribute to limb impedance. To determine whether long-latency reflexes also contribute to asymmetric motor behavior in the upper limbs, we investigated the effect of arm dominance on stretch reflexes during a postural task that required varying degrees of impedance control. Our results demonstrated slightly but significantly larger reflex responses in the biarticular muscles of the nondominant arm, as would be consistent with increased impedance control. These differences were attributed solely to higher levels of voluntary background activity in the nondominant biarticular muscles, indicating that feedforward strategies for postural stability may differ between arms. Reflex sensitivity, which was defined as the magnitude of the reflex response for matched levels of background activity, was not significantly different between arms for a broad subject population ranging from 23 to 51 years of age. These results indicate that inter-arm differences in feedforward strategies are more influential during posture than differences in feedback sensitivity, in a broad subject population. Interestingly, restricting our analysis to subjects under 40 years of age revealed a small increase in long-latency reflex sensitivity in the nondominant arm relative to the dominant arm. Though our subject numbers were small for this secondary analysis, it suggests that further studies may be required to assess the influence of reflex lateralization throughout development.
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Schaefer SY. Preserved motor asymmetry in late adulthood: is measuring chronological age enough? Neuroscience 2015; 294:51-9. [PMID: 25772792 DOI: 10.1016/j.neuroscience.2015.03.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Revised: 03/03/2015] [Accepted: 03/05/2015] [Indexed: 02/01/2023]
Abstract
When comparing motor performance of the dominant and nondominant hands, older adults tend to be less asymmetric compared to young adults. This has suggested decreased motor lateralization and functional compensation within the aging brain. The current study further addressed this question by testing whether motor asymmetry was reduced in a sample of 44 healthy right-handed adults ages 65-89. We hypothesized that the older the age, the less the motor asymmetry, and that 'old old' participants (age 80+) would have less motor asymmetry than 'young old' participants (age 65-79). Using two naturalistic tasks that selectively biased the dominant or nondominant hands, we compared asymmetries in performance (measured as a ratio) across chronological age. Results showed preserved motor asymmetry across ages in both tasks, with no difference in asymmetry ratios in the 'old old' compared to the 'young old.' In the context of previous work, our findings suggest that the aging brain may also be characterized by additional measures besides chronological age.
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Affiliation(s)
- Sydney Y Schaefer
- Emma Eccles Jones College of Education and Human Services, Utah State University, 7000 Old Main Hill, Logan, UT 84322, USA; Department of Physical Therapy, University of Utah, 520 Wakara Way, Salt Lake City, UT 84108, USA; The Center on Aging, University of Utah, 30 North 1900 East, AB193 SOM, Salt Lake City, UT 84132, USA.
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50
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Meziane HB, Moisello C, Perfetti B, Kvint S, Isaias IU, Quartarone A, Di Rocco A, Ghilardi MF. Movement preparation and bilateral modulation of beta activity in aging and Parkinson's disease. PLoS One 2015; 10:e0114817. [PMID: 25635777 PMCID: PMC4312096 DOI: 10.1371/journal.pone.0114817] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 10/24/2014] [Indexed: 11/18/2022] Open
Abstract
In previous studies of young subjects performing a reaction-time reaching task, we found that faster reaction times are associated with increased suppression of beta power over primary sensorimotor areas just before target presentation. Here we ascertain whether such beta decrease similarly occurs in normally aging subjects and also in patients with Parkinson’s disease (PD), where deficits in movement execution and abnormalities of beta power are usually present. We found that in both groups, beta power decreased during the motor task in the electrodes over the two primary sensorimotor areas. However, before target presentation, beta decreases in PD were significantly smaller over the right than over the left areas, while they were symmetrical in controls. In both groups, functional connectivity between the two regions, measured with imaginary coherence, increased before the target appearance; however, in PD, it decreased immediately after, while in controls, it remained elevated throughout motor planning. As in previous studies with young subjects, the degree of beta power before target appearance correlated with reaction time. The values of coherence during motor planning, instead, correlated with movement time, peak velocity and acceleration. We conclude that planning of prompt and fast movements partially depends on coordinated beta activity of both sensorimotor areas, already at the time of target presentation. The delayed onset of beta decreases over the right region observed in PD is possibly related to a decreased functional connectivity between the two areas, and this might account for deficits in force programming, movement duration and velocity modulation.
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Affiliation(s)
- Hadj Boumediene Meziane
- Dept. of Physiology, Pharmacology & Neuroscience, CUNY Medical School, New York, New York, United States of America
| | - Clara Moisello
- Dept. of Physiology, Pharmacology & Neuroscience, CUNY Medical School, New York, New York, United States of America
| | - Bernardo Perfetti
- Dept. of Physiology, Pharmacology & Neuroscience, CUNY Medical School, New York, New York, United States of America
| | - Svetlana Kvint
- Dept. of Physiology, Pharmacology & Neuroscience, CUNY Medical School, New York, New York, United States of America
| | - Ioannis Ugo Isaias
- Department of Neurology, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080 Würzburg, Germany
| | - Angelo Quartarone
- Department of Neurosciences, Psychiatry and Anaesthesiological Sciences, University of Messina, Messina, Italy
- Department of Neurology, Movement Disorders Center, NYU-Langone School of Medicine, New York, New York, United States of America
| | - Alessandro Di Rocco
- Department of Neurology, Movement Disorders Center, NYU-Langone School of Medicine, New York, New York, United States of America
| | - Maria Felice Ghilardi
- Dept. of Physiology, Pharmacology & Neuroscience, CUNY Medical School, New York, New York, United States of America
- Department of Neurology, Movement Disorders Center, NYU-Langone School of Medicine, New York, New York, United States of America
- * E-mail:
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