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da Silva Costa AA, Moraes R, den Otter R, Gennaro F, Bakker L, Rocha Dos Santos PC, Hortobágyi T. Corticomuscular and intermuscular coherence as a function of age and walking balance difficulty. Neurobiol Aging 2024; 141:85-101. [PMID: 38850592 DOI: 10.1016/j.neurobiolaging.2024.05.004] [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: 09/25/2023] [Revised: 04/12/2024] [Accepted: 05/08/2024] [Indexed: 06/10/2024]
Abstract
We determined beta-band intermuscular (IMC) and corticomuscular coherence (CMC) as a function of age and walking balance difficulty. Younger (n=14, 23y) and older individuals (n=19, 71y) walked 13 m overground, on a 6-cm-wide ribbon overground, and on a 6-cm-wide (5-cm-high) beam. Walking distance as a proxy for walking balance and speed were computed. CMC was estimated between electroencephalographic signal at Cz electrode and surface electromyographic signals of seven leg muscles, while IMC was calculated in four pairs of leg muscles, during stance and swing gait phases. With increasing difficulty, walking balance decreased in old individuals and speed decreased gradually independent of age. Beam walking increased IMC, while age increased IMC in proximal muscle pairs, and decreased IMC in distal muscle pairs. Age and difficulty increased CMC independent of gait phases. Concluding, CMC and IMC increased with walking balance difficulty and age, except for distal muscle pairs, which had lower IMC with age. These findings suggest an age-related increase in corticospinal involvement in the neural control of walking balance. DATA AVAILABILITY: The datasets used in this study are available from the corresponding author upon reasonable request.
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Affiliation(s)
- Andréia Abud da Silva Costa
- Ribeirão Preto Medical School, Graduate Program in Rehabilitation and Functional Performance, University of São Paulo, Brazil; Biomechanics and Motor Control Lab, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Brazil; Department of Human Movement Sciences, University of Groningen Medical Center, Groningen, the Netherlands.
| | - Renato Moraes
- Ribeirão Preto Medical School, Graduate Program in Rehabilitation and Functional Performance, University of São Paulo, Brazil; Biomechanics and Motor Control Lab, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Brazil
| | - Rob den Otter
- Department of Human Movement Sciences, University of Groningen Medical Center, Groningen, the Netherlands
| | - Federico Gennaro
- Department of Biomedical Sciences, University of Padua, Padua, Italy
| | - Lisanne Bakker
- Department of Human Movement Sciences, University of Groningen Medical Center, Groningen, the Netherlands
| | - Paulo Cezar Rocha Dos Santos
- Department of Computer Science & Applied Mathematics, Weizmann Institute of Science, Israel; The Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Israel; IDOR/Pioneer Science Initiative, Rio de Janeiro, RJ, Brazil
| | - Tibor Hortobágyi
- Department of Human Movement Sciences, University of Groningen Medical Center, Groningen, the Netherlands; Department of Kinesiology, Hungarian University of Sports Science, Budapest 1123, Hungary; Department of Sport Biology, Institute of Sport Sciences and Physical Education, University of Pécs, Pécs, Hungary
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Borhanazad M, van Wijk BC, Buizer AI, Kerkman JN, Bekius A, Dominici N, Daffertshofer A. Lateralized modulation of cortical beta power during human gait is related to arm swing. iScience 2024; 27:110301. [PMID: 39055930 PMCID: PMC11269954 DOI: 10.1016/j.isci.2024.110301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 05/15/2024] [Accepted: 06/14/2024] [Indexed: 07/28/2024] Open
Abstract
Human gait is a complex behavior requiring dynamic control of upper and lower extremities that is accompanied by cortical activity in multiple brain areas. We investigated the contribution of beta (15-30 Hz) and gamma (30-50 Hz) band electroencephalography (EEG) activity during specific phases of the gait cycle, comparing treadmill walking with and without arm swing. Modulations of spectral power in the beta band during early double support and swing phases source-localized to the sensorimotor cortex ipsilateral, but not contralateral, to the leading leg. The lateralization disappeared in the condition with constrained arms, together with an increase of activity in bilateral supplementary motor areas. By contrast, gamma band modulations that localized to the presumed leg area of sensorimotor cortex around the heel-strike events were unaffected by arm movement. Our findings demonstrate that arm swing is accompanied by considerable cortical activation that should not be neglected in gait-related neuroimaging studies.
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Affiliation(s)
- Marzieh Borhanazad
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam 1081 BT, the Netherlands
- Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands
- Institute for Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Bernadette C.M. van Wijk
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam 1081 BT, the Netherlands
- Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands
- Institute for Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Department of Neurology, Amsterdam UMC Location University of Amsterdam, Amsterdam 1105 AZ, the Netherlands
| | - Annemieke I. Buizer
- Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands
- Department of Rehabilitation Medicine, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam 1081 HZ, the Netherlands
| | - Jennifer N. Kerkman
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam 1081 BT, the Netherlands
- Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands
- Institute for Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Annike Bekius
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam 1081 BT, the Netherlands
- Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands
- Institute for Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Centre, Utrecht University, Utrecht 3584 CG, the Netherlands
| | - Nadia Dominici
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam 1081 BT, the Netherlands
- Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands
- Institute for Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Andreas Daffertshofer
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam 1081 BT, the Netherlands
- Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands
- Institute for Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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3
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Roeder L, Breakspear M, Kerr GK, Boonstra TW. Dynamics of brain-muscle networks reveal effects of age and somatosensory function on gait. iScience 2024; 27:109162. [PMID: 38414847 PMCID: PMC10897916 DOI: 10.1016/j.isci.2024.109162] [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: 09/19/2023] [Revised: 11/16/2023] [Accepted: 02/05/2024] [Indexed: 02/29/2024] Open
Abstract
Walking is a complex motor activity that requires coordinated interactions between the sensory and motor systems. We used mobile EEG and EMG to investigate the brain-muscle networks involved in gait control during overground walking in young people, older people, and individuals with Parkinson's disease. Dynamic interactions between the sensorimotor cortices and eight leg muscles within a gait cycle were assessed using multivariate analysis. We identified three distinct brain-muscle networks during a gait cycle. These networks include a bilateral network, a left-lateralized network activated during the left swing phase, and a right-lateralized network active during the right swing. The trajectories of these networks are contracted in older adults, indicating a reduction in neuromuscular connectivity with age. Individuals with the impaired tactile sensitivity of the foot showed a selective enhancement of the bilateral network, possibly reflecting a compensation strategy to maintain gait stability. These findings provide a parsimonious description of interindividual differences in neuromuscular connectivity during gait.
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Affiliation(s)
- Luisa Roeder
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
- School of Information Systems, Faculty of Science, Queensland University of Technology, Brisbane, QLD, Australia
- Chair of Human Movement Science, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Michael Breakspear
- College of Engineering Science and Environment, College of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia
| | - Graham K Kerr
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Tjeerd W Boonstra
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
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4
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Lai J, Ye Y, Huang D, Zhang X. Age-related differences in the capacity and neuromuscular control of the foot core system during quiet standing. Scand J Med Sci Sports 2024; 34:e14522. [PMID: 37872662 DOI: 10.1111/sms.14522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 09/08/2023] [Accepted: 09/29/2023] [Indexed: 10/25/2023]
Abstract
The foot core system is essential for upright stability. However, aging-induced changes in the foot core function remain poorly understood. The present study aimed to examine age-related differences in postural stability from the perspective of foot core capacity and neuromuscular control during quiet standing. Thirty-six older and 25 young adults completed foot core capacity tests including toe flexion strength, muscle ultrasonography, and plantar cutaneous sensitivity. The center of pressure (COP) and electromyography (EMG) of abductor hallucis (ABH), peroneus longus (PL), tibialis anterior (TA) and medial gastrocnemius (GM) were simultaneously recorded during double-leg and single-leg standing (SLS). EMG data were used to calculate muscle synergy and intermuscular coherence across three frequency bands. Compared to young adults, older adults exhibited thinner hallucis flexors, weaker toe strength, and lower plantar cutaneous sensitivity. The ABH thickness and plantar cutaneous sensitivity were negatively associated with the COP mean peak velocity in older adults, but not in young adults. Besides, older adults had higher cocontraction of muscles spanning the arch (ABH-PL) and ankle (TA-GM), and had lower beta- and gamma-band coherence of the ABH-PL and TA-PL during SLS. Foot core capacities became compromised with advancing age, and the balance control of older adults was susceptible to foot core than young adults in balance tasks. To compensate for the weakened foot core, older adults may adopt arch and ankle stiffening strategies via increasing muscle cocontraction. Furthermore, coherence analysis indicated that aging may increase the demand for cortical brain resources during SLS.
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Affiliation(s)
- Jiaqi Lai
- School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen, China
- Key Laboratory of Sensing Technology and Biomedical Instrument of Guangdong Province, School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, China
| | - Yinyan Ye
- Department of Rehabilitation Medicine, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
| | - Dongfeng Huang
- Department of Rehabilitation Medicine, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
- Guangdong Engineering and Technology Research Center for Rehabilitation Medicine and Translation, Guangdong, China
| | - Xianyi Zhang
- School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen, China
- Key Laboratory of Sensing Technology and Biomedical Instrument of Guangdong Province, School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, China
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Wen L, Watanabe T, Iwamoto Y, Ishii Y, Miyoshi F, Shiraishi K, Date S, Siu KC, Kirimoto H, Takahashi M. Intramuscular and intermuscular coherence analysis while obstacle crossing during treadmill gait. Somatosens Mot Res 2023:1-11. [PMID: 38145411 DOI: 10.1080/08990220.2023.2296516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 11/30/2023] [Indexed: 12/26/2023]
Abstract
PURPOSE This study aimed to identify the contribution of the common synaptic drives to motor units during obstacle avoidance, using coherence analysis between a-pair electromyography (EMG) signals (EMG-EMG coherence). MATERIALS AND METHODS Fourteen healthy volunteers walked on a treadmill with and without obstacle avoidance. During obstacle gait, subjects were instructed to step over an obstacle with their right leg while walking that would randomly and unpredictably appear. Surface EMG signals were recorded from the following muscles of the right leg: the proximal and distal ends of tibialis anterior (TAp and TAd), biceps femoris (BF), semitendinosus (ST), lateral gastrocnemius (LG), and medial gastrocnemius (MG). Beta-band (13-30 Hz) EMG-EMG coherence was analysed. RESULTS Beta-band EMG-EMG coherence of TAp-TAd during swing phase and BF-ST during pre and initial swing phase when stepping over an obstacle were significantly higher compared to normal gait (both p < 0.05). Beta-band EMG-EMG coherence of TAp-TAd, BF-ST, and LG-MG during stance phase were not significantly different between the two gait conditions (all p > 0.05). CONCLUSIONS The present findings suggest increased common synaptic drives to motor units in ankle dorsiflexor and knee flexor muscles during obstacle avoidance. It also may reflect an increased cortical contribution to modify the gait patterns to avoid an obstacle.
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Affiliation(s)
- Lin Wen
- Department of Biomechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tatsunori Watanabe
- Department of Sensorimotor Neuroscience, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Department of Health Sciences, Aomori University of Health and Welfare, Aomori, Japan
| | - Yoshitaka Iwamoto
- Department of Biomechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yosuke Ishii
- Department of Biomechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Fumiya Miyoshi
- Department of Biomechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kanako Shiraishi
- Department of Biomechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shota Date
- Department of Analysis and Control of Upper Extremity Function, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Ka-Chun Siu
- Physical Therapy Education, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, USA
| | - Hikari Kirimoto
- Department of Sensorimotor Neuroscience, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Makoto Takahashi
- Department of Biomechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Martins VF, Gomeñuka NA, Correale L, Martinez FG, Buzzachera CF, Gonçalves AK, Peyré-Tartaruga LA. Effects of aging on arm coordination at different walking speeds. Gait Posture 2023; 103:6-11. [PMID: 37075555 DOI: 10.1016/j.gaitpost.2023.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 03/19/2023] [Accepted: 04/13/2023] [Indexed: 04/21/2023]
Abstract
BACKGROUND Previous work has shown that the mean continuous relative phase and coordination variability of lower limbs are modified in older adults when walking. RESEARCH QUESTION Here, we propose to understand the extent to which such control mechanisms for upper limbs are present during gait. Specifically, we seek to understand if aging and gait speed constraints influence the interjoint control of upper limbs during walking. METHODS This observational study evaluated thirty-three participants, divided into older (n = 20, age 66.4 ± 4.3 years; mass: 77.2 ± 14.2 kg; height: 165 ± 9.20 cm) and young adults (n = 13, age 29.5 ± 4.7 years; mass 75.5 ± 9.6 kg; height: 172 ± 6.24 cm) were asked to walk at 0.28, 0.83, 1.38 m.s-1 on a level treadmill while their segmental movements were simultaneously registered with 3D motion capture system. We calculated the mean continuous relative phase and coordination variability (continuous relative phase variability) in elbow-shoulder and shoulder-hip pairs, and a generalized estimating equation was used to test the main and interaction effects of age and speed. RESULTS Older adults had a reduced continuous relative phase (more in-phase coordination) of upper limbs at whole stance for elbow-shoulder, at loading response for shoulder-hip, at mid-stance and terminal stance for elbow-shoulder and shoulder-hip in comparison to young adults at different speeds (p < 0.05). The coordination variability of upper limbs was greater (higher continuous relative phase variability) in older than young adults at 0.28 and 1.38 m.s-1. SIGNIFICANCE These findings substantiate the altered motor control role of upper limbs in gait aging, suggesting that lower self-selected speed may be related to the reduced ability to control arm movement during the intermediate phases of gait.
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Affiliation(s)
- Valéria Feijó Martins
- LaBiodin Biodynamics Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Luca Correale
- Department of Public Health, Experimental Medicine and Forensic Sciences, University of Pavia, Pavia, Italy
| | - Flávia Gomes Martinez
- LaBiodin Biodynamics Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Cosme Franklim Buzzachera
- Department of Public Health, Experimental Medicine and Forensic Sciences, University of Pavia, Pavia, Italy
| | - Andréa Kruger Gonçalves
- LaBiodin Biodynamics Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Leonardo Alexandre Peyré-Tartaruga
- LaBiodin Biodynamics Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
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Yamaguchi T, Xu J, Sasaki K. Age and sex differences in force steadiness and intermuscular coherence of lower leg muscles during isometric plantar flexion. Exp Brain Res 2023; 241:277-288. [PMID: 36484793 DOI: 10.1007/s00221-022-06517-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 11/24/2022] [Indexed: 12/13/2022]
Abstract
Age- and sex-related alterations in the control of multiple muscles during contractions are not well understood. The purpose of the present study was to examine the age and sex differences in force steadiness and intermuscular coherence (IMC), and thereby to clarify the functional role of IMC during plantar flexion. Twenty-six young (YNG, 23-34 years), thirty middle-aged (MID, 35-64 years) and twenty-four older adults (OLD, 65-82 years) performed submaximal isometric contractions of plantar flexion, while electromyography was recorded from the soleus (SOL), gastrocnemius lateralis/medialis (GL/GM) and tibialis anterior (TA) muscles. Coefficient of variation (CV) of torque and IMC in the alpha, beta and gamma bands was calculated. We found that OLD demonstrated significantly higher torque CV than YNG and MID, and males demonstrated significantly higher torque CV than females (both p < 0.05). The IMC in the gamma band (five out of the six pairs) was significantly higher in YNG than MID and/or OLD (p < 0.05), while the gamma band IMC between GL and SOL was significantly higher in females. However, age or sex differences were not detected in the alpha or beta band. Moreover, the gamma band IMC between SOL and TA had a weak (r = - 0.229) but significant (p < 0.05) negative correlation with torque CV. These results suggest that force steadiness differs with age and sex, and that the higher gamma band IMC may contribute to more stable force control during plantar flexion.
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Affiliation(s)
- Tatsuhiro Yamaguchi
- Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, 153-8902, Japan.
| | - Jierui Xu
- Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, 153-8902, Japan
| | - Kazushige Sasaki
- Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, 153-8902, Japan
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Li S, Zhang H, Leng Y, Lei D, Yu Q, Li K, Ding M, Lo WLA. A protocol to analyze the global literature on the clinical benefit of interlimb-coordinated intervention in gait recovery and the associated neurophysiological changes in patients with stroke. Front Neurol 2022; 13:959917. [DOI: 10.3389/fneur.2022.959917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 10/26/2022] [Indexed: 11/18/2022] Open
Abstract
BackgroundStroke is among the leading causes of disability of worldwide. Gait dysfunction is common in stroke survivors, and substantial advance is yet to be made in stroke rehabilitation practice to improve the clinical outcome of gait recovery. The role of the upper limb in gait recovery has been emphasized in the literature. Recent studies proposed that four limbs coordinated interventions, coined the term “interlimb-coordinated interventions,” could promote gait function by increasing the neural coupling between the arms and legs. A high-quality review is essential to examine the clinical improvement and neurophysiological changes following interlimb-coordinated interventions in patients with stroke.MethodsSystematic review and meta-analysis will be conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The literature will be retrieved from the databases of OVID, MEDLINE, PubMed, Web of Science, EMBASE, and PsycINFO. Studies published in English over the past 15 years will be included. All of the clinical studies (e.g., randomized, pseudorandomized and non-randomized controlled trials, uncontrolled trials, and case series) that employed interlimb intervention and assessed gait function of patients with stroke will be included. Clinical functions of gait, balance, lower limb functions, and neurophysiologic changes are the outcome measures of interest. Statistical analyses will be performed using the Comprehensive Meta-Analysis version 3.DiscussionThe findings of this study will provide insight into the clinical benefits and the neurophysiological adaptations of the nervous system induced by interlimb-coordinated intervention in patients with stroke. This would guide clinical decision-making and the future development of targeted neurorehabilitation protocol in stroke rehabilitation to improve gait and motor function in patients with stroke. Increasing neuroplasticity through four-limb intervention might complement therapeutic rehabilitation strategies in this patient group. The findings could also be insightful for other cerebral diseases.
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Charalambous CC, Hadjipapas A. Is there frequency-specificity in the motor control of walking? The putative differential role of alpha and beta oscillations. Front Syst Neurosci 2022; 16:922841. [PMID: 36387306 PMCID: PMC9650482 DOI: 10.3389/fnsys.2022.922841] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 10/14/2022] [Indexed: 11/04/2023] Open
Abstract
Alpha and beta oscillations have been assessed thoroughly during walking due to their potential role as proxies of the corticoreticulospinal tract (CReST) and corticospinal tract (CST), respectively. Given that damage to a descending tract after stroke can cause walking deficits, detailed knowledge of how these oscillations mechanistically contribute to walking could be utilized in strategies for post-stroke locomotor recovery. In this review, the goal was to summarize, synthesize, and discuss the existing evidence on the potential differential role of these oscillations on the motor descending drive, the effect of transcranial alternate current stimulation (tACS) on neurotypical and post-stroke walking, and to discuss remaining gaps in knowledge, future directions, and methodological considerations. Electrophysiological studies of corticomuscular, intermuscular, and intramuscular coherence during walking clearly demonstrate that beta oscillations are predominantly present in the dorsiflexors during the swing phase and may be absent post-stroke. The role of alpha oscillations, however, has not been pinpointed as clearly. We concluded that both animal and human studies should focus on the electrophysiological characterization of alpha oscillations and their potential role to the CReST. Another approach in elucidating the role of these oscillations is to modulate them and then quantify the impact on walking behavior. This is possible through tACS, whose beneficial effect on walking behavior (including boosting of beta oscillations in intramuscular coherence) has been recently demonstrated in both neurotypical adults and stroke patients. However, these studies still do not allow for specific roles of alpha and beta oscillations to be delineated because the tACS frequency used was much lower (i.e., individualized calculated gait frequency was used). Thus, we identify a main gap in the literature, which is tACS studies actually stimulating at alpha and beta frequencies during walking. Overall, we conclude that for beta oscillations there is a clear connection to descending drive in the corticospinal tract. The precise relationship between alpha oscillations and CReST remains elusive due to the gaps in the literature identified here. However, better understanding the role of alpha (and beta) oscillations in the motor control of walking can be used to progress and develop rehabilitation strategies for promoting locomotor recovery.
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Affiliation(s)
- Charalambos C. Charalambous
- Department of Basic and Clinical Sciences, Medical School, University of Nicosia, Nicosia, Cyprus
- Center for Neuroscience and Integrative Brain Research (CENIBRE), Medical School, University of Nicosia, Nicosia, Cyprus
| | - Avgis Hadjipapas
- Department of Basic and Clinical Sciences, Medical School, University of Nicosia, Nicosia, Cyprus
- Center for Neuroscience and Integrative Brain Research (CENIBRE), Medical School, University of Nicosia, Nicosia, Cyprus
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Lee JB, Katayama K, Millar PJ. Upper and lower limb muscle sympathetic responses to contralateral exercise in healthy humans: A pilot study. Auton Neurosci 2022; 243:103024. [PMID: 36108469 DOI: 10.1016/j.autneu.2022.103024] [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: 02/22/2022] [Revised: 08/30/2022] [Accepted: 09/05/2022] [Indexed: 10/14/2022]
Abstract
Muscle sympathetic nerve activity (MSNA) is similar between limbs at rest, although a subset of MSNA bursts do demonstrate limb-specific discharge. Whether limb differences in MSNA synchronicity are present during exercise remains controversial. We concurrently measured MSNA from the radial and fibular nerves at rest and during rhythmic handgrip (RHG), static handgrip (SHG), and post-exercise circulatory occlusion (PECO). MSNA burst frequency and incidence were similar between nerve sites during all conditions. Synchronous bursts resulted in larger increases in sympathetic-blood pressure transduction compared to isolated bursts (∆ + 3.6 ± 2.1 vs. +2.3 ± 2.4 mmHg, P = 0.01). The proportion of bursts firing synchronously between nerves at rest was slightly increased during RHG ([rest vs. exercise; mean ± SD] 45.3 ± 7.1 vs. 61.6 ± 7.2 %) and similar during SHG (56.2 ± 7.2 vs. 54 ± 10.6 %). In contrast, burst firing synchronicity increased during PECO (83.8 ± 12.4 %) alongside larger burst amplitudes. Inter-limb differences in resting MSNA are preserved during handgrip exercise, whereas isolated metaboreflex activation results in greater burst synchronization between limbs.
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Affiliation(s)
- Jordan B Lee
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Keisho Katayama
- Research Center of Health, Physical Fitness and Sports, Graduate School of Medicine, Nagoya University, Japan
| | - Philip J Millar
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada; Toronto General Research Institute, Toronto General Hospital, Toronto, Ontario, Canada.
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Effect of Unilateral Shoulder Disorder on the Stance Phase of Human Gait. ScientificWorldJournal 2022; 2022:8205879. [PMID: 35509375 PMCID: PMC9061043 DOI: 10.1155/2022/8205879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/14/2022] [Accepted: 04/13/2022] [Indexed: 11/17/2022] Open
Abstract
Background. Gait analysis systems serve as important tools for assessing disturbed gait patterns. Amongst other factors, functional limitations of the shoulder joint may relate to such disturbances. Patient-reported outcome measures, assessment of pain, and active range of motion are commonly used to describe shoulder impairment. Purpose. The aim of this cohort study was to evaluate the impact of unilateral limitations of shoulder mobility and pain on gait patterns and to detect correlations between pain, shoulder mobility, and particular phases of human gait using a Zebris gait analysis system. Methods. 20 subjects with unilaterally restricted mobility and pain of the affected shoulder and a control group of 10 healthy subjects underwent a gait analysis. Various gait parameters, the DASH score, pain at rest and movement of the affected shoulder, and the active range of motion (aROM) for shoulder flexion and abduction were recorded. Results. We determined significant differences of the duration of the loading response (
= 0.021), midstance (
= 0.033), and the terminal stance phase (
= 0.019) between the shoulder group and the control group, with a shorter loading response phase and a longer terminal stance phase of the affected side in the shoulder group. In the shoulder group, we found significant correlations between the DASH and the duration of the midstance phase (
= 0.023) and the terminal stance phase (
= 0.038). In addition, there was a significant correlation between shoulder flexion and the duration of the midstance phase (
= 0.047).
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Time-dependent directional intermuscular coherence analysis reveals that forward and backward arm swing equally drive the upper leg muscles during gait initiation. Gait Posture 2022; 92:290-293. [PMID: 34896841 DOI: 10.1016/j.gaitpost.2021.11.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 07/30/2021] [Accepted: 11/24/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Human bipedal gait benefits from arm swing, as it drives and shapes lower limb muscle activity in healthy participants as well as patients suffering from neurological impairment. Also during gait initiation, arm swing instructions were found to facilitate leg muscle recruitment. RESEARCH QUESTION The aim of the present study is to exploit the directional decomposition of coherence to examine to what extent forward and backward arm swing contribute to leg muscle recruitment during gait initiation. METHODS Ambulant electromyography (EMG) from shoulder muscles (deltoideus anterior and posterior) and upper leg muscles (biceps femoris and rectus femoris) was analysed during gait initiation in nineteen healthy participants (median age of 67 ± 12 (IQR) years). To assess to what extent either deltoideus anterior or posterior muscles were able to drive upper leg muscle activity during distinct stages of the gait initiation process, time dependent intermuscular coherence was decomposed into directional components based on their time lag (i.e. forward, reverse and zero-lag). RESULTS Coherence from the forward directed components, representing shoulder muscle signals leading leg muscle signals, revealed that deltoideus anterior (i.e. forward arm swing) and deltoideus posterior (i.e. backward arm swing) equally drive upper leg muscle activity during the gait initiation process. SIGNIFICANCE The presently demonstrated time dependent directional intermuscular coherence analysis could be of use for future studies examining directional coupling between muscles or brain areas relative to certain gait (or other time) events. In the present study, this analysis provided neural underpinning that both forward and backward arm swing can provide neuronal support for leg muscle recruitment during gait initiation and can therefore both serve as an effective gait rehabilitation method in patients with gait initiation difficulties.
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Samejima S, Caskey CD, Inanici F, Shrivastav SR, Brighton LN, Pradarelli J, Martinez V, Steele KM, Saigal R, Moritz CT. Multisite Transcutaneous Spinal Stimulation for Walking and Autonomic Recovery in Motor-Incomplete Tetraplegia: A Single-Subject Design. Phys Ther 2022; 102:6514473. [PMID: 35076067 PMCID: PMC8788019 DOI: 10.1093/ptj/pzab228] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 06/07/2021] [Accepted: 08/23/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVE This study investigated the effect of cervical and lumbar transcutaneous spinal cord stimulation (tSCS) combined with intensive training to improve walking and autonomic function after chronic spinal cord injury (SCI). METHODS Two 64-year-old men with chronic motor incomplete cervical SCI participated in this single-subject design study. They each underwent 2 months of intensive locomotor training and 2 months of multisite cervical and lumbosacral tSCS paired with intensive locomotor training. RESULTS The improvement in 6-Minute Walk Test distance after 2 months of tSCS with intensive training was threefold greater than after locomotor training alone. Both participants improved balance ability measured by the Berg Balance Scale and increased their ability to engage in daily home exercises. Gait analysis demonstrated increased step length for each individual. Both participants experienced improved sensation and bowel function, and 1 participant eliminated the need for intermittent catheterization after the stimulation phase of the study. CONCLUSION These results suggest that noninvasive spinal cord stimulation might promote recovery of locomotor and autonomic functions beyond traditional gait training in people with chronic incomplete cervical SCI. IMPACT Multisite transcutaneous spinal stimulation may induce neuroplasticity of the spinal networks and confer functional benefits following chronic cervical SCI.
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Affiliation(s)
- Soshi Samejima
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA,Center for Neurotechnology, University of Washington, Seattle, Washington, USA,Department of Electrical and Computer Engineering, University of Washington, Seattle, Washington, USA
| | - Charlotte D Caskey
- Department of Mechanical Engineering, University of Washington, Seattle, Washington, USA
| | - Fatma Inanici
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA,Center for Neurotechnology, University of Washington, Seattle, Washington, USA,Department of Electrical and Computer Engineering, University of Washington, Seattle, Washington, USA
| | - Siddhi R Shrivastav
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA,Center for Neurotechnology, University of Washington, Seattle, Washington, USA,Department of Electrical and Computer Engineering, University of Washington, Seattle, Washington, USA
| | - Lorie N Brighton
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - Jared Pradarelli
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - Vincente Martinez
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - Katherine M Steele
- Department of Mechanical Engineering, University of Washington, Seattle, Washington, USA
| | - Rajiv Saigal
- Department of Neurological Surgery, University of Washington, Seattle, Washington, USA
| | - Chet T Moritz
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA,Center for Neurotechnology, University of Washington, Seattle, Washington, USA,Department of Electrical and Computer Engineering, University of Washington, Seattle, Washington, USA,Department of Physiology and Biophysics, University of Washington, Seattle, Washington, USA,Address all correspondence to Dr Moritz at:
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Weersink JB, de Jong BM, Maurits NM. Neural coupling between upper and lower limb muscles in Parkinsonian gait. Clin Neurophysiol 2021; 134:65-72. [PMID: 34979292 DOI: 10.1016/j.clinph.2021.11.072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 11/08/2021] [Accepted: 11/22/2021] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To explore to what extent neuronal coupling between upper and lower limb muscles during gait is preserved or affected in patients with Parkinson's Disease (PD). METHODS Electromyography recordings were obtained from the bilateral deltoideus anterior and bilateral rectus femoris and biceps femoris muscles during overground gait in 20 healthy participants (median age 69 years) and 20 PD patients (median age 68.5 years). PD patients were able to walk independently (Hoehn and Yahr scale: Stage 2-3), had an equally distributed symptom laterality (6 left side, 7 both sides and 7 right side) and no cognitive problems or tremor dominant PD. Time-dependent directional intermuscular coherence analysis was employed to compare the neural coupling between upper and lower limb muscles between healthy participants and PD patients in three different directions: zero-lag (i.e. common driver), forward (i.e. shoulders driving the legs) and reverse component (i.e. legs driving the shoulders). RESULTS Compared to healthy participants, PD patients exhibited (i) reduced intermuscular zero-lag coherence in the beta/gamma frequency band during end-of-stance and (ii) enhanced forward as well as reverse directed coherence in the alpha and beta/gamma frequency bands around toe-off. CONCLUSIONS PD patients had a reduced common cortical drive to upper and lower limb muscles during gait, possibly contributing to disturbed interlimb coordination. Enhanced bidirectional coupling between upper and lower limb muscles on subcortical and transcortical levels in PD patients suggests a mechanism of compensation. SIGNIFICANCE These findings provide support for the facilitating effect of arm swing instructions in PD gait.
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Affiliation(s)
- Joyce B Weersink
- University of Groningen, University Medical Center Groningen, Department of Neurology, Hanzeplein 1, POB 30.001, Groningen, the Netherlands
| | - Bauke M de Jong
- University of Groningen, University Medical Center Groningen, Department of Neurology, Hanzeplein 1, POB 30.001, Groningen, the Netherlands
| | - Natasha M Maurits
- University of Groningen, University Medical Center Groningen, Department of Neurology, Hanzeplein 1, POB 30.001, Groningen, the Netherlands.
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The Efficacy of Interlimb-Coordinated Intervention on Gait and Motor Function Recovery in Patients with Acute Stroke: A Multi-Center Randomized Controlled Trial Study Protocol. Brain Sci 2021; 11:brainsci11111495. [PMID: 34827494 PMCID: PMC8615375 DOI: 10.3390/brainsci11111495] [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: 08/04/2021] [Revised: 11/05/2021] [Accepted: 11/08/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The efficacy of interlimb-coordinated training on gait and upper limb functional improvement remains unclear. The latest published randomized controlled trials have supported the potential benefits of interlimb-coordinated training to enhance gait function. Upper limb functional recovery may also benefit from interlimb-coordinated training since most everyday activities require the coordinated use of both hands to complete a task. This study investigates the efficacy of interlimb-coordinated training on gait and upper limb functional recovery over a short-medium term period. METHODS A total of 226 acute stroke patients will be recruited from four centres over four years. Patients will be randomly allocated to either conventional therapy or conventional therapy plus interlimb-coordinated training. Outcomes will be recorded at baseline, after 2 weeks of intervention, and at 3- and 6-months post-intervention. Gait speed is the primary outcome measure. Secondary outcome measures include Fugl-Meyer Assessment of Motor Recovery, Berg Balance Scale, Timed Up and Go test, Action Research Arm Test, electroencephalography, and magnetic resonance imaging. CONCLUSION The results of this trial will provide an in-depth understanding of the efficacy of early interlimb-coordinated intervention on gait and upper functional rehabilitation and how it may relate to the neural plasticity process.
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Weersink JB, Maurits NM, van Laar T, de Jong BM. Enhanced arm swing improves Parkinsonian gait with EEG power modulations resembling healthy gait. Parkinsonism Relat Disord 2021; 91:96-101. [PMID: 34547655 DOI: 10.1016/j.parkreldis.2021.09.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 09/02/2021] [Accepted: 09/12/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND The supplementary motor area (SMA) is implicated in stereotypic multi-limb movements such as walking with arm swing. Gait difficulties in Parkinson's Disease (PD) include reduced arm swing, which is associated with reduced SMA activity. OBJECTIVE To test whether enhanced arm swing improves Parkinsonian gait and explore the role of the SMA in such an improvement. METHODS Cortical activity and gait characteristics were assessed by ambulant EEG, accelerometers and video recordings in 27 PD patients with self-reported gait difficulties and 35 healthy participants when walking normally. Within these two groups, 19 PD patients additionally walked with enhanced arm swing and 30 healthy participants walked without arm swing. Power changes across the EEG frequency spectrum were assessed by Event Related Spectral Perturbation analysis of recordings from Fz over the putative SMA and gait analysis was performed. RESULTS Baseline PD gait, characterized by reduced arm swing among other features, exhibited reduced within-step Event Related Desynchronization (ERD)/Synchronization (ERS) alternation (Fz; 20-50Hz), accompanied by a reduced step length and walking speed. All became similar to normal gait when patients walked with enhanced arm swing. When healthy controls walked without arm swing, their alternating ERD-ERS pattern decreased, mimicking baseline PD gait. CONCLUSION Enhanced arm swing may serve as a driving force to overcome impaired gait control in PD patients by restoring reduced ERD-ERS alternation over the putative SMA. Accompanied by increased step length and walking speed, this provides a neural underpinning of arm swing as an effective rehabilitation concept for improving Parkinsonian gait.
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Affiliation(s)
- Joyce B Weersink
- Department of Neurology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, POB 30.001, Groningen, the Netherlands
| | - Natasha M Maurits
- Department of Neurology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, POB 30.001, Groningen, the Netherlands
| | - Teus van Laar
- Department of Neurology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, POB 30.001, Groningen, the Netherlands
| | - Bauke M de Jong
- Department of Neurology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, POB 30.001, Groningen, the Netherlands.
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Weersink JB, Maurits NM, de Jong BM. Amble Gait EEG Points at Complementary Cortical Networks Underlying Stereotypic Multi-Limb Co-ordination. Front Hum Neurosci 2021; 15:691482. [PMID: 34413729 PMCID: PMC8370810 DOI: 10.3389/fnhum.2021.691482] [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: 04/06/2021] [Accepted: 07/16/2021] [Indexed: 11/15/2022] Open
Abstract
Background Walking is characterized by stable antiphase relations between upper and lower limb movements. Such bilateral rhythmic movement patterns are neuronally generated at levels of the spinal cord and brain stem, that are strongly interconnected with cortical circuitries, including the Supplementary Motor Area (SMA). Objective To explore cerebral activity associated with multi-limb phase relations in human gait by manipulating mutual attunement of the upper and lower limb antiphase patterns. Methods Cortical activity and gait were assessed by ambulant EEG, accelerometers and videorecordings in 35 healthy participants walking normally and 19 healthy participants walking in amble gait, where upper limbs moved in-phase with the lower limbs. Power changes across the EEG frequency spectrum were assessed by Event Related Spectral Perturbation analysis and gait analysis was performed. Results Amble gait was associated with enhanced Event Related Desynchronization (ERD) prior to and during especially the left swing phase and reduced Event Related Synchronization (ERS) at final swing phases. ERD enhancement was most pronounced over the putative right premotor, right primary motor and right parietal cortex, indicating involvement of higher-order organization and somatosensory guidance in the production of this more complex gait pattern, with an apparent right hemisphere dominance. The diminished within-step ERD/ERS pattern in amble gait, also over the SMA, suggests that this gait pattern is more stride driven instead of step driven. Conclusion Increased four-limb phase complexity recruits distributed networks upstream of the primary motor cortex, primarily lateralized in the right hemisphere. Similar parietal-premotor involvement has been described to compensate impaired SMA function in Parkinson’s disease bimanual antiphase movement, indicating a role as cortical support regions.
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Affiliation(s)
- Joyce B Weersink
- Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Natasha M Maurits
- Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Bauke M de Jong
- Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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