The cerebellum contributes to proprioception during motion

Prioritized adjustments in posture stabilization and adaptive reaching during neuromuscular fatigue of lower-limb muscles

Neuromuscular fatigue (NMF) induces temporary reductions in muscle force production capacity, affecting various aspects of motor function. Although studies have extensively explored NMF's impact on muscle activation patterns and postural stability, its influence on motor adaptation processes remains less understood. This article investigates the effects of localized NMF on motor adaptation during upright stance, focusing on reaching tasks. Using a force-field perturbation paradigm, participants performed reaching movements while standing upright before and after inducing NMF in the ankle dorsiflexor muscles. Results revealed that despite maintained postural stability, participants in the NMF group exhibited larger movement errors during reaching tasks, suggesting impaired motor adaptation. This was evident in both initial and terminal phases of adaptation, indicating a disruption in learning processes rather than a decreased adaptation rate. Analysis of electromyography activation patterns highlighted distinct strategies between groups, with the NMF group showing altered activation of both fatigued and nonfatigued muscles. In addition, differences in coactivation patterns suggested compensatory mechanisms to prioritize postural stability despite NMF-induced disruptions. These findings underscore the complex interplay between NMF, motor adaptation, and postural control, suggesting a potential role for central nervous system mechanisms in mediating adaptation processes. Understanding these mechanisms has implications for sports performance, rehabilitation, and motor skill acquisition, where NMF may impact the learning and retention of motor tasks. Further research is warranted to elucidate the transient or long-term effects of NMF on motor adaptation and its implications for motor rehabilitation interventions.NEW & NOTEWORTHY We assessed motor adaptation during force-field reaching following exercise-induced neuromuscular fatigue (NMF) on postural muscles. NMF impaired adaptation in performance. Similarly, diverging activation strategies were observed in the muscles. No effects were seen on measures of postural control. These results suggest the remodulation of motor commands to the muscles in the presence of NMF, which may be relevant in settings where participants could be exposed to NMF while learning, such as sports and rehabilitation.

Stability, Balance, and Physical Variables in Patients with Bilateral Hemophilic Arthropathy of the Ankle versus Their Healthy Peers: A Case-Control Study

(1) Background: The recurrence of hemarthrosis in patients with hemophilia triggers a pathophysiological process of degenerative, progressive, and irreversible joint destruction. This hemophilic arthropathy is characterized by chronic pain, muscle atrophy, loss of mobility, and proprioceptive alterations. As the same joint undergoes repeated hemarthrosis, the function of the mechanical receptors deteriorates, causing a pathophysiological modulation and deterioration of the musculoskeletal system. The objective was to analyze the differences in stability and balance, as well as in ankle dorsal flexion, functionality, and muscle strength, between patients with bilateral hemophilic arthropathy and their healthy peers. (2) Methods: A cross-sectional descriptive case-control study was performed. Twenty-two participants were recruited: 10 adult patients with bilateral hemophilic arthropathy of the knee and ankle and 12 healthy subjects. The variables were balance (Rs Scan pressure platform), ankle dorsiflexion range of motion (Leg Motion), functionality (2-Minute Walk Test), and ankle dorsal strength (dynamometry). (3) Results: Statistically significant differences (p < 0.05) were found in the balance without visual support in the Max-Y variable (MD = 2.83; CI95%: 0.33;5.33; Effect size (d) = 0.67), ankle dorsiflexion (MD = 16.00; CI95%: 14.30; 20.0; d = 7.46), and strength of the ankle flexor muscles (MD = 128.50; CI95%: 92.50; 153.60; d = 2.76). (4) Conclusions: Ankle range of motion in dorsal flexion, functionality, and muscle strength in dorsal flexion is poorer in patients with bilateral lower limb hemophilic arthropathy than in their healthy peers. Patients with bilateral hemophilic ankle arthropathy have statistically poorer stability and balance without visual support than their healthy peers.

Automatic learning mechanisms for flexible human locomotion

Movement flexibility and automaticity are necessary to successfully navigate different environments. When encountering difficult terrains such as a muddy trail, we can change how we step almost immediately so that we can continue walking. This flexibility comes at a cost since we initially must pay deliberate attention to how we are moving. Gradually, after a few minutes on the trail, stepping becomes automatic so that we do not need to think about our movements. Canonical theory indicates that different adaptive motor learning mechanisms confer these essential properties to movement: explicit control confers rapid flexibility, while forward model recalibration confers automaticity. Here we uncover a distinct mechanism of treadmill walking adaptation - an automatic stimulus-response mapping - that confers both properties to movement. The mechanism is flexible as it learns stepping patterns that can be rapidly changed to suit a range of treadmill configurations. It is also automatic as it can operate without deliberate control or explicit awareness by the participants. Our findings reveal a tandem architecture of forward model recalibration and automatic stimulus-response mapping mechanisms for walking, reconciling different findings of motor adaptation and perceptual realignment.

Reinforcement Motor Learning After Cerebellar Damage Is Related to State Estimation

Recent work showed that individuals with cerebellar degeneration could leverage intact reinforcement learning (RL) to alter their movement. However, there was marked inter-individual variability in learning, and the factors underlying it were unclear. Cerebellum-dependent sensory prediction may contribute to RL in motor contexts by enhancing body state estimates, which are necessary to solve the credit-assignment problem. The objective of this study was to test the relationship between the predictive component of state estimation and RL in individuals with cerebellar degeneration. Individuals with cerebellar degeneration and neurotypical control participants completed two tasks: an RL task that required them to alter the angle of reaching movements and a state estimation task that tested the somatosensory perception of active and passive movement. The state estimation task permitted the calculation of the active benefit shown by each participant, which is thought to reflect the cerebellum-dependent predictive component of state estimation. We found that the cerebellar and control groups showed similar magnitudes of learning with reinforcement and active benefit on average, but there was substantial variability across individuals. Using multiple regression, we assessed potential predictors of RL. Our analysis included active benefit, somatosensory acuity, clinical ataxia severity, movement variability, movement speed, and age. We found a significant relationship in which greater active benefit predicted better learning with reinforcement in the cerebellar, but not the control group. No other variables showed significant relationships with learning. Overall, our results support the hypothesis that the integrity of sensory prediction is a strong predictor of RL after cerebellar damage.

Imprecise perception of hand position during early motor adaptation

Localizing one's body parts is important for movement control and motor learning. Recent studies have shown that the precision with which people localize their hand places constraints on motor adaptation. Although these studies have assumed that hand localization remains equally precise across learning, we show that precision decreases rapidly during early motor learning. In three experiments, healthy young participants (n = 92) repeatedly adapted to a 45° visuomotor rotation for a cycle of two to four reaches, followed by a cycle of two to four reaches with veridical feedback. Participants either used an aiming strategy that fully compensated for the rotation (experiment 1), or always aimed directly at the target, so that adaptation was implicit (experiment 2). We omitted visual feedback for the last reach of each cycle, after which participants localized their unseen hand. We observed an increase in the variability of angular localization errors when subjects used a strategy to counter the visuomotor rotation (experiment 1). This decrease in precision was less pronounced in the absence of reaiming (experiment 2), and when subjects knew that they would have to localize their hand on the upcoming trial, and could thus focus on hand position (experiment 3). We propose that strategic reaiming decreases the precision of perceived hand position, possibly due to attention to vision rather than proprioception. We discuss how these dynamics in precision during early motor learning could impact on motor control and shape the interplay between implicit and strategy-based motor adaptation.NEW & NOTEWORTHY Recent studies indicate that the precision with which people localize their hand limits implicit visuomotor learning. We found that localization precision is not static, but decreases early during learning. This decrease is pronounced when people apply a reaiming strategy to compensate for a visuomotor perturbation and is partly resistant to allocation of attention to the hand. We propose that these dynamics in position sense during learning may influence how implicit and strategy-based motor adaption interact.

Brain activation and connection across resting and motor-task states in patients with generalized tonic-clonic seizures

AIMS

Motor abnormalities have been identified as one common symptom in patients with generalized tonic-clonic seizures (GTCS) inspiring us to explore the disease in a motor execution condition, which might provide novel insight into the pathomechanism.

METHODS

Resting-state and motor-task fMRI data were collected from 50 patients with GTCS, including 18 patients newly diagnosed without antiepileptic drugs (ND_GTCS) and 32 patients receiving antiepileptic drugs (AEDs_GTCS). Motor activation and its association with head motion and cerebral gradients were assessed. Whole-brain network connectivity across resting and motor states was further calculated and compared between groups.

RESULTS

All patients showed over-activation in the postcentral gyrus and the ND_GTCS showed decreased activation in putamen. Specifically, activation maps of ND_GTCS showed an abnormal correlation with head motion and cerebral gradient. Moreover, we detected altered functional network connectivity in patients within states and across resting and motor states by using repeated-measures analysis of variance. Patients did not show abnormal connectivity in the resting state, while distributed abnormal connectivity in the motor-task state. Decreased across-state network connectivity was also found in all patients.

CONCLUSION

Convergent findings suggested the over-response of activation and connection of the brain to motor execution in GTCS, providing new clues to uncover motor susceptibility underlying the disease.

Olfactory Dysfunction and Balance Dysfunction are Associated with Increased Falls in Older Adults

OBJECTIVE

This study aims to characterize the association between impairments in olfaction and balance, both of which are mediated in part by the cerebellum, and how this relates to prospective incidence of falls in a cohort of aging adults.

METHODS

The Health ABC study was queried to identify 296 participants with data on both olfaction (measured using the 12-item Brief Smell Identification Test) and balance-related function (measured using the Romberg test). The relationship between olfaction and balance was investigated using multivariable logistic regression. Predictors of performance on a standing balance assessment and predictors of falls were studied.

RESULTS

Of 296 participants, 52.7% had isolated olfactory dysfunction, 7.4% had isolated balance dysfunction, and 5.7% had dual dysfunction. Severe olfactory dysfunction was associated with increased odds of balance dysfunction when compared to those without olfactory dysfunction, even when adjusting for age, gender, race, education, BMI, smoking, diabetes, depression, and dementia (OR = 4.1, 95% CI [1.5, 13.7], p = 0.011). Dual sensory dysfunction was associated with worse performance on a standing balance assessment (β = -22.8, 95% CI [-35.6, -10.1], p = 0.0005) and increased falls (β = 1.5, 95% CI [1.0, 2.3], p = 0.037).

CONCLUSION

This study highlights a unique relationship between olfaction and balance, and how dual dysfunction is associated with increased falls. With substantial implications of falls on morbidity and mortality in older adults, this novel relationship between olfaction and balance emphasizes a potentially shared mechanism between olfactory dysfunction and increased fall risk in older adults; however, further study is required to explore the novel relationship of olfaction with balance and future falls.

LEVEL OF EVIDENCE

3 Laryngoscope, 133:1964-1969, 2023.

Acuity of Proprioceptive Localization Varies with Body Region

We accurately sense locations of objects touching various points on the body and, if they are irritants, make accurate rapid movements to remove them. Such movements require accurate proprioception of orientation and motion of the reaching limb and of the target. However, it is unknown whether acuity of these sensations is similar for different points on the body. We investigated accuracy of comfortable speed reaching movements of the right index-tip by 10 subjects (five females) to touch 12 different body locations with and without vision with the body part stationary in different locations and moving in different directions. Reaching movements to points on the face/head and trunk had mean errors averaging less than 0.2 cm greater than under vision conditions. Mean errors for reaches to touch points on the left arm and digits were less accurate (p < 0.05), but average less than 1 cm relative to vision conditions. Mean errors for reaches to touch points on the left lower limb were least accurate (p < 0.05), with mean errors averaging 1.5-3.1 cm relative to movements made with vision. We conclude that there is high proprioceptive acuity for locations of points on axial structures and the left upper limb including the digits, which contrasts with previous reports of greatly distorted proprioceptive maps of the face/head and hand. Apparently low proprioceptive acuity for points on the leg may be task sensitive as many lower limb motor tasks can be performed accurately without vision.

Understanding implicit sensorimotor adaptation as a process of proprioceptive re-alignment

Multiple learning processes contribute to successful goal-directed actions in the face of changing physiological states, biomechanical constraints, and environmental contexts. Amongst these processes, implicit sensorimotor adaptation is of primary importance, ensuring that movements remain well-calibrated and accurate. A large body of work on reaching movements has emphasized how adaptation centers on an iterative process designed to minimize visual errors. The role of proprioception has been largely neglected, thought to play a passive role in which proprioception is affected by the visual error but does not directly contribute to adaptation. Here, we present an alternative to this visuo-centric framework, outlining a model in which implicit adaptation acts to minimize a proprioceptive error, the distance between the perceived hand position and its intended goal. This proprioceptive re-alignment model (PReMo) is consistent with many phenomena that have previously been interpreted in terms of learning from visual errors, and offers a parsimonious account of numerous unexplained phenomena. Cognizant that the evidence for PReMo rests on correlational studies, we highlight core predictions to be tested in future experiments, as well as note potential challenges for a proprioceptive-based perspective on implicit adaptation.

Extracurricular sports activities modify the proprioceptive map in children aged 5-8 years

The Chinese government has recently issued the strictest ever guideline to improve the compulsory education system. The new policy aims at reducing the burden of excessive homework and supplementary tutoring, whilst promoting extracurricular activities, including sports and arts, for primary and junior middle school students. To examine the impact that this reform might have on sensory development—which is critical for higher-order cognitive functions—we assessed proprioceptive abilities in children from 5 to 8 years of age. Proprioception refers to sensations of position and motion of the body in space and is mediated by activity in somatosensory and prefrontal cortical areas. By asking participants to perform position matching tasks in the forward–backward directions, we were able to compare the proprioceptive maps of children with and without regular sports training. We demonstrate that extracurricular sports activities can modify the proprioceptive map and improve proprioceptive acuity and stability in school-aged children.

Strabismus and postural control: a systematic review

The primary aim of this systematic review is to evaluate how postural balance and visual system are related in cross-eyed patients. The secondary goal is to assess the benefits of eye realignment on motor skills and body balance. Analyzing two different approaches: surgical or conservative, a systematic literature search was conducted using PubMed-Medline, Google Scholar and Cochrane Central in order to identify randomized controlled trials, case series and case-control studies which contained clinical evaluation of balance in strabismic patients as well as re-evaluation after surgery or conservative treatments via posturography to evaluate surface, length and mean speed of the center of pressure (CoP). A total of 11 studies were included in this review. The MINORS score is used to assess the methodological quality of the included studies, and its mean value was 12.8 for non-comparative studies and 17.5 for comparative studies. The postural balance was lower in strabismic patients compared with the control group, with statically higher value (p < 0.05) of surface, length and mean speed of the CoP in the study group. All patients show improvement in stability after surgery, as surface, length and mean speed of the CoP decreased after surgery in all the studies with statistical significance (p < 0.05).

Regulating synchronous oscillations of cerebellar granule cells by different types of inhibition

Synchronous oscillations in neural populations are considered being controlled by inhibitory neurons. In the granular layer of the cerebellum, two major types of cells are excitatory granular cells (GCs) and inhibitory Golgi cells (GoCs). GC spatiotemporal dynamics, as the output of the granular layer, is highly regulated by GoCs. However, there are various types of inhibition implemented by GoCs. With inputs from mossy fibers, GCs and GoCs are reciprocally connected to exhibit different network motifs of synaptic connections. From the view of GCs, feedforward inhibition is expressed as the direct input from GoCs excited by mossy fibers, whereas feedback inhibition is from GoCs via GCs themselves. In addition, there are abundant gap junctions between GoCs showing another form of inhibition. It remains unclear how these diverse copies of inhibition regulate neural population oscillation changes. Leveraging a computational model of the granular layer network, we addressed this question to examine the emergence and modulation of network oscillation using different types of inhibition. We show that at the network level, feedback inhibition is crucial to generate neural oscillation. When short-term plasticity was equipped on GoC-GC synapses, oscillations were largely diminished. Robust oscillations can only appear with additional gap junctions. Moreover, there was a substantial level of cross-frequency coupling in oscillation dynamics. Such a coupling was adjusted and strengthened by GoCs through feedback inhibition. Taken together, our results suggest that the cooperation of distinct types of GoC inhibition plays an essential role in regulating synchronous oscillations of the GC population. With GCs as the sole output of the granular network, their oscillation dynamics could potentially enhance the computational capability of downstream neurons.

The capacity to learn new motor and perceptual calibrations develops concurrently in childhood

Learning new movements through an error-based process called motor adaptation is thought to involve multiple mechanisms which are still largely not understood. Previous studies have shown that young children adapt movement more slowly than adults, perhaps supporting the involvement of distinct neural circuits that come online at different stages of development. Recent studies in adults have shown that in addition to recalibrating a movement, motor adaptation also leads to changes in the perception of that movement. However, we do not yet understand the relationship between the processes that underlie motor and perceptual recalibration. Here we studied motor and perceptual recalibration with split-belt walking adaptation in adults and children aged 6-8 years. Consistent with previous work, we found that this group of children adapted their walking patterns more slowly than adults, though individual children ranged from slow to adult-like in their adaptation rates. Perceptual recalibration was also reduced in the same group of children compared to adults, with individual children ranging from having no recalibration to having adult-like recalibration. In sum, faster motor adaptation and the ability to recalibrate movement perception both come online within a similar age-range, raising the possibility that the same sensorimotor mechanisms underlie these processes.

The cerebellum as a movement sensor

In this article, we review a broad range of studies of cerebellar function and dysfunction and interpret them within the framework that the cerebellum acts as part of a mechanism of predictive control. We describe studies that span human behaviour and consider the motor and sensory impairments that result from cerebellar damage. We conclude that a parsimonious explanation of cerebellar function is as a predictor of the sensory outcomes of movement. However, future studies are needed to more rigorously test this hypothesis and determine how the cerebellar circuit might perform this type of computation.

Analysis of Lower Extremity Proprioception for Anterior Cruciate Ligament Injury Prevention: Current Opinion

Lower extremity musculoskeletal injuries-such as ACL injury-are common, and the majority of those injuries occur without external player contact. In order to prevent non-contact musculoskeletal injuries, athletes must rely on accurate sensory information (such as visual, vestibular, and somatosensory) and stabilize joints during athletic tasks. Previously, proprioception tests (the senses of joint position, movement, tension or force) have been examined using static tests. Due to the role of proprioception in achievement of joint stability, it is essential to explore the development of dynamic proprioception tests. In this current opinion, the basic background on proprioception is covered, and the research gaps and future directions are discussed.

Increasing Motor Noise Impairs Reinforcement Learning in Healthy Individuals

Motor variability from exploration is crucial for reinforcement learning as it allows the nervous system to find new task solutions. However, motor variability from noise can be detrimental to learning and may underlie slowed reinforcement learning performance observed in individuals with cerebellar damage. Here we examine whether artificially increasing noise in healthy individuals slows reinforcement learning in a manner similar to that seen in patients with cerebellar damage. Participants used binary reinforcement to learn to rotate their reach angle in a series of directions. By comparing task performance between conditions with different levels of added noise, we show that adding a high level of noise-matched to a group of patients with cerebellar damage-slows learning. In additional experiments, we show that the detrimental effect of noise may lie in reinforcing incorrect behavior, rather than not reinforcing correct behavior. By comparing performance between healthy participants with added noise and a group of patients with cerebellar damage, we found that added noise does not slow the learning of the control group to the same degree observed in the patient group. Using a mechanistic model, we show that added noise in the present study matched patients' motor noise and total learning. However, increased exploration in the control group relative to the group with cerebellar damage supports faster learning. Our results suggest that motor noise slows reinforcement learning by impairing the mapping of reward to the correct action and that this may underlie deficits induced by cerebellar damage.

Relative Contributions of the Speed Characteristic and Other Possible Ecological Factors in Synchronization to a Visual Beat Consisting of Periodically Moving Stimuli

Daily music experience involves synchronizing movements in time with a perceived periodic beat. Contrary to the auditory-specific view of beat synchronization, synchronization to a visual beat composed of a periodically bouncing ball has been shown to be not less stable than synchronization to auditory beats. The ecological relevance of periodically moving visual stimuli is considered to be essential for such synchronization improvement. However, multiple factors could be associated with the ecological relevance and the relative contributions of the ecological factors to the synchronization improvement remain unclear. The present study investigated whether ecological factors other than a proposed critical factor, i.e., the speed characteristic, are required to account for the synchronization improvement of the bouncing ball. A periodically contracting ring that had the same speed characteristic as the periodically bouncing ball but lacked other possible ecological factors of the ball was designed. The results showed that synchronization was more stable for the bouncing ball than for the contracting ring, and this stability difference was larger in the difficult 300-ms than in the comfortable 600-ms inter-beat interval tapping condition. The finding suggests that ecological factors other than the speed characteristic are required to explain the synchronization improvement of periodically moving visual stimuli, particularly in difficult tapping conditions.

Pointing to One's Moving Hand: Putative Internal Models Do Not Contribute to Proprioceptive Acuity

We can easily and without sight bring our fingertip to our nose, or swat a mosquito on our arm. These actions rely on proprioception, also known as kinesthesia, which classically has been attributed to processing of sensory inflow by the CNS. However, internal model theories of sensorimotor neuroscience propose that proprioceptive localization also involves a contribution from estimates of limb kinematics derived from motor commands. We tested this prediction in 19 subjects who moved the right index finger tip to touch the moving left index finger tip under three conditions: (1) vision allowed, active movement of the left hand (2) vision blocked, active movement of the left hand, and (3) vision blocked, passive movement of the left hand imposed by the experimenter. The target left index finger tip was moved in a wide range of directions by unrestricted movements of the arm. Mean errors in apposition of the right to the left index finger tips were small, averaging <2 cm between sensors fixed to the finger nails. Note that the average distance between the sensors was ~1.7 cm when the fingertips were brought together in “perfect” apposition under visual guidance. The 3D mean distance and variable distance errors were marginally lower by some 2 mm with eyes open compared to the eyes closed active condition. However, mean distance and variable distance errors did not differ between the active and passive conditions with eyes closed. Thus, proprioceptive localization of one's moving hand is very accurate, essentially as accurate as when vision is allowed. More importantly, our results demonstrate that hypothesized internal model derived estimates of arm kinematics do not contribute to localization accuracy beyond that provided by sensory signals, casting doubt on their existence.