The effects of digital anesthesia on force control using a precision grip

PVA/PANI-DBSA Nanomesh Tactile Sensor for Force Feedback

Touch serves as an important medium for human-environment interaction. The piezoresistive tactile sensor has attracted much attention due to its convenient technology, simple principle, and convenient signal acquisition and analysis. In this paper, conductive beads-on-string polyvinyl alcohol (PVA)/polyaniline doped with dodecyl benzene sulfonic acid (PANI-DBSA) nanofibers were fabricated via the electrospinning technique. Due to the special nanostructure of PVA-coated PANI-DBSA, the tactile sensor presented a wide measuring range of 12 Pa-121 kPa and appreciable sensitivity of 8.576 kPa-1 at 12 Pa~484 Pa. In addition, the response time and recovery time of the sensor were approximately 500 ms, demonstrating promising prospects in the field of tactile sensing for active upper limb prostheses.

Comparison of tactile acuity between patients with chronic patellofemoral pain with central sensitization and healthy persons: A cross-sectional study

BACKGROUND

Patellofemoral pain (PFP) is a common multifactorial condition in young and physically active people.

OBJECTIVE

The occurrence of central sensitization may play an important role in sensory disturbance. This study was designed to investigate, in patients with chronic PFP, the presence of disturbances in tactile acuity with central sensitization.

METHODS

Thirty patients with chronic PFP and 30 matched healthy controls entered this cross-sectional study. Graphesthesia (numerical score), two-point discrimination (mm), and point-to-point sensation (mm) were assessed in all participants.

RESULTS

The results of between-group comparisons showed that there were significant differences between the involved knee in patients with chronic PFP and healthy participants in graphesthesia (median = 13 [case], 19 [control]; p < .001), two-point discrimination (median = 25.8 [case], 20.3 [control]; p < .001), and point-to-point sensation (median = 14.5 [case], 6.2 [control]; p < .001). There was also a significant difference in graphesthesia between the non-involved knee in patients with chronic PFP and healthy participants (median = 17 [case], 19 [control]; p = .003). The results of within-group comparisons revealed a significant difference in graphesthesia, two-point discrimination, and point-to-point sensation between the involved and non-involved knee in patients with chronic PFP (p < .001). Moreover, there was a positive correlation between two-point discrimination and pain in patients with chronic PFP (r = 0.446, p = .014).

CONCLUSION

The findings of this study reveal that there is a sensory deficit in patients with chronic PFP. Because sensory information is necessary for motor control and pain perception, we can assume that clinical symptoms in these patients are related to sensory deficits.

Open-Source Instrumented Object to Study Dexterous Object Manipulation

Humans use tactile feedback to perform skillful manipulation. When tactile sensory feedback is unavailable, for instance, if the fingers are anesthetized, dexterity is severely impaired. Imaging the deformation of the finger pad skin when in contact with a transparent plate provides information about the tactile feedback received by the central nervous system. Indeed, skin deformations are transduced into neural signals by the mechanoreceptors of the finger pad skin. Understanding how this feedback is used for active object manipulation would improve our understanding of human dexterity. In this paper, we present a new device for imaging the skin of the finger pad of one finger during manipulation performed with a precision grip. The device's mass (300 g) makes it easy to use during unconstrained dexterous manipulation. Using this device, we reproduced the experiment performed in Delhaye et al. (2021) We extracted the strains aligned with the object's movement, i.e., the vertical strains in the ulnar and radial parts of the fingerpad, to see how correlated they were with the grip force (GF) adaptation. Interestingly, parts of our results differed from those in Delhaye et al. (2021) due to weight and inertia differences between the devices, with average GF across participants differing significantly. Our results highlight a large variability in the behavior of the skin across participants, with generally low correlations between strain and GF adjustments, suggesting that skin deformations are not the primary driver of GF adaptation in this manipulation scenario.

The effect of type 2 diabetes and diabetic peripheral neuropathy on predictive grip force control

This study investigated the impact of type 2 diabetes and diabetic peripheral neuropathy on grip force control during object manipulation. The study included three age-matched groups: type 2 diabetes alone (n = 11), type 2 diabetes with neuropathy (n = 13), and healthy controls (n = 12). Grip force control variables derived from lifting and holding an experimental cup were the ratio between grip force and load forces during lifting (GFR), latency 1 and latency 2, which represented the time between the object's grip and its lift-off from the table, and the period between object's lift-off and the grip force peak, respectively; time lag, which denoted the time difference between the grip and load force peaks during the lifting phase, and finally static force, which was the grip force average during the holding phase. Grip force control variables were compared between groups using one-way ANOVA and Kruskal-Wallis test. Post-hoc analysis was used to compare differences between groups. GFR and latency 1 showed significant differences between groups; the type 2 diabetes with neuropathy group showed larger GFR than the type 2 diabetes alone and healthy control groups. The latency 1was longer for the group with neuropathy in comparison with the health control group. There were no significant differences between groups for latency 2, time lag, and static force. Our results showed impaired GFR and latency 1 in participants with type 2 diabetes with neuropathy while the time lag was preserved. People with type 2 diabetes alone might not have any deficits in grip force control. Higher grip forces might expose people with type 2 diabetes and diabetic peripheral neuropathy to the risk of fatigue and injuring their hands. Future studies should investigate strategies to help people with type 2 diabetes with neuropathy adjust grip forces during object manipulation.

Brain-machine interface learning is facilitated by specific patterning of distributed cortical feedback

Neuroprosthetics offer great hope for motor-impaired patients. One obstacle is that fine motor control requires near-instantaneous, rich somatosensory feedback. Such distributed feedback may be recreated in a brain-machine interface using distributed artificial stimulation across the cortical surface. Here, we hypothesized that neuronal stimulation must be contiguous in its spatiotemporal dynamics to be efficiently integrated by sensorimotor circuits. Using a closed-loop brain-machine interface, we trained head-fixed mice to control a virtual cursor by modulating the activity of motor cortex neurons. We provided artificial feedback in real time with distributed optogenetic stimulation patterns in the primary somatosensory cortex. Mice developed a specific motor strategy and succeeded to learn the task only when the optogenetic feedback pattern was spatially and temporally contiguous while it moved across the topography of the somatosensory cortex. These results reveal spatiotemporal properties of the sensorimotor cortical integration that set constraints on the design of neuroprosthetics.

Neural Correlates of Impaired Grasp Function in Children with Unilateral Spastic Cerebral Palsy

Unilateral spastic cerebral palsy (USCP) is caused by damage to the developing brain and affects motor function, mainly lateralized to one side of the body. Children with USCP have difficulties grasping objects, which can affect their ability to perform daily activities. Although cerebral palsy is typically classified according to motor function, sensory abnormalities are often present as well and may contribute to motor impairments, including grasping. In this review, we show that the integrity and connectivity pattern of the corticospinal tract (CST) is related to execution and anticipatory control of grasping. However, as this may not explain all the variance of impairments in grasping function, we also describe the potential roles of sensory and sensorimotor integration deficits that contribute to grasp impairments. We highlight studies measuring fingertip forces during object manipulation tasks, as this approach allows for the dissection of the close association of sensory and motor function and can detect the discriminant use of sensory information during a complex, functional task (i.e., grasping). In addition, we discuss the importance of examining the interactions of the sensory and motor systems together, rather than in isolation. Finally, we suggest future directions for research to understand the underlying mechanisms of grasp impairments.

Biomimetic multi-channel microstimulation of somatosensory cortex conveys high resolution force feedback for bionic hands

Manual interactions with objects are supported by tactile signals from the hand. This tactile feedback can be restored in brain-controlled bionic hands via intracortical microstimulation (ICMS) of somatosensory cortex (S1). In ICMS-based tactile feedback, contact force can be signaled by modulating the stimulation intensity based on the output of force sensors on the bionic hand, which in turn modulates the perceived magnitude of the sensation. In the present study, we gauged the dynamic range and precision of ICMS-based force feedback in three human participants implanted with arrays of microelectrodes in S1. To this end, we measured the increases in sensation magnitude resulting from increases in ICMS amplitude and participant's ability to distinguish between different intensity levels. We then assessed whether we could improve the fidelity of this feedback by implementing "biomimetic" ICMS-trains, designed to evoke patterns of neuronal activity that more closely mimic those in natural touch, and by delivering ICMS through multiple channels at once. We found that multi-channel biomimetic ICMS gives rise to stronger and more distinguishable sensations than does its single-channel counterpart. Finally, we implemented biomimetic multi-channel feedback in a bionic hand and had the participant perform a compliance discrimination task. We found that biomimetic multi-channel tactile feedback yielded improved discrimination over its single-channel linear counterpart. We conclude that multi-channel biomimetic ICMS conveys finely graded force feedback that more closely approximates the sensitivity conferred by natural touch.

Learning in a closed-loop brain-machine interface with distributed optogenetic cortical feedback

Objective.Distributed microstimulations at the cortical surface can efficiently deliver feedback to a subject during the manipulation of a prosthesis through a brain-machine interface (BMI). Such feedback can convey vast amounts of information to the prosthesis user and may be key to obtain an accurate control and embodiment of the prosthesis. However, so far little is known of the physiological constraints on the decoding of such patterns. Here, we aimed to test a rotary optogenetic feedback that was designed to encode efficiently the 360° movements of the robotic actuators used in prosthetics. We sought to assess its use by mice that controlled a prosthesis joint through a closed-loop BMI.Approach.We tested the ability of mice to optimize the trajectory of a virtual prosthesis joint in order to solve a rewarded reaching task. They could control the speed of the joint by modulating the activity of individual neurons in the primary motor cortex. During the task, the patterned optogenetic stimulation projected on the primary somatosensory cortex continuously delivered information to the mouse about the position of the joint.Main results.We showed that mice are able to exploit the continuous, rotating cortical feedback in the active behaving context of the task. Mice achieved better control than in the absence of feedback by detecting reward opportunities more often, and also by moving the joint faster towards the reward angular zone, and by maintaining it longer in the reward zone. Mice controlling acceleration rather than speed of the joint failed to improve motor control.Significance.These findings suggest that in the context of a closed-loop BMI, distributed cortical feedback with optimized shapes and topology can be exploited to control movement. Our study has direct applications on the closed-loop control of rotary joints that are frequently encountered in robotic prostheses.

Influence of emotion on precision grip force control: A comparison of pleasant and neutral emotion

Objective

The present study aimed to investigate the impact of emotion on force steadiness of isometric precision pinch grip that is not direction-specific.

Methods

Thirty-two healthy volunteer subjects participated in the present study. Subjects were divided into two experimental groups: pleasant image group and neutral image group. The isometric precision pinch grip task was performed for three times. Specifically, the first task was performed before pleasant or neutral picture viewing, the second task was performed immediately after picture viewing, further the third task was performed 30 seconds after the second task. During the isometric precision pinch grip task, participants were asked to exert pinch grip force at 10% of maximal voluntary contraction with visual feedback. The coefficient of variation of force production and normalized root mean square value of electromyography activity were calculated.

Results

After pleasant picture viewing, coefficient of variation of pinch force production and normalized root mean square value of electromyography was decreased. While, in the neutral image condition, theses variables were not altered. More important, compared to the neutral image condition, pleasant emotion led to lower coefficient of variation of pinch grip force production.

Conclusion

These findings indicate that pleasant emotion improves force control of isometric precision pinch grip. Therefore, in clinical settings, the emotional state of patients may affect the effectiveness of rehabilitation and should be taken into consideration.

Control of Mammalian Locomotion by Somatosensory Feedback

When animals walk overground, mechanical stimuli activate various receptors located in muscles, joints, and skin. Afferents from these mechanoreceptors project to neuronal networks controlling locomotion in the spinal cord and brain. The dynamic interactions between the control systems at different levels of the neuraxis ensure that locomotion adjusts to its environment and meets task demands. In this article, we describe and discuss the essential contribution of somatosensory feedback to locomotion. We start with a discussion of how biomechanical properties of the body affect somatosensory feedback. We follow with the different types of mechanoreceptors and somatosensory afferents and their activity during locomotion. We then describe central projections to locomotor networks and the modulation of somatosensory feedback during locomotion and its mechanisms. We then discuss experimental approaches and animal models used to investigate the control of locomotion by somatosensory feedback before providing an overview of the different functional roles of somatosensory feedback for locomotion. Lastly, we briefly describe the role of somatosensory feedback in the recovery of locomotion after neurological injury. We highlight the fact that somatosensory feedback is an essential component of a highly integrated system for locomotor control. © 2021 American Physiological Society. Compr Physiol 11:1-71, 2021.

Effect of Object Texture and Weight on Ipsilateral Corticospinal Influences During Bimanual Holding in Humans

We tested the hypothesis that the ipsilateral corticospinal system, like the contralateral corticospinal system, controls the threshold muscle length at which wrist muscles and the stretch reflex begin to act during holding tasks. Transcranial magnetic stimulation was applied over the right primary motor cortex in 21 healthy subjects holding a smooth or coarse block between the hands. Regardless of the lifting force, motor evoked potentials in right wrist flexors were larger for the smooth block. This result was explained based on experimental evidence that motor actions are controlled by shifting spatial stretch reflex thresholds. Thus, the ipsilateral corticospinal system is involved in threshold position control by modulating facilitatory influences of hand skin afferents on motoneurons of wrist muscles during bimanual object manipulation.

Aging and Bimanual Effects on Finger Center of Pressure during Precision Grip: Different Strategies for Spatial Stability

The purpose of this study was to examine aging and bimanual effects on finger spatial stability during precision grip. Twenty-one older and 21 younger adults performed precision grip tasks consisting of a single task (grip and lift an object with the thumb and index finger) and a dual task (the grip-lifting task with one hand and a peg board task with the other hand). The center of pressure (COP) trajectory and the grip force were evaluated using a pressure sensor with a high spatial resolution. In the COP trajectory, the main effects of age for the thumb (F_1,140 = 46.17, p < 0.01) and index finger (F_1,140 = 22.14, p < 0.01) and task difficulty for the thumb (F_1,140 = 6.47, p = 0.01) were significant based on ANCOVA. The COP trajectory was statistically decreased in the older adults. The COP trajectory was also decreased in the dual task, regardless of age. The results suggest the existence of a safety strategy to prioritize the spatial stability in the elderly group and in the dual task. This study provides new insights into the interpretation of the COP trajectory.

Initial contact shapes the perception of friction

Humans have the remarkable ability to manipulate a large variety of objects, regardless of how fragile, heavy, or slippery they are. To correctly scale the grip forces, the nervous system gauges the slipperiness of the surface. This information is present at the instant we first touch an object, even before any lateral force develops. However, how friction could be estimated without slippage only from the fingertip skin deformation is not understood, either in neuroscience or engineering disciplines. This study demonstrates that a radial tensile strain of the skin is involved in the perception of slipperiness during this initial contact. These findings can inform the design of advanced tactile sensors for robotics or prosthetics and for improving haptic human–machine interactions.

Humans efficiently estimate the grip force necessary to lift a variety of objects, including slippery ones. The regulation of grip force starts with the initial contact and takes into account the surface properties, such as friction. This estimation of the frictional strength has been shown to depend critically on cutaneous information. However, the physical and perceptual mechanism that provides such early tactile information remains elusive. In this study, we developed a friction-modulation apparatus to elucidate the effects of the frictional properties of objects during initial contact. We found a correlation between participants’ conscious perception of friction and radial strain patterns of skin deformation. The results provide insights into the tactile cues made available by contact mechanics to the sensorimotor regulation of grip, as well as to the conscious perception of the frictional properties of an object.

Testing silicone digit extensions as a way to suppress natural sensation to evaluate supplementary tactile feedback

Dexterous use of the hands depends critically on sensory feedback, so it is generally agreed that functional supplementary feedback would greatly improve the use of hand prostheses. Much research still focuses on improving non-invasive feedback that could potentially become available to all prosthesis users. However, few studies on supplementary tactile feedback for hand prostheses demonstrated a functional benefit. We suggest that confounding factors impede accurate assessment of feedback, e.g., testing non-amputee participants that inevitably focus intently on learning EMG control, the EMG’s susceptibility to noise and delays, and the limited dexterity of hand prostheses. In an attempt to assess the effect of feedback free from these constraints, we used silicone digit extensions to suppress natural tactile feedback from the fingertips and thus used the tactile feedback-deprived human hand as an approximation of an ideal feed-forward tool. Our non-amputee participants wore the extensions and performed a simple pick-and-lift task with known weight, followed by a more difficult pick-and-lift task with changing weight. They then repeated these tasks with one of three kinds of audio feedback. The tests were repeated over three days. We also conducted a similar experiment on a person with severe sensory neuropathy to test the feedback without the extensions. Furthermore, we used a questionnaire based on the NASA Task Load Index to gauge the subjective experience. Unexpectedly, we did not find any meaningful differences between the feedback groups, neither in the objective nor the subjective measurements. It is possible that the digit extensions did not fully suppress sensation, but since the participant with impaired sensation also did not improve with the supplementary feedback, we conclude that the feedback failed to provide relevant grasping information in our experiments. The study highlights the complex interaction between task, feedback variable, feedback delivery, and control, which seemingly rendered even rich, high-bandwidth acoustic feedback redundant, despite substantial sensory impairment.

Neural correlates of tactile hardness intensity perception during active grasping

While tactile sensation plays an essential role in interactions with the surroundings, relatively little is known about the neural processes involved in the perception of tactile information. In particular, it remains unclear how different intensities of tactile hardness are represented in the human brain during object manipulation. This study aims to investigate neural responses to various levels of tactile hardness using functional magnetic resonance imaging while people grasp objects to perceive hardness intensity. We used four items with different hardness levels but otherwise identical in shape and texture. A total of Twenty-five healthy volunteers participated in this study. Before scanning, participants performed a behavioral task in which they received a pair of stimuli and they were to report the perceived difference of hardness between them. During scanning, without any visual information, they were randomly given one of the four objects and asked to grasp it. We found significant blood oxygen-level-dependent (BOLD) responses in the posterior insula in the right hemisphere (rpIns) and the right posterior lobe of the cerebellum (rpCerebellum), which parametrically tracked hardness intensity. These responses were supported by BOLD signal changes in the rpCerebellum and rpIns correlating with tactile hardness intensity. Multidimensional scaling analysis showed similar representations of hardness intensity among physical, perceptual, and neural information. Our findings demonstrate the engagement of the rpCerebellum and rpIns in perceiving tactile hardness intensity during active object manipulation.

Evoking highly focal percepts in the fingertips through targeted stimulation of sulcal regions of the brain for sensory restoration

Background:

Paralysis and neuropathy, affecting millions of people worldwide, can be accompanied by significant loss of somatosensation. With tactile sensation being central to achieving dexterous movement, brain-computer interface (BCI) researchers have used intracortical and cortical surface electrical stimulation to restore somatotopically-relevant sensation to the hand. However, these approaches are restricted to stimulating the gyral areas of the brain. Since representation of distal regions of the hand extends into the sulcal regions of human primary somatosensory cortex (S1), it has been challenging to evoke sensory percepts localized to the fingertips.

Objective/hypothesis:

Targeted stimulation of sulcal regions of S1, using stereoelectroencephalography (SEEG) depth electrodes, can evoke focal sensory percepts in the fingertips.

Methods:

Two participants with intractable epilepsy received cortical stimulation both at the gyri via high-density electrocorticography (HD-ECoG) grids and in the sulci via SEEG depth electrode leads. We characterized the evoked sensory percepts localized to the hand.

Results:

We show that highly focal percepts can be evoked in the fingertips of the hand through sulcal stimulation. fMRI, myelin content, and cortical thickness maps from the Human Connectome Project elucidated specific cortical areas and sub-regions within S1 that evoked these focal percepts. Within-participant comparisons showed that percepts evoked by sulcal stimulation via SEEG electrodes were significantly more focal (80% less area; p = 0.02) and localized to the fingertips more often, than by gyral stimulation via HD-ECoG electrodes. Finally, sulcal locations with consistent modulation of high-frequency neural activity during mechanical tactile stimulation of the fingertips showed the same somatotopic correspondence as cortical stimulation.

Conclusions:

Our findings indicate minimally invasive sulcal stimulation via SEEG electrodes could be a clinically viable approach to restoring sensation.

Dependence and reduced motor function in heart failure: future directions for well-being

While patients with heart failure experience a wide range of symptoms, evidence is mounting that patients with heart failure suffer from reduced functional independence. Given that the number of patients with heart failure is rising and considering the adverse outcomes of reduced functional independence, understanding the underlying mechanisms of reduced functionality in patients with heart failure is of increasing importance. Yet, little information exists on how heart failure negatively affects functional independence, including motor function. This article summarizes reports of reduced independence and highlights its significant adverse outcomes in the patients with heart failure. Finally, this article discusses potential causes of reduced independence based on existing reports of impaired central and peripheral nervous systems in the patients with heart failure. Overall, the article provides a solid foundation for future studies investigating motor impairments in patients with heart failure. Such studies may lead to advances in treatment and prevention of reduced independence associated with heart failure, which ultimately contribute to the well-being of patients with heart failure.

Fine adaptive precision grip control without maximum pinch strength changes after upper limb neurodynamic mobilization

Before and immediately after passive upper limb neurodynamic mobilizations targeting the median nerve, grip (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$G_F$$\end{document}GF) and load (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$L_F$$\end{document}LF) forces applied by the thumb, index and major fingers (three-jaw chuck pinch) were collected using a manipulandum during three different grip precision tasks: grip-lift-hold-replace (GLHR), vertical oscillations (OSC), and vertical oscillations with up and down collisions (OSC/COLL/u, OSC/COLL/d). Several parameters were collected or computed from \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$G_F$$\end{document}GF and \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$L_F$$\end{document}LF. Maximum pinch strength and fingertips pressure sensation threshold were also examined. After the mobilizations, \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$L_F$$\end{document}LF max changes from 3.2 ± 0.4 to 3.4 ± 0.4 N (p = 0.014), d\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$G_F$$\end{document}GF from 89.0 ± 66.6 to 102.2 ± 59.6 \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$N~\text{s}^{-1}$$\end{document}Ns-1 (p = 0.009), and d\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$L_F$$\end{document}LF from 43.6 ± 17.0 to 56.0 ± 17.9 \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$N~\text{s}^{-1}$$\end{document}Ns-1 (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$p<$$\end{document}p<0.001) during GLHR. \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$L_F$$\end{document}LF SD changes from 0.9 ± 0.3 to 1.0 ± 0.2 N (p = 0.004) during OSC. \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$L_F$$\end{document}LF peak changes from 17.4 ± 8.3 to 15.1 ± 7.5 N (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$p<$$\end{document}p<0.001), \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$G_F$$\end{document}GF from 12.4 ± 6.7 to 11.3 ± 6.8 N (p = 0.033), and \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$L_F$$\end{document}LF from 2.9 ± 0.4 to 3.00 ± 0.4 N (p = 0.018) during OSC/COLL/u. \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$G_F$$\end{document}GF peak changes from 13.5 ± 7.4 to 12.3 ± 7.7 N (p = 0.030) and \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$L_F$$\end{document}LF from 14.5 ± 6.0 to 13.6 ± 5.5 N (p = 0.018) during OSC/COLL/d. Sensation thresholds at index and thumb were reduced (p = 0.001, p = 0.008). Precision grip adaptations observed after the mobilizations could be partly explained by changes in cutaneous median-nerve pressure afferents from the thumb and index fingertips.

Anticipation and compensation for somatosensory deficits in object handling: evidence from a patient with large fiber sensory neuropathy

The purpose of this study was to determine the contributions of feedforward and feedback processes on grip force regulation and object orientation during functional manipulation tasks. One patient with massive somatosensory loss resulting from large fiber sensory neuropathy and 10 control participants were recruited. Three experiments were conducted: 1) perturbation to static holding; 2) discrete vertical movement; and 3) functional grasp and place. The availability of visual feedback was also manipulated to assess the nature of compensatory mechanisms. Results from experiment 1 indicated that both the deafferented patient and controls used anticipatory grip force adjustments before self-induced perturbation to static holding. The patient exhibited increased grip response time, but the magnitude of grip force adjustments remained correlated with perturbation forces in the self-induced and external perturbation conditions. In experiment 2, the patient applied peak grip force substantially in advance of maximum load force. Unlike controls, the patient's ability to regulate object orientation was impaired without visual feedback. In experiment 3, the duration of unloading, transport, and release phases were longer for the patient, with increased deviation of object orientation at phase transitions. These findings show that the deafferented patient uses distinct modes of anticipatory control according to task constraints and that responses to perturbations are mediated by alternative afferent information. The loss of somatosensory feedback thus appears to impair control of object orientation, whereas variation in the temporal organization of functional tasks may reflect strategies to mitigate object instability associated with changes in movement dynamics.NEW & NOTEWORTHY This study evaluates the effects of sensory neuropathy on the scaling and timing of grip force adjustments across different object handling tasks (i.e., holding, vertical movement, grasping, and placement). In particular, these results illustrate how novel anticipatory and online control processes emerge to compensate for the loss of somatosensory feedback. In addition, we provide new evidence on the role of somatosensory feedback for regulating object orientation during functional prehensile movement.

Impairment and Compensation in Dexterous Upper-Limb Function After Stroke. From the Direct Consequences of Pyramidal Tract Lesions to Behavioral Involvement of Both Upper-Limbs in Daily Activities

Impairments in dexterous upper limb function are a significant cause of disability following stroke. While the physiological basis of movement deficits consequent to a lesion in the pyramidal tract is well demonstrated, specific mechanisms contributing to optimal recovery are less apparent. Various upper limb interventions (motor learning methods, neurostimulation techniques, robotics, virtual reality, and serious games) are associated with improvements in motor performance, but many patients continue to experience significant limitations with object handling in everyday activities. Exactly how we go about consolidating adaptive motor behaviors through the rehabilitation process thus remains a considerable challenge. An important part of this problem is the ability to successfully distinguish the extent to which a given gesture is determined by the neuromotor impairment and that which is determined by a compensatory mechanism. This question is particularly complicated in tasks involving manual dexterity where prehensile movements are contingent upon the task (individual digit movement, grasping, and manipulation…) and its objective (placing, two step actions…), as well as personal factors (motivation, acquired skills, and life habits…) and contextual cues related to the environment (presence of tools or assistive devices…). Presently, there remains a lack of integrative studies which differentiate processes related to structural changes associated with the neurological lesion and those related to behavioral change in response to situational constraints. In this text, we shall question the link between impairments, motor strategies and individual performance in object handling tasks. This scoping review will be based on clinical studies, and discussed in relation to more general findings about hand and upper limb function (manipulation of objects, tool use in daily life activity). We shall discuss how further quantitative studies on human manipulation in ecological contexts may provide greater insight into compensatory motor behavior in patients with a neurological impairment of dexterous upper-limb function.

Exploring the Use of Brain-Computer Interfaces in Stroke Neurorehabilitation

With the continuous development of artificial intelligence technology, "brain-computer interfaces" are gradually entering the field of medical rehabilitation. As a result, brain-computer interfaces (BCIs) have been included in many countries' strategic plans for innovating this field, and subsequently, major funding and talent have been invested in this technology. In neurological rehabilitation for stroke patients, the use of BCIs opens up a new chapter in "top-down" rehabilitation. In our study, we first reviewed the latest BCI technologies, then presented recent research advances and landmark findings in BCI-based neurorehabilitation for stroke patients. Neurorehabilitation was focused on the areas of motor, sensory, speech, cognitive, and environmental interactions. Finally, we summarized the shortcomings of BCI use in the field of stroke neurorehabilitation and the prospects for BCI technology development for rehabilitation.

A brain-computer interface that evokes tactile sensations improves robotic arm control

Prosthetic arms controlled by a brain-computer interface can enable people with tetraplegia to perform functional movements. However, vision provides limited feedback because information about grasping objects is best relayed through tactile feedback. We supplemented vision with tactile percepts evoked using a bidirectional brain-computer interface that records neural activity from the motor cortex and generates tactile sensations through intracortical microstimulation of the somatosensory cortex. This enabled a person with tetraplegia to substantially improve performance with a robotic limb; trial times on a clinical upper-limb assessment were reduced by half, from a median time of 20.9 to 10.2 seconds. Faster times were primarily due to less time spent attempting to grasp objects, revealing that mimicking known biological control principles results in task performance that is closer to able-bodied human abilities.

The Relationship Between Corticomotor Reorganization and Acute Pain Severity: A Randomized, Controlled Study Using Rapid Transcranial Magnetic Stimulation Mapping

OBJECTIVE

Although acute pain has been shown to reduce corticomotor excitability, it remains unknown whether this response resolves over time or is related to symptom severity. Furthermore, acute pain research has relied upon data acquired from the cranial "hotspot," which do not provide valuable information regarding reorganization, such as changes to the distribution of a painful muscle's representation within M1. Using a novel, rapid transcranial magnetic stimulation (TMS) mapping method, this study aimed to 1) explore the temporal profile and variability of corticomotor reorganization in response to acute pain and 2) determine whether individual patterns of corticomotor reorganization are associated with differences in pain, sensitivity, and somatosensory organization.

METHODS

Corticomotor (TMS maps), pain processing (pain intensity, pressure pain thresholds), and somatosensory (two-point discrimination, two-point estimation) outcomes were taken at baseline, immediately after injection (hypertonic [n = 20] or isotonic saline [n = 20]), and at pain resolution. Follow-up measures were recorded every 15 minutes until 90 minutes after injection.

RESULTS

Corticomotor reorganization persisted at least 90 minutes after pain resolution. Corticomotor depression was associated with lower pain intensity than was corticomotor facilitation (r = 0.47 [P = 0.04]). These effects were not related to somatosensory reorganization or peripheral sensitization mechanisms.

CONCLUSIONS

Individual patterns of corticomotor reorganization during acute pain appear to be related to symptom severity, with early corticomotor depression possibly reflecting a protective response. These findings hold important implications for the management and potential prevention of pain chronicity. However, further research is required to determine whether these adaptations relate to long-term outcomes in clinical populations.

Influence of Stochastic Resonance on Manual Dexterity in Children With Developmental Coordination Disorder: A Double-Blind Interventional Study

Background: There is increasing evidence that the stochastic resonance (SR) phenomenon provided by subthreshold mechanical noise stimulation improves the sensory-motor system. However, the effect of SR on children with developmental coordination disorder (DCD) is unclear. The purpose of this study was to assess whether SR activated by subthreshold vibrotactile noise stimulation of the wrist influences manual dexterity in children with DCD.

Methods: A double-blind interventional study was conducted. Participants were 30 children (age: 9.3 ± 1.44 years, range 6–11 years; 27 male, three female; 25 right-handed, five left-handed) meeting DCD diagnostic criteria in DSM-5. The manual dexterity test was administered the day before SR intervention (baseline-data). SR was elicited using subthreshold vibrotactile noise stimulation at 60% of the vibrotactile threshold measured at the wrist. SR was delivered two times and the manual dexterity test was administered during each SR stimulation block (SR-on condition) and after each SR stimulation block (SR-off), for a total of four measurements. Target outcomes were the component score, the standard score, and the percentile score of the manual dexterity test.

Results: The manual dexterity test scores in the SR-on condition were significantly improved compared to scores at the baseline and in the SR-off condition (p < 0.001).

Conclusions: The present study showed that subthreshold noise stimulation eliciting SR significantly improved manual dexterity outcomes in children with DCD during stimulation but not after stimulation. Future studies will need to investigate the carry-over effects of SR stimulation.

Unveiling the neuromechanical mechanisms underlying the synergistic interactions in human sensorimotor system

Motor synergies are neural organizations of a set of redundant motor effectors that interact with one another to compensate for each other’s error and ensure the stabilization of a performance variable. Recent studies have demonstrated that central nervous system synergistically coordinates its numerous motor effectors through Bayesian multi-sensory integration. Deficiency in sensory synergy weakens the synergistic interaction between the motor effectors. Here, we scrutinize the neuromechanical mechanism underlying this phenomenon through spectral analysis and modeling. We validate our model-generated results using experimental data reported in the literature collected from participants performing a finger force production task with and without tactile feedback (manipulated through injection of anesthetic in fingers). Spectral analysis reveals that the error compensation feature of synergies occurs only at low frequencies. Modeling suggests that the neurophysiological structures involving short-latency back-coupling loops similar to the well-known Renshaw cells explain the deterioration of synergy due to sensory deprivation.

Increased visual bias in children with developmental coordination disorder: Evidence from a visual-tactile temporal order judgment task

BACKGROUND

Previous studies have suggested that children with developmental coordination disorder (DCD) rely heavily on vision to perform movements, which may contribute to their clumsy movements. However, few studies have objectively and quantitatively investigated the perceptual biases of children with DCD.

METHODS

A visual-tactile temporal order judgment (TOJ) task was used to measure and compare the perceptual biases of 19 children with DCD and 19 age- and sex-matched typically developing children. The point of subjective equality, which demonstrates when "visual first" and "tactile first" judgment probabilities are equal (50%), obtained by analyzing the results of the visual-tactile TOJ task, was used as an indicator of perceptual biases. Further, variables (age and manual dexterity in all participants; motor function, autism spectrum disorder and attention-deficit hyperactivity disorder traits, and depressive symptoms in children with DCD) associated with perceptual biases were examined with correlation analysis.

RESULTS

Children with DCD had significantly stronger visual bias than typically developing children. Overall correlation analysis showed that increased visual bias was significantly correlated with poor manual dexterity.

CONCLUSION

Children with DCD had a strong visual bias, which was associated with poor manual dexterity.

Sensory-to-Motor Overflow: Cooling Foot Soles Impedes Squat Jump Performance

Evidence from recent studies on animals and humans suggest that neural overflow from the primary sensory cortex (S1) to the primary motor cortex (M1) may play a critical role in motor control. However, it is unclear if whole-body maximal motor tasks are also governed by this mechanism. Maximum vertical squat jumps were performed by 15 young adults before cooling, then immediately following a 15-min cooling period using an ice-water bath for the foot soles, and finally immediately following a 15-min period of natural recovery from cooling. Jump heights were, on average, 3.1 cm lower immediately following cooling compared to before cooling (p = 3.39 × 10⁻⁸) and 1.9 cm lower following natural recovery from cooling (p = 0.00124). The average vertical ground reaction force (vGRF) was also lower by 78.2 N in the condition immediately following cooling compared to before cooling (p = 8.1 × 10⁻⁵) and 56.7N lower following natural recovery from cooling (p = 0.0043). The current study supports the S1-to-M1 overflow mechanism in a whole-body dynamic jump.

A Computational Internal Model to Quantify the Effect of Sensorimotor Augmentation on Motor Output

The aging process, as well as neurological disorders, causes a decline in sensorimotor functions, which can often bring degraded motor output. As a means of compensation for such sensorimotor deficiencies, sensorimotor augmentation has been actively investigated. Consequently, exoskeleton devices or functional electrical stimulation could augment the muscle activity, while textured surfaces or electrical nerve stimulations could augment the sensory feedback. However, it is not easy to precisely anticipate the effects of specific augmentation because sensory feedback and motor output interact with each other as a closed-loop operation via the central and peripheral nervous systems. A computational internal model can play a crucial role in anticipating such an effect of augmentation therapy on the motor outcome. Still, no existing internal sensorimotor loop model has been represented in a complete computational form facilitating the anticipation. This paper presents such a computational internal model, including numerical values representing the effect of sensorimotor augmentation. With the existing experimental results, the model performance was evaluated indirectly. The change of sensory gain affects motor output inversely, while the change of motor gain did not change or minimally affects the motor output.Clinical Relevance- The presented computational internal model will provide a simple and easy tool for clinicians to design therapeutic intervention using sensorimotor augmentation.

Evaluation of Load Distributions and Contact Areas in 4 Common Grip Types Used in Daily Living Activities

PURPOSE

Grip analysis systems, with sensors quantifying load distributions and contact areas applied by the hand while grasping objects, are useful for collecting and recording instant data; these systems are popular in hand assessment. The purpose of this study was to determine the load distribution (LD) and contact area (CA) size of the palmar surface of the hand during 4 common grip types used in activities of daily living (standard, lateral, pinch, and tripod grips).

METHODS

A convenience sample of 80 right-handed subjects were enrolled in this study. Participants wore special gloves equipped with sensors and grasped a variety of objects. Contact area size and LD were determined for the 4 grip types.

RESULTS

The CA and the LD were different for each grip. For standard grip, although the largest CA occurred at the metacarpophalangeal joint level, the largest LD was over the middle finger pulp. For standard grip, index, middle, and ring fingers appear to be loaded with almost the same frequency as the thumb. Although CA on the thumb was maximum in the pinch, lateral and tripod grip types, the LD on the thumb was not.

CONCLUSIONS

This study shows that the LD and CA patterns differ widely among standard, pinch, lateral, and tripod grips. The percentage of CA occurring on the thumb was maximum in all grip types.

CLINICAL RELEVANCE

This information is important to optimize the design of artificial manipulators or assistive devices and to optimize the hand rehabilitation process. In addition, results of the study can be used to guide the design of prostheses and biomedical implants better.

Manual Dexterity is not Related to Media Viewing but is Related to Perceptual Bias in School-Age Children

Although the media can have both negative and positive effects on children’s cognitive and motor functions, its influence on their perceptual bias and manual dexterity is unclear. Thus, we investigated the association between media viewing time, media preference level, perceptual bias, and manual dexterity in 100 school-aged children. Questionnaires completed by children and their parents were used to ascertain media viewing time and preference levels. Perceptual bias and manual dexterity were measured using the visual-tactile temporal order judgment task and Movement Assessment Battery for Children—2nd edition, respectively. There were significant positive correlations between age and media viewing time and between media viewing time and media preference level. There was also a significant negative correlation between visual bias and manual dexterity. Hierarchical multiple regression analysis revealed that increasing visual bias was a significant predictor of decreasing manual dexterity. Further, children with low manual dexterity showed significant visual bias compared to those with high manual dexterity, when matched for age and gender. The present results demonstrated that, in school-aged children, although viewing media was not associated with perceptual bias and manual dexterity, there was a significant association between perceptual bias and manual dexterity.

A Finger Grip Force Sensor with an Open-Pad Structure for Glove-Type Assistive Devices

This paper presents a fingertip grip force sensor based on custom capacitive sensors for glove-type assistive devices with an open-pad structure. The design of the sensor allows using human tactile sensations during grasping and manipulating an object. The proposed sensor can be attached on both sides of the fingertip and measure the force caused by the expansion of the fingertip tissue when a grasping force is applied to the fingertip. The number of measurable degrees of freedom (DoFs) are the two DoFs (flexion and adduction) for the thumb and one DoF (flexion) for the index and middle fingers. The proposed sensor allows the combination with a glove-type assistive device to measure the fingertip force. Calibration was performed for each finger joint angle because the variations in the expansion of the fingertip tissue depend on the joint angles. The root mean square error (RMSE) for fingertip force estimation ranged from 3.75% to 9.71% after calibration, regardless of the finger joint angles or finger posture.

Force-stabilizing synergies can be retained by coordinating sensory-blocked and sensory-intact digits

The present study examined the effects of selective digital deafferentation on the multi-finger synergies as a function of total force requirement and the number of digits involved in isometric pressing. 12 healthy adults participated in maximal and sub-maximal isometric pressing tasks with or without digital anesthesia to selective digits from the right hand. Our results indicate that selective anesthesia paradigm induces changes in both anesthetized (local) and non-anesthetized (non-local) digits’ performance, including: (1) decreased maximal force abilities in both local and non-local digits; (2) reduced force share during multi-finger tasks from non-local but not local digits; (3) decreased force error-making; and (4) marginally increased motor synergies. These results reinforce the contribution of somatosensory feedback in the process of maximal voluntary contraction force, motor performance, and indicate that somatosensation may play a role in optimizing secondary goals during isometric force production rather than ensuring task performance.

Short reaction times in response to multi-electrode intracortical microstimulation may provide a basis for rapid movement-related feedback

OBJECTIVE

Tetraplegic patients using brain-machine interfaces can make visually guided reaches with robotic arms. However, restoring proprioceptive feedback to these patients will be critical, as evidenced by the movement deficit in patients with proprioceptive loss. Proprioception is critical in large part because it provides faster feedback than vision. Intracortical microstimulation (ICMS) is a promising approach, but the ICMS-evoked reaction time (RT) is typically slower than that to natural proprioceptive and often even visual cues, implying that ICMS feedback may not be fast enough to guide movement.

APPROACH

For most sensory modalities, RT decreases with increased stimulus intensity. Thus, it may be that stimulation intensities beyond what has previously been used will result in faster RTs. To test this, we compared the RT to ICMS applied through multi-electrode arrays in area 2 of somatosensory cortex to that of mechanical and visual cues.

MAIN RESULTS

We found that the RT to single-electrode ICMS decreased with increased current, frequency, and train length. For 100 µA, 330 Hz stimulation, the highest single-electrode intensity we tested routinely, most electrodes resulted in RTs slower than the mechanical cue but slightly faster than the visual cue. While increasing the current beyond 100 µA resulted in faster RTs, sustained stimulation at this level may damage tissue. Alternatively, by stimulating through multiple electrodes (mICMS), a large amount of current can be injected while keeping that through each electrode at a safe level. We found that stimulation with at least 480 µA equally distributed over 16 electrodes could produce RTs as much as 20 ms faster than the mechanical cue, roughly the conduction delay to cortex from the periphery.

SIGNIFICANCE

These results suggest that mICMS may provide a means to supply rapid, movement-related feedback. Future neuroprosthetics may need spatiotemporally patterned mICMS to convey useful somatosensory information. Novelty & Significance Intracortical microstimulation (ICMS) is a promising approach for providing artificial somatosensation to patients with spinal cord injury or limb amputation, but in prior experiments, subjects have been unable to respond as quickly to it as to natural cues. We have investigated the use of multi-electrode stimulation (mICMS) and discovered that it can produce reaction times as fast or faster even than natural mechanical cues. Although our stimulus trains were not modulated in time, this result opens the door to more complex spatiotemporal patterns of mICMS that might be used to rapidly write in complex somatosensory information to the CNS.

The effect of lower leg sensory impulses on the force sense of knee extensor muscles in healthy adults: The accuracy of sense-of-force studies

BACKGROUND

Producing the target force of a muscle group by using visual feedback and reproducing the same force fully blind are regarded as a common approach for quantifying the sense of force. Force sense error is considered to be the difference between the produced target force and reproduced force. The present study aimed to evaluate the effects of tactile sensory feedback in the lower leg on the perceived magnitude of force sense.

METHODS AND MATERIALS

In this cross-sectional study, 18 healthy men (mean age 24.31 ± 3.94 years) were selected based on a simple randomized method. First, the quantity of force sense error of the knee extensor muscle group was measured before and after manipulating the tactile inputs of the leg. Then, methods A, B, and C were applied to measure force sense errors. In addition, the tactile impulses were manipulated in methods B and C by placing a piece of thick foam between the distal portion of lower leg among the subjects and the dynamometer. The tactile inputs remained intact during method A.

RESULTS

The accuracy of the reproduced target force was significantly affected following the disturbance of tactile inputs in the lower leg in methods B and C, compared to method A (p < 0.05).

CONCLUSION

Altering tactile inputs in the lower leg can affect the force sense of the knee extensor muscles. The received somatosensory inputs across the lower leg can affect the whole process of force perception at this joint.

Brain Computer Interfaces in Rehabilitation Medicine

One innovation currently influencing physical medicine and rehabilitation is brain-computer interface (BCI) technology. BCI systems used for motor control record neural activity associated with thoughts, perceptions, and motor intent; decode brain signals into commands for output devices; and perform the user's intended action through an output device. BCI systems used for sensory augmentation transduce environmental stimuli into neural signals interpretable by the central nervous system. Both types of systems have potential for reducing disability by facilitating a user's interaction with the environment. Investigational BCI systems are being used in the rehabilitation setting both as neuroprostheses to replace lost function and as potential plasticity-enhancing therapy tools aimed at accelerating neurorecovery. Populations benefitting from motor and somatosensory BCI systems include those with spinal cord injury, motor neuron disease, limb amputation, and stroke. This article discusses the basic components of BCI for rehabilitation, including recording systems and locations, signal processing and translation algorithms, and external devices controlled through BCI commands. An overview of applications in motor and sensory restoration is provided, along with ethical questions and user perspectives regarding BCI technology.

The anatomy of the human frontal lobe

Throughout evolution the frontal lobes have progressively acquired a central role in most aspects of cognition and behavior. In humans, frontal lobe functions are conditional on the development of an intricate set of short- and long-range connections that guarantee direct access to sensory information and control over regions dedicated to planning and motor execution. Here the frontal cortical anatomy and the major connections that constitute the local and extended frontal connectivity are reviewed in the context of diffusion tractography studies, contemporary models of frontal lobe functions, and clinical syndromes. A particular focus of this chapter is the use of comparative anatomy and neurodevelopmental data to address the question of how frontal networks evolved and what this signified for unique human abilities.

Cutaneous sensory feedback from paw pads affects lateral balance control during split-belt locomotion in the cat

Cutaneous sensory feedback from the paw pads plays an important role in regulating body balance, especially in challenging environments like ladder or slope walking. Here, we investigated the contribution of cutaneous sensory feedback from the paw pads to balance control in cats stepping on a split-belt treadmill. Forepaws and hindpaws were anesthetized unilaterally using lidocaine injections. We evaluated body balance in intact and compromised cutaneous feedback conditions during split-belt locomotion with belt-speed ratios of 0.5, 1.0, 1.5 and 2.0. Measures of body balance included step width, relative duration of limb support phases, lateral bias of center of mass (CoM) and margins of static and dynamic stability. In the intact condition, static and dynamic balance declined with increasing belt-speed ratio as a result of a lateral shift of the CoM toward the borders of support on the slower moving belt. Anesthesia of the ipsilateral paws improved locomotor balance with increasing belt-speed ratios by reversing the CoM shift, decreasing the relative duration of the two-limb support phase, increasing the duration of four- or three-limb support phases, and increasing the hindlimb step width and static stability. We observed no changes in most balance measures in anesthetized conditions during tied-belt locomotion at 0.4 m s-1 CoM lateral displacements closely resembled those of the inverted pendulum and of human walking. We propose that unilaterally compromised cutaneous feedback from the paw pads is compensated for by improving lateral balance and by shifting the body toward the anesthetized paws to increase tactile sensation during the stance phase.

Subthreshold Vibrotactile Noise Stimulation Immediately Improves Manual Dexterity in a Child With Developmental Coordination Disorder: A Single-Case Study

Developmental coordination disorder (DCD) is the most common childhood movement disorder. It is characterized by clumsiness of fine and gross motor skills in developing children. Children with DCD have low ability to effectively use tactile information for movements, instead relying on visual information. In addition, children with DCD have deficits in visuo-motor temporal integration, which is important in motor control. These traits subsequently lead to clumsiness of movements. Conversely, however, imperceptible vibrotactile noise stimulation (at 60%-intensity of the sensory threshold) to the wrist provides stochastic resonance (SR) phenomenon to the body, improving the sensory and motor systems. However, the effects of SR have not yet been validated in children with DCD. Thus, we conducted a single case study of a 10-year-old boy with a diagnosis of DCD to investigate the effect of SR on visual dependence, visuo-motor temporal integration, and manual dexterity. SR was provided by vibrotactile noise stimulation (at an intensity of 60% of the sensory threshold) to the wrist. Changes in manual dexterity (during the SR on- and off-conditions) were measured using the manual dexterity test of the Movement Assessment Battery for Children-2nd edition. The point of subjective equality measured by visual or tactile temporal order judgment task served as a quantitative indicator reflecting specific sensory dependence. The delay detection threshold and steepness of delay detection probability curve, which were measured using the delayed visual feedback detection task, were used as quantitative indicators of visuo-motor temporal integration. The results demonstrated alleviated visual dependence and improved visuo-motor temporal integration during the SR on-conditions rather than the SR off-conditions. Most importantly, manual dexterity during the SR on-conditions was significantly improved compared to that during the SR off-conditions. Thus, the present results highlighted that SR could contribute to improving poor movement in children with DCD. However, since this was a single case study, a future interventional study with a large sample size is needed to determine the effectiveness of SR for children with DCD.

Loss of haptic feedback impairs control of hand posture: a study in chronically deafferented individuals when grasping and lifting objects

Previous work has highlighted the role of haptic feedback for manual dexterity, in particular for the control of precision grip forces between the index finger and thumb. It is unclear how fine motor skills involving more than just two digits might be affected, especially given that loss of sensation from the hand affects many neurological patients, and impacts on everyday actions. To assess the functional consequences of haptic deficits on multi-digit grasp of objects, we studied the ability of three rare individuals with permanent large-fibre sensory loss involving the entire upper limb. All three reported difficulties in everyday manual actions (ABILHAND questionnaire). Their performance in a reach-grasp-lift task was compared to that of healthy controls. Twenty objects of varying shape, mass, opacity and compliance were used. In the reach-to-grasp phase, we found slower movement, larger grip aperture and less dynamic modulation of grip aperture in deafferented participants compared to controls. Hand posture during the lift phase also differed; deafferented participants often adopted hand postures that may have facilitated visual guidance, and/or reduced control complexity. For example, they would extend fingers that were not in contact with the object, or fold these fingers into the palm of the hand. Variability in hand postures was increased in deafferented participants, particularly for smaller objects. Our findings provide new insights into how the complex control required for whole hand actions is compromised by loss of haptic feedback, whose contribution is, thus, highlighted.

Grip control and motor coordination with implanted and surface electrodes while grasping with an osseointegrated prosthetic hand

Background

Replacement of a lost limb by an artificial substitute is not yet ideal. Resolution and coordination of motor control approximating that of a biological limb could dramatically improve the functionality of prosthetic devices, and thus reduce the gap towards a suitable limb replacement.

Methods

In this study, we investigated the control resolution and coordination exhibited by subjects with transhumeral amputation who were implanted with epimysial electrodes and an osseointegrated interface that provides bidirectional communication in addition to skeletal attachment (e-OPRA Implant System). We assessed control resolution and coordination in the context of routine and delicate grasping using the Pick and Lift and the Virtual Eggs Tests. Performance when utilizing implanted electrodes was compared with the standard-of-care technology for myoelectric prostheses, namely surface electrodes.

Results

Results showed that implanted electrodes provide superior controllability over the prosthetic terminal device compared to conventional surface electrodes. Significant improvements were found in the control of the grip force and its reliability during object transfer. However, these improvements failed to increase motor coordination, and surprisingly decreased the temporal correlation between grip and load forces observed with surface electrodes. We found that despite being more functional and reliable, prosthetic control via implanted electrodes still depended highly on visual feedback.

Conclusions

Our findings indicate that incidental sensory feedback (visual, auditory, and osseoperceptive in this case) is insufficient for restoring natural grasp behavior in amputees, and support the idea that supplemental tactile sensory feedback is needed to learn and maintain the motor tasks internal model, which could ultimately restore natural grasp behavior in subjects using prosthetic hands.

Force perception at the shoulder after a unilateral suprascapular nerve block

There are two key sources of information that can be used to match forces-the centrally generated sense of effort and afferent signals from mechanical receptors located in peripheral tissues. There is currently no consensus on which source of information is more important for matching forces. The corollary discharge hypothesis argues that subjects match forces using the centrally generated sense of effort. The purpose of this study was to investigate force matching at the shoulder before and after a suprascapular nerve block. The nerve block creates a sensory and muscle force mismatch between sides when matching loads. The torque matching accuracy did not change after the nerve block was administered. Directionally, the torque error was in the direction proposed by the corollary discharge hypothesis. However, the mismatch between deltoid EMG was substantially greater compared to the changes in the torque matching error after the block. The results support that sensory information is used during force matching tasks. However, since the nerve block also created a sensory disruption between sides, it is not clear how sensory information is reweighted following the nerve block and a role for sense of effort is still implicated.

Visual delay affects force scaling and weight perception during object lifting in virtual reality

Lifting an object requires precise scaling of fingertip forces based on a prediction of object weight. At object contact, a series of tactile and visual events arise that need to be rapidly processed online to fine-tune the planned motor commands for lifting the object. The brain mechanisms underlying multisensory integration serially at transient sensorimotor events, a general feature of actions requiring hand-object interactions, are not yet understood. In this study we tested the relative weighting between haptic and visual signals when they are integrated online into the motor command. We used a new virtual reality setup to desynchronize visual feedback from haptics, which allowed us to probe the relative contribution of haptics and vision in driving participants’ movements when they grasped virtual objects simulated by two force-feedback robots. We found that visual delay changed the profile of fingertip force generation and led participants to perceive objects as heavier than when lifts were performed without visual delay. We further modeled the effect of vision on motor output by manipulating the extent to which delayed visual events could bias the force profile, which allowed us to determine the specific weighting the brain assigns to haptics and vision. Our results show for the first time how visuo-haptic integration is processed at discrete sensorimotor events for controlling object-lifting dynamics and further highlight the organization of multisensory signals online for controlling action and perception.

NEW & NOTEWORTHY Dexterous hand movements require rapid integration of information from different senses, in particular touch and vision, at different key time points as movement unfolds. The relative weighting between vision and haptics for object manipulation is unknown. We used object lifting in virtual reality to desynchronize visual and haptic feedback and find out their relative weightings. Our findings shed light on how rapid multisensory integration is processed over a series of discrete sensorimotor control points.

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.