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Ashtiyani M, Moradi Birgani P, Soleimani M, Jameie SB, Shahrokhi A, Mirbagheri MM, Deevband MR. Corpus Callosum Functional Activities in Children with Cerebral Palsy. J Biomed Phys Eng 2024; 14:21-30. [PMID: 38357606 PMCID: PMC10862116 DOI: 10.31661/jbpe.v0i0.2106-1354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 08/02/2021] [Indexed: 02/16/2024]
Abstract
Background Since cerebral palsy (CP) is a corollary to brain damage, persistent treatment should accompany an alteration in brain functional activity in line with clinical improvements. In this regard, the corpus callosum (CC), as a connecting bridge between the two hemispheres, plays an essential role. Objective This study aimed to investigate the therapeutic effects of occupational therapy (OT) on CC functional activity and walking capacity in children with cerebral palsy. Material and Methods In this clinical trial study, 4 children with CP (8.25±1.71 years) received 45 min OT sessions 3 times weekly for 8 weeks. Functional magnetic resonance imaging (fMRI) was acquired while conducting passive motor tasks to quantify CC activation. The pre-post activation changes in CC following therapy were quantified in terms of activated voxels. Walking capacity was evaluated using the timed-up-and-go (TUG), 6-minute walk test (6 MWT), and 10-meter walk test (10 MWT) in pre-and post-treatment. Results The number of activated voxels in CC indicated significant improvement in participants. Post-treatment activated voxels substantially exceeded pre-treatment active voxels. Clinical measures, including TUG, 6 MWT, and 10 MWT are improved by 11.9%, 12.6%, and 25.4%, respectively. Conclusion Passive task-based fMRI can detect the effects of OT on CC functional activity in children with CP. According to the results, OT improves CC functional activity in addition to gait and balance performance.
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Affiliation(s)
- Meghdad Ashtiyani
- Department of Biomedical Engineering and Medical Physics, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parmida Moradi Birgani
- Department of Medical Physics and Biomedical Engineering, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Soleimani
- Department of Basic Science, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | - Amin Shahrokhi
- Department of Basic Science, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | - Mohammad Reza Deevband
- Department of Biomedical Engineering and Medical Physics, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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BOLD fMRI and DTI fiber tracking for preoperative mapping of eloquent cerebral regions in brain tumor patients: impact on surgical approach and outcome. Neurol Sci 2023:10.1007/s10072-023-06667-2. [PMID: 36914833 DOI: 10.1007/s10072-023-06667-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 02/01/2023] [Indexed: 03/15/2023]
Abstract
PURPOSE Task-based BOLD fMRI and DTI-fiber tracking have become part of the routine presurgical work-up of brain tumor patients in many institutions. However, their potential impact on both surgical treatment and neurologic outcome remains unclear, in despite of the high costs and complex implementation. METHODS We retrospectively investigated whether performing fMRI and DTI-ft preoperatively substantially impacted surgical planning and patient outcome in a series of brain tumor patients. We assessed (i) the quality of fMRI and DTI-ft results, by using a scale of 0-2 (0 = failed mapping; 1 = intermediate confidence; 2 = good confidence), (ii) whether functional planning substantially contributed to defining the surgical strategy to be undertaken (i.e., no surgery, biopsy, or resection, with or without ESM), the surgical entry point and extent of resection, and (iii) the incidence of neurological deficits post-operatively. RESULTS Twenty-seven patients constituted the study population. The mean confidence rating was 1.9/2 for fMRI localization of the eloquent cortex and lateralization of the language function and 1.7/2 for DTI-ft results. Treatment strategy was altered in 33% (9/27) of cases. Surgical entry point was modified in 8% (2/25) of cases. The extent of resection was modified in 40% (10/25). One patient (1/25, 4%) developed one new functional deficit post-operatively. CONCLUSION Functional MR mapping - which must not be considered an alternative to ESM - has a critical role preoperatively, potentially modifying treatment strategy or increasing the neurosurgeons' confidence in the surgical approach hypothesized based on conventional imaging.
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Wang H, Xiong X, Zhang K, Wang X, Sun C, Zhu B, Xu Y, Fan M, Tong S, Guo X, Sun L. Motor network reorganization after motor imagery training in stroke patients with moderate to severe upper limb impairment. CNS Neurosci Ther 2022; 29:619-632. [PMID: 36575865 PMCID: PMC9873524 DOI: 10.1111/cns.14065] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 11/22/2022] [Accepted: 12/06/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Motor imagery training (MIT) has been widely used to improve hemiplegic upper limb function in stroke rehabilitation. The effectiveness of MIT is associated with the functional neuroplasticity of the motor network. Currently, brain activation and connectivity changes related to the motor recovery process after MIT are not well understood. AIM We aimed to investigate the neural mechanisms of MIT in stroke rehabilitation through a longitudinal intervention study design with task-based functional magnetic resonance imaging (fMRI) analysis. METHODS We recruited 39 stroke patients with moderate to severe upper limb motor impairment and randomly assigned them to either the MIT or control groups. Patients in the MIT group received 4 weeks of MIT therapy plus conventional rehabilitation, while the control group only received conventional rehabilitation. The assessment of Fugl-Meyer Upper Limb Scale (FM-UL) and Barthel Index (BI), and fMRI scanning using a passive hand movement task were conducted on all patients before and after treatment. The changes in brain activation and functional connectivity (FC) were analyzed. Pearson's correlation analysis was conducted to evaluate the association between neural functional changes and motor improvement. RESULTS The MIT group achieved higher improvements in FM-UL and BI relative to the control group after the treatment. Passive movement of the affected hand evoked an abnormal bilateral activation pattern in both groups before intervention. A significant Group × Time interaction was found in the contralesional S1 and ipsilesional M1, showing a decrease of activation after intervention specifically in the MIT group, which was negatively correlated with the FM-UL improvement. FC analysis of the ipsilesional M1 displayed the motor network reorganization within the ipsilesional hemisphere, which correlated with the motor score changes. CONCLUSIONS MIT could help decrease the compensatory activation at both hemispheres and reshape the FC within the ipsilesional hemisphere along with functional recovery in stroke patients.
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Affiliation(s)
- Hewei Wang
- Department of Rehabilitation MedicineHuashan Hospital Fudan UniversityShanghaiChina
| | - Xin Xiong
- School of Biomedical EngineeringShanghai Jiaotong UniversityShanghaiChina
| | - Kexu Zhang
- School of Biomedical EngineeringShanghai Jiaotong UniversityShanghaiChina
| | - Xu Wang
- School of Biomedical EngineeringShanghai Jiaotong UniversityShanghaiChina
| | - Changhui Sun
- Department of Rehabilitation MedicineHuashan Hospital Fudan UniversityShanghaiChina
| | - Bing Zhu
- Department of Rehabilitation MedicineHuashan Hospital Fudan UniversityShanghaiChina
| | - Yiming Xu
- Department of Rehabilitation MedicineHuashan Hospital Fudan UniversityShanghaiChina
| | - Mingxia Fan
- Shanghai Key Laboratory of Magnetic ResonanceEast China Normal UniversityShanghaiChina
| | - Shanbao Tong
- School of Biomedical EngineeringShanghai Jiaotong UniversityShanghaiChina
| | - Xiaoli Guo
- School of Biomedical EngineeringShanghai Jiaotong UniversityShanghaiChina
| | - Limin Sun
- Department of Rehabilitation MedicineHuashan Hospital Fudan UniversityShanghaiChina
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Dissanayake UC, Steuber V, Amirabdollahian F. EEG Spectral Feature Modulations Associated With Fatigue in Robot-Mediated Upper Limb Gross and Fine Motor Interactions. Front Neurorobot 2022; 15:788494. [PMID: 35126082 PMCID: PMC8812383 DOI: 10.3389/fnbot.2021.788494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 12/20/2021] [Indexed: 11/26/2022] Open
Abstract
This paper investigates the EEG spectral feature modulations associated with fatigue induced by robot-mediated upper limb gross and fine motor interactions. Twenty healthy participants were randomly assigned to perform a gross motor interaction with HapticMASTER or a fine motor interaction with SCRIPT passive orthosis for 20 min or until volitional fatigue. Relative and ratio band power measures were estimated from the EEG data recorded before and after the robot-mediated interactions. Paired-samples t-tests found a significant increase in the relative alpha band power and a significant decrease in the relative delta band power due to the fatigue induced by the robot-mediated gross and fine motor interactions. The gross motor task also significantly increased the (θ + α)/β and α/β ratio band power measures, whereas the fine motor task increased the relative theta band power. Furthermore, the robot-mediated gross movements mostly changed the EEG activity around the central and parietal brain regions, whereas the fine movements mostly changed the EEG activity around the frontopolar and central brain regions. The subjective ratings suggest that the gross motor task may have induced physical fatigue, whereas the fine motor task may have induced mental fatigue. Therefore, findings affirm that changes to localised brain activity patterns indicate fatigue developed from the robot-mediated interactions. It can also be concluded that the regional differences in the prominent EEG spectral features are most likely due to the differences in the nature of the task (fine/gross motor and distal/proximal upper limb) that may have differently altered an individual's physical and mental fatigue level. The findings could potentially be used in future to detect and moderate fatigue during robot-mediated post-stroke therapies.
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Affiliation(s)
- Udeshika C. Dissanayake
- School of Physics, Engineering and Computer Science, University of Hertfordshire, Hatfield, United Kingdom
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Li IH, Lin YS, Lee LW, Lin WT. Design, Manufacturing, and Control of a Pneumatic-Driven Passive Robotic Gait Training System for Muscle-Weakness in a Lower Limb. SENSORS 2021; 21:s21206709. [PMID: 34695920 PMCID: PMC8540960 DOI: 10.3390/s21206709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/02/2021] [Accepted: 10/04/2021] [Indexed: 02/04/2023]
Abstract
We designed and manufactured a pneumatic-driven robotic passive gait training system (PRPGTS), providing the functions of body-weight support, postural support, and gait orthosis for patients who suffer from weakened lower limbs. The PRPGTS was designed as a soft-joint gait training rehabilitation system. The soft joints provide passive safety for patients. The PRPGTS features three subsystems: a pneumatic body weight support system, a pneumatic postural support system, and a pneumatic gait orthosis system. The dynamic behavior of these three subsystems are all involved in the PRPGTS, causing an extremely complicated dynamic behavior; therefore, this paper applies five individual interval type-2 fuzzy sliding controllers (IT2FSC) to compensate for the system uncertainties and disturbances in the PRGTS. The IT2FSCs can provide accurate and correct positional trajectories under passive safety protection. The feasibility of weight reduction and gait training with the PRPGTS using the IT2FSCs is demonstrated with a healthy person, and the experimental results show that the PRPGTS is stable and provides a high-trajectory tracking performance.
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Affiliation(s)
- I-Hsum Li
- Department of Mechanical and Electro-Mechanical Engineering, Tamkang University, New Taipei City 25137, Taiwan; (I.-H.L.); (W.-T.L.)
| | - Yi-Shan Lin
- Department of Mechanical Engineering, National Chung Hsing University, Taichung City 40227, Taiwan;
| | - Lian-Wang Lee
- Department of Mechanical Engineering, National Chung Hsing University, Taichung City 40227, Taiwan;
- Correspondence: ; Tel.: +886-4-22840433 (ext. 420); Fax: +886-4-22877170
| | - Wei-Ting Lin
- Department of Mechanical and Electro-Mechanical Engineering, Tamkang University, New Taipei City 25137, Taiwan; (I.-H.L.); (W.-T.L.)
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Pneumatic artificial muscle-based stimulator for passive functional magnetic resonance imaging sensorimotor mapping in patients with brain tumours. J Neurosci Methods 2021; 359:109227. [PMID: 34052287 DOI: 10.1016/j.jneumeth.2021.109227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 04/30/2021] [Accepted: 05/21/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Two concerns with respect to pre-operative task-based motor functional magnetic resonance imaging (fMRI) in patients with brain tumours are inadequate performance due to patients' impaired motor function and head motion artefacts. NEW METHOD In the present study we validate the use of a stimulator based on a pneumatic artificial muscle (PAM) for fMRI mapping of the primary sensorimotor (SM1) cortex in twenty patients with rolandic or perirolandic brain tumours. All patients underwent both active and passive motor block-design fMRI paradigms, performing comparable active and passive PAM-induced flexion-extensions of the icontralesional index finger. RESULTS PAM-induced movements resulted in a significant BOLD signal increase in contralateral primary motor (M1) and somatosensory (S1) cortices in 18/20 and 19/20 (p<.05 FWE corrected in 16/18 and 18/19) patients, versus 18/20 and 16/20 (p<.05 FWE corrected) during active movements. The two patients in whom the PAM-based stimulator failed to induce any significant BOLD signal change in the contralateral M1 cortex differed from the two in whom active motion was conversely ineffective. At the group level, no significant difference in contrast magnitude was observed within the contralateral SM1 cortex when comparing active with passive movements. During passive movements, head motion was significantly reduced. Comparison with existing method(s) As compared to the several robotic devices for passive motion that were introduced in the past decades, our PAM-based stimulator appears smaller, handier, and easier to use. CONCLUSION The use of PAM-based stimulators should be included in routine pre-operative fMRI protocols along with active paradigms in such patients' population.
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Niu C, Cohen AD, Wen X, Chen Z, Lin P, Liu X, Menze BH, Wiestler B, Wang Y, Zhang M. Modeling motor task activation from resting-state fMRI using machine learning in individual subjects. Brain Imaging Behav 2021; 15:122-132. [PMID: 31903530 DOI: 10.1007/s11682-019-00239-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Resting-state functional MRI (rs-fMRI) has provided important insights into brain physiology. It has become an increasingly popular method for presurgical mapping, as an alternative to task-based functional MRI wherein the subject performs a task while being scanned. However, there is no commonly acknowledged gold standard approach for detecting eloquent brain areas using rs-fMRI data in clinical settings. In this study, a general linear model-based machine learning (GLM-ML) approach was tested to predict individual motor task activation based on rs-fMRI data. Its accuracy was then compared to a conventional independent component analysis (ICA) approach. 47 healthy subjects were scanned using resting state, active and passive motor task fMRI experiments using a clinically applicable low-resolution fMRI protocol. The model was trained to associate rs-fMRI network maps with that of hand movement task fMRI, then used to predict task activation maps for unseen subjects solely based on their rs-fMRI data. Our results showed that the GLM-ML approach can accurately predict individual differences in task activation using rs-fMRI data and outperform conventional ICA to detect task activation in the primary sensorimotor region. Furthermore, the predicted activation maps using the GLM -ML model matched well with the activation of passive hand movement fMRI on an individual basis. These results suggest that GLM-ML approach can robustly predict individual differences of task activation based on conventional low-resolution rs-fMRI data and has important implications for future clinical applications.
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Affiliation(s)
- Chen Niu
- Department of Medical Imaging, the First Affiliated Hospital of Xi'an Jiaotong University, No. 277 West Yanta Road, Xi'an, 710061, Shaanxi Province, China
- Institute for Biomedical Engineering, Technical University of Munich, Munich, Germany
| | - Alexander D Cohen
- Department of Radiology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA
| | - Xin Wen
- Department of Medical Imaging, the First Affiliated Hospital of Xi'an Jiaotong University, No. 277 West Yanta Road, Xi'an, 710061, Shaanxi Province, China
| | - Ziyi Chen
- Department of Radiology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA
| | - Pan Lin
- Department of Psychology and Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, China
| | - Xin Liu
- Institute for Biomedical Engineering, Technical University of Munich, Munich, Germany
| | - Bjoern H Menze
- Institute for Biomedical Engineering, Technical University of Munich, Munich, Germany
- Department of Computer Science, Technical University of Munich, Munich, Germany
| | - Benedikt Wiestler
- Department of Neuroradiology, Klinikum rechts der Isar, TU München, Munich, Germany
| | - Yang Wang
- Department of Radiology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA.
| | - Ming Zhang
- Department of Medical Imaging, the First Affiliated Hospital of Xi'an Jiaotong University, No. 277 West Yanta Road, Xi'an, 710061, Shaanxi Province, China.
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Richard N, Desmurget M, Teillac A, Beuriat PA, Bardi L, Coudé G, Szathmari A, Mottolese C, Sirigu A, Hiba B. Anatomical bases of fast parietal grasp control in humans: A diffusion-MRI tractography study. Neuroimage 2021; 235:118002. [PMID: 33789136 DOI: 10.1016/j.neuroimage.2021.118002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 01/26/2021] [Accepted: 03/24/2021] [Indexed: 11/26/2022] Open
Abstract
The dorso-posterior parietal cortex (DPPC) is a major node of the grasp/manipulation control network. It is assumed to act as an optimal forward estimator that continuously integrates efferent outflows and afferent inflows to modulate the ongoing motor command. In agreement with this view, a recent per-operative study, in humans, identified functional sites within DPPC that: (i) instantly disrupt hand movements when electrically stimulated; (ii) receive short-latency somatosensory afferences from intrinsic hand muscles. Based on these results, it was speculated that DPPC is part of a rapid grasp control loop that receives direct inputs from the hand-territory of the primary somatosensory cortex (S1) and sends direct projections to the hand-territory of the primary motor cortex (M1). However, evidence supporting this hypothesis is weak and partial. To date, projections from DPPC to M1 grasp zone have been identified in monkeys and have been postulated to exist in humans based on clinical and transcranial magnetic studies. This work uses diffusion-MRI tractography in two samples of right- (n = 50) and left-handed (n = 25) subjects randomly selected from the Human Connectome Project. It aims to determine whether direct connections exist between DPPC and the hand control sectors of the primary sensorimotor regions. The parietal region of interest, related to hand control (hereafter designated DPPChand), was defined permissively as the 95% confidence area of the parietal sites that were found to disrupt hand movements in the previously evoked per-operative study. In both hemispheres, irrespective of handedness, we found dense ipsilateral connections between a restricted part of DPPChand and focal sectors within the pre and postcentral gyrus. These sectors, corresponding to the hand territories of M1 and S1, targeted the same parietal zone (spatial overlap > 92%). As a sensitivity control, we searched for potential connections between the angular gyrus (AG) and the pre and postcentral regions. No robust pathways were found. Streamline densities identified using AG as the starting seed represented less than 5 % of the streamline densities identified from DPPChand. Together, these results support the existence of a direct sensory-parietal-motor loop suited for fast manual control and more generally, for any task requiring rapid integration of distal sensorimotor signals.
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Affiliation(s)
- Nathalie Richard
- Institute of Cognitive Neuroscience Marc Jeannerod, CNRS / UMR 5229, 69500 Bron, France; Université Claude Bernard, Lyon 1, 69100 Villeurbanne, France
| | - Michel Desmurget
- Institute of Cognitive Neuroscience Marc Jeannerod, CNRS / UMR 5229, 69500 Bron, France; Université Claude Bernard, Lyon 1, 69100 Villeurbanne, France
| | - Achille Teillac
- Institute of Cognitive Neuroscience Marc Jeannerod, CNRS / UMR 5229, 69500 Bron, France; Université Claude Bernard, Lyon 1, 69100 Villeurbanne, France; Institut de neurosciences cognitives et intégratives d'Aquitaine, CNRS / UMR 5287, 33076 Bordeaux, France
| | - Pierre-Aurélien Beuriat
- Institute of Cognitive Neuroscience Marc Jeannerod, CNRS / UMR 5229, 69500 Bron, France; Université Claude Bernard, Lyon 1, 69100 Villeurbanne, France; Department of Pediatric Neurosurgery, Hôpital Femme Mère Enfant, 69500, Bron, France
| | - Lara Bardi
- Institute of Cognitive Neuroscience Marc Jeannerod, CNRS / UMR 5229, 69500 Bron, France; Université Claude Bernard, Lyon 1, 69100 Villeurbanne, France
| | - Gino Coudé
- Institute of Cognitive Neuroscience Marc Jeannerod, CNRS / UMR 5229, 69500 Bron, France; Université Claude Bernard, Lyon 1, 69100 Villeurbanne, France
| | - Alexandru Szathmari
- Institute of Cognitive Neuroscience Marc Jeannerod, CNRS / UMR 5229, 69500 Bron, France; Université Claude Bernard, Lyon 1, 69100 Villeurbanne, France; Department of Pediatric Neurosurgery, Hôpital Femme Mère Enfant, 69500, Bron, France
| | - Carmine Mottolese
- Institute of Cognitive Neuroscience Marc Jeannerod, CNRS / UMR 5229, 69500 Bron, France; Université Claude Bernard, Lyon 1, 69100 Villeurbanne, France; Department of Pediatric Neurosurgery, Hôpital Femme Mère Enfant, 69500, Bron, France
| | - Angela Sirigu
- Institute of Cognitive Neuroscience Marc Jeannerod, CNRS / UMR 5229, 69500 Bron, France; Université Claude Bernard, Lyon 1, 69100 Villeurbanne, France
| | - Bassem Hiba
- Institute of Cognitive Neuroscience Marc Jeannerod, CNRS / UMR 5229, 69500 Bron, France; Université Claude Bernard, Lyon 1, 69100 Villeurbanne, France.
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Age-Related Decline of Sensorimotor Integration Influences Resting-State Functional Brain Connectivity. Brain Sci 2020; 10:brainsci10120966. [PMID: 33321926 PMCID: PMC7764051 DOI: 10.3390/brainsci10120966] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 12/07/2020] [Indexed: 11/16/2022] Open
Abstract
Age-related decline in sensorimotor integration involves both peripheral and central components related to proprioception and kinesthesia. To explore the role of cortical motor networks, we investigated the association between resting-state functional connectivity and a gap-detection angle measured during an arm-reaching task. Four region pairs, namely the left primary sensory area with the left primary motor area (S1left-M1left), the left supplementary motor area with M1left (SMAleft-M1left), the left pre-supplementary motor area with SMAleft (preSMAleft-SMAleft), and the right pre-supplementary motor area with the right premotor area (preSMAright-PMdright), showed significant age-by-gap detection ability interactions in connectivity in the form of opposite-sign correlations with gap detection ability between younger and older participants. Morphometry and tractography analyses did not reveal corresponding structural effects. These results suggest that the impact of aging on sensorimotor integration at the cortical level may be tracked by resting-state brain activity and is primarily functional, rather than structural. From the observation of opposite-sign correlations, we hypothesize that in aging, a "low-level" motor system may hyper-engage unsuccessfully, its dysfunction possibly being compensated by a "high-level" motor system, wherein stronger connectivity predicts higher gap-detection performance. This hypothesis should be tested in future neuroimaging and clinical studies.
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(Re)organisation of the somatosensory system after early brain lesion: A lateralization index fMRI study. Ann Phys Rehabil Med 2020; 63:416-421. [DOI: 10.1016/j.rehab.2019.02.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 01/14/2019] [Accepted: 02/03/2019] [Indexed: 12/16/2022]
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Bermejo F, Hüg MX, Di Paolo EA. Rediscovering Richard Held: Activity and Passivity in Perceptual Learning. Front Psychol 2020; 11:844. [PMID: 32508708 PMCID: PMC7248214 DOI: 10.3389/fpsyg.2020.00844] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 04/06/2020] [Indexed: 12/19/2022] Open
Abstract
Understanding the role of self-generated movements in perceptual learning is central to action-based theories of perception. Pioneering work on sensory adaptation by Richard M. Held during the 1950s and 1960s can still shed light on this question. In a variety of rich experiments Held and his team demonstrated the need for self-generated movements in sensory adaptation and perceptual learning. This body of work received different critical interpretations, was then forgotten for some time, and saw a surge of revived interest within embodied cognitive science. Through a brief review of Held’s work and reactions to it, we seek to contribute to discussions on the role of activity and passivity in perceptual learning. We classify different positions according to whether this role is considered to be contextual (facilitatory, but not necessary), enabling (causally necessary), or constitutive (an inextricable part of the learning process itself). We also offer a critique of the notions of activity and passivity and how they are operationalized in experimental studies. The active-passive distinction is not a binary but involves a series of dimensions and relative degrees that can make it difficult to interpret and replicate experimental results. We introduce three of these dimensions drawing on work on the sense of agency: action initiation, control, and monitoring. These refinements in terms of causal relations and dimensions of activity-passivity should help illuminate open questions concerning the role of activity in perception and perceptual learning and clarify the convergences and differences between enaction and ecological psychology.
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Affiliation(s)
- Fernando Bermejo
- Centro de Investigación y Transferencia en Acústica, Universidad Tecnológica Nacional - Facultad Regional Córdoba, CONICET, Córdoba, Argentina.,Facultad de Psicología, Universidad Nacional de Córdoba, Córdoba, Argentina.,Consejo Nacional de Investigaciones Científicas y Tecnológicas, Buenos Aires, Argentina
| | - Mercedes X Hüg
- Centro de Investigación y Transferencia en Acústica, Universidad Tecnológica Nacional - Facultad Regional Córdoba, CONICET, Córdoba, Argentina.,Facultad de Psicología, Universidad Nacional de Córdoba, Córdoba, Argentina.,Consejo Nacional de Investigaciones Científicas y Tecnológicas, Buenos Aires, Argentina
| | - Ezequiel A Di Paolo
- Ikerbasque, Basque Foundation for Science, Bilbao, Spain.,IAS Research Center for Life, Mind and Society, University of the Basque Country, San Sebastián, Spain.,Centre for Computational Neuroscience and Robotics, University of Sussex, Brighton, United Kingdom
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12
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Snyder DB, Beardsley SA, Schmit BD. Role of the cortex in visuomotor control of arm stability. J Neurophysiol 2019; 122:2156-2172. [PMID: 31553682 DOI: 10.1152/jn.00003.2019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Whereas numerous motor control theories describe the control of arm trajectory during reach, the control of stabilization in a constant arm position (i.e., visuomotor control of arm posture) is less clear. Three potential mechanisms have been proposed for visuomotor control of arm posture: 1) increased impedance of the arm through co-contraction of antagonistic muscles, 2) corrective muscle activity via spinal/supraspinal reflex circuits, and/or 3) intermittent voluntary corrections to errors in position. We examined the cortical mechanisms of visuomotor control of arm posture and tested the hypothesis that cortical error networks contribute to arm stabilization. We collected electroencephalography (EEG) data from 10 young healthy participants across four experimental planar movement tasks. We examined brain activity associated with intermittent voluntary corrections of position error and antagonist co-contraction during stabilization. EEG beta-band (13-26 Hz) power fluctuations were used as indicators of brain activity, and coherence between EEG electrodes was used as a measure of functional connectivity between brain regions. Cortical activity in the sensory, motor, and visual areas during arm stabilization was similar to activity during volitional arm movements and was larger than activity during co-contraction of the arm. However, cortical connectivity between the sensorimotor and visual regions was higher during arm stabilization compared with volitional arm movements and co-contraction of the arm. The difference in cortical activity and connectivity between tasks might be attributed to an underlying visuomotor error network used to update motor commands for visuomotor control of arm posture.NEW & NOTEWORTHY We examined cortical activity and connectivity during control of stabilization in a constant arm position (i.e., visuomotor control of arm posture). Our findings provide evidence for cortical involvement during control of stabilization in a constant arm position. A visuomotor error network appears to be active and may update motor commands for visuomotor control of arm posture.
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Affiliation(s)
- Dylan B Snyder
- Department of Biomedical Engineering, Marquette University and Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Scott A Beardsley
- Department of Biomedical Engineering, Marquette University and Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Brian D Schmit
- Department of Biomedical Engineering, Marquette University and Medical College of Wisconsin, Milwaukee, Wisconsin
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13
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Wilke M, Baldeweg T. A multidimensional artefact-reduction approach to increase robustness of first-level fMRI analyses: Censoring vs. interpolating. J Neurosci Methods 2019; 318:56-68. [PMID: 30779930 DOI: 10.1016/j.jneumeth.2019.02.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 02/07/2019] [Accepted: 02/15/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND This manuscript describes a new, multidimensional and data-driven approach to identify outlying datapoints from a first-level fMRI dataset. NEW METHOD Using three different indicators of data corruption (the fast variance component of DVARS [Δ%D-var], scan-to-scan total displacement [STS], and each scan's overall explained variance [R2]), it identifies outlying datapoints while being balanced using Akaike'c corrected criterion (AIC C) to avoid overcorrection. We then explore the impact of censoring, interpolating, or both, to remove a bad scan's contribution to the final timeseries. RESULTS AND COMPARISON WITH EXISTING METHODS Our results (using three real-life datasets and extensive simulations) show that motion-corrupted datapoints as well as non-motion related image artefacts are detected reliably. Using several indicators is shown to be an advantage over existing single-indicator solutions in different settings. As a result of using our algorithm, stronger activation (as detected by both T-value and number of activated voxels) and an increase in the temporal signal-to-noise ratio can be seen. The effects of censoring and interpolation are distinct and complex. CONCLUSIONS The multidimensional approach described here is able to identify outlying datapoints in fMRI timeseries, with demonstrable positive effects on several outcome measures. While censoring datapoints may be preferable in many settings, the ultimate choice on which approach to choose may depend on the data at hand. Recommendations are provided for different scenarios.
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Affiliation(s)
- Marko Wilke
- Department of Pediatric Neurology and Developmental Medicine, Children's Hospital, Germany; Experimental Pediatric Neuroimaging, Children's Hospital and Department of Neuroradiology, University Hospital Tübingen, Germany.
| | - Torsten Baldeweg
- Developmental Neurosciences Programme, UCL Great Ormond Street Institute of Child Health, United Kingdom; Great Ormond Street Hospital NHS Trust, London, United Kingdom
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14
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Assessing motor, visual and language function using a single 5-minute fMRI paradigm: three birds with one stone. Brain Imaging Behav 2019; 12:1775-1785. [PMID: 29480439 DOI: 10.1007/s11682-018-9848-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Clinical functional Magnetic Resonance Imaging (fMRI) requires inferences on localization of major brain functions at the individual subject level. We hypothesized that a single "triple use" task would satisfy sensitivity and reliability requirements for successfully assessing the motor, visual and language domain in this context. This was tested here by the application in a group of healthy adults, assessing sensitivity and reliability at the individual subject level, separately for each domain.Our "triple use" task consisted of 2 conditions (condition 1, assessing motor and visual domain, and condition 2, assessing the language domain), serving mutually as active/control. We included 20 healthy adult subjects. Random effect analyses showed activation in primary motor, visual and language regions, as expected. Less expected regions were activated both for the motor and visual domains. Further, reliability of primary activation patterns was very high across individual subjects, with activation seen in 70-100% of subjects in primary motor, visual, and left-lateralized language regions.These findings suggest the "triple use" task to be reliable at the individual subject's level to assess motor, visual and language domains in the clinical fMRI context. Benefits of such an approach include shortening of acquisition time, simplicity of the task for each domain, and using a visual stimulus. Following establishment of reliability in adults, the task may also be a valuable addition in the pediatric clinical fMRI context, where each of these factors is of high relevance.
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15
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Brain Activation During Passive and Volitional Pedaling After Stroke. Motor Control 2019; 23:52-80. [PMID: 30012052 PMCID: PMC6685765 DOI: 10.1123/mc.2017-0059] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 01/06/2018] [Accepted: 02/25/2018] [Indexed: 11/18/2022]
Abstract
Background: Prior work indicates that pedaling-related brain activation is lower in people with stroke than in controls. We asked whether this observation could be explained by between-group differences in volitional motor commands and pedaling performance. Methods: Individuals with and without stroke performed passive and volitional pedaling while brain activation was recorded with functional magnetic resonance imaging. The passive condition eliminated motor commands to pedal and minimized between-group differences in pedaling performance. Volume, intensity, and laterality of brain activation were compared across conditions and groups. Results: There were no significant effects of condition and no Group × Condition interactions for any measure of brain activation. Only 53% of subjects could minimize muscle activity for passive pedaling. Conclusions: Altered motor commands and pedaling performance are unlikely to account for reduced pedaling-related brain activation poststroke. Instead, this phenomenon may be due to functional or structural brain changes. Passive pedaling can be difficult to achieve and may require inhibition of excitatory descending drive.
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16
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Gaberova K, Pacheva I, Timova E, Petkova A, Velkova K, Ivanov I. An Individualized Approach to Neuroplasticity After Early Unilateral Brain Damage. Front Psychiatry 2019; 10:747. [PMID: 31798467 PMCID: PMC6878729 DOI: 10.3389/fpsyt.2019.00747] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 09/17/2019] [Indexed: 12/21/2022] Open
Abstract
Introduction: Reorganization after early lesions in the developing brain has been an object of extensive scientific work, but even growing data from translational neuroscience studies in the last 20 years does not provide unified factors for prediction of type of reorganization and rehabilitation potential of patients with unilateral cerebral palsy (UCP) due to pre/perinatal insult. Aim: To analyze the type of motor, language, and sensory brain reorganization in patients with right-sided cerebral palsy due to pre/perinatal isolated left-sided brain lesions taking into consideration the type (cortico-subcortical or periventricular) and extent (gray and white matter damage) of the lesion, etiology, comorbidity, and other postnatal factors that could have played a role in the complex process of brain plasticity. Material and Methods: Eight patients with unilateral right cerebral palsy were included in the study. The individual data from fMRI of primary sensory, motor, and language representation were analyzed and compared with respective comprehensive etiological, clinical, and morphological data. Patients were examined clinically and psychologically, and investigated by structural and functional 3T GE scanner. A correlation between the type and extent of the lesion (involvement of cortical and subcortical structures), timing of lesion, type of reorganization (laterality index), and clinical and psychological outcome was done. Results: Significant interindividual diversity was found in the patient group predominantly in the patterns of motor reorganization. Patients with small periventricular lesions have ipsilesional representation of primary motor, sensory, and word generation function. Patients with lesions involving left cortico-subcortical regions show various models of reorganization in all three modalities (ipsilesional, contralesional, and bilateral) and different clinical outcome that seem to be impossible for prediction. However, patients with UCP who demonstrate ipsilesional motor cortical activation have better motor functional capacity. Conclusion: The type and size of the pre/perinatal lesion in left hemisphere could affect the natural potential of the young brain for reorganization and therefore the clinical outcome. Much larger sample and additional correlation with morphological data (volumetry, morphometry, tractography) is needed for determination of possible risk or protective factors that could play a role in the complex process of brain plasticity.
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Affiliation(s)
- Katerina Gaberova
- Department of Pediatrics, University Hospital "St.George", Plovdiv, Bulgaria.,Complex of Translational Neuroscience, Medical University - Plovdiv, Plovdiv, Bulgaria
| | - Iliyana Pacheva
- Department of Pediatrics, University Hospital "St.George", Plovdiv, Bulgaria.,Complex of Translational Neuroscience, Medical University - Plovdiv, Plovdiv, Bulgaria.,Department of Pediatrics and Medical Genetics, Medical University - Plovdiv, Plovdiv, Bulgaria
| | - Elena Timova
- Department of Pediatrics, University Hospital "St.George", Plovdiv, Bulgaria
| | - Anelia Petkova
- Department of Pediatrics, University Hospital "St.George", Plovdiv, Bulgaria
| | - Kichka Velkova
- Complex of Translational Neuroscience, Medical University - Plovdiv, Plovdiv, Bulgaria.,Department of Medical imaging, Medical University - Plovdiv, Plovdiv, Bulgaria
| | - Ivan Ivanov
- Department of Pediatrics, University Hospital "St.George", Plovdiv, Bulgaria.,Complex of Translational Neuroscience, Medical University - Plovdiv, Plovdiv, Bulgaria.,Department of Pediatrics and Medical Genetics, Medical University - Plovdiv, Plovdiv, Bulgaria
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17
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Nurmi T, Henriksson L, Piitulainen H. Optimization of Proprioceptive Stimulation Frequency and Movement Range for fMRI. Front Hum Neurosci 2018; 12:477. [PMID: 30559657 PMCID: PMC6286983 DOI: 10.3389/fnhum.2018.00477] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 11/14/2018] [Indexed: 01/12/2023] Open
Abstract
For vision, audition and tactile sense, the optimal stimulus frequency for fMRI is somewhat known. For proprioception, i.e., the “movement sense”, however, the optimal frequency is unknown. We studied the effect of passive-finger-movement frequency on proprioceptive fMRI responses using a novel pneumatic-movement actuator. Eleven healthy right-handed volunteers participated in the study. The movement actuator passively moved the participant’s right index finger at frequencies of 0.3, 1, 3, 6, 9, or 12 Hz in a blocked design. A functional localizer was used to define regions-of-interest in SI and SII cortices. In addition, effect of movement range on the fMRI responses was tested in a separate session with 1, 3, 5, and 7 mm movement ranges at a fixed 2 Hz frequency. In primary somatosensory (SI) cortex, the responses were stronger at 3 Hz than at 0.3 Hz (p < 0.001) or 1 Hz (p < 0.05), and at ≥6 Hz than 0.3 Hz (p < 0.001 for frequencies ≥ 6 Hz). In secondary somatosensory (SII) cortex, all movements, except at 0.3 Hz, elicited significant responses of similar strength. In addition, 6, 9, and 12-Hz movements elicited a significant offset response in both SI and SII cortices (p < 0.001–0.05). SI cortex required a total stimulation duration of 4 min to elicit significant activations at the group-level whereas for SII cortex 1 min 20 s was sufficient. Increase in the movement range led to stronger responses in SI cortex, but not in SII cortex. Movements above 3 Hz elicited the strongest SI cortex responses, and increase in the movement range enhanced the response strength. We thus recommend that movements at 3–6 Hz with a movement range of 5 mm or higher to be used in future studies of proprioception. Our results are in-line with previous fMRI and PET studies using tactile or median nerve stimulation at different stimulation frequencies.
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Affiliation(s)
- Timo Nurmi
- Department of Neuroscience and Biomedical Engineering (NBE), Aalto University, Espoo, Finland.,Aalto NeuroImaging, Aalto University, Espoo, Finland
| | - Linda Henriksson
- Department of Neuroscience and Biomedical Engineering (NBE), Aalto University, Espoo, Finland.,Aalto NeuroImaging, Aalto University, Espoo, Finland
| | - Harri Piitulainen
- Department of Neuroscience and Biomedical Engineering (NBE), Aalto University, Espoo, Finland.,Aalto NeuroImaging, Aalto University, Espoo, Finland
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18
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Potentials of Ultrahigh-Field MRI for the Study of Somatosensory Reorganization in Congenital Hemiplegia. Neural Plast 2018; 2018:8472807. [PMID: 30595689 PMCID: PMC6286762 DOI: 10.1155/2018/8472807] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 08/03/2018] [Accepted: 09/04/2018] [Indexed: 12/03/2022] Open
Abstract
Reorganization of somatosensory function influences the clinical recovery of subjects with congenital unilateral brain lesions. Ultrahigh-field (UHF) functional MRI (fMRI) with the use of a 7 T magnet has the potential to contribute fundamentally to the current knowledge of such plasticity mechanisms. The purpose of this study was to obtain preliminary information on the possible advantages of the study of somatosensory reorganization at UHF fMRI. We enrolled 6 young adults (mean age 25 ± 6 years) with congenital unilateral brain lesions (4 in the left hemisphere and 2 in the right hemisphere; 4 with perilesional motor reorganization and 2 with contralesional motor reorganization) and 7 healthy age-matched controls. Nondominant hand sensory assessment included stereognosis and 2-point discrimination. Task-dependent fMRI was performed to elicit a somatosensory activation by using a safe and quantitative device developed ad hoc to deliver a reproducible gentle tactile stimulus to the distal phalanx of thumb and index fingers. Group analysis was performed in the control group. Individual analyses in the native space were performed with data of hemiplegic subjects. The gentle tactile stimulus showed great accuracy in determining somatosensory cortex activation. Single-subject gentle tactile stimulus showed an S1 activation in the postcentral gyrus and an S2 activation in the inferior parietal insular cortex. A correlation emerged between an index of S1 reorganization (distance between expected and reorganized S1) and sensory deficit (p < 0.05) in subjects with hemiplegia, with higher distance related to a more severe sensory deficit. Increase in spatial resolution at 7 T allows a better localization of reorganized tactile function validated by its correlation with clinical measures. Our results support the S1 early-determination hypothesis and support the central role of topography of reorganized S1 compared to a less relevant S1-M1 integration.
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19
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Wilke M, Groeschel S, Lorenzen A, Rona S, Schuhmann MU, Ernemann U, Krägeloh‐Mann I. Clinical application of advanced MR methods in children: points to consider. Ann Clin Transl Neurol 2018; 5:1434-1455. [PMID: 30480038 PMCID: PMC6243383 DOI: 10.1002/acn3.658] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 08/10/2018] [Accepted: 08/10/2018] [Indexed: 12/11/2022] Open
Abstract
The application of both functional MRI and diffusion MR tractography prior to a neurosurgical operation is well established in adults, but less so in children, for several reasons. For this review, we have identified several aspects (task design, subject preparation, actual scanning session, data processing, interpretation of results, and decision-making) where pediatric peculiarities should be taken into account. Further, we not only systematically identify common issues, but also provide solutions, based on our experience as well as a review of the pertinent literature. The aim is to provide the clinician as well as the imaging scientist with information that helps to plan, conduct, and interpret such a clinically-indicated exam in a way that maximizes benefit for, and minimizes the burden on the individual child.
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Affiliation(s)
- Marko Wilke
- Department of Pediatric Neurology and Developmental MedicineChildren's HospitalTuebingenGermany
- Children's Hospital and Department of NeuroradiologyExperimental Pediatric NeuroimagingTuebingenGermany
| | - Samuel Groeschel
- Department of Pediatric Neurology and Developmental MedicineChildren's HospitalTuebingenGermany
- Children's Hospital and Department of NeuroradiologyExperimental Pediatric NeuroimagingTuebingenGermany
| | - Anna Lorenzen
- Department of Pediatric Neurology and Developmental MedicineChildren's HospitalTuebingenGermany
- Children's Hospital and Department of NeuroradiologyExperimental Pediatric NeuroimagingTuebingenGermany
| | - Sabine Rona
- Department of NeurosurgeryUniversity HospitalTuebingenGermany
| | | | - Ulrike Ernemann
- Department of Diagnostic and Interventional NeuroradiologyUniversity HospitalUniversity of TübingenTuebingenGermany
| | - Ingeborg Krägeloh‐Mann
- Department of Pediatric Neurology and Developmental MedicineChildren's HospitalTuebingenGermany
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20
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Dueñas J, Sulzer J, Stämpfli P, Hepp-Reymond MC, Kollias S, Seifritz E, Gassert R. BOLD signal in sensorimotor regions reveals differential encoding of passive forefinger velocity and displacement amplitude. Neuroimage 2018; 173:332-340. [DOI: 10.1016/j.neuroimage.2018.02.052] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 02/01/2018] [Accepted: 02/25/2018] [Indexed: 11/16/2022] Open
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21
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Lee SH, Jin SH, An J. Distinction of directional coupling in sensorimotor networks between active and passive finger movements using fNIRS. BIOMEDICAL OPTICS EXPRESS 2018; 9:2859-2870. [PMID: 30258695 PMCID: PMC6154205 DOI: 10.1364/boe.9.002859] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 05/23/2018] [Accepted: 05/24/2018] [Indexed: 06/08/2023]
Abstract
The purpose of this study is to investigate cerebral cortex activation during active movement and passive movement by using a functional near-infrared spectroscopy (fNIRS). Tasks were the flexion/extension of the right hand finger by active movement and passive movement. Oxy-hemoglobin concentration changes calculated from fNIRS and analyzed the activation and connectivity so as to understand dynamical brain relationship. The results demonstrated that the brain activation in passive movements is similar to motor execution. During active movement, the estimated causality patterns showed significant causality value from the supplementary motor area (SMA) to the primary motor cortex (M1). During the passive movement, the causality from the primary somatosensory cortex (S1) to the primary motor cortex (M1) was stronger than active movement. These results demonstrated that active and passive movements had a direct effect on the cerebral cortex but the stimulus pathway of active and passive movement is different. This study may contribute to better understanding how active and passive movements can be expressed into cortical activation by means of fNIRS.
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22
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Llwyd O, Panerai RB, Robinson TG. Effects of dominant and non-dominant passive arm manoeuvres on the neurovascular coupling response. Eur J Appl Physiol 2017; 117:2191-2199. [PMID: 28875348 DOI: 10.1007/s00421-017-3707-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 08/24/2017] [Indexed: 01/10/2023]
Abstract
PURPOSE Models designed to study neurovascular coupling (NVC) describe a possible cerebral hemisphere dominance dependent on task completed and preference in handedness. We investigated whether passive arm manoeuvre performed with dominant (Dom-Arm) or non-dominant arm (ND-Arm) stimulated haemodynamic differences in either contralateral (Cont-H) or ipsilateral (Ipsil-H) cerebral hemisphere. METHODS Healthy individuals lying in supine position, had measurements of beat-to-beat blood pressure (BP, mmHg), electrocardiogram (HR, bpm), end-tidal CO2 (etCO2, mmHg), and bilateral insonation of the middle cerebral arteries (MCA, cm s-1). Arm movement was performed for 60 s with passive flexion and extension of the elbow (1 Hz), before manoeuvre was repeated on other arm. Data were normalised and effect of treatment was analysed for differences between manoeuvres and within each time period. RESULTS Seventeen (eight males) healthy volunteers, aged 56 ± 7 years, were studied. Dom-Arm and ND-Arm manoeuvres stimulated a comparable temporal response in peripheral and cerebral haemodynamic parameters between Cont-H and Ipsil-H. CONCLUSIONS Both manoeuvres can be used to evoke similar bilateral MCA responses in assessing NVC. This finding should lead to more efficient protocols when using passive arm movement for NVC studies in healthy subjects.
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Affiliation(s)
- Osian Llwyd
- Department of Cardiovascular Sciences, Cerebral Haemodynamics in Ageing and Stroke Medicine Research Group, University of Leicester, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, Leicester, LE2 7LX, UK. .,NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK.
| | - Ronney B Panerai
- Department of Cardiovascular Sciences, Cerebral Haemodynamics in Ageing and Stroke Medicine Research Group, University of Leicester, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, Leicester, LE2 7LX, UK.,NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | - Thompson G Robinson
- Department of Cardiovascular Sciences, Cerebral Haemodynamics in Ageing and Stroke Medicine Research Group, University of Leicester, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, Leicester, LE2 7LX, UK.,NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
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23
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Scheef L, Nordmeyer-Massner JA, Smith-Collins APR, Müller N, Stegmann-Woessner G, Jankowski J, Gieseke J, Born M, Seitz H, Bartmann P, Schild HH, Pruessmann KP, Heep A, Boecker H. Functional Laterality of Task-Evoked Activation in Sensorimotor Cortex of Preterm Infants: An Optimized 3 T fMRI Study Employing a Customized Neonatal Head Coil. PLoS One 2017; 12:e0169392. [PMID: 28076368 PMCID: PMC5226735 DOI: 10.1371/journal.pone.0169392] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 12/16/2016] [Indexed: 12/27/2022] Open
Abstract
Background Functional magnetic resonance imaging (fMRI) in neonates has been introduced as a non-invasive method for studying sensorimotor processing in the developing brain. However, previous neonatal studies have delivered conflicting results regarding localization, lateralization, and directionality of blood oxygenation level dependent (BOLD) responses in sensorimotor cortex (SMC). Amongst the confounding factors in interpreting neonatal fMRI studies include the use of standard adult MR-coils providing insufficient signal to noise, and liberal statistical thresholds, compromising clinical interpretation at the single subject level. Patients / methods Here, we employed a custom-designed neonatal MR-coil adapted and optimized to the head size of a newborn in order to improve robustness, reliability and validity of neonatal sensorimotor fMRI. Thirteen preterm infants with a median gestational age of 26 weeks were scanned at term-corrected age using a prototype 8-channel neonatal head coil at 3T (Achieva, Philips, Best, NL). Sensorimotor stimulation was elicited by passive extension/flexion of the elbow at 1 Hz in a block design. Analysis of temporal signal to noise ratio (tSNR) was performed on the whole brain and the SMC, and was compared to data acquired with an ‘adult’ 8 channel head coil published previously. Task-evoked activation was determined by single-subject SPM8 analyses, thresholded at p < 0.05, whole-brain FWE-corrected. Results Using a custom-designed neonatal MR-coil, we found significant positive BOLD responses in contralateral SMC after unilateral passive sensorimotor stimulation in all neonates (analyses restricted to artifact-free data sets = 8/13). Improved imaging characteristics of the neonatal MR-coil were evidenced by additional phantom and in vivo tSNR measurements: phantom studies revealed a 240% global increase in tSNR; in vivo studies revealed a 73% global and a 55% local (SMC) increase in tSNR, as compared to the ‘adult’ MR-coil. Conclusions Our findings strengthen the importance of using optimized coil settings for neonatal fMRI, yielding robust and reproducible SMC activation at the single subject level. We conclude that functional lateralization of SMC activation, as found in children and adults, is already present in the newborn period.
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Affiliation(s)
- Lukas Scheef
- Department of Radiology, University of Bonn, Bonn, Germany
| | | | | | - Nicole Müller
- Department of Neonatology, University of Bonn, Bonn, Germany
| | | | | | | | - Mark Born
- Department of Radiology, University of Bonn, Bonn, Germany
| | - Hermann Seitz
- Department of Mechanical Engineering and Marine Technology, University of Rostock, Rostock, Germany
| | - Peter Bartmann
- Department of Neonatology, University of Bonn, Bonn, Germany
| | - Hans H. Schild
- Department of Radiology, University of Bonn, Bonn, Germany
| | - Klaas P. Pruessmann
- Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Axel Heep
- School of Clinical Sciences, University of Bristol, Bristol, United Kingdom
- Department of Neonatology, University of Bonn, Bonn, Germany
- * E-mail:
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Kirton A. Advancing non-invasive neuromodulation clinical trials in children: Lessons from perinatal stroke. Eur J Paediatr Neurol 2017; 21:75-103. [PMID: 27470654 DOI: 10.1016/j.ejpn.2016.07.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 06/21/2016] [Accepted: 07/02/2016] [Indexed: 12/18/2022]
Abstract
Applications of non-invasive brain stimulation including therapeutic neuromodulation are expanding at an alarming rate. Increasingly established scientific principles, including directional modulation of well-informed cortical targets, are advancing clinical trial development. However, high levels of disease burden coupled with zealous enthusiasm may be getting ahead of rational research and evidence. Experience is limited in the developing brain where additional issues must be considered. Properly designed and meticulously executed clinical trials are essential and required to advance and optimize the potential of non-invasive neuromodulation without risking the well-being of children and families. Perinatal stroke causes most hemiplegic cerebral palsy and, as a focal injury of defined timing in an otherwise healthy brain, is an ideal human model of developmental plasticity. Advanced models of how the motor systems of young brains develop following early stroke are affording novel windows of opportunity for neuromodulation clinical trials, possibly directing neuroplasticity toward better outcomes. Reviewing the principles of clinical trial design relevant to neuromodulation and using perinatal stroke as a model, this article reviews the current and future issues of advancing such trials in children.
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Affiliation(s)
- Adam Kirton
- Departments of Pediatrics and Clinical Neurosciences, Cumming School of Medicine, Hotchkiss Brain Institute and Alberta Children's Hospital Research Institute, 2888 Shaganappi Trail NW, Calgary, AB T3B6A8, Canada.
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Interpreting Intervention Induced Neuroplasticity with fMRI: The Case for Multimodal Imaging Strategies. Neural Plast 2015; 2016:2643491. [PMID: 26839711 PMCID: PMC4709757 DOI: 10.1155/2016/2643491] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 09/27/2015] [Indexed: 12/03/2022] Open
Abstract
Direct measurement of recovery from brain injury is an important goal in neurorehabilitation, and requires reliable, objective, and interpretable measures of changes in brain function, referred to generally as “neuroplasticity.” One popular imaging modality for measuring neuroplasticity is task-based functional magnetic resonance imaging (t-fMRI). In the field of neurorehabilitation, however, assessing neuroplasticity using t-fMRI presents a significant challenge. This commentary reviews t-fMRI changes commonly reported in patients with cerebral palsy or acquired brain injuries, with a focus on studies of motor rehabilitation, and discusses complexities surrounding their interpretations. Specifically, we discuss the difficulties in interpreting t-fMRI changes in terms of their underlying causes, that is, differentiating whether they reflect genuine reorganisation, neurological restoration, compensation, use of preexisting redundancies, changes in strategy, or maladaptive processes. Furthermore, we discuss the impact of heterogeneous disease states and essential t-fMRI processing steps on the interpretability of activation patterns. To better understand therapy-induced neuroplastic changes, we suggest that researchers utilising t-fMRI consider concurrently acquiring information from an additional modality, to quantify, for example, haemodynamic differences or microstructural changes. We outline a variety of such supplementary measures for investigating brain reorganisation and discuss situations in which they may prove beneficial to the interpretation of t-fMRI data.
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26
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Ben-Shabat E, Matyas TA, Pell GS, Brodtmann A, Carey LM. The Right Supramarginal Gyrus Is Important for Proprioception in Healthy and Stroke-Affected Participants: A Functional MRI Study. Front Neurol 2015; 6:248. [PMID: 26696951 PMCID: PMC4668288 DOI: 10.3389/fneur.2015.00248] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Accepted: 11/12/2015] [Indexed: 01/15/2023] Open
Abstract
Human proprioception is essential for motor control, yet its central processing is still debated. Previous studies of passive movements and illusory vibration have reported inconsistent activation patterns related to proprioception, particularly in high-order sensorimotor cortices. We investigated brain activation specific to proprioception, its laterality, and changes following stroke. Twelve healthy and three stroke-affected individuals with proprioceptive deficits participated. Proprioception was assessed clinically with the Wrist Position Sense Test, and participants underwent functional magnetic resonance imaging scanning. An event-related study design was used, where each proprioceptive stimulus of passive wrist movement was followed by a motor response of mirror -copying with the other wrist. Left (LWP) and right (RWP) wrist proprioception were tested separately. Laterality indices (LIs) were calculated for the main cortical regions activated during proprioception. We found proprioception-related brain activation in high-order sensorimotor cortices in healthy participants especially in the supramarginal gyrus (SMG LWP z = 4.51, RWP z = 4.24) and the dorsal premotor cortex (PMd LWP z = 4.10, RWP z = 3.93). Right hemispheric dominance was observed in the SMG (LI LWP mean 0.41, SD 0.22; RWP 0.29, SD 0.20), and to a lesser degree in the PMd (LI LWP 0.34, SD 0.17; RWP 0.13, SD 0.25). In stroke-affected participants, the main difference in proprioception-related brain activation was reduced laterality in the right SMG. Our findings indicate that the SMG and PMd play a key role in proprioception probably due to their role in spatial processing and motor control, respectively. The findings from stroke--affected individuals suggest that decreased right SMG function may be associated with decreased proprioception. We recommend that clinicians pay particular attention to the assessment and rehabilitation of proprioception following right hemispheric lesions.
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Affiliation(s)
- Ettie Ben-Shabat
- Neurorehabilitation and Recovery, Stroke, Florey Institute of Neuroscience and Mental Health , Melbourne, VIC , Australia ; Occupational Therapy, School of Allied Health, College of Science, Health and Engineering, La Trobe University , Melbourne, VIC , Australia
| | - Thomas A Matyas
- Neurorehabilitation and Recovery, Stroke, Florey Institute of Neuroscience and Mental Health , Melbourne, VIC , Australia ; Occupational Therapy, School of Allied Health, College of Science, Health and Engineering, La Trobe University , Melbourne, VIC , Australia
| | - Gaby S Pell
- Neurorehabilitation and Recovery, Stroke, Florey Institute of Neuroscience and Mental Health , Melbourne, VIC , Australia
| | - Amy Brodtmann
- Neurorehabilitation and Recovery, Stroke, Florey Institute of Neuroscience and Mental Health , Melbourne, VIC , Australia
| | - Leeanne M Carey
- Neurorehabilitation and Recovery, Stroke, Florey Institute of Neuroscience and Mental Health , Melbourne, VIC , Australia ; Occupational Therapy, School of Allied Health, College of Science, Health and Engineering, La Trobe University , Melbourne, VIC , Australia
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Fiori S, Staudt M, Pannek K, Borghetti D, Biagi L, Scelfo D, Rose SE, Tosetti M, Cioni G, Guzzetta A. Is one motor cortex enough for two hands? Dev Med Child Neurol 2015; 57:977-80. [PMID: 26104046 DOI: 10.1111/dmcn.12817] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/04/2015] [Indexed: 10/23/2022]
Abstract
We report on a patient with mirror movements sustained by a mono-hemispheric fast control of bilateral hand muscles and normal hand function. Transcranial magnetic stimulation of the right motor cortex evoked contractions of muscles in both hands while no responses were observed from the left hemisphere. Somatosensory-evoked potentials, functional magnetic resonance, and diffusion tractography showed evidence of sensorimotor dissociation and asymmetry of corticospinal projections, suggestive of reorganization after early unilateral left brain lesion. This is the first evidence that, in certain rare conditions, good hand function is possible with ipsilateral corticospinal reorganization, supporting the role of unexplored mechanisms of motor recovery.
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Affiliation(s)
| | - Martin Staudt
- Clinic for Neuropediatrics and Neurorehabilitation, Epilepsy Center for Children and Adolescents, Schön Klinik Vogtareuth, Germany.,Department of Pediatric Neurology and Developmental Medicine, University Children's Hospital, Tübingen, Germany
| | - Kerstin Pannek
- The Australian e-Health Research Centre CSIRO, Royal Brisbane and Women's Hospital, Brisbane, Qld, Australia
| | | | | | | | - Stephen E Rose
- The Australian e-Health Research Centre CSIRO, Royal Brisbane and Women's Hospital, Brisbane, Qld, Australia
| | | | - Giovanni Cioni
- IRCCS Stella Maris Foundation, Pisa, Italy.,Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Andrea Guzzetta
- IRCCS Stella Maris Foundation, Pisa, Italy.,Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Choudhri AF, Patel RM, Siddiqui A, Whitehead MT, Wheless JW. Cortical Activation Through Passive-Motion Functional MRI. AJNR Am J Neuroradiol 2015; 36:1675-81. [PMID: 26228890 DOI: 10.3174/ajnr.a4345] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 02/13/2015] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND PURPOSE Functional brain mapping is an important technique for neurosurgical planning, particularly for patients with tumors or epilepsy; however, mapping has traditionally involved invasive techniques. Existing noninvasive techniques require patient compliance and may not be suitable for young children. We performed a retrospective review of our experience with passive-motion functional MR imaging in anesthetized patients to determine the diagnostic yield of this technique. MATERIALS AND METHODS A retrospective review of patients undergoing passive-motion fMRI under general anesthesia at a single institution over a 2.5-year period was performed. Clinical records were evaluated to determine the indication for fMRI, the ability to detect cortical activation, and, if present, the location of cortical activation. RESULTS We identified 62 studies in 56 patients in this time period. The most common indication for fMRI was epilepsy/seizures. Passive-motion fMRI identified upper-extremity cortical activation in 105 of 119 (88%) limbs evaluated, of which 90 (86%) activations were in an orthotopic location. Lower-extremity cortical activation was identified in 86 of 118 (73%) limbs evaluated, of which 73 (85%) activations were in an orthotopic location. CONCLUSIONS Passive-motion fMRI was successful in identifying cortical activation in most of the patients. This tool can be implemented easily and can aid in surgical planning for children with tumors or candidates for epilepsy surgery, particularly those who may be too young to comply with existing noninvasive functional measures.
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Affiliation(s)
- A F Choudhri
- From the Departments of Radiology (A.F.C., A.S., M.T.W.) Neurosurgery (A.F.C.) Le Bonheur Neuroscience Institute (A.F.C., A.S., M.T.W., J.W.W.), Le Bonheur Children's Hospital, Memphis, Tennessee
| | - R M Patel
- College of Medicine (R.M.P.), University of Tennessee Health Science Center, Memphis, Tennessee
| | - A Siddiqui
- From the Departments of Radiology (A.F.C., A.S., M.T.W.) Le Bonheur Neuroscience Institute (A.F.C., A.S., M.T.W., J.W.W.), Le Bonheur Children's Hospital, Memphis, Tennessee
| | - M T Whitehead
- From the Departments of Radiology (A.F.C., A.S., M.T.W.) Le Bonheur Neuroscience Institute (A.F.C., A.S., M.T.W., J.W.W.), Le Bonheur Children's Hospital, Memphis, Tennessee Department of Radiology (M.T.W.), Children's National Medical Center, Washington, DC
| | - J W Wheless
- Pediatrics (J.W.W.) Le Bonheur Neuroscience Institute (A.F.C., A.S., M.T.W., J.W.W.), Le Bonheur Children's Hospital, Memphis, Tennessee
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An J, Jin SH, Lee SH, Jang G, Abibullaev B, Lee H, Moon JI. Cortical activation pattern for grasping during observation, imagery, execution, FES, and observation-FES integrated BCI: an fNIRS pilot study. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2015; 2013:6345-8. [PMID: 24111192 DOI: 10.1109/embc.2013.6611005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Passive movement, action observation and motor imagery as well as motor execution have been suggested to facilitate the motor function of human brain. The purpose of this study is to investigate the cortical activation patterns of these four modes using a functional near-infrared spectroscopy (fNIRS) system. Seven healthy volunteers underwent optical brain imaging by fNIRS. Passive movements were provided by a functional electrical stimulation (FES). Results demonstrated that while all movement modes commonly activated premotor cortex, there were considerable differences between modes. The pattern of neural activation in motor execution was best resembled by passive movement, followed by motor imagery, and lastly by action observation. This result indicates that action observation may be the least preferred way to activate the sensorimotor cortices. Thus, in order to show the feasibility of motor facilitation by a brain computer interface (BCI) for an extreme case, we paradoxically adopted the observation as a control input of the BCI. An observation-FES integrated BCI activated sensorimotor system stronger than observation but slightly weaker than FES. This limitation should be overcome to utilize the observation-FES integrated BCI as an active motor training method.
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Heuer H, Lüttgen J. Robot assistance of motor learning: A neuro-cognitive perspective. Neurosci Biobehav Rev 2015; 56:222-40. [PMID: 26192105 DOI: 10.1016/j.neubiorev.2015.07.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2015] [Revised: 06/15/2015] [Accepted: 07/15/2015] [Indexed: 10/23/2022]
Abstract
The last several years have seen a number of approaches to robot assistance of motor learning. Experimental studies have produced a range of findings from beneficial effects through null-effects to detrimental effects of robot assistance. In this review we seek an answer to the question under which conditions which outcomes should be expected. For this purpose we derive tentative predictions based on a classification of learning tasks in terms of the products of learning, the mechanisms involved, and the modulation of these mechanisms by robot assistance. Consistent with these predictions, the learning of dynamic features of trajectories is facilitated and the learning of kinematic and dynamic transformations is impeded by robotic guidance, whereas the learning of dynamic transformations can profit from robot assistance with error-amplifying forces. Deviating from the predictions, learning of spatial features of trajectories is impeded by haptic guidance, but can be facilitated by divergent force fields. The deviations point to the existence of additional effects of robot assistance beyond the modulation of learning mechanisms, e.g., the induction of a passive role of the motor system during practice with haptic guidance.
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Affiliation(s)
- Herbert Heuer
- Leibniz Research Centre for Working Environment and Human Factors, Ardeystr. 67, 44139 Dortmund, Germany.
| | - Jenna Lüttgen
- Leibniz Research Centre for Working Environment and Human Factors, Ardeystr. 67, 44139 Dortmund, Germany
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Sulzer J, Dueñas J, Stämpili P, Hepp-Reymond MC, Kollias S, Seifritz E, Gassert R. Delineating the whole brain BOLD response to passive movement kinematics. IEEE Int Conf Rehabil Robot 2014; 2013:6650474. [PMID: 24187291 DOI: 10.1109/icorr.2013.6650474] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The field of brain-machine interfaces (BMIs) has made great advances in recent years, converting thought to movement, with some of the most successful implementations measuring directly from the motor cortex. However, the ability to record from additional regions of the brain could potentially improve flexibility and robustness of use. In addition, BMIs of the future will benefit from integrating kinesthesia into the control loop. Here, we examine whether changes in passively induced forefinger movement amplitude are represented in different regions than forefinger velocity via a MR compatible robotic manipulandum. Using functional magnetic resonance imaging (fMRI), five healthy participants were exposed to combinations of forefinger movement amplitude and velocity in a factorial design followed by an epoch-based analysis. We found that primary and secondary somatosensory regions were activated, as well as cingulate motor area, putamen and cerebellum, with greater activity from changes in velocity compared to changes in amplitude. This represents the first investigation into whole brain response to parametric changes in passive movement kinematics. In addition to informing BMIs, these results have implications towards neural correlates of robotic rehabilitation.
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Effects of involuntary eccentric contraction training by neuromuscular electrical stimulation on the enhancement of muscle strength. Clin Biomech (Bristol, Avon) 2014; 29:767-72. [PMID: 24985694 DOI: 10.1016/j.clinbiomech.2014.06.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Revised: 06/02/2014] [Accepted: 06/02/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND Neuromuscular electrical stimulation is well-known as a modality to improve the performance of neuromuscular system, but its clinical value on muscle strengthening remains equivocal. In this study, we designed a system for an involuntary eccentric contraction of biceps brachii muscles using continuous passive movement and commercial neuromuscular electrical stimulation devices. METHODS To investigate the effects of involuntary eccentric contraction training by neuromuscular electrical stimulation on the enhancement of muscle strength, seven healthy men between the ages of 24 and 29 years participated in this study. Participants were trained two times per week for 12 weeks. Each exercise session was performed for 30 min with no rest intervals. Isometric elbow flexion torque and biceps brachii muscle thickness were chosen as evaluation indices, and were measured at pre-/post-training. FINDINGS After the 12-week training, the isometric elbow flexion torque of the trained side significantly increased by approximately 23% compared to the initial performance (P<0.01). Meanwhile, the torque of the untrained side showed no significant change (P=0.862). During the 12-week training period, the biceps brachii muscle thickness of the trained side significantly increased by around 8% at rest and 16% at maximum voluntary contraction (P<0.01). INTERPRETATION The developed system and the technique show promising results, suggesting that it has the potential to be used to increase the muscle strength in patients with neuromuscular disease and to be implemented in design rehabilitative protocols.
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Boscolo Galazzo I, Storti SF, Formaggio E, Pizzini FB, Fiaschi A, Beltramello A, Bertoldo A, Manganotti P. Investigation of brain hemodynamic changes induced by active and passive movements: A combined arterial spin labeling-BOLD fMRI study. J Magn Reson Imaging 2013; 40:937-48. [DOI: 10.1002/jmri.24432] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Accepted: 08/30/2013] [Indexed: 12/13/2022] Open
Affiliation(s)
- Ilaria Boscolo Galazzo
- Department of Neurological and Movement Sciences, Section of Neurology; University of Verona; Italy
| | - Silvia F. Storti
- Department of Neurological and Movement Sciences, Section of Neurology; University of Verona; Italy
| | - Emanuela Formaggio
- Department of Neurophysiology Foundation IRCCS; San Camillo Hospital; Venice Italy
| | | | - Antonio Fiaschi
- Department of Neurological and Movement Sciences, Section of Neurology; University of Verona; Italy
- Department of Neurophysiology Foundation IRCCS; San Camillo Hospital; Venice Italy
- Clinical Neurophysiology and Functional Neuroimaging Unit; AOUI of Verona; Italy
| | | | | | - Paolo Manganotti
- Department of Neurological and Movement Sciences, Section of Neurology; University of Verona; Italy
- Department of Neurophysiology Foundation IRCCS; San Camillo Hospital; Venice Italy
- Clinical Neurophysiology and Functional Neuroimaging Unit; AOUI of Verona; Italy
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Dinomais M, Chinier E, Lignon G, Richard I, Ter Minassian A, Tich SNT. The effect of video-guidance on passive movement in patients with cerebral palsy: fMRI study. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:3487-3496. [PMID: 23927991 DOI: 10.1016/j.ridd.2013.07.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Revised: 07/06/2013] [Accepted: 07/09/2013] [Indexed: 06/02/2023]
Abstract
In patients with cerebral palsy (CP), neuroimaging studies have demonstrated that passive movement and action-observation tasks have in common to share neuronal activation in all or part of areas involved in motor system. Action observation with simultaneous congruent passive movements may have additional effects in the recruitment of brain motor areas. The aim of this functional magnetic resonance imaging (fMRI) study was to examine brain activation in patients with unilateral CP during passive movement with and without simultaneous observation of simple hand movement. Eighteen patients with unilateral CP (fourteen male, mean age 14 years and 2 months) participated in the study. Using fMRI block design, brain activation following passive simple opening-closing hand movement of either the paretic or nonparetic hand with and without simultaneous observation of a similar movement performed by either the left or right hand of an actor was compared. Passive movement of the paretic hand performed simultaneously to the observation of congruent movement activated more "higher motor areas" including contralesional pre-supplementary motor area, superior frontal gyrus (extending to premotor cortex), and superior and inferior parietal regions than nonvideo-guided passive movement of the paretic hand. Passive movement of the paretic hand recruited more ipsilesional sensorimotor areas compared to passive movement of the nonparetic hand. Our study showed that the combination of observation of congruent hand movement simultaneously to passive movement of the paretic hand recruits more motor areas, giving neuronal substrate to propose video-guided passive movement of paretic hand in CP rehabilitation.
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Affiliation(s)
- Mickael Dinomais
- LUNAM, Université d'Angers, Laboratoire d'Ingénierie des Systèmes Automatisés (LISA) - EA4094, F-49000, France; LUNAM, Université d'Angers, CHU Angers, Département de Médecine Physique et de Réadaptation, F-49933, France.
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Salinet ASM, Robinson TG, Panerai RB. Cerebral blood flow response to neural activation after acute ischemic stroke: a failure of myogenic regulation? J Neurol 2013; 260:2588-95. [PMID: 23824356 DOI: 10.1007/s00415-013-7022-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Revised: 06/17/2013] [Accepted: 06/23/2013] [Indexed: 12/19/2022]
Abstract
We tested two hypotheses: (1) neurovascular coupling is impaired after acute ischemic stroke, (2) subcomponent analysis of cerebral blood flow velocity can reveal significant differences between acute ischemic stroke and healthy controls. This was explored through the comparison of nineteen acute ischemic stroke patients with healthy controls. Recordings of cerebral blood flow velocity, blood pressure and end-tidal CO2 were obtained during 60s of passive elbow flexion. Cerebral blood flow velocity changes were decomposed into standardized subcomponents describing the contributions of blood pressure (V BP), resistance area product (V RAP) and critical closing pressure (V CrCP). The passive paradigm led to a bilateral cerebral blood flow velocity increase in both groups, but in acute ischemic stroke the magnitude of change was significantly lower. Blood pressure increases were shown to be an important contributor to cerebral blood flow velocity response throughout the paradigm in both groups, with no significant difference between groups. The V CrCP contribution was not different between groups or hemispheres; its continuous rise during activation indicating a vasodilatory effect. On the other hand, the V RAP contribution showed significant differences (p = 0.03), thus suggesting myogenic impairment in acute ischemic stroke. Cerebral blood flow velocity responses to passive elbow flexion suggest an impairment of neurovascular coupling in acute ischemic stroke. Subcomponent analysis suggests an impairment of the myogenic pathways, giving a greater insight into the different mechanisms contributing to neurovascular coupling. Further research is needed to assess the clinical value of subcomponent analysis of neurovascular coupling and the natural history of such changes following acute ischemic stroke.
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Affiliation(s)
- Angela S M Salinet
- Department of Cardiovascular Sciences, University of Leicester, Trent Stroke Research Network Office, Victoria Building, Leicester Royal Infirmary, LE1 5WW, Leicester, UK,
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Kirton A. Can noninvasive brain stimulation measure and modulate developmental plasticity to improve function in stroke-induced cerebral palsy? Semin Pediatr Neurol 2013; 20:116-26. [PMID: 23948686 DOI: 10.1016/j.spen.2013.06.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The permanent nature of motor deficits is a consistent cornerstone of cerebral palsy definitions. Such pessimism is disheartening to children, families, and researchers alike and may no longer be appropriate for it ignores the fantastic plastic potential of the developing brain. Perinatal stroke is presented as the ideal human model of developmental neuroplasticity following distinct, well-defined, focal perinatal brain injury. Elegant animal models are merging with human applied technology methods, including noninvasive brain stimulation for increasingly sophisticated models of plastic motor development following perinatal stroke. In this article, how potential central therapeutic targets are identified and potentially modulated to enhance motor function within these models is discussed. Also, future directions and emerging clinical trials are reviewed.
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Affiliation(s)
- Adam Kirton
- Calgary Pediatric Stroke Program, Alberta Children's Hospital Research Institute, Section of Neurology, Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada.
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Salinet ASM, Robinson TG, Panerai RB. Active, passive, and motor imagery paradigms: component analysis to assess neurovascular coupling. J Appl Physiol (1985) 2013; 114:1406-12. [PMID: 23449939 DOI: 10.1152/japplphysiol.01448.2012] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The association between neural activity and cerebral blood flow (CBF) has been used to assess neurovascular coupling (NVC) in health and diseases states, but little attention has been given to the contribution of simultaneous changes in peripheral covariates. We used an innovative approach to assess the contributions of arterial blood pressure (BP), PaCO2, and the stimulus itself to changes in CBF velocities (CBFv) during active (MA), passive (MP), and motor imagery (MI) paradigms. Continuous recordings of CBFv, beat-to-beat BP, heart rate, and breath-by-breath end-tidal CO2 (EtCO2) were performed in 17 right-handed subjects before, during, and after motor-cognitive paradigms performed with the right arm. A multivariate autoregressive-moving average model was used to calculate the separate contributions of BP, EtCO2, and the neural activation stimulus (represented by a metronome on-off signal) to the CBFv response during paradigms. Differences were found in the bilateral CBFv responses to MI compared with MA and MP, due to the contributions of stimulation (P < 0.05). BP was the dominant contributor to the initial peaked CBFv response in all paradigms with no significant differences between paradigms, while the contribution of the stimulus explained the plateau phase and extended duration of the CBFv responses. Separating the neural activation contribution from the influences of other covariates, it was possible to detect differences between three paradigms often used to assess disease-related NVC. Apparently similar CBFv responses to different motor-cognitive paradigms can be misleading due to the contributions from peripheral covariates and could lead to inaccurate assessment of NVC, particularly during MI.
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Affiliation(s)
- Angela S M Salinet
- Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom.
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Kirton A. Modeling developmental plasticity after perinatal stroke: defining central therapeutic targets in cerebral palsy. Pediatr Neurol 2013; 48:81-94. [PMID: 23337000 DOI: 10.1016/j.pediatrneurol.2012.08.001] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Accepted: 08/02/2012] [Indexed: 01/18/2023]
Abstract
Perinatal stroke is presented as the ideal human model of developmental neuroplasticity. The precise timing, mechanisms, and locations of specific perinatal stroke diseases provide common examples of well defined, focal, perinatal brain injuries. Motor disability (hemiparetic cerebral palsy) constitutes the primary adverse outcome and the focus of models explaining how motor systems develop in health and after early injury. Combining basic science animal work with human applied technology (functional magnetic resonance imaging, diffusion tensor imaging, and transcranial magnetic stimulation), a model of plastic motor development after perinatal stroke is presented. Potential central therapeutic targets are revealed. The means to measure and modulate these targets, including evidence-based rehabilitation therapies and noninvasive brain stimulation, are suggested. Implications for clinical trials and future directions are discussed.
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Affiliation(s)
- Adam Kirton
- Calgary Pediatric Stroke Program, Alberta Children's Hospital Research Institute, and Section of Neurology, Department of Pediatrics and Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.
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Van de Winckel A, Klingels K, Bruyninckx F, Wenderoth N, Peeters R, Sunaert S, Van Hecke W, De Cock P, Eyssen M, De Weerdt W, Feys H. How does brain activation differ in children with unilateral cerebral palsy compared to typically developing children, during active and passive movements, and tactile stimulation? An fMRI study. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:183-97. [PMID: 22940170 DOI: 10.1016/j.ridd.2012.07.030] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Revised: 07/27/2012] [Accepted: 07/30/2012] [Indexed: 05/25/2023]
Abstract
The aim of the functional magnetic resonance imaging (fMRI) study was to investigate brain activation associated with active and passive movements, and tactile stimulation in 17 children with right-sided unilateral cerebral palsy (CP), compared to 19 typically developing children (TD). The active movements consisted of repetitive opening and closing of the hand. For passive movements, an MRI-compatible robot moved the finger up and down. Tactile stimulation was provided by manually stroking the dorsal surface of the hand with a sponge cotton cloth. In both groups, contralateral primary sensorimotor cortex activation (SM1) was seen for all tasks, as well as additional contralateral primary somatosensory cortex (S1) activation for passive movements. Ipsilateral cerebellar activity was observed in TD children during all tasks, but only during active movements in CP children. Of interest was additional ipsilateral SM1 recruitment in CP during active movements as well as ipsilateral S1 activation during passive movements and tactile stimulation. Another interesting new finding was the contralateral cerebellum activation in both groups during different tasks, also in cerebellar areas not primarily linked to the sensorimotor network. Active movements elicited significantly more brain activation in CP compared to TD children. In both groups, active movements displayed significantly more brain activation compared to passive movements and tactile stimulation.
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Affiliation(s)
- Ann Van de Winckel
- Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Belgium.
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Van Poppel M, Wheless JW, Clarke DF, McGregor A, McManis MH, Perkins FF, Van Poppel K, Fulton S, Boop FA. Passive language mapping with magnetoencephalography in pediatric patients with epilepsy. J Neurosurg Pediatr 2012; 10:96-102. [PMID: 22725975 DOI: 10.3171/2012.4.peds11301] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECT Functional mapping is important for determining surgical candidacy and also in epilepsy surgery planning. However, in young children and uncooperative patients, language mapping has been particularly challenging despite the advances in performing noninvasive functional studies. In this study the authors review a series of children with epilepsy who underwent language mapping with magnetoencephalography (MEG) while sedated or sleeping, to determine receptive language localization for presurgical evaluation. METHODS The authors undertook a retrospective review of patients who underwent MEG between December 2007 and July 2009, and identified 15 individuals who underwent passive language testing as part of their presurgical evaluation because they were unable to participate in traditional language testing, such as Wada or functional MRI. Factors necessitating passive language testing included age and neurocognitive development. RESULTS Three of the 15 patients were deemed candidates for epilepsy surgery based on the results from standard preoperative testing, including video electroencephalography, MRI, and passive receptive language testing using MEG technology. The MEG studies were used successfully to localize language in all 3 patients, creating opportunities for seizure freedom through surgery that would not otherwise have been available. All 3 patients then underwent resective epilepsy surgery without experiencing postoperative language deficits. CONCLUSIONS This case series is the first to look at language mapping during sleep (passive language mapping) in which MEG was used and is the first to evaluate passive language testing in a patient population with intracranial pathological entities. This case series demonstrates that MEG can provide an alternative method for receptive language localization in patients with barriers to more traditional language testing, and in these 3 cases surgery was performed safely based on the results.
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Affiliation(s)
- Mark Van Poppel
- Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA
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41
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Salinet ASM, Panerai RB, Robinson TG. Effects of active, passive and motor imagery paradigms on cerebral and peripheral hemodynamics in older volunteers: a functional TCD study. ULTRASOUND IN MEDICINE & BIOLOGY 2012; 38:997-1003. [PMID: 22502887 DOI: 10.1016/j.ultrasmedbio.2012.02.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2011] [Revised: 01/09/2012] [Accepted: 02/16/2012] [Indexed: 05/31/2023]
Abstract
This study aimed to compare the response of metabolic-induced cerebral hemodynamic changes measured using transcranial Doppler (TCD) ultrasonography during passive, active and motor imagery paradigms, and associated peripheral hemodynamic responses. Continuous recordings of bilateral cerebral blood flow velocity (CBFv), blood pressure, heart rate and end-tidal CO(2) were performed in 12 right-handed subjects (aged ≥45 y) before, during and after 60 s of active, passive and mental-imagined paradigms. The results revealed no significant difference in CBFv responses between the paradigms and, furthermore, the temporal patterns of the hemodynamic responses showed some degree of similarity. Moreover, significant changes were seen in cerebral and peripheral hemodynamic responses for all paradigms. Our results suggest that active, passive and motor imagery paradigms can be used interchangeably to assess hemodynamic responses. This will enable more detailed noninvasive assessment in patients, where voluntary movement is not possible, but where abnormalities of cerebral hemodynamic control mechanisms can be anticipated.
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Affiliation(s)
- Angela S M Salinet
- Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom.
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42
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Szameitat AJ, Shen S, Conforto A, Sterr A. Cortical activation during executed, imagined, observed, and passive wrist movements in healthy volunteers and stroke patients. Neuroimage 2012; 62:266-80. [PMID: 22584231 DOI: 10.1016/j.neuroimage.2012.05.009] [Citation(s) in RCA: 103] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Revised: 04/27/2012] [Accepted: 05/05/2012] [Indexed: 11/29/2022] Open
Abstract
Motor imagery, passive movement, and movement observation have been suggested to activate the sensorimotor system without overt movement. The present study investigated these three covert movement modes together with overt movement in a within-subject design to allow for a fine-grained comparison of their abilities in activating the sensorimotor system, i.e. premotor, primary motor, and somatosensory cortices. For this, 21 healthy volunteers underwent functional magnetic resonance imaging (fMRI). In addition we explored the abilities of the different covert movement modes in activating the sensorimotor system in a pilot study of 5 stroke patients suffering from chronic severe hemiparesis. Results demonstrated that while all covert movement modes activated sensorimotor areas, there were profound differences between modes and between healthy volunteers and patients. In healthy volunteers, the pattern of neural activation in overt execution was best resembled by passive movement, followed by motor imagery, and lastly by movement observation. In patients, attempted overt execution was best resembled by motor imagery, followed by passive movement, and lastly by movement observation. Our results indicate that for severely hemiparetic stroke patients motor imagery may be the preferred way to activate the sensorimotor system without overt behavior. In addition, the clear differences between the covert movement modes point to the need for within-subject comparisons.
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Affiliation(s)
- André J Szameitat
- Department of Psychology, Ludwig Maximilians University, Munich, Germany.
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43
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Salinet AS, Robinson TG, Panerai RB. Reproducibility of cerebral and peripheral haemodynamic responses to active, passive and motor imagery paradigms in older healthy volunteers: A fTCD study. J Neurosci Methods 2012; 206:143-50. [DOI: 10.1016/j.jneumeth.2012.02.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2012] [Accepted: 02/10/2012] [Indexed: 11/29/2022]
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Blatow M, Reinhardt J, Riffel K, Nennig E, Wengenroth M, Stippich C. Clinical functional MRI of sensorimotor cortex using passive motor and sensory stimulation at 3 tesla. J Magn Reson Imaging 2011; 34:429-37. [DOI: 10.1002/jmri.22629] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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45
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Domenech J, García-Martí G, Martí-Bonmatí L, Barrios C, Tormos JM, Pascual-Leone A. Abnormal activation of the motor cortical network in idiopathic scoliosis demonstrated by functional MRI. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2011; 20:1069-78. [PMID: 21499781 PMCID: PMC3176702 DOI: 10.1007/s00586-011-1776-8] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2010] [Revised: 02/24/2011] [Accepted: 03/10/2011] [Indexed: 11/29/2022]
Abstract
The aetiology of idiopathic scoliosis (IS) remains unknown, but there is growing support for the possibility of an underlying neurological disorder. Functional magnetic resonance imaging (fMRI) can characterize the abnormal activation of the sensorimotor brain network in movement disorders and could provide further insights into the neuropathogenesis of IS. Twenty subjects were included in the study; 10 adolescents with IS (mean age of 15.2, 8 girls and 2 boys) and 10 age-matched healthy controls. The average Cobb angle of the primary curve in the IS patients was 35° (range 27°-55°). All participants underwent a block-design fMRI experiment in a 1.5-Tesla MRI scanner to explore cortical activation following a simple motor task. Rest periods alternated with activation periods during which participants were required to open and close their hand at an internally paced rate of approximately 1 Hz. Data were analyzed with Statistical Parametric Mapping (SPM5) including age, sex and laterality as nuisance variables to minimise the presence of bias in the results. Compared to controls, IS patients showed significant increases in blood oxygenation level dependent (BOLD) activity in contralateral supplementary motor area when performing the motor task with either hand. No significant differences were observed when testing between groups in the functional activation in the primary motor cortex, premotor cortex and somatosensory cortex. Additionally, the IS group showed a greater interhemispheric asymmetry index than the control group (0.30 vs. 0.13, p < 0.001). This study demonstrates an abnormal pattern of brain activation in secondary motor areas during movement execution in patients with IS. These findings support the hypothesis that a sensorimotor integration disorder underlies the pathogenesis of IS.
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Affiliation(s)
- Julio Domenech
- Orthopedic Surgery Department, Hospital Arnau de Vilanova, Valencia, Spain.
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46
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Sgandurra G, Ferrari A, Cossu G, Guzzetta A, Biagi L, Tosetti M, Fogassi L, Cioni G. Upper limb children action-observation training (UP-CAT): a randomised controlled trial in hemiplegic cerebral palsy. BMC Neurol 2011; 11:80. [PMID: 21711525 PMCID: PMC3141400 DOI: 10.1186/1471-2377-11-80] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2011] [Accepted: 06/28/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rehabilitation for children with hemiplegic cerebral palsy (HCP) aimed to improve function of the impaired upper limb (UL) uses a wide range of intervention programs. A new rehabilitative approach, called Action-Observation Therapy, based on the recent discovery of mirror neurons, has been used in adult stroke but not in children. The purpose of the present study is to design a randomised controlled trial (RCT) for evaluating the efficacy of Action-Observation Therapy in improving UL activity in children with HCP. METHODS/DESIGN The trial is designed according to CONSORT Statement. It is a randomised, evaluator-blinded, match-pair group trial. Children with HCP will be randomised within pairs to either experimental or control group. The experimental group will perform an Action-Observation Therapy, called UP-CAT (Upper Limb-Children Action-Observation Training) in which they will watch video sequences showing goal-directed actions, chosen according to children UL functional level, combined with motor training with their hemiplegic UL. The control group will perform the same tailored actions after watching computer games. A careful revision of psychometric properties of UL outcome measures for children with hemiplegia was performed. Assisting Hand Assessment was chosen as primary measure and, based on its calculation power, a sample size of 12 matched pairs was established. Moreover, Melbourne and ABILHAND-Kids were included as secondary measures. The time line of assessments will be T0 (in the week preceding the onset of the treatment), T1 and T2 (in the week after the end of the treatment and 8 weeks later, respectively). A further assessment will be performed at T3 (24 weeks after T1), to evaluate the retention of effects. In a subgroup of children enrolled in both groups functional Magnetic Resonance Imaging, exploring the mirror system and sensory-motor function, will be performed at T0, T1 and T2. DISCUSSION The paper aims to describe the methodology of a RCT for evaluating the efficacy of Action-Observation Therapy in improving UL activity in children with hemiplegia. This study will be the first to test this new type of treatment in childhood. The paper presents the theoretical background, study hypotheses, outcome measures and trial methodology. TRIAL REGISTRATION NCT01016496.
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Affiliation(s)
- Giuseppina Sgandurra
- Scuola Superiore Sant'Anna, Piazza Martiri della Libertà, 33 - 56127 Pisa, Italy
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47
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Functional MRI comparison of passive and active movement: possible inhibitory role of supplementary motor area. Neuroreport 2011; 20:1351-5. [PMID: 19734813 DOI: 10.1097/wnr.0b013e328330cd43] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Recent studies have hypothesized that the supplementary motor area plays a role in motor inhibition. To study this possible role, we used functional MRI study to compare conditions, which require various level of inhibition of motor patterns. Seventeen healthy participants were scanned while executing - actively or passively - rhythmic opening/closing movements of their right hand, with and without congruent visual information. The contrast passive>active movement in the visual guidance condition which requires inhibition in order 'not' to perform the movement, yields to significant activation of areas commonly involved in the inhibitory brain circuitry among which, notably, controlateral supplementary motor area.
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Abstract
Functional magnetic resonance imaging (fMRI) is frequently used in the presurgical diagnostic procedure of epilepsy patients, in particular for lateralization of speech and memory and for localization of the primary motor cortex to delineate the epileptogenic lesion from eloquent brain areas. fMRI is one of the non-invasive procedures in the presurgical diagnostic process, together with medical history, seizure semiology, neurological examination, interictal and ictal EEG, structural MRI, video EEG monitoring and neuropsychology. This diagnostic sequence leads either to the decision for or against elective epilepsy surgery or to the decision to proceed with invasive diagnostic techniques (Wada test, intra-operative or extra-operative cortical stimulation). It is difficult to evaluate the contribution of the fMRI test in isolation to the validity of the entire diagnostic sequence. Complications such as memory loss and aphasia in temporal lobe resections or paresis after frontal lobe resections are rare and rarely of disastrous extent. This further complicates the evaluation of the clinical relevance of fMRI as a predictive tool. In this article studies which investigated the concordance between fMRI and other diagnostic gold standards will be presented as well as the association between presurgical fMRI and postsurgical morbidity.
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Functional MRI in children: clinical and research applications. Pediatr Radiol 2010; 40:31-49. [PMID: 19937236 DOI: 10.1007/s00247-009-1452-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2009] [Revised: 09/29/2009] [Accepted: 10/19/2009] [Indexed: 10/20/2022]
Abstract
Functional MRI has become a critical research tool for evaluating brain function and developmental trajectories in children. Its clinical use in children is becoming more common. This presentation will review the basic underlying physiologic and technical aspects of fMRI, review research applications that have direct clinical relevance, and outline the current clinical uses of this technology.
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Arichi T, Moraux A, Melendez A, Doria V, Groppo M, Merchant N, Combs S, Burdet E, Larkman DJ, Counsell SJ, Beckmann CF, Edwards AD. Somatosensory cortical activation identified by functional MRI in preterm and term infants. Neuroimage 2009; 49:2063-71. [PMID: 19854281 DOI: 10.1016/j.neuroimage.2009.10.038] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2009] [Revised: 09/03/2009] [Accepted: 10/13/2009] [Indexed: 10/20/2022] Open
Abstract
Functional MRI (fMRI) has not previously been used systematically to investigate brain function in preterm infants. We here describe statistically robust and reproducible fMRI results in this challenging subject group using a programmable somatosensory stimulus synchronized with MR image acquisition which induced well-localized positive blood oxygen level dependent (BOLD) responses contralateral to the side of the stimulation in: 11 preterm infants (median post menstrual age 33 weeks and 4 days, range 29+1 to 35+3); 6 control infants born at term gestational age; and 18 infants born preterm (median gestational age at birth 30 weeks and 5 days, range 25+4 to 36+0) but studied at term corrected gestational age. Bilateral signals were identified in 8 of the ex-preterm infants at term age. Anatomical confirmation of appropriate activations was provided with diffusion tensor imaging (DTI) based tractography which identified connecting pathways from the regions of activation through the ipsilateral corticospinal tracts and posterior limb of the internal capsule. These results demonstrate that it is possible to reliably identify positive BOLD signals in the infant brain and that fMRI techniques can also be applied in the study of preterm infants.
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Affiliation(s)
- T Arichi
- Division of Clinical Sciences, Imperial College London, and MRC Clinical Sciences Centre, Hammersmith Hospital, London, UK
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