Illusory arm movements activate cortical motor areas: a positron emission tomography study

Local vibration induces changes in spinal and corticospinal excitability in vibrated and antagonist muscles

Local vibration (LV) applied over the muscle tendon constitutes a powerful stimulus to activate the muscle spindle primary (Ia) afferents that project to the spinal level and are conveyed to the cortical level. This study aimed to identify the neuromuscular changes induced by a 30-min LV-inducing illusions of hand extension on the vibrated flexor carpi radialis (FCR) and the antagonist extensor carpi radialis (ECR) muscles. We studied the change of the maximal voluntary isometric contraction (MVIC, experiment 1) for carpal flexion and extension, motor-evoked potentials (MEPs, experiment 2), cervicomedullary motor-evoked potentials (CMEPs, experiment 2), and Hoffmann's reflex (H-reflex, experiment 3) for both muscles at rest. Measurements were performed before (PRE) and at 0, 30, and 60 min after LV protocol. A lasting decrease in strength was only observed for the vibrated muscle. The reduction in CMEPs observed for both muscles seems to support a decrease in alpha motoneurons excitability. In contrast, a slight decrease in MEPs responses was observed only for the vibrated muscle. The MEP/CMEP ratio increase suggested greater cortical excitability after LV for both muscles. In addition, the H-reflex largely decreased for the vibrated and the antagonist muscles. The decrease in the H/CMEP ratio for the vibrated muscle supported both pre- and postsynaptic causes of the decrease in the H-reflex. Finally, LV-inducing illusions of movement reduced alpha motoneurons excitability for both muscles with a concomitant increase in cortical excitability.NEW & NOTEWORTHY Spinal disturbances confound the interpretation of excitability changes in motor areas and compromise the conclusions reached by previous studies using only a corticospinal marker for both vibrated and antagonist muscles. The time course recovery suggests that the H-reflex perturbations for the vibrated muscle do not only depend on changes in alpha motoneurons excitability. Local vibration induces neuromuscular changes in both vibrated and antagonist muscles at the spinal and cortical levels.

Cortical activity associated with focal muscle vibration applied directly to the affected forearm flexor muscle in post-stroke patients: an fNIRS study

Objective

The purpose of this study was to utilize functional near-infrared spectroscopy (fNIRS) to identify changes in cortical activity caused by focal muscle vibration (FMV), which was directly administered to the affected forearm flexor muscles of hemiplegic stroke patients. Additionally, the study aimed to investigate the correlation between these changes and the clinical characteristics of the patients, thereby expanding the understanding of potential neurophysiological mechanisms linked to these effects.

Methods

Twenty-two stroke patients with right hemiplegia who were admitted to our ward for rehabilitation were selected for this study. The fNIRS data were collected from subjects using a block-design paradigm. Subsequently, the collected data were analyzed using the NirSpark software to determine the mean Oxyhemoglobin (Hbo) concentrations for each cortical region of interest (ROI) in the task and rest states for every subject. The stimulation task was FMV (frequency 60 Hz, amplitude 6 mm) directly applied to belly of the flexor carpi radialis muscle (FCR) on the affected side. Hbo was measured in six regions of interest (ROIs) in the cerebral cortex, which included the bilateral prefrontal cortex (PFC), sensorimotor cortex (SMC), and occipital cortex (OC). The clinical characteristics of the patients were assessed concurrently, including Lovett's 6-level muscle strength assessment, clinical muscle tone assessment, the upper extremity function items of the Fugl-Meyer Assessment (FMA-UE), Bruunstrom staging scale (BRS), and Modified Barthel index (MBI). Statistical analyses were conducted to determine the activation in the ROIs and to comprehend its correlation with the clinical characteristics of the patients.

Results

Statistical analysis revealed that, except for right OC, there were statistically significant differences between the mean Hbo in the task state and rest state for bilateral SMC, PFC, and left OC. A positive correlation was observed between the muscle strength of the affected wrist flexor group and the change values of Hbo (Hbo-CV), as well as the beta values in the left SMC, PFC, and OC. However, no statistical correlation was found between muscle strength and Hbo-CV or beta values in the right SMC, PFC, and OC. The BRS of the affected upper limb exhibited a positive correlation with the Hbo-CV or beta values in the left SMC and PFC. In contrast, no statistical correlation was observed in the right SMC, PFC, and bilateral OC. No significant correlation was found between the muscle tone of the affected wrist flexor group, FMA-UE, MBI, and Hbo-CV or beta values of cortical ROIs.

Conclusion

FMV-evoked sensory stimulation applied directly to the FCR belly on the paralyzed side activated additional brain cortices, including bilateral PFC and ipsilesional OC, along with bilateral SMC in stroke patients. However, the clinical characteristics of the patients were only correlated with the intensity of ipsilesional SMC and PFC activation. The results of this study provide neurophysiological theoretical support for the expanded clinical application of FMV.

Hypnotic suggestion versus sensory modulation of bodily awareness

Bodily awareness arises from somatosensory, vestibular, and visual inputs but cannot be reduced to these incoming sensory signals. Cognitive factors are known to also impact bodily awareness, though their specific influence is poorly understood. Here we systematically compared the effects of sensory (bottom-up) and cognitive (top-down) manipulations on the estimated size of body parts. Toward this end, in a repeated-measures design, we sought to induce the illusion that the right index finger was elongating by vibrating the biceps tendon of the left arm whilst participants grasped the tip of their right index finger (Lackner illusion; bottom-up) and separately by hypnotic suggestion (top-down), with a sham version of the Lackner illusion as an active control condition. The effects of these manipulations were assessed with perceptual and motor tasks to capture different components of the representation of body size. We found that hypnotic suggestion significantly induced the illusion in both tasks relative to the sham condition. The magnitudes of these effects were stronger than those in the Lackner illusion condition, which only produced a significantly stronger illusion than the sham condition in the perceptual task. We further observed that illusion magnitude significantly correlated across tasks and conditions, suggesting partly shared mechanisms. These results are in line with theories of separate but interacting representational processes for perception and action and highlight the influence of cognitive factors on low-level body representations.

Quantifying body ownership information processing and perceptual bias in the rubber hand illusion

Bodily illusions have fascinated humankind for centuries, and researchers have studied them to learn about the perceptual and neural processes that underpin multisensory channels of bodily awareness. The influential rubber hand illusion (RHI) has been used to study changes in the sense of body ownership - that is, how a limb is perceived to belong to one's body, which is a fundamental building block in many theories of bodily awareness, self-consciousness, embodiment, and self-representation. However, the methods used to quantify perceptual changes in bodily illusions, including the RHI, have mainly relied on subjective questionnaires and rating scales, and the degree to which such illusory sensations depend on sensory information processing has been difficult to test directly. Here, we introduce a signal detection theory (SDT) framework to study the sense of body ownership in the RHI. We provide evidence that the illusion is associated with changes in body ownership sensitivity that depend on the information carried in the degree of asynchrony of correlated visual and tactile signals, as well as with perceptual bias and sensitivity that reflect the distance between the rubber hand and the participant's body. We found that the illusion's sensitivity to asynchrony is remarkably precise; even a 50 ms visuotactile delay significantly affected body ownership information processing. Our findings conclusively link changes in a complex bodily experience such as body ownership to basic sensory information processing and provide a proof of concept that SDT can be used to study bodily illusions.

Proprioceptive uncertainty promotes the rubber hand illusion

Body ownership is the multisensory perception of a body as one's own. Recently, the emergence of body ownership illusions like the visuotactile rubber hand illusion has been described by Bayesian causal inference models in which the observer computes the probability that visual and tactile signals come from a common source. Given the importance of proprioception for the perception of one's body, proprioceptive information and its relative reliability should impact this inferential process. We used a detection task based on the rubber hand illusion where participants had to report whether the rubber hand felt like their own or not. We manipulated the degree of asynchrony of visual and tactile stimuli delivered to the rubber hand and the real hand under two levels of proprioceptive noise using tendon vibration applied to the lower arm's antagonist extensor and flexor muscles. As hypothesized, the probability of the emergence of the rubber hand illusion increased with proprioceptive noise. Moreover, this result, well fitted by a Bayesian causal inference model, was best described by a change in the a priori probability of a common cause for vision and touch. These results offer new insights into how proprioceptive uncertainty shapes the multisensory perception of one's own body.

Brain activity differences between susceptible and non-susceptible populations under visually induced motion sickness based on sensor-space and source-space analyses

The neural mechanisms underlying visually induced motion sickness (VIMS) in different susceptible populations are unclear, as it is not clear how brain activity changes in different susceptible populations during the vection section (VS). This study aimed to analyze the brain activity changes in different susceptible populations during VS. Twenty subjects were included in this study and divided into the VIMS-susceptible group (VIMSSG) and VIMS-resistant group (VIMSRG) based on a motion sickness questionnaire. 64-channel electroencephalogram (EEG) data from these subjects during VS were collected. The brain activities during VS for VIMSSG and VIMSRG were analyzed with time-frequency based sensor-space analysis and EEG source imaging based source-space analysis. Under VS, delta and theta energies were significantly increased in VIMSSG and VIMSRG, while alpha and beta energies were only significantly increased in VIMSRG. Also, the superior and middle temporal were activated in VIMSSG and VIMSRG, while lateral occipital, supramarginal gyrus, and precentral gyrus were activated only in VIMSSG. The spatiotemporal differences in brain activity observed between VIMSSG and VIMSRG may be attributed to the different susceptibility of participants in each group and the different severity of MS symptoms experienced. Long-term vestibular training can effectively improve the ability of anti-VIMS. The knowledge gained from this study helps advance understanding of the neural mechanism of VIMS in different susceptible populations.

Enhanced lower-limb motor imagery by kinesthetic illusion

Brain-computer interface (BCI) based on lower-limb motor imagery (LMI) enables hemiplegic patients to stand and walk independently. However, LMI ability is usually poor for BCI-illiterate (e.g., some stroke patients), limiting BCI performance. This study proposed a novel LMI-BCI paradigm with kinesthetic illusion(KI) induced by vibratory stimulation on Achilles tendon to enhance LMI ability. Sixteen healthy subjects were recruited to carry out two research contents: (1) To verify the feasibility of induced KI by vibrating Achilles tendon and analyze the EEG features produced by KI, research 1 compared the subjective feeling and brain activity of participants during rest task with and without vibratory stimulation (V-rest, rest). (2) Research 2 compared the LMI-BCI performance with and without KI (KI-LMI, no-LMI) to explore whether KI enhances LMI ability. The analysis methods of both experiments included classification accuracy (V-rest vs. rest, no-LMI vs. rest, KI-LMI vs. rest, KI-LMI vs. V-rest), time-domain features, oral questionnaire, statistic analysis and brain functional connectivity analysis. Research 1 verified that induced KI by vibrating Achilles tendon might be feasible, and provided a theoretical basis for applying KI to LMI-BCI paradigm, evidenced by oral questionnaire (Q1) and the independent effect of vibratory stimulation during rest task. The results of research 2 that KI enhanced mesial cortex activation and induced more intensive EEG features, evidenced by ERD power, topographical distribution, oral questionnaire (Q2 and Q3), and brain functional connectivity map. Additionally, the KI increased the offline accuracy of no-LMI/rest task by 6.88 to 82.19% (p < 0.001). The simulated online accuracy was also improved for most subjects (average accuracy for all subjects: 77.23% > 75.31%, and average F1_score for all subjects: 76.4% > 74.3%). The LMI-BCI paradigm of this study provides a novel approach to enhance LMI ability and accelerates the practical applications of the LMI-BCI system.

When proprioceptive feedback enhances visual perception of self-body movement: rehabilitation perspectives

Introduction

Rehabilitation approaches take advantage of vision's important role in kinesthesia, using the mirror paradigm as a means to reduce phantom limb pain or to promote recovery from hemiparesis. Notably, it is currently applied to provide a visual reafferentation of the missing limb to relieve amputees' pain. However, the efficiency of this method is still debated, possibly due to the absence of concomitant coherent proprioceptive feedback. We know that combining congruent visuo-proprioceptive signals at the hand level enhances movement perception in healthy people. However, much less is known about lower limbs, for which actions are far less visually controlled in everyday life than upper limbs. Therefore, the present study aimed to explore, with the mirror paradigm, the benefit of combined visuo-proprioceptive feedback from the lower limbs of healthy participants.

Methods

We compared the movement illusions driven by visual or proprioceptive afferents and tested the extent to which adding proprioceptive input to the visual reflection of the leg improved the resulting movement illusion. To this end, 23 healthy adults were exposed to mirror or proprioceptive stimulation and concomitant visuo-proprioceptive stimulation. In the visual conditions, participants were asked to voluntarily move their left leg in extension and look at its reflection in the mirror. In the proprioceptive conditions, a mechanical vibration was applied to the hamstring muscle of the leg hidden behind the mirror to simulate an extension of the leg, either exclusively or concomitantly, to the visual reflection of the leg in the mirror.

Results

(i) Visual stimulation evoked leg movement illusions but with a lower velocity than the actual movement reflection on the mirror; (ii) proprioceptive stimulation alone provided more salient illusions than the mirror illusion; and (iii) adding a congruent proprioceptive stimulation improved the saliency, amplitude, and velocity of the illusion.

Conclusion

The present findings confirm that visuo-proprioceptive integration occurs efficiently when the mirror paradigm is coupled with mechanical vibration at the lower limbs, thus providing promising new perspectives for rehabilitation.

Neural Substrates of Body Ownership and Agency during Voluntary Movement

Body ownership and the sense of agency are two central aspects of bodily self-consciousness. While multiple neuroimaging studies have investigated the neural correlates of body ownership and agency separately, few studies have investigated the relationship between these two aspects during voluntary movement when such experiences naturally combine. By eliciting the moving rubber hand illusion with active or passive finger movements during functional magnetic resonance imaging, we isolated activations reflecting the sense of body ownership and agency, respectively, as well as their interaction, and assessed their overlap and anatomic segregation. We found that perceived hand ownership was associated with activity in premotor, posterior parietal, and cerebellar regions, whereas the sense of agency over the movements of the hand was related to activity in the dorsal premotor cortex and superior temporal cortex. Moreover, one section of the dorsal premotor cortex showed overlapping activity for ownership and agency, and somatosensory cortical activity reflected the interaction of ownership and agency with higher activity when both agency and ownership were experienced. We further found that activations previously attributed to agency in the left insular cortex and right temporoparietal junction reflected the synchrony or asynchrony of visuoproprioceptive stimuli rather than agency. Collectively, these results reveal the neural bases of agency and ownership during voluntary movement. Although the neural representations of these two experiences are largely distinct, there are interactions and functional neuroanatomical overlap during their combination, which has bearing on theories on bodily self-consciousness.SIGNIFICANCE STATEMENT How does the brain generate the sense of being in control of bodily movement (agency) and the sense that body parts belong to one's body (body ownership)? Using fMRI and a bodily illusion triggered by movement, we found that agency is associated with activity in premotor cortex and temporal cortex, and body ownership with activity in premotor, posterior parietal, and cerebellar regions. The activations reflecting the two sensations were largely distinct, but there was overlap in premotor cortex and an interaction in somatosensory cortex. These findings advance our understanding of the neural bases of and interplay between agency and body ownership during voluntary movement, which has implications for the development of advanced controllable prosthetic limbs that feel like real limbs.

Proprioception: A New Era Set in Motion by Emerging Genetic and Bionic Strategies?

The generation of an internal body model and its continuous update is essential in sensorimotor control. Although known to rely on proprioceptive sensory feedback, the underlying mechanism that transforms this sensory feedback into a dynamic body percept remains poorly understood. However, advances in the development of genetic tools for proprioceptive circuit elements, including the sensory receptors, are beginning to offer new and unprecedented leverage to dissect the central pathways responsible for proprioceptive encoding. Simultaneously, new data derived through emerging bionic neural machine-interface technologies reveal clues regarding the relative importance of kinesthetic sensory feedback and insights into the functional proprioceptive substrates that underlie natural motor behaviors.

In the back of your mind: Cortical mapping of paraspinal afferent inputs

Topographic organisation is a hallmark of vertebrate cortex architecture, characterised by ordered projections of the body's sensory surfaces onto brain systems. High-resolution functional magnetic resonance imaging (fMRI) has proven itself as a valuable tool to investigate the cortical landscape and its (mal-)adaptive plasticity with respect to various body part representations, in particular extremities such as the hand and fingers. Less is known, however, about the cortical representation of the human back. We therefore validated a novel, MRI-compatible method of mapping cortical representations of sensory afferents of the back, using vibrotactile stimulation at varying frequencies and paraspinal locations, in conjunction with fMRI. We expected high-frequency stimulation to be associated with differential neuronal activity in the primary somatosensory cortex (S1) compared with low-frequency stimulation and that somatosensory representations would differ across the thoracolumbar axis. We found significant differences between neural representations of high-frequency and low-frequency stimulation and between representations of thoracic and lumbar paraspinal locations, in several bilateral S1 sub-regions, and in regions of the primary motor cortex (M1). High-frequency stimulation preferentially activated Brodmann Area (BA) regions BA3a and BA4p, whereas low-frequency stimulation was more encoded in BA3b and BA4a. Moreover, we found clear topographic differences in S1 for representations of the upper and lower back during high-frequency stimulation. We present the first neurobiological validation of a method for establishing detailed cortical maps of the human back, which might serve as a novel tool to evaluate the pathological significance of neuroplastic changes in clinical conditions such as chronic low back pain.

The myokinetic stimulation interface: activation of proprioceptive neural responses with remotely actuated magnets implanted in rodent forelimb muscles

OBJECTIVE

Proprioception is the sense of one's position, orientation, and movement in space, and it is of fundamental importance for motor control. When proprioception is impaired or absent, motor execution becomes error-prone, leading to poorly coordinated movements. The kinaesthetic illusion, which creates perceptions of limb movement in humans through non-invasively applying vibrations to muscles or tendons, provides an avenue for studying and restoring the sense of joint movement (kinaesthesia). This technique, however, leaves ambiguity between proprioceptive percepts that arise from muscles versus those that arise from skin receptors. Here we propose the concept of a stimulation system to activate kinaesthesia through the untethered application of localized vibration through implanted magnets.

APPROACH

In this proof-of-concept study, we use two simplified 1-DoF systems to show the feasibility of eliciting muscle-sensory responses in an animal model across multiple frequencies, including those that activate the kinaesthetic illusion (70 - 115 Hz). Furthermore, we generalized the concept by developing a 5-DoF prototype system capable of generating directional, frequency-selective vibrations with desired displacement profiles.

MAIN RESULTS

In-vivo tests with the 1-DoF systems demonstrated the feasibility to elicit muscle sensory neural responses in the median nerve of an animal model. Instead, in-vitro tests with the 5-DoF prototype demonstrated high accuracy in producing directional and frequency selective vibrations along different magnet axes.

SIGNIFICANCE

These results provide evidence for a new technique that interacts with the native neuro-muscular anatomy to study proprioception and eventually pave the way towards the development of advanced limb prostheses or assistive devices for the sensory impaired.

Experience-Dependent Modulation of Rubber Hand Illusion in Badminton Players

Badminton players have a plastic modification of their arm representation in the brain due to the prolonged use of their racket. However, it is not known whether their arm representation can be altered through short-term visuotactile integration. The neural representation of the body is easily altered when multiple sensory signals are integrated in the brain. One of the most popular experimental paradigms for investigating this phenomenon is the "rubber hand illusion." This study was designed to investigate the effect of prolonged use of a racket on the modulation of arm representation during the rubber hand illusion in badminton players. When badminton players hold the racket, their badminton experience in years is negatively correlated with the magnitude of the rubber hand illusion. This finding suggests that tool embodiment obtained by the prolonged use of the badminton racket is less likely to be disturbed when holding the racket.

Visual feedback improves movement illusions induced by tendon vibration after chronic stroke

BACKGROUND

Illusion of movement induced by tendon vibration is commonly used in rehabilitation and seems valuable for motor rehabilitation after stroke, by playing a role in cerebral plasticity. The aim was to study if congruent visual cues using Virtual Reality (VR) could enhance the illusion of movement induced by tendon vibration of the wrist among participants with stroke.

METHODS

We included 20 chronic stroke participants. They experienced tendon vibration of their wrist (100 Hz, 30 times) inducing illusion of movement. Three VR visual conditions were added to the vibration: a congruent moving virtual hand (Moving condition); a static virtual hand (Static condition); or no virtual hand at all (Hidden condition). The participants evaluated for each visual condition the intensity of the illusory movement using a Likert scale, the sensation of wrist's movement using a degree scale and they answered a questionnaire about their preferred condition.

RESULTS

The Moving condition was significantly superior to the Hidden condition and to the Static condition in terms of illusion of movement (p < 0.001) and the wrist's extension (p < 0.001). There was no significant difference between the Hidden and the Static condition for these 2 criteria. The Moving condition was considered the best one to increase the illusion of movement (in 70% of the participants). Two participants did not feel any illusion of movement.

CONCLUSIONS

This study showed the interest of using congruent cues in VR in order to enhance the consistency of the illusion of movement induced by tendon vibration among participants after stroke, regardless of their clinical severity. By stimulating the brain motor areas, this visuo-proprioceptive feedback could be an interesting tool in motor rehabilitation. Record number in Clinical Trials: NCT04130711, registered on October 17th 2019 ( https://clinicaltrials.gov/ct2/show/NCT04130711?id=NCT04130711&draw=2&rank=1 ).

Comparison of Functional Connectivity during Visual-Motor Illusion, Observation, and Motor Execution

This study investigated the functional connectivity during visual-motor illusion and compared it with observation and motor execution using functional near-infrared spectroscopy (fNIRS). Thirty subjects were randomly assigned to: illusion, observation, and motor execution group. Illusion group watched own finger joint movement video image and induced kinesthetic illusion, while the other group only performed observation or motor execution. Continuous brain activity was measured using fNIRS and functional connectivity was analyzed. The illusion group perceived (using 7-point Likert scale) a higher degree of kinesthetic illusion and sense of body ownership than the observation group. Visual-motor illusion was associated with stronger functional connectivity between the left premotor cortex and the left parietal area compared with observation and motor execution only, suggesting that these areas respond to visual-motor illusion.

Influence of the visuo-proprioceptive illusion of movement and motor imagery of the wrist on EEG cortical excitability among healthy participants

INTRODUCTION

Motor Imagery (MI) is a powerful tool to stimulate sensorimotor brain areas and is currently used in motor rehabilitation after a stroke. The aim of our study was to evaluate whether an illusion of movement induced by visuo-proprioceptive immersion (VPI) including tendon vibration (TV) and Virtual moving hand (VR) combined with MI tasks could be more efficient than VPI alone or MI alone on cortical excitability assessed using Electroencephalography (EEG).

METHODS

We recorded EEG signals in 20 healthy participants in 3 different conditions: MI tasks involving their non-dominant wrist (MI condition); VPI condition; and VPI with MI tasks (combined condition). Each condition lasted 3 minutes, and was repeated 3 times in randomized order. Our main judgment criterion was the Event-Related De-synchronization (ERD) threshold in sensori-motor areas in each condition in the brain motor area.

RESULTS

The combined condition induced a greater change in the ERD percentage than the MI condition alone, but no significant difference was found between the combined and the VPI condition (p = 0.07) and between the VPI and MI condition (p = 0.20).

CONCLUSION

This study demonstrated the interest of using a visuo-proprioceptive immersion with MI rather than MI alone in order to increase excitability in motor areas of the brain. Further studies could test this hypothesis among patients with stroke to provide new perspectives for motor rehabilitation in this population.

Perception of gait motion during multiple lower-limb vibrations in young healthy individuals: a pilot study

In virtual reality (VR), immersion can be created through synchronous visuomotor stimulations and enhanced by adding auditory or kinesthetic stimulations. Multiple patterned vibrations applied at the lower limbs might be a way to induce kinesthetic perception of gait motion that could be combined with VR stimulations to add the perception of self-motion. However, gait motion perception using multiple vibrations has not yet been evaluated. The objective of the study was to quantify the perception of gait motion while applying multiple, patterned vibrations to the lower limbs in healthy individuals. Twenty young healthy participants (25.1 ± 4.4 years) experienced multiple vibrations in 1-min trials. Stimulation consisted of a vibration pattern based on the sequence of muscle lengthening during a 2-s gait cycle. Stimulation was applied on participants in a standing position, under 11 experimental conditions controlling visual information (eyes open/closed), vibration frequency (40-80 Hz), and number and location of the joints stimulated (hips, knees, ankles isolated or combined two by two). Perception of gait motion was quantified for each condition using a 10-point visual analog scale (VAS, 0: "no perception", 10: "Perception of gait movements"). All participants except one achieved a score higher than 5/10 in at least one condition. Great variability was found for perception of gait motion within participants and conditions (VAS ranging from 0 to 9.6/10). Differences were found between conditions (p < 0.01), with higher mean and median scores in conditions that included knee vibration. Inducing gait motion perception is possible using multiple vibrations in healthy individuals. Stimulation of the knees seems to positively influence perception of gait motion.

Degree of muscle-and-tendon tonus effects on kinesthetic illusion in wrist joints toward advanced rehabilitation robotics

Due to increasing demand for rehabilitation and therapy for cerebrovascular diseases, patients require advanced development of medical rehabilitation robots. In our laboratory, we focus on the formation capability of the substitute neural path caused by brain plasticity using the kinesthetic illusion (KI), which is effective for therapies using robots. In KI, people perceive an illusionary limb movement without an actual movement when a vibration stimulus is applied to a limb’s tendons. In previous research, the optimal frequency that induces the maximum KI has a correlation factor of about 0.5 with the tendon’s natural frequency when a human subject is in a state of laxity. However, we do not know whether the above finding can be applied to actual rehabilitation because muscles and tendons are sometimes in tonus during rehabilitation, a state that varies the natural frequency. In this study, we investigate the correlation between the optimal and natural frequencies of tendon by systematically changing their tension to clarify the effects on the illusion induced by the muscle and the tendon when they are in tonus. We identified a negative correlation between the optimal and natural frequencies when they are in tonus, although a positive correlation appeared when they are in laxity. This result suggests that KI’s optimal frequency should be changed based on the degree of the tendon and muscle tonus. Therefore, our present findings provide a suitable vibration frequency that induces KI due to the degree of the tendon and muscle tonus during robot therapies.

Disentangling the percepts of illusory movement and sensory stimulation during tendon vibration in the EEG

Mechanical vibration of muscle tendons in specific frequencies - termed functional proprioceptive stimulation (FPS) - has the ability to induce the illusion of a movement which is congruent with a lengthening of the vibrated tendon and muscle. The majority of previous reports of the brain correlates of this illusion are based on functional neuroimaging. Contrary to the electroencephalogram (EEG) however, such technologies are not suitable for bedside or ambulant use. While a handful of studies have shown EEG changes during FPS, it remains underinvestigated whether these changes were due to the perceived illusion or the perceived vibration. Here, we aimed at disentangling the neural correlates of the illusory movement from those produced by the vibration sensation by comparing the neural responses to two vibration types, one that did and one that did not elicit an illusion. We recruited 40 naïve participants, 20 for the EEG experiment and 20 for a supporting behavioral study, who received functional tendon co-vibration on the biceps and triceps tendon at their left elbow, pseudo-randomly switching between the illusion and non-illusion trials. Time-frequency decomposition uncovered a strong and lasting event-related desynchronization (ERD) in the mu and beta band in both conditions, suggesting a strong somatosensory response to the vibration. Additionally, the analysis of the evoked potentials revealed a significant difference between the two experimental conditions from 310 to 990ms post stimulus onset. Training classifiers on the frequency-based and voltage-based correlates of illusion perception yielded above chance accuracies for 17 and 13 out of the 20 subjects respectively. Our findings show that FPS-induced illusions produce EEG correlates that are distinct from a vibration-based control and which can be classified reliably in a large number of participants. These results encourage pursuing EEG-based detection of kinesthetic illusions as a tool for clinical use, e.g., to uncover aspects of cognitive perception in unresponsive patients.

Bimanual coupling effect during a proprioceptive stimulation

Circle-line drawing paradigm is used to study bimanual coupling. In the standard paradigm, subjects are asked to draw circles with one hand and lines with the other hand; the influence of the concomitant tasks results in two "elliptical" figures. Here we tested whether proprioceptive information evoked by muscle vibration inducing a proprioceptive illusion (PI) of movement at central level, was able to affect the contralateral hand drawing circles or lines. A multisite 80 Hz-muscle vibration paradigm was used to induce the illusion of circle- and line-drawing on the right hand of 15 healthy participants. During muscle vibration, subjects had to draw a congruent or an incongruent figure with the left hand. The ovalization induced by PI was compared with Real and Motor Imagery conditions, which already have proved to induce bimanual coupling. We showed that the ovalization of a perceived circle over a line drawing during PI was comparable to that observed in Real and Motor Imagery condition. This finding indicates that PI can induce bimanual coupling, and proprioceptive information can influence the motor programs of the contralateral hand.

Proprioceptive Augmentation With Illusory Kinaesthetic Sensation in Stroke Patients Improves Movement Quality in an Active Upper Limb Reach-and-Point Task

Stroke patients often have difficulty completing motor tasks even after substantive rehabilitation. Poor recovery of motor function can often be linked to stroke-induced damage to motor pathways. However, stroke damage in pathways that impact effective integration of sensory feedback with motor control may represent an unappreciated obstacle to smooth motor coordination. In this study we investigated the effects of augmenting movement proprioception during a reaching task in six stroke patients as a proof of concept. We used a wearable neurorobotic proprioceptive feedback system to induce illusory kinaesthetic sensation by vibrating participants' upper arm muscles over active limb movements. Participants were instructed to extend their elbow to reach-and-point to targets of differing sizes at various distances, while illusion-inducing vibration (90 Hz), sham vibration (25 Hz), or no vibration was applied to the distal tendons of either their biceps brachii or their triceps brachii. To assess the impact of augmented kinaesthetic feedback on motor function we compared the results of vibrating the biceps or triceps during arm extension in the affected arm of stroke patients and able-bodied participants. We quantified performance across conditions and participants by tracking limb/hand kinematics with motion capture, and through Fitts' law analysis of reaching target acquisition. Kinematic analyses revealed that injecting 90 Hz illusory kinaesthetic sensation into the actively contracting (agonist) triceps muscle during reaching increased movement smoothness, movement directness, and elbow extension. Conversely, injecting 90 Hz illusory kinaesthetic sensation into the antagonistic biceps during reaching negatively impacted those same parameters. The Fitts' law analyses reflected similar effects with a trend toward increased throughput with triceps vibration during reaching. Across all analyses, able-bodied participants were largely unresponsive to illusory vibrational augmentation. These findings provide evidence that vibration-induced movement illusions delivered to the primary agonist muscle involved in active movement may be integrated into rehabilitative approaches to help promote functional motor recovery in stroke patients.

Primary motor cortex excitability as a marker of plasticity in a stimulation protocol combining action observation and kinesthetic illusion of movement

Action observation combined with proprioceptive stimulation able to induce a kinesthetic illusion of movement (AO-KI) was shown to elicit a plastic increase in primary motor cortex (M1) excitability, with promising applications in rehabilitative interventions. Nevertheless, the known individual variability in response to combined stimulation protocols limits its application. The aim of this study was to examine whether a relationship exists between changes in M1 excitability during AO-KI and the long-lasting changes in M1 induced by AO-KI. Fifteen volunteers received a conditioning protocol consisting in watching a video showing a thumb-opposition movement and a simultaneous proprioceptive stimulation that evoked an illusory kinesthetic experience of their thumbs closing. M1 excitability was evaluated by means of single-pulse transcranial magnetic stimulation before, DURING the conditioning protocol, and up to 60 min AFTER it was administered. M1 excitability significantly increased during AO-KI with respect to a rest condition. Furthermore, AO-KI induced a long-lasting increase in M1 excitability up to 60 min after administration. Finally, a significant positive correlation appeared between M1 excitability changes during and after AO-KI; that is, participants who were more responsive during AO-KI showed greater motor cortical activity changes after it. These findings suggest that M1 response during AO-KI can be considered a neurophysiological marker of individual responsiveness to the combined stimulation since it was predictive of its efficacy in inducing long-lasting M1 increase excitability. This information would allow knowing in advance whether an individual will be a responder to AO-KI.

Influence of virtual reality visual feedback on the illusion of movement induced by tendon vibration of wrist in healthy participants

Introduction

Illusion of movement induced by tendon vibration is an effective approach for motor and sensory rehabilitation in case of neurological impairments. The aim of our study was to investigate which modality of visual feedback in Virtual Reality (VR) associated with tendon vibration of the wrist could induce the best illusion of movement.

Methods

We included 30 healthy participants in the experiment. Tendon vibration inducing illusion of movement (wrist extension, 100Hz) was applied on their wrist during 3 VR visual conditions (10 times each): a moving virtual hand corresponding to the movement that the participants could feel during the tendon vibration (Moving condition), a static virtual hand (Static condition), or no virtual hand at all (Hidden condition). After each trial, the participants had to quantify the intensity of the illusory movement on a Likert scale, the subjective degree of extension of their wrist and afterwards they answered a questionnaire.

Results

There was a significant difference between the 3 visual feedback conditions concerning the Likert scale ranking and the degree of wrist’s extension (p<0.001). The Moving condition induced a higher intensity of illusion of movement and a higher sensation of wrist’s extension than the Hidden condition (p<0.001 and p<0.001 respectively) than that of the Static condition (p<0.001 and p<0.001 respectively). The Hidden condition also induced a higher intensity of illusion of movement and a higher sensation of wrist’s extension than the Static condition (p<0.01 and p<0.01 respectively). The preferred condition to facilitate movement’s illusion was the Moving condition (63.3%).

Conclusions

This study demonstrated the importance of carefully selecting a visual feedback to improve the illusion of movement induced by tendon vibration, and the increase of illusion by adding VR visual cues congruent to the illusion of movement. Further work will consist in testing the same hypothesis with stroke patients.

Functional properties of extended body representations in the context of kinesthesia

A person's internal representation of his/her body is not fixed. It can be substantially modified by neurological injuries and can also be extended (in healthy participants) to incorporate objects that have a corporeal appearance (such as fake body segments, e.g. a rubber hand), virtual whole bodies (e.g. avatars), and even objects that do not have a corporeal appearance (e.g. tools). Here, we report data from patients and healthy participants that emphasize the flexible nature of body representation and question the extent to which incorporated objects have the same functional properties as biological body parts. Our data shed new light by highlighting the involvement of visual motion information from incorporated objects (rubber hands, full body avatars and hand-held tools) in the perception of one's own movement (kinesthesia). On the basis of these findings, we argue that incorporated objects can be treated as body parts, especially when kinesthesia is involved.

Immediate Effects of Plantar Vibration on Fall Risk and Postural Stability in Stroke Patients: A Randomized Controlled Trial

BACKGROUND

Local vibration can improve balance problems of individuals with stroke when applied to the plantar region.

AIMS

This study aimed to determine the immediate effect of local vibration applied to the plantar region on fall risk and postural stability in patients with stroke.

STUDY DESIGN

Randomized controlled study.

METHODS

30 patients (23 male,7 female) with stroke were randomized to either vibration (n = 15; 58.47 ± 8.23 years) or control (n = 15; 58.27 ± 9.50 years) groups. Before and after the intervention, the patients were evaluated using a Biodex Balance System. Local vibration was applied to the plantar region of two feet in the supine position using a vibration device for a total of 15 min to the individuals in the vibration group. While the patients in the placebo group were in the supine position, the device was brought into contact and no vibration was applied to the plantar region of two feet for 15 min.

RESULTS

While significant improvements were observed in the postural stability and fall risk of the vibration group (p < 0.05), no significant change was observed in the placebo group (p > 0.05). Furthermore, significant improvements occurred in the SD values of the postural stability expressing postural oscillation in the vibration group (p < 0.05).

CONCLUSION

As a result of local vibration applied to the plantar region, immediate (within 5 min) significant improvements in postural stability and fall risk values were detected.

Changes in the Organization of the Secondary Somatosensory Cortex While Processing Lumbar Proprioception and the Relationship With Sensorimotor Control in Low Back Pain

OBJECTIVES

Patients with nonspecific low back pain (NSLBP) rely more on the ankle compared with the lower back proprioception while standing, perform sit-to-stand-to-sit (STSTS) movements slower, and exhibit perceptual impairments at the lower back. However, no studies investigated whether these sensorimotor impairments relate to a reorganization of the primary and secondary somatosensory cortices (S1 and S2) and primary motor cortex (M1) during proprioceptive processing.

MATERIALS AND METHODS

Proprioceptive stimuli were applied at the lower back and ankle muscles during functional magnetic resonance imaging in 15 patients with NSLBP and 13 controls. The location of the activation peaks during the processing of proprioception within S1, S2, and M1 were determined and compared between groups. Proprioceptive use during postural control was evaluated, the duration to perform 5 STSTS movements was recorded, and participants completed the Fremantle Back Awareness Questionnaire (FreBAQ) to assess back-specific body perception.

RESULTS

The activation peak during the processing of lower back proprioception in the right S2 was shifted laterally in the NSLBP group compared with the healthy group (P=0.007). Moreover, patients with NSLSP performed STSTS movements slower (P=0.018), and reported more perceptual impairments at the lower back (P<0.001). Finally, a significant correlation between a more lateral location of the activation peak during back proprioceptive processing and a more disturbed body perception was found across the total group (ρ=0.42, P=0.025).

CONCLUSIONS

The results suggest that patients with NSLBP show a reorganization of the higher-order processing of lower back proprioception, which could negatively affect spinal control and body perception.

Errors in proprioceptive matching post-stroke are associated with impaired recruitment of parietal, supplementary motor, and temporal cortices

Deficits in proprioception, the ability to discriminate the relative position and movement of our limbs, affect ~50% of stroke patients and reduce functional outcomes. Our lack of knowledge of the anatomical correlates of proprioceptive processing limits our understanding of the impact that such deficits have on recovery. This research investigated the relationship between functional impairment in brain activity and proprioception post-stroke. We developed a novel device and task for arm position matching during functional MRI (fMRI), and investigated 16 subjects with recent stroke and nine healthy age-matched controls. The stroke-affected arm was moved by an experimenter (passive arm), and subjects were required to match the position of this limb with the opposite arm (active arm). Brain activity during passive and active arm movements was determined, as well as activity in association with performance error. Passive arm movement in healthy controls was associated with activity in contralateral primary somatosensory (SI) and motor cortices (MI), bilateral parietal cortex, supplementary (SMA) and premotor cortices, secondary somatosensory cortices (SII), and putamen. Active arm matching was associated with activity in contralateral SI, MI, bilateral SMA, premotor cortex, putamen, and ipsilateral cerebellum. In subjects with stroke, similar patterns of activity were observed. However, in stroke subjects, greater proprioceptive error was associated with less activity in ipsilesional supramarginal and superior temporal gyri, and lateral thalamus. During active arm movement, greater proprioceptive error was associated with less activity in bilateral SMA and ipsilesional premotor cortex. Our results enhance our understanding of the correlates of proprioception within the temporal parietal cortex and supplementary/premotor cortices. These findings also offer potential targets for therapeutic intervention to improve proprioception in recovering stroke patients and thus improve functional outcome.

A new method to elicit and measure movement illusions in stroke by means of muscle tendon vibration: the Standardized Kinesthetic Illusion Procedure (SKIP)

Purpose: Muscle tendon vibration (MTV) strongly activates muscle spindles and can evoke kinaesthetic illusions. Although potentially relevant for sensorimotor rehabilitation in stroke, MTV is scarcely used in clinical practice, likely because of the absence of standardised procedures to elicit and characterise movement illusions. This work developed and validated a Standardised Kinaesthetic Illusion Procedure (SKIP) to favour the use of MTV-induced illusions in clinical settings.Materials and methods: SKIP scores were obtained in 15 individuals with chronic stroke and 18 age- and gender-matched healthy counterparts. A further 13 healthy subjects were tested to provide more data with the general population. MTV was applied over the Achilles tendon and SKIP scoring system characterised the clearness and direction of the illusions of ankle dorsiflexion movements.Results: All healthy and stroke participants perceived movement illusions. SKIP scores on the paretic side were significantly lower compared to the non paretic and healthy. Illusions were less clear and sometimes in unexpected directions with the impaired ankle, but still possible to elicit in the presence of sensorimotor deficits.Conclusions: SKIP represents an ancillary and potentially useful clinical method to elicit and characterise illusions of movements induced by MTV. SKIP could be relevant to further assess the processing of proprioceptive afferents in stroke and their potential impact on motor control and recovery. It may be used to guide therapy and improve sensorimotor recovery. Future work is needed to investigate the metrological properties of our method (reliability, responsiveness, etc.), and also the neurophysiological underpinnings of MTV-induced illusions.

Differential Effect of Visual and Proprioceptive Stimulation on Corticospinal Output for Reciprocal Muscles

This study investigated the corticospinal excitability of reciprocal muscles during tasks involving sensory difference between proprioceptive and visual inputs. Participants were instructed to relax their muscles and to observe a screen during vibratory stimulation. A video screen was placed on the board covering the right hand and forearm. Participants were randomly tested in four conditions: resting, control, static, and dynamic. The resting condition involved showing a black screen, the control condition, a mosaic patterned static videoclip; the static condition, a static videoclip of wrist flexion 0°; and the dynamic condition, a videoclip that corresponded to each participant's closely-matched illusory wrist flexion angle and speed by vibration. Vibratory stimulation (frequency 80 Hz and duration 4 s) was applied to the distal tendon of the dominant right extensor carpi radialis (ECR) using a tendon vibrator in the control, static, and dynamic conditions. Four seconds after the vibratory stimulation (end of vibration), the primary motor cortex at the midpoint between the centers of gravity of the flexor carpi radialis (FCR) and ECR muscles was stimulated by transcranial magnetic stimulation (TMS). The ECR motor evoked potential (MEP) amplitudes significantly increased in the control condition compared to the resting condition, whereas the FCR MEP amplitudes did not change between the resting and control conditions. In addition, the ECR MEP amplitudes significantly increased in the static condition compared to the dynamic condition. However, the FCR MEP amplitudes significantly increased in the dynamic condition compared to the static condition. These results imply that the difference between visuo-proprioceptive information had an effect on corticospinal excitability for the muscle. In conclusion, we found that proprioceptive and visual information differentially altered the corticospinal excitability of reciprocal muscles.

High-frequency peripheral vibration decreases completion time on a number of motor tasks

A recent theoretical account of motor control proposes that modulation of afferent information plays a role in affecting how readily we can move. Increasing the estimate of uncertainty surrounding the afferent input is a necessary step in being able to move. It has been proposed that an inability to modulate the gain of this sensory information underlies the cardinal symptoms of Parkinson's disease (PD). We aimed to test this theory by modulating the uncertainty of the proprioceptive signal using high‐frequency peripheral vibration, to determine the subsequent effect on motor performance. We investigated if this peripheral stimulus might modulate oscillatory activity over the sensorimotor cortex in order to understand the mechanism by which peripheral vibration can change motor performance. We found that 80 Hz peripheral vibration applied to the right wrist of a total of 54 healthy human participants reproducibly improved performance across four separate randomised experiments on a number of motor control tasks (nine‐hole peg task, box and block test, reaction time task and finger tapping). Improved performance on all motor tasks (except the amplitude of finger tapping) was also seen for a sample of 18PD patients ON medication. EEG data investigating the effect of vibration on oscillatory activity revealed a significant decrease in beta power (15–30 Hz) over the contralateral sensorimotor cortex at the onset and offset of 80 Hz vibration. This finding is consistent with a novel theoretical account of motor initiation, namely that modulating uncertainty of the proprioceptive afferent signal improves motor performance potentially by gating the incoming sensory signal and allowing for top‐down proprioceptive predictions.

Event-related desynchronization possibly discriminates the kinesthetic illusion induced by visual stimulation from movement observation

Visual stimulation of a repetitive self-movement image can evoke kinesthetic illusion when a virtual body part is set over the actual body part (kinesthetic illusion induced by visual stimulation, KINVIS). KINVIS induces activity in cerebral network, similar to that produced during motor execution, and triggers motor imagery passively. This study sought to identify a biomarker of KINVIS using event-related desynchronization (ERD) to improve the application of KINVIS to brain-machine interface (BMI) therapy of patients with stroke with hemiparesis. We included healthy adults in whom KINVIS could be induced. Scalp electroencephalograms were recorded during the KINVIS condition, where KINVIS was induced using a self-movement image. The findings were compared to signals recorded during an observation (OB) condition where only the self-movement image was viewed. For the signal intensity of the α- and low β-frequency bands, we calculated ERD during a movie period. The ERD of the α-frequency band in P3 and CP3 during KINVIS was significantly higher than that during OB. Furthermore, using the ERD of the α-frequency band recorded from FC3 and CP3, we could discriminate illusory perception with a 70% success rate. In this study, KINVIS could be detected using the ERD of the α-frequency band recorded from the posterior portion of the sensorimotor cortex. Furthermore, adding ERD recorded from FC3 to that recorded from CP3 may enable the objective discrimination of KINVIS from OB. When applying KINVIS in BMI therapy, the combination ERD of FC3 and CP3 will become a parameter for objectively judging the degree of kinesthetic perception achieved.

Synchronous Neural Oscillation Between the Right Inferior Fronto-Parietal Cortices Contributes to Body Awareness

The right inferior fronto-parietal network monitors the current status of the musculoskeletal system and builds-up and updates our postural model. The kinesthetic illusion induced by tendon vibration has been utilized in experiments on the modulation of body awareness. The right inferior fronto-parietal cortices activate during the kinesthetic illusion. We aimed to determine the relationship between the right inferior fronto-parietal cortices and body awareness by applying transcranial alternating current stimulation (tACS) to exogenously modulate oscillatory neural activity in the right fronto-parietal cortices during the kinesthetic illusion. Sixteen young adults participated in this study. We counterbalanced the order in which participants received the three types of tACS (55 Hz enveloped by 6 Hz; synchronous, desynchronous, and sham) across the subjects. The illusory movement perception induced by tendon vibration of the left extensor carpi ulnaris muscle was assessed before and during tACS. Application of synchronous tACS over the right inferior fronto-parietal cortices significantly increased kinesthetic illusion compared with sham tACS. The kinesthetic illusion during desynchronous tACS decreased from baseline. There was no change in vibration sensation during any tACS condition. The modulation of oscillatory brain activity between the right fronto-parietal cortices alters the illusory movement perception without altering actual vibration sensation. tACS over the right inferior fronto-parietal cortices is considered to modulate the neural processing involved in updating the postural model when the stimulated muscle spindle sends kinesthetic signals. This is the first study that reveals that rhythmic communication between the right inferior fronto-parietal cortices has a causal role in body awareness.

Local Vibration Stimuli Induce Mechanical Stress-Induced Factors and Facilitate Recovery From Immobilization-Induced Oxidative Myofiber Atrophy in Rats

Muscle atrophy can be caused by unloading stress such as microgravity environments or cast immobilization. Therapies for such disuse muscle atrophy and their underlying mechanisms are incompletely understood. Here, we investigated the therapeutic effects of local vibration stimulation on immobilization-induced skeletal muscle atrophy. A rat model was made by placing the left hindlimb in a cast for 1 week, leading to oxidative myofiber atrophy without myopathic changes in soleus skeletal muscle. Vibration stimulus (90 Hz, 15 min) to the plantar fascia of the atrophic hindlimb was performed once a day using a hand-held vibration massager after removal of a cast at the end of the immobilization period. After 2 weeks, rats were dissected, and quantitative analysis of the cross-sectional areas of soleus myofibers was performed. The results revealed that vibration induced significant recovery from disuse muscle atrophy, compared with untreated immobilized samples. Furthermore, vibration treatment suppressed the fiber transition from slow to fast fiber types compared with vibration-untreated immobilized samples. Western blotting analyses of mechanical stress-induced factors revealed that the expression of mechano-growth factor (MGF), systemic insulin-like growth factor I, and the mechanotransduction protein, Yes-associated protein 1 (YAP1), was decreased in untreated immobilized soleus muscle, whereas vibration stimulation restored their expression. No change in the level of phosphorylation of YAP1^Ser127 was observed, leading to no change in p-YAP1/YAP1 ratio in vibration-treated immobilized soleus muscle. The results indicate that vibration stimulus is effective to restore immobilization-induced inactivation of YAP1 pathway. Phosphorylation of ERK 1/2, but not AKT, was enhanced in vibration-treated immobilized soleus muscle. Furthermore, vibration stimuli restored immobilization-induced downregulation of the paired box transcription factor, PAX7, a critical factor for regenerative myogenesis in muscle satellite cells. Our results indicate that cyclic vibration stimuli are effective in activating satellite cells and facilitate recovery from immobilization-induced oxidative myofiber atrophy through upregulation of MGF and YAP1.

Differences in brain processing of proprioception related to postural control in patients with recurrent non-specific low back pain and healthy controls

Patients with non-specific low back pain (NSLBP) show an impaired postural control during standing and a slower performance of sit-to-stand-to-sit (STSTS) movements. Research suggests that these impairments could be due to an altered use of ankle compared to back proprioception. However, the neural correlates of these postural control impairments in NSLBP remain unclear. Therefore, we investigated brain activity during ankle and back proprioceptive processing by applying local muscle vibration during functional magnetic resonance imaging in 20 patients with NSLBP and 20 controls. Correlations between brain activity during proprioceptive processing and (Airaksinen et al., 2006) proprioceptive use during postural control, evaluated by using muscle vibration tasks during standing, and (Altmann et al., 2007) STSTS performance were examined across and between groups. Moreover, fear of movement was assessed. Results revealed that the NSLBP group performed worse on the STSTS task, and reported more fear compared to healthy controls. Unexpectedly, no group differences in proprioceptive use during postural control were found. However, the relationship between brain activity during proprioceptive processing and behavioral indices of proprioceptive use differed significantly between NSLBP and healthy control groups. Activity in the right amygdala during ankle proprioceptive processing correlated with an impaired proprioceptive use in the patients with NSLBP, but not in healthy controls. Moreover, while activity in the left superior parietal lobule, a sensory processing region, during back proprioceptive processing correlated with a better use of proprioception in the NSLBP group, it was associated with a less optimal use of proprioception in the control group. These findings suggest that functional brain changes during proprioceptive processing in patients with NSLBP may contribute to their postural control impairments.

Kinaesthetic illusion shapes the cortical plasticity evoked by action observation

KEY POINTS

The combination of action observation (AO) and a peripheral nerve stimulation has been shown to induce plasticity in the primary motor cortex (M1). However, using peripheral nerve stimulation little is known about the specificity of the sensory inputs. The current study, using muscle tendon vibration to stimulate muscle spindles and transcranial magnetic stimulation to assess M1 excitability, investigated whether a proprioceptive stimulation leading to a kinaesthetic illusion of movement (KI) was able to evoke M1 plasticity when combined with AO. M1 excitability increased immediately and up to 60 min after AO-KI stimulation as a function of the vividness of the perceived illusion, and only when the movement directions of AO and KI were congruent. Tactile stimulation coupled with AO and KI alone were not sufficient to induce M1 plasticity. This methodology might be proposed to subjects during a period of immobilization to promote M1 activity without requiring any voluntary movement.

ABSTRACT

Physical practice is crucial to evoke cortical plasticity, but motor cognition techniques, such as action observation (AO), have shown their potentiality in promoting it when associated with peripheral afferent inputs, without the need of performing a movement. Here we investigated whether the combination of AO and a proprioceptive stimulation, able to evoke a kinaesthetic illusion of movement (KI), induced plasticity in the primary motor cortex (M1). In the main experiment, the role of congruency between the observed action and the illusory movement was explored together with the importance of the specificity of the sensory input modality (proprioceptive vs. tactile stimulation) to induce plasticity in M1. Further, a control experiment was carried out to assess the role of the mere kinaesthetic illusion on M1 excitability. Results showed that the combination of AO and KI evoked plasticity in M1, with an increase of the excitability immediately and up to 60 min after the conditioning protocol (P always <0.05). Notably, a significant increase in M1 excitability occurred only when the directions of the observed and illusory movements were congruent. Further, a significant positive linear relationship was found between the amount of M1 excitability increase and the vividness of the perceived illusion (P = 0.03). Finally, the tactile stimulation coupled with AO was not sufficient to induce changes in M1 excitability as well as the KI alone. All these findings indicate the importance of combining different sensory input signals to induce plasticity in M1, and that proprioception is the most suitable sensory modality to allow it.

The preload force affects the perception threshold of muscle vibration-induced movement illusions

The control and the execution of motor tasks are largely influenced by proprioceptive feedback, i.e. the information about the position and movement of the body. In 1972, it was discovered that a vibratory stimulation applied non-invasively to a muscle or a tendon induces a movement illusion consistent with the elongation of the vibrated muscle/tendon. Although this phenomenon was reported by several studies, it is still unclear how to reliably reproduce it because of the many different features of the stimulation altering the sensation (e.g. frequency, duration, location). By performing a psychophysical test, we analysed the effects of the stimulation point and the preload force on the minimum stimulation amplitude needed to elicit an illusion of movement. In particular, we stimulated two groups of healthy subjects on three target regions of the biceps brachii muscle (the distal tendon, the muscle belly and one of the proximal tendons) applying three preload force ranges (0.5–0.75N, 1–2N and 3–4N). Our results showed that the minimum stimulation amplitude eliciting a sensation is affected by the preload force. On the contrary, it did not change significantly among the three stimulated regions. Nevertheless, the reported vividness of the illusion of movement changed across the stimulated points decreasing while moving from the distal to the proximal tendons. Overall, these outcomes contribute to the scientific debate on the features that modulate the vibration-induced movement illusion proposing ways to increase the reliability of the procedure in basic and applied research studies.

Development of Right-hemispheric Dominance of Inferior Parietal Lobule in Proprioceptive Illusion Task

Functional lateralization can be an indicator of brain maturation. We have consistently shown that, in the adult brain, proprioceptive processing of muscle spindle afferents generating illusory movement of the right hand activates inferior frontoparietal cortical regions in a right-side dominant manner in addition to the cerebrocerebellar motor network. Here we provide novel evidence regarding the development of the right-dominant use of the inferior frontoparietal cortical regions in humans using this task. We studied brain activity using functional magnetic resonance imaging while 60 right-handed blindfolded healthy children (8-11 years), adolescents (12-15 years), and young adults (18-23 years) (20 per group) experienced the illusion. Adult-like right-dominant use of the inferior parietal lobule (IPL) was observed in adolescents, while children used the IPL bilaterally. In contrast, adult-like lateralized cerebrocerebellar motor activation patterns were already observable in children. The right-side dominance progresses during adolescence along with the suppression of the left-sided IPL activity that emerges during childhood. Therefore, the neuronal processing implemented in the adult's right IPL during the proprioceptive illusion task is likely mediated bilaterally during childhood, and then becomes right-lateralized during adolescence at a substantially later time than the lateralized use of the cerebrocerebellar motor system for kinesthetic processing.

Protracted Development of the Proprioceptive Brain Network During and Beyond Adolescence

Proprioceptive processing is important for appropriate motor control, providing error-feedback and internal representation of movement for adjusting the motor command. Although proprioceptive functioning improves during childhood and adolescence, we still have few clues about how the proprioceptive brain network develops. Here, we investigated developmental changes in the functional organization of this network in early adolescents (n = 18, 12 ± 1 years), late adolescents (n = 18, 15 ± 1), and young adults (n = 18, 32 ± 4), by examining task-evoked univariate activity and patterns of functional connectivity (FC) associated with seeds placed in cortical (supramarginal gyrus) and subcortical (dorsal rostral putamen) regions. We found that although the network is already well established in early adolescence both in terms of topology and functioning principles (e.g., long-distance communication and economy in wiring cost), it is still undergoing refinement during adolescence, including a shift from diffuse to focal FC and a decreased FC strength. This developmental effect was particularly pronounced for fronto-striatal connections. Furthermore, changes in FC features continued beyond adolescence, although to a much lower extent. Altogether, these findings point to a protracted developmental time course for the proprioceptive network, which breaks with the relatively early functional maturation often associated with sensorimotor networks.

The neural response properties and cortical organization of a rapidly adapting muscle sensory group response that overlaps with the frequencies that elicit the kinesthetic illusion

Kinesthesia is the sense of limb movement. It is fundamental to efficient motor control, yet its neurophysiological components remain poorly understood. The contributions of primary muscle spindles and cutaneous afferents to the kinesthetic sense have been well studied; however, potential contributions from muscle sensory group responses that are different than the muscle spindles have not been ruled out. Electrophysiological recordings in peripheral nerves and brains of male Sprague Dawley rats with a degloved forelimb preparation provide evidence of a rapidly adapting muscle sensory group response that overlaps with vibratory inputs known to generate illusionary perceptions of limb movement in humans (kinesthetic illusion). This group was characteristically distinct from type Ia muscle spindle fibers, the receptor historically attributed to limb movement sensation, suggesting that type Ia muscle spindle fibers may not be the sole carrier of kinesthetic information. The sensory-neural structure of muscles is complex and there are a number of possible sources for this response group; with Golgi tendon organs being the most likely candidate. The rapidly adapting muscle sensory group response projected to proprioceptive brain regions, the rodent homolog of cortical area 3a and the second somatosensory area (S2), with similar adaption and frequency response profiles between the brain and peripheral nerves. Their representational organization was muscle-specific (myocentric) and magnified for proximal and multi-articulate limb joints. Projection to proprioceptive brain areas, myocentric representational magnification of muscles prone to movement error, overlap with illusionary vibrational input, and resonant frequencies of volitional motor unit contraction suggest that this group response may be involved with limb movement processing.

The association between brain activity and motor imagery during motor illusion induction by vibratory stimulation

Background:

The association between motor imagery ability and brain neural activity that leads to the manifestation of a motor illusion remains unclear.

Objective:

In this study, we examined the association between the ability to generate motor imagery and brain neural activity leading to the induction of a motor illusion by vibratory stimulation.

Methods:

The sample consisted of 20 healthy individuals who did not have movement or sensory disorders. We measured the time between the starting and ending points of a motor illusion (the time to illusion induction, TII) and performed electroencephalography (EEG). We conducted a temporo-spatial analysis on brain activity leading to the induction of motor illusions using the EEG microstate segmentation method. Additionally, we assessed the ability to generate motor imagery using the Japanese version of the Movement Imagery Questionnaire-Revised (JMIQ-R) prior to performing the task and examined the associations among brain neural activity levels as identified by microstate segmentation method, TII, and the JMIQ-R scores.

Results:

The results showed four typical microstates during TII and significantly higher neural activity in the ventrolateral prefrontal cortex, primary sensorimotor area, supplementary motor area (SMA), and inferior parietal lobule (IPL). Moreover, there were significant negative correlations between the neural activity of the primary motor cortex (MI), SMA, IPL, and TII, and a significant positive correlation between the neural activity of the SMA and the JMIQ-R scores.

Conclusion:

These findings suggest the possibility that a neural network primarily comprised of the neural activity of SMA and M1, which are involved in generating motor imagery, may be the neural basis for inducing motor illusions. This may aid in creating a new approach to neurorehabilitation that enables a more robust reorganization of the neural base for patients with brain dysfunction with a motor function disorder.

Neural adaptations in quadriceps muscle after 4 weeks of local vibration training in young versus older subjects

This study investigated the effects of a 4-week local vibration training (LVT) on the function of the knee extensors and corticospinal properties in healthy young and older subjects. Seventeen subjects (9 young and 8 older) performed 3 testing sessions: before (PRE₁) and after (PRE₂) a 4-week resting period to control the repeatability of the data as well as after the LVT (POST). Jump performance, maximal voluntary contraction (MVC) and electromyographic (EMG) activity on vastus lateralis and rectus femoris muscles were assessed. Single-pulse transcranial magnetic stimulation (TMS) allowed evaluation of cortical voluntary activation (VA_TMS), motor evoked potential (MEP) area, and silent period (SP) duration. All training adaptations were similar between young and older subjects (p > 0.05) and the following results reflect the pooled sample of subjects. MVC (+11.9% ± 8.0%, p < 0.001) and VA_TMS (+3.6% ± 5.2%, p = 0.004) were significantly increased at POST compared with PRE₂. Maximal vastus lateralis EMG was significantly increased at POST (+21.9% ± 33.7%, p = 0.03). No changes were reported for MEPs on both muscles (p > 0.05). SPs recorded during maximal and submaximal contractions decreased in both muscles at POST (p < 0.05). Vertical jump performance was increased at POST (p < 0.05). LVT seems as effective in young as in older subjects to improve maximal functional capacities through neural modulations occurring at least partly at the supra-spinal level. Local vibration may be used as an efficient alternative training method to improve muscular performance in both healthy young and older subjects.

Optimized statistical parametric mapping procedure for NIRS data contaminated by motion artifacts : Neurometric analysis of body schema extension

This study investigated the spatial distribution of brain activity on body schema (BS) modification induced by natural body motion using two versions of a hand-tracing task. In Task 1, participants traced Japanese Hiragana characters using the right forefinger, requiring no BS expansion. In Task 2, participants performed the tracing task with a long stick, requiring BS expansion. Spatial distribution was analyzed using general linear model (GLM)-based statistical parametric mapping of near-infrared spectroscopy data contaminated with motion artifacts caused by the hand-tracing task. Three methods were utilized in series to counter the artifacts, and optimal conditions and modifications were investigated: a model-free method (Step 1), a convolution matrix method (Step 2), and a boxcar-function-based Gaussian convolution method (Step 3). The results revealed four methodological findings: (1) Deoxyhemoglobin was suitable for the GLM because both Akaike information criterion and the variance against the averaged hemodynamic response function were smaller than for other signals, (2) a high-pass filter with a cutoff frequency of .014 Hz was effective, (3) the hemodynamic response function computed from a Gaussian kernel function and its first- and second-derivative terms should be included in the GLM model, and (4) correction of non-autocorrelation and use of effective degrees of freedom were critical. Investigating z-maps computed according to these guidelines revealed that contiguous areas of BA7-BA40-BA21 in the right hemisphere became significantly activated ([Formula: see text], [Formula: see text], and [Formula: see text], respectively) during BS modification while performing the hand-tracing task.