Cerebellar contribution to feedforward control of locomotion

The cerebellum and the Mirror Neuron System: A matter of inhibition? From neurophysiological evidence to neuromodulatory implications. A narrative review

Mirror neurons show activity during both the execution (AE) and observation of actions (AO). The Mirror Neuron System (MNS) could be involved during motor imagery (MI) as well. Extensive research suggests that the cerebellum is interconnected with the MNS and may be critically involved in its activities. We gathered evidence on the cerebellum's role in MNS functions, both theoretically and experimentally. Evidence shows that the cerebellum plays a major role during AO and MI and that its lesions impair MNS functions likely because, by modulating the activity of cortical inhibitory interneurons with mirror properties, the cerebellum may contribute to visuomotor matching, which is fundamental for shaping mirror properties. Indeed, the cerebellum may strengthen sensory-motor patterns that minimise the discrepancy between predicted and actual outcome, both during AE and AO. Furthermore, through its connections with the hippocampus, the cerebellum might be involved in internal simulations of motor programs during MI. Finally, as cerebellar neuromodulation might improve its impact on MNS activity, we explored its potential neurophysiological and neurorehabilitation implications.

Dynamic causal modelling highlights the importance of decreased self-inhibition of the sensorimotor cortex in motor fatigability

Motor fatigability emerges when challenging motor tasks must be maintained over an extended period of time. It is frequently observed in everyday life and affects patients as well as healthy individuals. Motor fatigability can be measured using simple tasks like finger tapping at maximum speed for 30 s. This typically results in a rapid decrease of tapping frequency, a phenomenon called motor slowing. In a previous study (Bächinger et al, eLife, 8 (September), https://doi.org/10.7554/eLife.46750 , 2019), we showed that motor slowing goes hand in hand with a gradual increase in blood oxygen level dependent signal in the primary sensorimotor cortex (SM1), supplementary motor area (SMA), and dorsal premotor cortex (PMd). It is unclear what drives the activity increase in SM1 caused by motor slowing and whether motor fatigability affects the dynamic interactions between SM1, SMA, and PMd. Here, we performed dynamic causal modelling (DCM) on data of 24 healthy young participants collected during functional magnetic resonance imaging to answer this question. The regions of interest (ROI) were defined based on the peak activation within SM1, SMA, and PMd. The model space consisted of bilateral connections between all ROI, with intrinsic self-modulation as inhibitory, and driving inputs set to premotor areas. Our findings revealed that motor slowing was associated with a significant reduction in SM1 self-inhibition, as uncovered by testing the maximum à posteriori against 0 (t(23)=-4.51, p < 0.001). Additionally, the model revealed a significant decrease in the driving input to premotor areas (t(23) > 2.71, p < 0.05) suggesting that structures other than cortical motor areas may contribute to motor fatigability.

Cerebellar Metabolic Connectivity during Treadmill Walking before and after Unilateral Dopamine Depletion in Rats

Compensatory changes in brain connectivity keep motor symptoms mild in prodromal Parkinson's disease. Studying compensation in patients is hampered by the steady progression of the disease and a lack of individual baseline controls. Furthermore, combining fMRI with walking is intricate. We therefore used a seed-based metabolic connectivity analysis based on 2-deoxy-2-[18F]fluoro-D-glucose ([18F]FDG) uptake in a unilateral 6-OHDA rat model. At baseline and in the chronic phase 6-7 months after lesion, rats received an intraperitoneal injection of [18F]FDG and spent 50 min walking on a horizontal treadmill, followed by a brain PET-scan under anesthesia. High activity was found in the cerebellar anterior vermis in both conditions. At baseline, the anterior vermis showed hardly any stable connections to the rest of the brain. The (future) ipsilesional cerebellar hemisphere was not particularly active during walking but was extensively connected to many brain areas. After unilateral dopamine depletion, rats still walked normally without obvious impairments. The ipsilesional cerebellar hemisphere increased its activity, but narrowed its connections down to the vestibulocerebellum, probably aiding lateral stability. The anterior vermis established a network involving the motor cortex, hippocampus and thalamus. Adding those regions to the vermis network of (previously) automatic control of locomotion suggests that after unilateral dopamine depletion considerable conscious and cognitive effort has to be provided to achieve stable walking.

Dissociated cerebellar contributions to feedforward gait adaptation

The cerebellum is important for motor adaptation. Lesions to the vestibulo-cerebellum selectively cause gait ataxia. Here we investigate how such damage affects locomotor adaptation when performing the 'broken escalator' paradigm. Following an auditory cue, participants were required to step from the fixed surface onto a moving platform (akin to an airport travellator). The experiment included three conditions: 10 stationary (BEFORE), 15 moving (MOVING) and 10 stationary (AFTER) trials. We assessed both behavioural (gait approach velocity and trunk sway after stepping onto the moving platform) and neuromuscular outcomes (lower leg muscle activity, EMG). Unlike controls, cerebellar patients showed reduced after-effects (AFTER trials) with respect to gait approach velocity and leg EMG activity. However, patients with cerebellar damage maintain the ability to learn the trunk movement required to maximise stability after stepping onto the moving platform (i.e., reactive postural behaviours). Importantly, our findings reveal that these patients could even initiate these behaviours in a feedforward manner, leading to an after-effect. These findings reveal that the cerebellum is crucial for feedforward locomotor control, but that adaptive locomotor behaviours learned via feedback (i.e., reactive) mechanisms may be preserved following cerebellum damage.

When direction matters: Neural correlates of interlimb coordination of rhythm and beat

In a previous experiment, we found evidence for a bodily hierarchy governing interlimb coordination of rhythm and beat, using five effectors: 1) Left foot, 2) Right foot, 3) Left hand, 4) Right hand and 5) Voice. The hierarchy implies that, during simultaneous rhythm and beat performance and using combinations of two of these effectors, executing the task by performing the rhythm with an effector that has a higher number than the beat effector is significantly easier than vice versa. To investigate the neural underpinnings of this proposed bodily hierarchy, we here scanned 46 professional musicians using fMRI as they performed a rhythmic pattern with one effector while keeping the beat with another. The conditions combined the voice and the right hand (V + RH), the right hand and the left hand (RH + LH), and the left hand and the right foot (LH + RF). Each effector combination was performed with and against the bodily hierarchy. Going against the bodily hierarchy increased tapping errors significantly and also increased activity in key brain areas functionally associated with top-down sensorimotor control and bottom-up feedback processing, such as the cerebellum and SMA. Conversely, going with the bodily hierarchy engaged areas functionally associated with the default mode network and regions involved in emotion processing. Theories of general brain function that hold prediction as a key principle, propose that action and perception are governed by the brain's attempt to minimise prediction error at different levels in the brain. Following this viewpoint, our results indicate that going against the hierarchy induces stronger prediction errors, while going with the hierarchy allows for a higher degree of automatization. Our results also support the notion of a bodily hierarchy in motor control that prioritizes certain conductive and supportive tapping roles in specific effector combinations.

Harnessing the Power of Voice: A Deep Neural Network Model for Alzheimer's Disease Detection

Background and Purpose

Voice, reflecting cerebral functions, holds potential for analyzing and understanding brain function, especially in the context of cognitive impairment (CI) and Alzheimer's disease (AD). This study used voice data to distinguish between normal cognition and CI or Alzheimer's disease dementia (ADD).

Methods

This study enrolled 3 groups of subjects: 1) 52 subjects with subjective cognitive decline; 2) 110 subjects with mild CI; and 3) 59 subjects with ADD. Voice features were extracted using Mel-frequency cepstral coefficients and Chroma.

Results

A deep neural network (DNN) model showed promising performance, with an accuracy of roughly 81% in 10 trials in predicting ADD, which increased to an average value of about 82.0%±1.6% when evaluated against unseen test dataset.

Conclusions

Although results did not demonstrate the level of accuracy necessary for a definitive clinical tool, they provided a compelling proof-of-concept for the potential use of voice data in cognitive status assessment. DNN algorithms using voice offer a promising approach to early detection of AD. They could improve the accuracy and accessibility of diagnosis, ultimately leading to better outcomes for patients.

Investigating Perceptual Subgroups in Speakers With Ataxic Dysarthria: An Auditory Free Classification Approach

PURPOSE

Ataxic dysarthria has presented with considerable heterogeneity in the presentation of speech characteristics. Converging evidence supports the existence of subgroups, specifically related to the instability and inflexibility of motor patterns as a possible explanation of this variability.

METHOD

To further examine the alignment of the speech characteristics of ataxic dysarthria with the instability/inflexibility framework, 23 graduate student listeners participated in an auditory free classification task and a guided classification task. Listeners grouped 15 speakers with ataxic dysarthria based on their judgment of the most salient perceptual characteristics during two speaking tasks: alternating motion rates (AMRs) and connected speech (one to two sentences). Listener ratings were then compared with a priori determinations of speakers who fit the instability subgroup profile and the inflexibility subgroup profile.

RESULTS

Results of both the free classification and guided classification listening paradigms provided supportive evidence of subgroups, particularly for the AMR task, in the context of strong inter- and intrarater reliability.

CONCLUSION

This study adds to the growing evidence of the existence of instability and inflexibility subgroups in ataxic dysarthria and serves as a proof of concept for use of the auditory free classification paradigm in dysarthria subgroup research.

Touch may reduce cognitive load during assisted typing by individuals with developmental disabilities

Many techniques have attempted to provide physical support to ease the execution of a typing task by individuals with developmental disabilities (DD). These techniques have been controversial due to concerns that the support provider's touch can influence the typed content. The most common interpretation of assisted typing as an ideomotor phenomenon has been qualified recently by studies showing that users with DD make identifiable contributions to the process. This paper suggests a neurophysiological pathway by which touch could lower the cognitive load of seated typing by people with DD. The required sensorimotor processes (stabilizing posture and planning and executing manual reaching movements) and cognitive operations (generating and transcribing linguistic material) place concurrent demands on cognitive resources, particularly executive function (EF). A range of developmental disabilities are characterized by deficits in sensorimotor and EF capacity. As light touch has been shown to facilitate postural coordination, it is proposed that a facilitator's touch could assist the seated typist with sensorimotor and EF deficits by reducing their sensorimotor workload and thereby freeing up shared cognitive resources for the linguistic elements of the task. This is the first theoretical framework for understanding how a facilitator's touch may assist individuals with DD to contribute linguistic content during touch-assisted typing.

Unexpected inversion perturbation during a single-leg landing in patients with chronic ankle instability

It remains unclear how unexpected perturbations during single-leg landings affect lower extremity kinematics and muscle activations in patients with chronic ankle instability (CAI). The purpose of this study was to identify the differences in lower extremity movement patterns among CAI subjects, copers, and healthy controls. Sixty-six people including 22 CAI subjects, 22 copers, and 22 healthy controls volunteered to participate in the study. Lower extremity joint kinematics and EMG activations from 200-ms pre to 200-ms post the initial contact during unexpected tilted landings were measured. Functional data analysis was used to evaluate between-group differences for outcome measures. Relative to copers and healthy controls, CAI subjects showed more inversion from 40-ms to 200-ms after initial contact. Relative to healthy controls, CAI subjects and copers showed more dorsiflexion. Relative to healthy controls, CAI subjects and copers showed more muscle activation in tibialis anterior and peroneus longus, respectively. In conclusion, CAI subjects demonstrated greater inversion angles and muscle activation before initial contact compared to LAS copers and healthy controls. This suggests that CAI subjects and copers prepare for their landing with protective movements, but the prepared movements shown by CAI subjects may be insufficient to reduce risk of recurrent injury.

Transcranial direct current stimulation to facilitate neurofunctional rehabilitation in children with autism spectrum disorder: a protocol for a randomized, sham-controlled, double-blind clinical trial

Background

Anodal transcranial direct current stimulation (tDCS) over the primary motor cortex and cerebellum is gaining prominence in the literature due to its potential to favor learning and motor performance. If administered during motor training, tDCS is capable of increasing the effect of training. Considering the motor impairment presented by children with Autism Spectrum Disorders (ASD), atDCS applied during motor training may contribute to the rehabilitation of these children. However, it is necessary to examine and compare the effects of atDCS over the motor cortex and the cerebellum on the motor skills of children with ASD. This information may benefit future clinical indications of tDCS for rehabilitation of children with ASD. The aim of the proposed study is to determine whether anodal tDCS over the primary motor cortex and cerebellum can enhance the effects of gait training and postural control on motor skills, mobility, functional balance, cortical excitability, cognitive aspects and behavioral aspects in children with ASD. Our hypothesis is the active tDCS combined with motor training will enhance the performance of the participants in comparison to sham tDCS.

Methods and design

A randomized, sham-controlled, double-blind clinical trial will be conducted involving 30 children with ASD that will be recruited to receive ten sessions of sham or ten sessions of active anodal tDCS (1 mA, 20 min) over the primary motor cortex or cerebellun combined with motor training. The participants will be assessed before as well as one, four and eight weeks after the interventions. The primary outcome will be gross and fine motor skills. The secondary outcomes will be mobility, functional balance, motor cortical excitability, cognitive aspects and behavioral aspects.

Discussion

Although abnormalities in gait and balance are not primary characteristics of ASD, such abnormalities compromise independence and global functioning during the execution of routine activities of childhood. If demonstrated that anodal tDCS administered over areas of the brain involved in motor control, such as the primary motor cortex and cerebellum, can enhance the effects of gait and balance training in only ten sessions in two consecutive weeks, the clinical applicability of this stimulation modality will be expanded as well as more scientifically founded.Clinical trial registration February 16, 2023 (https://ensaiosclinicos.gov.br/rg/RBR-3bskhwf).

Lower cerebello-cortical functional connectivity in veterans with reactive aggression symptoms: A pilot study

A significant number of veterans experience irritability and aggression symptoms as a result of being exposed to extremely stressful and life-threatening situations. In addition to the well-established involvement of the brain's cortico-subcortical circuit in aggression-related behaviours, a role of the deep cerebellar nuclei (DCN) in reactive aggression has been suggested. In the present study, seed-based resting-state functional connectivity between the DCN and cortico-subcortical areas was explored in veterans with and without reactive aggression symptoms. Nineteen male veterans with reactive aggression symptoms and twenty-two control veterans without reactive aggression symptoms underwent 3T resting-state functional MRI scans. Region-of-interest (ROI) analyses that included the amygdala, hypothalamus and periaqueductal grey as ROIs did not yield significant group-related differences in resting-state functional connectivity with the DCN. However, exploratory whole-brain analysis showed that veterans with reactive aggression symptoms exhibited lower functional connectivity between the DCN and the orbitofrontal cortex compared to control veterans. Our findings provide preliminary evidence for the possible involvement of a cerebello-prefrontal pathway in reactive aggression in male veterans.

To Do or Not to Do: The cerebellum and neocortex contribute to predicting sequences of social intentions

Humans read the minds of others to predict their actions and efficiently navigate social environments, a capacity called mentalizing. Accumulating evidence suggests that the cerebellum, especially Crus 1 and 2, and lobule IX are involved in identifying the sequence of others' actions. In the current study, we investigated the neural correlates that underly predicting others' intentions and how this plays out in the sequence of their actions. We developed a novel intention prediction task, which required participants to put protagonists' behaviors in the correct chronological order based on the protagonists' honest or deceitful intentions (i.e., inducing true or false beliefs in others). We found robust activation of cerebellar lobule IX and key mentalizing areas in the neocortex when participants ordered protagonists' intentional behaviors compared with not ordering behaviors or to ordering object scenarios. Unlike a previous task that involved prediction based on personality traits that recruited cerebellar Crus 1 and 2, and lobule IX (Haihambo et al., 2021), the present task recruited only the cerebellar lobule IX. These results suggest that cerebellar lobule IX may be generally involved in social action sequence prediction, and that different areas of the cerebellum are specialized for distinct mentalizing functions.

Cerebello-cortical functional connectivity may regulate reactive balance control in older adults with mild cognitive impairment

Background

Older adults with mild cognitive impairment (OAwMCI) experience a two-fold increased risk of falling compared to their cognitively intact counterparts. This increased risk could be attributed to impairments in balance control mechanisms (both volitional and reactive), however, the exact neural substrates contributing to the balance impairments remain unclear. While changes in functional connectivity (FC) networks in volitional balance control tasks have been well highlighted, the relationship between these changes and reactive balance control has not been examined. Therefore, this study aims to explore the relationship between FC networks of the brain obtained during resting state fMRI (no visualization or active task performed) and behavioral measures on a reactive balance task in OAwMCI.

Methods

Eleven OAwMCI (< 25/30 on MoCA, > 55 years) underwent fMRI and were exposed to slip-like perturbations on the Activestep treadmill. Postural stability, i.e., dynamic center of mass motion state (i.e., its position and velocity) was computed to determine reactive balance control performance. The relationship between reactive stability and FC networks was explored using the CONN software.

Results

OAwMCI with greater FC in default mode network-cerebellum (r² = 0.43, p < 0.05), and sensorimotor-cerebellum (r² = 0.41, p < 0.05) network exhibited lower reactive stability. Further, people with lower FC in middle frontal gyrus-cerebellum (r² = 0.37, p < 0.05), frontoparietal-cerebellum (r² = 0.79, p < 0.05) and cerebellar network-brainstem (r² = 0.49, p < 0.05) exhibited lower reactive stability.

Conclusion

Older adults with mild cognitive impairment demonstrate significant associations between reactive balance control and cortico-subcortical regions involved in cognitive-motor control. Results indicate that the cerebellum and its communications with higher cortical centers could be potential substrates contributing to impaired reactive responses in OAwMCI.

Case report: Backward gait training combined with gait-synchronized cerebellar transcranial alternating current stimulation in progressive supranuclear palsy

Progressive supranuclear palsy (PSP) is characterized by recurrent falls caused by postural instability, and a backward gait is considered beneficial for postural instability. Furthermore, a recent approach for rehabilitation combined with gait-oriented synchronized stimulation using non-invasive transcranial patterned stimulation could be promising for balance function. Here, we present a case of PSP with backward gait training combined with gait-synchronized transcranial alternating current stimulation (tACS). A 70-year-old woman with PSP-Richardson's syndrome underwent backward gait training combined with synchronized cerebellar tACS. Initially, she underwent short-term intervention with combined training of backward gait with synchronized cerebellar tACS, asynchronized, or sham stimulation according to the N-of-1 study design. Synchronized tACS training demonstrated a decrease in postural instability, whereas asynchronized or sham stimulation did not. The additional long-term interventions of combined backward gait training with synchronized cerebellar tACS demonstrated further decrease in postural instability with improvements in gait speed, balance function, and fall-related self-efficacy in daily life. The present case describes a novel approach for motor symptoms in a patient with PSP. Backward gait training with synchronized cerebellar tACS may be a promising therapeutic approach.

Cerebellum: From the identification of the cerebellar motor syndrome to the internal models

Cerebellar circuitry is topographically arranged in closed loops with the cerebral cortex. The three cornerstones of clinical ataxia have emerged from studies on connectional anatomy and from clinical/neuropsychological observations, leading to the definition of clinical syndromes encountered in daily practice: (a) the cerebellar motor syndrome (CMS), (b) the vestibulocerebellar syndrome (VCS), and (c) the cerebellar cognitive affective syndrome/Schmahmann syndrome (CCAS/SS). These syndromes are either isolated or coexist, depending on the underlying pathological process and its degree of extension within the cerebellum. Dysmetria is the core feature of cerebellar deficits, encompassing motor dysmetria (hypermetria, hypometria) in CMS, oculomotor dysmetria in VCS, and dysmetria of thought in CCAS/SS. The leading hypothesis is that dysmetria results from errors in building or maintaining internal models, which are inherent to predictive behavior. Errors in prediction would lead to clumsiness and incoordination of limbs, oculomotor impairments, and aberrant cognitive/affective behavior. The cerebellum is currently viewed as a learning machine enriched with multiple plasticity mechanisms, allowing the permanent adaptation to the external world by generating and maintaining predictive operations, from motor to cognitive, affective, emotional, and social operations essential for daily human life.

From thinking fast to moving fast: motor control of fast limb movements in healthy individuals

The ability to produce high movement speeds is a crucial factor in human motor performance, from the skilled athlete to someone avoiding a fall. Despite this relevance, there remains a lack of both an integrative brain-to-behavior analysis of these movements and applied studies linking the known dependence on open-loop, central control mechanisms of these movements to their real-world implications, whether in the sports, performance arts, or occupational setting. In this review, we cover factors associated with the planning and performance of fast limb movements, from the generation of the motor command in the brain to the observed motor output. At each level (supraspinal, peripheral, and motor output), the influencing factors are presented and the changes brought by training and fatigue are discussed. The existing evidence of more applied studies relevant to practical aspects of human performance is also discussed. Inconsistencies in the existing literature both in the definitions and findings are highlighted, along with suggestions for further studies on the topic of fast limb movement control. The current heterogeneity in what is considered a fast movement and in experimental protocols makes it difficult to compare findings in the existing literature. We identified the role of the cerebellum in movement prediction and of surround inhibition in motor slowing, as well as the effects of fatigue and training on central motor control, as possible avenues for further research, especially in performance-driven populations.

Potential Interactions Between Cerebellar Dysfunction and Sleep Disturbances in Dystonia

Dystonia is the third most common movement disorder. It causes debilitating twisting postures that are accompanied by repetitive and sometimes intermittent co- or over-contractions of agonist and antagonist muscles. Historically diagnosed as a basal ganglia disorder, dystonia is increasingly considered a network disorder involving various brain regions including the cerebellum. In certain etiologies of dystonia, aberrant motor activity is generated in the cerebellum and the abnormal signals then propagate through a “dystonia circuit” that includes the thalamus, basal ganglia, and cerebral cortex. Importantly, it has been reported that non-motor defects can accompany the motor symptoms; while their severity is not always correlated, it is hypothesized that common pathways may nevertheless be disrupted. In particular, circadian dysfunction and disordered sleep are common non-motor patient complaints in dystonia. Given recent evidence suggesting that the cerebellum contains a circadian oscillator, displays sleep-stage-specific neuronal activity, and sends robust long-range projections to several subcortical regions involved in circadian rhythm regulation, disordered sleep in dystonia may result from cerebellum-mediated dysfunction of the dystonia circuit. Here, we review the evidence linking dystonia, cerebellar network dysfunction, and cerebellar involvement in sleep. Together, these ideas may form the basis for the development of improved pharmacological and surgical interventions that could take advantage of cerebellar circuitry to restore normal motor function as well as non-motor (sleep) behaviors in dystonia.

Brain Region- and Age-Dependent 5-Hydroxymethylcytosine Activity in the Non-Human Primate

Because of the difficulty in collecting fresh brains of humans at different ages, it remains unknown how epigenetic regulation occurs in the primate brains during aging. In the present study, we examined the genomic distribution of 5hmC, an indicator of DNA methylation, in the brain regions of non-human primates (rhesus monkey) at the ages of 2 (juvenile), 8 (young adult), and 17 (old) years. We found that genomic 5hmC distribution was accumulated in the monkey brain as age increased and displayed unique patterns in the cerebellum and striatum in an age-dependent manner. We also observed a correlation between differentially hydroxymethylated regions (DhMRs) and genes that contribute to brain region-related functions and diseases. Our studies revealed, for the first time, the brain-region and age-dependent 5hmC modifications in the non-human primate and the association of these 5hmC modifications with brain region-specific function and potentially aging-related brain diseases.

Consensus Paper: Ataxic Gait

The aim of this consensus paper is to discuss the roles of the cerebellum in human gait, as well as its assessment and therapy. Cerebellar vermis is critical for postural control. The cerebellum ensures the mapping of sensory information into temporally relevant motor commands. Mental imagery of gait involves intrinsically connected fronto-parietal networks comprising the cerebellum. Muscular activities in cerebellar patients show impaired timing of discharges, affecting the patterning of the synergies subserving locomotion. Ataxia of stance/gait is amongst the first cerebellar deficits in cerebellar disorders such as degenerative ataxias and is a disabling symptom with a high risk of falls. Prolonged discharges and increased muscle coactivation may be related to compensatory mechanisms and enhanced body sway, respectively. Essential tremor is frequently associated with mild gait ataxia. There is growing evidence for an important role of the cerebellar cortex in the pathogenesis of essential tremor. In multiple sclerosis, balance and gait are affected due to cerebellar and spinal cord involvement, as a result of disseminated demyelination and neurodegeneration impairing proprioception. In orthostatic tremor, patients often show mild-to-moderate limb and gait ataxia. The tremor generator is likely located in the posterior fossa. Tandem gait is impaired in the early stages of cerebellar disorders and may be particularly useful in the evaluation of pre-ataxic stages of progressive ataxias. Impaired inter-joint coordination and enhanced variability of gait temporal and kinetic parameters can be grasped by wearable devices such as accelerometers. Kinect is a promising low cost technology to obtain reliable measurements and remote assessments of gait. Deep learning methods are being developed in order to help clinicians in the diagnosis and decision-making process. Locomotor adaptation is impaired in cerebellar patients. Coordinative training aims to improve the coordinative strategy and foot placements across strides, cerebellar patients benefiting from intense rehabilitation therapies. Robotic training is a promising approach to complement conventional rehabilitation and neuromodulation of the cerebellum. Wearable dynamic orthoses represent a potential aid to assist gait. The panel of experts agree that the understanding of the cerebellar contribution to gait control will lead to a better management of cerebellar ataxias in general and will likely contribute to use gait parameters as robust biomarkers of future clinical trials.

Mapping brain structure and function in professional fencers: A model to study training effects on central nervous system plasticity

Brain magnetic resonance imaging (MRI) studies have shown different patterns of structural and functional reorganization in high‐level athletes compared with controls, but little is known about their relationship with interlimb coordination mechanisms. To this aim, we investigated brain structural and functional differences in high‐level fencers compared with nonathlete controls and the MRI substrates of interlimb coordination in elite athletes. Fourteen right‐handed male fencers (median age = 22.3 years) and 15 right‐handed age‐ and sex‐matched healthy subjects (median age = 22.4 years) underwent structural and functional MRI acquisition during the execution of cyclic bimanual‐movements as well as during in‐phase and antiphase hand/foot‐movements of the dominant‐right limbs. No between‐group differences were found in gray matter volumes and white matter architecture. Active‐fMRI showed that controls versus fencers had higher activations in parietal and temporal areas during bimanual‐task; whereas fencers versus controls had higher activations in the basal ganglia. During in‐phase task, controls versus fencers showed higher activation of right cerebellum, whereas fencers had higher activity mainly in frontal areas. The functional‐connectivity (FC) analysis showed that fencers versus controls had an increased FC between left motor cortex and fronto‐temporal areas as well as bilateral thalami during the different tasks. Intensive and prolonged fencing activity is associated with brain functional changes mainly involving frontal regions related to high‐level motor control and planning of complex tasks. These modifications are likely to reflect an optimization of brain networks involved in motor activities, including interlimb coordination tasks, occurring after intensive training.

Control of mammalian locomotion by ventral spinocerebellar tract neurons

Locomotion is a complex behavior required for animal survival. Vertebrate locomotion depends on spinal interneurons termed the central pattern generator (CPG), which generates activity responsible for the alternation of flexor and extensor muscles and the left and right side of the body. It is unknown whether multiple or a single neuronal type is responsible for the control of mammalian locomotion. Here, we show that ventral spinocerebellar tract neurons (VSCTs) drive generation and maintenance of locomotor behavior in neonatal and adult mice. Using mouse genetics, physiological, anatomical, and behavioral assays, we demonstrate that VSCTs exhibit rhythmogenic properties and neuronal circuit connectivity consistent with their essential role in the locomotor CPG. Importantly, optogenetic activation and chemogenetic silencing reveals that VSCTs are necessary and sufficient for locomotion. These findings identify VSCTs as critical components for mammalian locomotion and provide a paradigm shift in our understanding of neural control of complex behaviors.

The Human Cerebellum as a Hub of the Predictive Brain

Although the cerebellum has long been believed to be involved uniquely in sensorimotor processes, recent research works pointed to its participation in a wide range of cognitive predictive functions. Here, we review the available evidence supporting a generalized role of the cerebellum in predictive computation. We then discuss the anatomo-physiological properties that make the cerebellum the ideal hub of the predictive brain. We further argue that cerebellar involvement in cognition may follow a continuous gradient, with higher cerebellar activity occurring for tasks relying more on predictive processes, and outline the empirical scenarios to probe this hypothesis.

The Involvement of the Posterior Cerebellum in Reconstructing and Predicting Social Action Sequences

Recent advances in social neuroscience have highlighted the critical role of the cerebellum and especially the posterior cerebellar Crus in social mentalizing (i.e., theory of mind). Research in the past 5 years has provided growing evidence supporting the view that the posterior cerebellum builds internal action models of our social interactions to predict how other people's actions will be executed, and what our most likely responses to these actions will be. This paper presents an overview of a series of fMRI experiments on novel tasks involving a combination of (a) the learning or generation of chronological sequences of social actions either in an explicit or implicit manner, which (b) require social mentalizing on another person's mental state such as goals, beliefs, and implied traits. Together, the results strongly confirm the central role of the posterior cerebellar Crus in identifying and automatizing action sequencing during social mentalizing, and in predicting future action sequences based on social mentalizing inferences about others. This research program has important implications: It provides for the first time (a) fruitful starting points for diagnosing and investigating social sequencing dysfunctions in a variety of mental disorders which have also been related to cerebellar dysfunctions, (b) provides the necessary tools for testing whether non-invasive neurostimulation targeting the posterior cerebellum has a causal effect on social functioning, and (c) whether these stimulation techniques and training programs guided by novel cerebellar social sequencing insights, can be exploited to increase posterior cerebellar plasticity in order to alleviate social impairments in mental disorders.

Effects of Anodal Cerebellar Transcranial Direct Current Stimulation on Movements in Patients with Cerebellar Ataxias: A Systematic Review

Cerebellar transcranial direct current stimulation (cerebellar tDCS) is a promising therapy for cerebellar ataxias and has attracted increasing attention from researchers and clinicians. A timely systematic review focusing on randomized sham-controlled trials and repeated measures studies is warranted. This study was to systematically review existing evidence regarding effects of anodal cerebellar tDCS on movements in patients with cerebellar ataxias. The searched databases included Web of Science, MEDLINE, PsycINFO, CINAHL, EMBASE, Cochrane Library, and EBSCOhost. Methodological quality of the selected studies was assessed using the Physiotherapy Evidence Database scale. Five studies with 86 patients were identified. Among these, four studies showed positive effects of anodal cerebellar tDCS. Specifically, anodal cerebellar tDCS decreased disease severity and improved finger dexterity and quality of life in patients, but showed incongruent effects on gait control and balance, which may be due to heterogeneity of research participants and choices of measures. The protocols of anodal cerebellar tDCS that improved movements in patients commonly placed the anode over the whole cerebellum and provided ten 2-mA 20-min stimulation sessions. The results may show preliminary evidence that anodal cerebellar tDCS is beneficial to reducing disease severity and improving finger dexterity and quality of life in patients, which lays the groundwork for future studies further examining responses in the cerebello-thalamo-cortical pathway. An increase in sample size, the use of homogeneous patient groups, exploration of the optimal stimulation protocol, and investigation of detailed neural mechanisms are clearly needed in future studies.

The posterior crus II cerebellum is specialized for social mentalizing and emotional self-experiences: a meta-analysis

This meta-analysis explores the role of the posterior cerebellum Crus I/II in social mentalizing. We identified over 200 functional magnetic resonance imaging (fMRI) studies via NeuroSynth that met our inclusion criteria and fell within bilateral Crus II areas related to ‘sequencing’ during mentalizing (coordinates ±24 −76 −40; from earlier studies) and mere social ‘mentalizing’ or self-related emotional cognition (coordinates ±26 −84 −34; from NeuroSynth), located in the cerebellar mentalizing network. A large majority of these studies (74%) involved mentalizing or self-related emotional cognition. Other functions formed small minorities. This high incidence in Crus II compares very favorably against the lower base rate for mentalizing and self-related emotions (around 35%) across the whole brain as revealed in NeuroSynth. In contrast, there was much less support for a similar role of Crus I (coordinates −40 −70 −40 from earlier ‘sequencing’ studies) as only 35% of the studies were related to mentalizing or self-related emotions. The present findings show that a domain-specific social mentalizing functionality is supported in the cerebellar Crus II. This has important implications for theories of the social cerebellum focusing on sequencing of social actions, and for cerebellar neurostimulation treatments.

Prelanding movement strategies among chronic ankle instability, coper, and control subjects

We describe feedforward neuromuscular control during a maximal jump landing/cutting task among groups of chronic ankle instability (CAI), coper, and uninjured control subjects. Sixty-six volunteers participated (22 CAI, 22 copers, and 22 uninjured controls). The subjects completed five trials of a maximal jump landing/cutting manoeuvre. Three-dimensional ground reaction force, lower-extremity joint angles, and activation of eight muscles were collected from 150 ms prelanding to initial contact. Functional analyses of variance (FANOVA) were used to evaluate between-group differences for these outcome variables. Compared to uninjured controls, both CAI patients and copers demonstrated altered sagittal lower-extremity movements. However, only copers exhibited unique kinematic alterations in frontal lower-extremity kinematics in the ankle and hip joints. While CAI patients demonstrated decreased most of lower-extremity EMG activation, copers displayed increased EMG activation during prelanding. Current data suggest that both CAI patients and copers demonstrated alterations in feedforward neuromuscular control prior to initial contact during a demanding jump landing/cutting task. Altered movement strategies during prelanding were observed in both proximal (e.g., knee and hip) and distal (e.g., ankle) joints in CAI patients and copers, while copers presumably had more protective jump landing/cutting movement strategies than CAI patients.

Case of cerebellar ataxia successfully treated by virtual reality-guided rehabilitation

A male patient in his 40s was transferred to our hospital for rehabilitation of ataxia after right cerebellar and brainstem infarction. After 3 weeks of conventional physical therapy, his activities of daily life successfully improved with an increase in the functional impedance measure from 101 to 124. However, he still fell short of gaining a higher level of balance function, which was necessary for his job as a standup forklift driver. We introduced virtual reality-guided balance training. The training was performed for approximately 40 min on weekdays for 2 weeks. As a result, the Scale for the Assessment and Rating of Ataxia score decreased from 5 to 1, Functional Balance Scale score improved from 48 to 56, and Mini-Balance Evaluation Systems Test score increased from 20 to 28. The trunk sway disappeared clinically. He regained confidence and returned to work after an additional 2 weeks of physical therapy.

Directionality of corticomuscular coupling in essential tremor and cortical myoclonic tremor

OBJECTIVE

A role of the motor cortex in tremor generation in essential tremor (ET) is assumed, yet the directionality of corticomuscular coupling is unknown. Our aim is to clarify the role of the motor cortex. To this end we also study 'familial cortical myoclonic tremor with epilepsy' (FCMTE) and slow repetitive voluntary movements with a known cortical drive.

METHODS

Directionality of corticomuscular coupling (EEG-EMG) was studied with renormalized partial directed coherence (rPDC) during tremor in 25 ET patients, 25 healthy controls (mimicked) and in seven FCMTE patients; and during a self-paced 2 Hz task in eight ET patients and seven healthy controls.

RESULTS

Efferent coupling around tremor frequency was seen in 33% of ET patients, 45.5% of healthy controls, all FCMTE patients, and, around 2 Hz, in all ET patients and all healthy controls. Ascending coupling, seen in the majority of all participants, was weaker in ET than in healthy controls around 5-6 Hz.

CONCLUSIONS

Possible explanations are that tremor in ET results from faulty subcortical output bypassing the motor cortex; rate-dependent transmission similar to generation of rhythmic movements; and/or faulty feedforward mechanism resulting from decreased afferent (sensory) coupling.

SIGNIFICANCE

A linear cortical drive is lacking in the majority of ET patients.

The posterior cerebellum and inconsistent trait implications when learning the sequence of actions

It has been proposed that the cerebellum contributes to social cognition. Based on the view that cerebellar internal models create predictions on motions and actions, we hypothesize that the posterior cerebellum supports identifying temporal sequences of persons’ actions as well as detecting inconsistent actions that violate the implied trait. Participants were required to memorize the temporal order of a set of sentences that implied a personality trait. Importantly, the sentence sets were designed in such a way that the first half of each set involved actions that were consistent with the same trait, while the other half was either consistent or inconsistent with that trait. As expected, we found robust posterior cerebellar activation when memorizing the order of the actions, irrespective of trait consistency, but more crucially also for actions implying an inconsistent trait in comparison to consistent trait actions. We also found that the medial prefrontal cortex and posterior cerebellum were associated with confidence level in retrieving the sequences. This study supports the hypothesis that the posterior cerebellum identifies and predicts the low-level temporal order of actions and demonstrates for the first time that this area is also involved in the high-level prediction of trait implications of those actions.

Relative Contribution of Proprioceptive and Vestibular Sensory Systems to Locomotion: Opportunities for Discovery in the Age of Molecular Science

Locomotion is a fundamental animal behavior required for survival and has been the subject of neuroscience research for centuries. In terrestrial mammals, the rhythmic and coordinated leg movements during locomotion are controlled by a combination of interconnected neurons in the spinal cord, referred as to the central pattern generator, and sensory feedback from the segmental somatosensory system and supraspinal centers such as the vestibular system. How segmental somatosensory and the vestibular systems work in parallel to enable terrestrial mammals to locomote in a natural environment is still relatively obscure. In this review, we first briefly describe what is known about how the two sensory systems control locomotion and use this information to formulate a hypothesis that the weight of the role of segmental feedback is less important at slower speeds but increases at higher speeds, whereas the weight of the role of vestibular system has the opposite relation. The new avenues presented by the latest developments in molecular sciences using the mouse as the model system allow the direct testing of the hypothesis.

The Effect of Parietal and Cerebellar Transcranial Direct Current Stimulation on Bimanual Coordinated Adaptive Motor Learning

Abstract. Many daily activities, such as typing, eating, playing the piano, and passing the ball in volleyball, require the proficient coordination of both hands. In this study, the effects of anodal transcranial direct current stimulation (atDCS) on the acquisition, retention, and transfer of bimanual adaptive motor tasks were investigated. To this end, 64 volunteers ( Mage = 24.36 years; SD = 2.51; 16 females) participated in this double-blind study and were categorized randomly into 4 groups. During the pretest, posttest, 24-h and 48-h retention, and transfer tests, two forms of bimanual coordination (BC) of the Vienna test system were performed. Between the pretest and posttest, all participants were trained in a bimanual coordination adaptive task with concurrent brain stimulation (1.5 mA for 15 min) for two consecutive days. The first experimental group (parietal-stim) received atDCS over the right parietal cortex (P4), while the second experimental group (cerebellar-stim) received atDCS over the bilateral cerebellum (2.5 cm bilateral to the inion). The third group (sham) received a sham stimulation. Finally, the control group did not receive any stimulation at all (control). Repeated-measure analysis of variance (ANOVARM) results indicated that parietal tDCS affected motor performance in the posttest, while overall mean duration and overall error mean duration of movement decreased. The results also revealed a significant impact of cerebellar tDCS on the posttest, 24-h and 48-h retention, and transfer tests. The overall mean duration and overall error mean durations of movement in this group were significantly lower than those in the other groups. Accordingly, we found evidence that atDCS over the cerebellum leads to more improvement in motor performance and transfer in a bimanual coordination task than atDCS over the right parietal. Finally, these results point to the possibly beneficial application of atDCS for learning and recovery of bimanual motor skills, especially when subjects are faced with a new challenging situation.

Uncontrolled manifold analysis of the effects of a perturbation-based training on the organization of leg joint variance in cerebellar ataxia

Walking patterns of persons affected by cerebellar ataxia (CA) are characterized by wide stride-to-stride variability ascribable to: the background pathology-related sensory-motor noise; the motor redundancy, i.e., an excess of elemental degrees of freedom that overcomes the number of variables underlying a specific task performance. In this study, we first tested the hypothesis that healthy and, especially, CA subjects can effectively exploit solutions in the domain of segmental angles to stabilize the position of either the foot or the pelvis (task performance) across heel strikes, in accordance with the uncontrolled manifold (UCM) theory. Next, we verified whether a specific perturbation-based training allows CA subjects to further take advantage of this coordination mechanism to better cope with their inherent pathology-related variability. Results always rejected the hypothesis of pelvis stabilization whereas supported the idea that the foot position is stabilized across heel strikes by a synergic covariation of elevation and azimuth angles of lower limb segments in CA subjects only. In addition, it was observed that the perturbation-based training involves a decreasing trend in the variance component orthogonal to the UCM in both groups, reflecting an improved accuracy of the foot control. Concluding, CA subjects can effectively structure the wide amount of pathology-related sensory-motor noise to stabilize specific task performance, such as the foot position across heel strikes. Moreover, the promising effects of the proposed perturbation-based training paradigm are expected to improve the coordinative strategy underlying the stabilization of the foot position across strides, thus ameliorating balance control during treadmill locomotion.

The Cerebellum and Implicit Sequencing: Evidence from Cerebellar Ataxia

The cerebellum recognizes sequences from prior experiences and uses this information to generate internal models that predict future outcomes in a feedforward manner [Front Hum Neurosci 8: 475, 2014; Cortex 47: 137-44, 2011; Cerebellum 7: 611-5, 2008; J Neurosci 26: 9107-16, 2006]. This process has been well documented in the motor domain, but the cerebellum's role in cognitive sequencing, within the context of implicit versus explicit processes, is not well characterized. In this study, we tested individuals with cerebellar ataxia and healthy controls to clarify the role of the cerebellum sequencing using variations on implicit versus explicit and motor versus cognitive demands across five experiments. Converging results across these studies suggest that cerebellar feedforward mechanisms may be necessary for sequencing in the implicit domain only. In the ataxia group, rhythmic tapping, rate of motor learning, and implicit sequence learning were impaired. However, for cognitive sequencing that could be accomplished using explicit strategies, the cerebellar group performed normally, as though they shifted to extra-cerebellar mechanisms to compensate. For example, when cognitive and motor functions relied on cerebellar function simultaneously, the ataxia group's motor function was unaffected, in contrast to that of controls whose motor performance declined as a function of cognitive load. These findings indicated that the cerebellum is not critical for all forms of sequencing per se. Instead, it plays a fundamental role for sequencing within the implicit domain, whether functions are motor or cognitive. Moreover, individuals with cerebellar ataxia are generally able to compensate for cognitive sequencing when explicit strategies are available in order to preserve resources for motor function.

Neural Processes Underlying Mirror-Induced Visual Illusion: An Activation Likelihood Estimation Meta-Analysis

Introduction: Neuroimaging studies on neural processes associated with mirror-induced visual illusion (MVI) are growing in number. Previous systematic reviews on these studies used qualitative approaches.

Objective: The present study conducted activation likelihood estimation (ALE) meta-analysis to locate the brain areas for unfolding the neural processes associated with the MVI.

Method: We searched the CINAHL, MEDLINE, Scopus, and PubMed databases and identified eight studies (with 14 experiments) that met the inclusion criteria.

Results: Contrasting with a rest condition, strong convergence in the bilateral primary and premotor areas and the inferior parietal lobule suggested top-down motor planning and execution. In addition, convergence was identified in the ipsilateral precuneus, cerebellum, superior frontal gyrus, and superior parietal lobule, clusters corresponding to the static hidden hand indicating self-processing operations, somatosensory processing, and motor control. When contrasting with an active movement condition, additional substantial convergence was revealed in visual-related areas, such as the ipsilateral cuneus, fusiform gyrus, middle occipital gyrus (visual area V2) and lingual gyrus, which mediate basic visual processing.

Conclusions: To the best of our knowledge, the current meta-analysis is the first to reveal the visualization, mental rehearsal and motor-related processes underpinning the MVI and offers theoretical support on using MVI as a clinical intervention for post-stroke patients.

Role of kinaesthetic motor imagery in mirror-induced visual illusion as intervention in post-stroke rehabilitation

Mirror-induced visual illusion obtained through mirror therapy is widely used to facilitate motor recovery after stroke. Activation of primary motor cortex (M1) ipsilateral to the moving limb has been reported during mirror-induced visual illusion. However, the mechanism through which the mirror illusion elicits motor execution processes without movements observed in the mirrored limb remains unclear. This study aims to review evidence based on brain imaging studies for testing the hypothesis that neural processes associated with kinaesthetic motor imagery are attributed to ipsilateral M1 activation. Four electronic databases were searched. Studies on functional brain imaging, investigating the instant effects of mirror-induced visual illusion among stroke survivors and healthy participants were included. Thirty-five studies engaging 78 stroke survivors and 396 healthy participants were reviewed. Results of functional brain scans (n = 20) indicated that half of the studies (n = 10, 50%) reported significant changes in the activation of ipsilateral M1, which mediates motor preparation and execution. Other common neural substrates included primary somatosensory cortex (45%, kinaesthesia), precuneus (40%, image generation and self-processing operations) and cerebellum (20%, motor control). Similar patterns of ipsilateral M1 activations were observed in the two groups. These neural substrates mediated the generation, maintenance, and manipulation of motor-related images, which were the key processes in kinaesthetic motor imagery. Relationships in terms of shared neural substrates and mental processes between mirror-induced visual illusion and kinaesthetic motor imagery generate new evidence on the role of the latter in mirror therapy. Future studies should investigate the imagery processes in illusion training for post-stroke patients.

Reactive Balance Adaptability and Retention in People With Multiple Sclerosis: A Systematic Review and Meta-Analysis

Aim. To compare reactive balance in people with multiple sclerosis (MS) with healthy controls and to examine the ability of people with MS to adapt their reactive balance and retain training effects. Data Sources. Electronic databases (PubMed, EMBASE, PsychINFO) and reference lists of included articles from inception to February 25, 2019. Study Selection. Case-control and intervention studies that assessed reactive balance using mechanical perturbations in people with a confirmed diagnosis of MS. Results. Meta-analyses of 9 studies (n = 342) showed that people with MS have significantly worse reactive balance than healthy controls (standardized mean difference [SMD] 0.78, 95% CI 0.44-1.11, P < .0001, I² = 47%). Specifically, people with MS have greater center of mass displacements (SMD 0.41, 95% CI 0.05-0.77, P = .02, I² = 9%) and longer response times (MD (ms) 31.45, 95% CI 19.91-42.98, P < .0001, I² = 75%) in response to standing perturbations than healthy controls. Subsequent meta-analyses revealed training comprising repeated exposure to perturbations improved response times (P < .001) and training effects on response times could be retained for 24 hours (P < .001) in people with MS. Conclusions. Reactive balance assessments can highlight functional impairments related to falls in people with MS, and perturbation training can acutely improve reactive balance control and such improvements can be retained for 24 hours in this population. Systematic review registration number: CRD42019126130.

Real-time biofeedback integrated into neuromuscular training reduces high-risk knee biomechanics and increases functional brain connectivity: A preliminary longitudinal investigation

Prospective evidence indicates that functional biomechanics and brain connectivity may predispose an athlete to an anterior cruciate ligament injury, revealing novel neural linkages for targeted neuromuscular training interventions. The purpose of this study was to determine the efficacy of a real-time biofeedback system for altering knee biomechanics and brain functional connectivity. Seventeen healthy, young, physically active female athletes completed 6 weeks of augmented neuromuscular training (aNMT) utilizing real-time, interactive visual biofeedback and 13 served as untrained controls. A drop vertical jump and resting state functional magnetic resonance imaging were separately completed at pre- and posttest time points to assess sensorimotor adaptation. The aNMT group had a significant reduction in peak knee abduction moment (pKAM) compared to controls (p = .03, d = 0.71). The aNMT group also exhibited a significant increase in functional connectivity between the right supplementary motor area and the left thalamus (p = .0473 after false discovery rate correction). Greater percent change in pKAM was also related to increased connectivity between the right cerebellum and right thalamus for the aNMT group (p = .0292 after false discovery rate correction, r²  = .62). No significant changes were observed for the controls (ps > .05). Our data provide preliminary evidence of potential neural mechanisms for aNMT-induced motor adaptations that reduce injury risk. Future research is warranted to understand the role of neuromuscular training alone and how each component of aNMT influences biomechanics and functional connectivity.

Phase resetting and intermittent control at the edge of stability in a simple biped model generates 1/f-like gait cycle variability

The 1/f-like gait cycle variability, characterized by temporal changes in stride-time intervals during steady-state human walking, is a well-documented gait characteristic. Such gait fractality is apparent in healthy young adults, but tends to disappear in the elderly and patients with neurological diseases. However, mechanisms that give rise to gait fractality have yet to be fully clarified. We aimed to provide novel insights into neuro-mechanical mechanisms of gait fractality, based on a numerical simulation model of biped walking. A previously developed heel-toe footed, seven-rigid-link biped model with human-like body parameters in the sagittal plane was implemented and expanded. It has been shown that the gait model, stabilized rigidly by means of impedance control with large values of proportional (P) and derivative (D) gains for a linear feedback controller, is destabilized only in a low-dimensional eigenspace, as P and D decrease below and even far below critical values. Such low-dimensional linear instability can be compensated by impulsive, phase-dependent actions of nonlinear controllers (phase resetting and intermittent controllers), leading to the flexible walking with joint impedance in the model being as small as that in humans. Here, we added white noise to the model to examine P-value-dependent stochastic dynamics of the model for small D-values. The simulation results demonstrated that introduction of the nonlinear controllers in the model determined the fractal features of gait for a wide range of the P-values, provided that the model operates near the edge of stability. In other words, neither the model stabilized only by pure impedance control even at the edge of linear stability, nor the model stabilized by specific nonlinear controllers, but with P-values far inside the stability region, could induce gait fractality. Although only limited types of controllers were examined, we suggest that the impulsive nonlinear controllers and criticality could be major mechanisms for the genesis of gait fractality.

Variability in locomotor dynamics reveals the critical role of feedback in task control

Animals vary considerably in size, shape, and physiological features across individuals, but yet achieve remarkably similar behavioral performances. We examined how animals compensate for morphophysiological variation by measuring the system dynamics of individual knifefish (Eigenmannia virescens) in a refuge tracking task. Kinematic measurements of Eigenmannia were used to generate individualized estimates of each fish’s locomotor plant and controller, revealing substantial variability between fish. To test the impact of this variability on behavioral performance, these models were used to perform simulated ‘brain transplants’—computationally swapping controllers and plants between individuals. We found that simulated closed-loop performance was robust to mismatch between plant and controller. This suggests that animals rely on feedback rather than precisely tuned neural controllers to compensate for morphophysiological variability.

People come in different shapes and sizes, but most will perform similarly well if asked to complete a task requiring fine manual dexterity – such as holding a pen or picking up a single grape. How can different individuals, with different sized hands and muscles, produce such similar movements? One explanation is that an individual’s brain and nervous system become precisely tuned to mechanics of the body’s muscles and skeleton. An alternative explanation is that brain and nervous system use a more “robust” control policy that can compensate for differences in the body by relying on feedback from the senses to guide the movements.

To distinguish between these two explanations, Uyanik et al. turned to weakly electric freshwater fish known as glass knifefish. These fish seek refuge within root systems, reed grass and among other objects in the water. They swim backwards and forwards to stay hidden despite constantly changing currents. Each fish shuttles back and forth by moving a long ribbon-like fin on the underside of its body. Uyanik et al. measured the movements of the ribbon fin under controlled conditions in the laboratory, and then used the data to create computer models of the brain and body of each fish. The models of each fish’s brain and body were quite different.

To study how the brain interacts with the body, Uyanik et al. then conducted experiments reminiscent of those described in the story of Frankenstein and transplanted the brain from each computer model into the body of different model fish. These “brain swaps” had almost no effect on the model’s simulated swimming behavior. Instead, these “Frankenfish” used sensory feedback to compensate for any mismatch between their brain and body.

This suggests that, for some behaviors, an animal’s brain does not need to be precisely tuned to the specific characteristics of its body. Instead, robust control of movement relies on many seemingly redundant systems that provide sensory feedback. This has implications for the field of robotics. It further suggests that when designing robots, engineers should prioritize enabling the robots to use sensory feedback to cope with unexpected events, a well-known idea in control engineering.

Cerebellar contribution to locomotor behavior: A neurodevelopmental perspective

The developmental trajectory of the formation of cerebellar circuitry has significant implications for locomotor plasticity and adaptive learning at later stages. While there is a wealth of knowledge on the development of locomotor behavior in human infants, children, and adolescents, pre-clinical animal models have fallen behind on the study of the emergence of behavioral motifs in locomotor function across postnatal development. Since cerebellar development is protracted, it is subject to higher risk of genetic or environmental disruption, potentially leading to abnormal behavioral development. This highlights the need for more sophisticated and specific functional analyses of adaptive cerebellar behavior within the context of whole-body locomotion across the entire span of postnatal development. Here we review evidence on cerebellar contribution to adaptive locomotor behavior, highlighting methodologies employed to quantify and categorize behavior at different developmental stages, with the ultimate goal of following the course of early behavioral alterations in neurodevelopmental disorders. Since experimental paradigms used to study cerebellar behavior are lacking in both specificity and applicability to locomotor contexts, we highlight the use of the Erasmus Ladder - an advanced, computerized, fully automated system to quantify adaptive cerebellar learning in conjunction with locomotor function. Finally, we emphasize the need to develop objective, quantitative, behavioral tasks which can track changes in developmental trajectories rather than endpoint measurement at the adult stage of behavior.

The Implementation of Predictions During Sequencing

Optimal control mechanisms require prediction capabilities. If one cannot predict the consequences of a motor act or behavior, one will continually collide with walls or become a social pariah. "Looking into the future" is thus one of the most important prerequisites for smooth movements and social interactions. To achieve this goal, the brain must constantly predict future events. This principle applies to all domains of information processing, including motor and cognitive control, as well as the development of decision-making skills, theory of mind, and virtually all cognitive processes. Sequencing is suggested to support the predictive capacity of the brain. To recognize that events are related, the brain must discover links among them in the spatiotemporal domain. To achieve this, the brain must often hold one event in working memory and compare it to a second one, and the characteristics of the two must be compared and correctly placed in space and time. Among the different brain structures involved in sequencing, the cerebellum has been proposed to have a central function. We have suggested that the operational mode of the cerebellum is based on "sequence detection" and that this process is crucial for prediction. Patterns of temporally or spatially structured events are conveyed to the cerebellum via the pontine nuclei and compared with actual ones conveyed through the climbing fibers olivary inputs. Through this interaction, data on previously encountered sequences can be obtained and used to generate internal models from which predictions can be made. This mechanism would allow the cerebellum not only to recognize sequences but also to detect sequence violations. Cerebellar pattern detection and prediction would thus be a means to allow feedforward control based on anticipation. We will argue that cerebellar sequencing allows implementation of prediction by setting the correct excitatory levels in defined brain areas to implement the adaptive response for a given pattern of stimuli that embeds sufficient information to be recognized as a previously encountered template. Here, we will discuss results from human and animal studies and correlate them with the present understanding of cerebellar function in cognition and behavior.

The posterior Cerebellum is involved in constructing Social Action Sequences: An fMRI Study

Social neuroscience largely ignored the role of the cerebellum, despite its implications in a broad range of tasks and neurological disorders related to social functioning and inferences on others' mental state such as beliefs. One hypothesis states that during human evolution, the cerebellum's function evolved from a mere coordinator of fluent sequences of motions and actions, to an interpreter of action sequences without overt movements that are important for social understanding. The present study introduces new tasks to investigate the role of the cerebellum in sequencing, in which participants generated the correct chronological order of new or well-known event stories with or without social elements during functional neuroimaging (fMRI). Results showed strong cerebellar activation during order generation for all event types compared to passive viewing or reading events. More importantly, new social events involving true or false beliefs showed stronger activation in the bilateral posterior cerebellum (Crus 1 and Crus 2) compared to routine social and non-social (mechanical) events. This confirms the critical role of the posterior cerebellum in the understanding and construction of the correct order of action sequences relevant for social understanding. The present tasks and results may facilitate diagnoses and treatments of cerebellar dysfunctions in the future.

Dysarthria Profiles in Adults With Hereditary Ataxia

Purpose This preliminary study examined whether speech profiles exist for adults with hereditary ataxia based on 2 competing frameworks: a pattern of instability/inflexibility or a pattern of differential subsystem involvement. Method Four dysarthria experts rated the speech samples of 8 adults with dysarthria from hereditary ataxia using visual analog scales and presence/severity rating scales of speech characteristics. Speaking tasks included diadochokinetics, sustained phonation, and a monologue. Results Speech profiles aligned with the instability/inflexibility framework, with the pattern of instability being the most common. Speech profiles did not emerge for the majority of speakers using the differential subsystem framework. Conclusions The findings extend previous research on pure ataxic dysarthria and suggest a possible framework for understanding the speech heterogeneity associated with the ataxias. The predominance of the instability profile is consistent with the notion of impaired feedforward control in speakers with cerebellar disruption.

Physiological and Morphological Principles Underpinning Recruitment of the Cerebellar Reserve

Background:

In order to optimize outcomes of novel therapies for cerebellar ataxias (CAs), it is desirable to start these therapies while declined functions are restorable: i.e. while the so-called cere-bellar reserve remains.

Objective:

In this mini-review, we tried to define and discuss the cerebellar reserve from physiological and morphological points of view.

Method: The cerebellar neuron circuitry is designed to generate spatiotemporally organized outputs, re-gardless of the region. Therefore, the cerebellar reserve may be defined as a mechanism to restore its proper input-output organization of the cerebellar neuron circuitry, when it is damaged. Then, the follow-ing four components are essential for recruitment of the cerebellar reserve: operational local neuron cir-cuitry; proper combination of mossy fiber inputs to be integrated; climbing fiber inputs to instruct favor-able reorganization of the integration; deep cerebellar nuclei to generate reorganized outputs.

Results:

We discussed three topics related to these resources, 1) principles of generating organized cere-bellar outputs, 2) redundant mossy fiber inputs to the cerebellum, 3) plasticity of the cerebellar neuron circuitry.

Conclusion:

To make most of the cerebellar reserve, it is desirable to start any intervention as early as possible when the cerebellar cell loss is minimal or even negligible. Therefore, an ideal future therapy for degenerative cerebellar diseases should start before consuming the cerebellar reserve at all. In the meantime, our real challenge is to establish a reliable method to identify the decrease in the cerebellar re-serve as early as possible.

Effects of two different protocols of cerebellar transcranial direct current stimulation combined with transcutaneous spinal direct current stimulation on robot-assisted gait training in patients with chronic supratentorial stroke: A single blind, randomized controlled trial

BACKGROUND

The neural organization of locomotion involves motor patterns generated by spinal interneuronal networks and supraspinal structures, which are approachable by noninvasive stimulation techniques. Recent evidences supported the hypothesis that transcranial direct current stimulation (combined with transcutaneous spinal direct current stimulation) may actually enhance the effects of robot-assisted gait training in chronic stroke patients. The cerebellum has many connections to interact with neocortical areas and may provide some peculiar plasticity mechanisms. So, it has been proposed as "non-lesioned entry" to the motor or cognitive system for the application of noninvasive stimulation techniques in patients with supratentorial stroke.

OBJECTIVE

To compare the effects of two different protocols of cerebellar transcranial direct current stimulation combined with transcutaneous spinal direct current stimulation on robotic gait training in patients with chronic supratentorial stroke.

METHODS

Forty patients with chronic supratentorial stroke were randomly assigned into two groups. All patients received ten, 20-minute robotic gait training sessions, five days a week, for two consecutive weeks. Group 1 underwent cathodal transcranial direct current stimulation over the contralesional cerebellar hemisphere + cathodal transcutaneous spinal direct current stimulation in combination with robotic training. Group 2 underwent cathodal transcranial direct current stimulation over the ipsilesional cerebellar hemisphere + cathodal transcutaneous spinal direct current stimulation in combination with robotic training. The primary outcome was the 6-minute walk test performed before, after, and at follow-up at 2 and 4 weeks post-treatment.

RESULTS

No significant difference in the 6-minute walk test between groups was found at the first post-treatment evaluation (P = 0.976), as well as at the 2-week (P = 0.178) and the 4-week (P = 0.069) follow-up evaluations. Both groups showed significant within-group improvements in the 6-minute walk test at all time points.∥Conclusions: Our findings support the hypothesis that cathodal transcranial direct current stimulation over the contralesional or ipsilesional cerebellar hemisphere in combination with cathodal transcutaneous spinal direct current stimulation may lead to similar effects on robotic gait training in chronic supratentorial stroke patients.

The role of the cerebellum in reconstructing social action sequences: a pilot study

Recent research has revealed that the cerebellum plays a critical role in social reasoning and in particular in understanding false beliefs and making trait attributions. One hypothesis is that the cerebellum is responsible for the understanding of sequences of motions and actions, which may be a prerequisite for social understanding. To investigate the role of action sequencing in mentalizing, we tested patients with generalized cerebellar degenerative lesions on tests of social understanding and compared their performance with matched healthy volunteers. The tests involved understanding violations of social norms making trait and causal attributions on the basis of short behavioral sentences and generating the correct chronological order of social actions depicted in cartoons (picture sequencing task). Cerebellar patients showed clear deficits only on the picture sequencing task when generating the correct order of cartoons depicting false belief stories and showed at or close to normal performance for mechanical stories and overlearned social scripts. In addition, they performed marginally worse on trait attributions inferred from verbal behavioral descriptions. We conclude that inferring the mental state of others through understanding the correct sequences of their actions requires the support of the cerebellum.

The sequencing process generated by the cerebellum crucially contributes to social interactions

The capacity to understand another person's emotions, intentions, beliefs and personality traits, based on observed or communicated behaviors, is termed social cognition. During the last decade, social neuroscience has made great progress in understanding the neural correlates of social cognition. However, because the cerebellum is traditionally viewed as only involved in motor processing, the contribution of this major part of the brain in social processing has been largely ignored and its specific role in social cognition remains unclear. Nevertheless, recent meta-analyses have made its crucial contribution to social cognition evident. This raises the question: What is the exact function of the cerebellum in social cognition? We hypothesize that the cerebellum builds internal action models of our social inter-actions to predict how other people's actions will be executed, what our most likely responses are to these actions, so that we can automatize our interactions and instantly detect disruptions in these action sequences. This mechanism likely allows to better anticipate action sequences during social interactions in an automatic and intuitive way and to fine-tune these anticipations, making it easier to understand behaviors and to detect violations. This hypothesis has major implications in neurological disorders affecting the cerebellum such as autism, with detrimental effects on social functionality, especially on more complex and abstract social cognitive processes. Because the fundamental anatomical organization of the cerebellum is identical in many species (cerebellar microcomplexes), this hypothesis could have major impacts to elucidate social interactions in social animals.