Different neural substrates for precision stepping and fast online step adjustments in youth

Humans can navigate through challenging environments (e.g., cluttered or uneven terrains) by modifying their preferred gait pattern (e.g., step length, step width, or speed). Growing behavioral and neuroimaging evidence suggests that the ability to modify preferred step patterns requires the recruitment of cognitive resources. In children, it is argued that prolonged development of complex gait is related to the ongoing development of involved brain regions, but this has not been directly investigated yet. Here, we aimed to elucidate the relationship between structural brain properties and complex gait in youth aged 9–18 years. We used volumetric analyses of cortical grey matter (GM) and whole-brain voxelwise statistical analyses of white matter (WM), and utilized a treadmill-based precision stepping task to investigate complex gait. Moreover, precision stepping was performed on step targets which were either unperturbed or perturbed (i.e., unexpectedly shifting to a new location). Our main findings revealed that larger unperturbed precision step error was associated with decreased WM microstructural organization of tracts that are particularly associated with attentional and visual processing functions. These results strengthen the hypothesis that precision stepping on unperturbed step targets is driven by cortical processes. In contrast, no significant correlations were found between perturbed precision stepping and cortical structures, indicating that other (neural) mechanisms may be more important for this type of stepping.

Neural predictors of motor control and impact of visuo-proprioceptive information in youth

For successful motor control, the central nervous system is required to combine information from the environment and the current body state, which is provided by vision and proprioception respectively. We investigated the relative contribution of visual and proprioceptive information to upper limb motor control and the extent to which structural brain measures predict this performance in youth (n = 40; age range 9-18 years). Participants performed a manual tracking task, adopting in-phase and anti-phase coordination modes. Results showed that, in contrast to older participants, younger participants performed the task with lower accuracy in general and poorer performance in anti-phase than in-phase modes. However, a proprioceptive advantage was found at all ages, that is, tracking accuracy was higher when proprioceptive information was available during both in- and anti-phase modes at all ages. The microstructural organization of interhemispheric connections between homologous dorsolateral prefrontal cortices, and the cortical thickness of the primary motor cortex were associated with sensory-specific accuracy of tracking performance. Overall, the findings suggest that manual tracking performance in youth does not only rely on brain regions involved in sensorimotor processing, but also on prefrontal regions involved in attention and working memory. Hum Brain Mapp 38:5628-5647, 2017. © 2017 Wiley Periodicals, Inc.

Slow maturation of planning in obstacle avoidance in humans

Complex gait (e.g., obstacle avoidance) requires a higher cognitive load than simple steady-state gait, which is a more automated movement. The higher levels of the central nervous system, responsible for adjusting motor plans to complex gait, develop throughout childhood into adulthood. Therefore, we hypothesize that gait strategies in complex gait are likely to mature until adulthood as well. However, little is known about the maturation of complex gait from childhood into adolescence and adulthood. To address this issue, we investigated obstacle avoidance in forty-four 8- to 18-yr-old participants who walked at preferred speed along a 6-m walkway on which a planar obstacle (150% of step length, 1 m wide) was projected. Participants avoided the obstacle by stepping over this projection, while lower body kinematics were recorded. Results showed that step length and speed adjustments during successful obstacle avoidance were similar across all ages, even though younger children modified step width to a greater extent. Additionally, the younger children used larger maximal toe elevations and take-off distances than older children. Moreover, during unsuccessful trials, younger children deployed exaggerated take-off distances, which resulted in obstacle contact upon the consecutive heel strike. These results indicate that obstacle avoidance is not fully matured in younger children, and that the inability to plan precise foot placements is an important factor contributing to failures in obstacle avoidance.

Vision of the active limb impairs bimanual motor tracking in young and older adults

Despite the intensive investigation of bimanual coordination, it remains unclear how directing vision toward either limb influences performance, and whether this influence is affected by age. To examine these questions, we assessed the performance of young and older adults on a bimanual tracking task in which they matched motor-driven movements of their right hand (passive limb) with their left hand (active limb) according to in-phase and anti-phase patterns. Performance in six visual conditions involving central vision, and/or peripheral vision of the active and/or passive limb was compared to performance in a no vision condition. Results indicated that directing central vision to the active limb consistently impaired performance, with higher impairment in older than young adults. Conversely, directing central vision to the passive limb improved performance in young adults, but less consistently in older adults. In conditions involving central vision of one limb and peripheral vision of the other limb, similar effects were found to those for conditions involving central vision of one limb only. Peripheral vision alone resulted in similar or impaired performance compared to the no vision (NV) condition. These results indicate that the locus of visual attention is critical for bimanual motor control in young and older adults, with older adults being either more impaired or less able to benefit from a given visual condition.

Balance control in multiple sclerosis: correlations of trunk sway during stance and gait tests with disease severity

OBJECTIVE

To investigate which measures of trunk sway taken during stance and gait tasks are best correlated with Expanded Disability Status Scale (EDSS) scores of multiple sclerosis (MS) patients.

METHODS

We studied 37 MS patients (mean age 43±10 years; 76% female; 81% relapsing-remitting MS; mean EDSS score 2.8±1.1). The study protocol comprised the subjective Dizziness Handicap Inventory (DHI) and recorded peak-to-peak trunk sway angles and velocities during 14 stance and gait balance tasks. 76 age- and gender-matched healthy subjects served as controls (HCs).

RESULTS

Patients had significant more trunk sway than HCs (p<0.001) and EDSS scores were highly correlated with sway measures in 6 of 14 balance tests (rho>0.4; p<0.001). Patients with normal clinical Romberg and tandem gait tests showed significantly more trunk sway than HCs when standing on one leg eyes open on foam support (p<0.001). Patients with spinal cord manifestation of MS (n=27) had higher trunk sway compared to patients without. Mean DHI score of the patients was 30±23.5%. DHI was highly correlated with trunk sway for all two-legged stance tasks in MS patients.

CONCLUSIONS

Balance deficits in trunk sway observed in MS patients during stance and gait tasks are highly correlated with their EDSS and DHI scores, with stance and tandem gait tasks providing the highest correlations. Measures of trunk sway during stance balance tests demonstrate a MS-related functional deficit even in patients with normal clinical Romberg and tandem gait tests, and therefore have the potential to provide objective data of sub-clinical deficits.