Robotic Assistance for Upper Limbs May Induce Slight Changes in Motor Modules Compared With Free Movements in Stroke Survivors: A Cluster-Based Muscle Synergy Analysis

Background: The efficacy of robot-assisted rehabilitation as a technique for achieving motor recovery is still being debated. The effects of robotic assistance are generally measured using standard clinical assessments. Few studies have investigated the value of human-centered instrumental analysis, taking the modular organization of the human neuromotor system into account in assessing how stroke survivors interact with robotic set-ups. In this paper, muscle synergy analysis was coupled with clustering procedures to elucidate the effect of human-robot interaction on the spatial and temporal features, and directional tuning of motor modules during robot-assisted movements. Methods: Twenty-two stroke survivors completed a session comprising a series of hand-to-mouth movements with and without robotic assistance. Patients were assessed instrumentally, recording kinematic, and electromyographic data to extract spatial muscle synergies and their temporal components. Patients' spatial synergies were grouped by means of a cluster analysis, matched pairwise across conditions (free and robot-assisted movement), and compared in terms of their spatial and temporal features, and directional tuning, to examine how robotic assistance altered their motor modules. Results: Motor synergies were successfully extracted for all 22 patients in both conditions. Seven clusters (spatial synergies) could describe the original datasets, in both free and robot-assisted movements. Interacting with the robot slightly altered the spatial synergies' features (to a variable extent), as well as their temporal components and directional tuning. Conclusions: Slight differences were identified in the characteristics of spatial synergies, temporal components and directional tuning of the motor modules of stroke survivors engaging in free and robot-assisted movements. Such effects are worth investigating in the framework of a modular description of the neuromusculoskeletal system to shed more light on human-robot interaction, and the effects of robotic assistance and rehabilitation.

Effort minimization and synergistic muscle recruitment for three-dimensional force generation

To generate a force at the hand in a given spatial direction and with a given magnitude the central nervous system (CNS) has to coordinate the recruitment of many muscles. Because of the redundancy in the musculoskeletal system, the CNS can choose one of infinitely many possible muscle activation patterns which generate the same force. What strategies and constraints underlie such selection is an open issue. The CNS might optimize a performance criterion, such as accuracy or effort. Moreover, the CNS might simplify the solution by constraining it to be a combination of a few muscle synergies, coordinated recruitment of groups of muscles. We tested whether the CNS generates forces by minimum effort recruitment of either individual muscles or muscle synergies. We compared the activation of arm muscles observed during the generation of isometric forces at the hand across multiple three-dimensional force targets with the activation predicted by either minimizing the sum of squared muscle activations or the sum of squared synergy activations. Muscle synergies were identified from the recorded muscle pattern using non-negative matrix factorization. To perform both optimizations we assumed a linear relationship between rectified and filtered electromyographic (EMG) signal which we estimated using multiple linear regressions. We found that the minimum effort recruitment of synergies predicted the observed muscle patterns better than the minimum effort recruitment of individual muscles. However, both predictions had errors much larger than the reconstruction error obtained by the synergies, suggesting that the CNS generates three-dimensional forces by sub-optimal recruitment of muscle synergies.

Robustness of muscle synergies during visuomotor adaptation

During visuomotor adaptation a novel mapping between visual targets and motor commands is gradually acquired. How muscle activation patterns are affected by this process is an open question. We tested whether the structure of muscle synergies is preserved during adaptation to a visuomotor rotation. Eight subjects applied targeted isometric forces on a handle instrumented with a force transducer while electromyographic (EMG) activity was recorded from 13 shoulder and elbow muscles. The recorded forces were mapped into horizontal displacements of a virtual sphere with simulated mass, elasticity, and damping. The task consisted of moving the sphere to a target at one of eight equally spaced directions. Subjects performed three baseline blocks of 32 trials, followed by six blocks with a 45° CW rotation applied to the planar force, and finally three wash-out blocks without the perturbation. The sphere position at 100 ms after movement onset revealed significant directional error at the beginning of the rotation, a gradual learning in subsequent blocks, and aftereffects at the beginning of the wash-out. The change in initial force direction was closely related to the change in directional tuning of the initial EMG activity of most muscles. Throughout the experiment muscle synergies extracted using a non-negative matrix factorization algorithm from the muscle patterns recorded during the baseline blocks could reconstruct the muscle patterns of all other blocks with an accuracy significantly higher than chance indicating structural robustness. In addition, the synergies extracted from individual blocks remained similar to the baseline synergies throughout the experiment. Thus synergy structure is robust during visuomotor adaptation suggesting that changes in muscle patterns are obtained by rotating the directional tuning of the synergy recruitment.

Local shaping of function in the motor cortex: motor contrast, directional tuning

In this review we bring together three different lines of evidence to bear on the issue of local shaping of function in the motor cortex. The first line of evidence comes from the description by Cajal (1904) of the recurrent collaterals of pyramidal cell axons in the precentral gyrus. The second line of evidence comes from the electrophysiological study of the functional effects of these collaterals [Stefanis, C., Jasper, H. 1964a. Intracellular microelectrode studies of antidromic responses in cortical pyramidal tract neurons. J. Neurophysiol. 27, 828-854.; Stefanis, C., Jasper, H. 1964b. Recurrent collateral inhibition in pyramidal tract neurons. J. Neurophysiol. 27, 855-877.] and associated interneurons [Stefanis, C. 1969. Interneuronal mechanisms in the cortex. In: The Interneuron, Brazier, M.A.B. (ed.), Berkeley, CA: University of California Press, pp. 497-526.] using intracellular recordings. And third came the discovery of directional tuning in the motor cortex [Georgopoulos, A.P., Kalaska, J.F., Caminiti, R., Massey, J.T. 1982. On the relations between the direction of two-dimensional arm movements and cell discharge in primate motor cortex. J. Neurosci. 2, 1527-1537.] in the behaving monkey. We hazard the hypothesis that the bell-shaped directional tuning curve is the outcome of orderly, local neuronal interactions in the motor cortex in which the recurrent pyramidal cell collaterals play a crucial role. Specifically, we propose that these collaterals and the intercalated interneurons they impinge upon serve to spatially sharpen the motor cortical activation to a locus corresponding to the direction of the intended movement. Thus, the originally proposed role of the pyramidal cell collaterals in enhancing "motor contrast" [Stefanis, C. 1969. Interneuronal mechanisms in the cortex. In: The Interneuron, Brazier, M.A.B. (ed.), Berkeley, CA: University of California Press, pp. 497-526.] would translate to creating a "directional tuning field" on the motor cortical surface, where the enhanced motor contrast would correspond to high activity at the center of directional field, and the suppression of the fringe would correspond to lower activity at the periphery of the field, resulting, together in spatial tuning.

Cortical representation of bimanual movements

It is well established that the discharge of neurons in primate motor cortex is tuned to the movement direction of the contralateral arm. Interestingly, it has been found that these neurons exhibit a directional tuning to the ipsilateral arm as well and that the preferred directions to both arms tend to be similar. A recent study showed that motor cortex cells are also directionally selective to bimanual movements, but the relationship between the bimanual and unimanual representations remains unclear. To address this issue, we analyzed the responses of motor cortical neurons recorded from two macaque monkeys during unimanual and bimanual reaching movements. We decomposed the bimanual movement representation into contralateral and ipsilateral directionally tuned components. Our major finding is that the movement of the contralateral arm modifies the tuning of the cells to the ipsilateral arm such that: (1) the offset and modulation depth of the tuning are suppressed; and (2) the preferred directions are randomly shifted. Both these effects eliminate the correlation between the contralateral and ipsilateral representations during bimanual movements. We suggest that the modification of the ipsilateral arm representation is caused by the recruitment of local inhibition that conveys callosal inputs during bimanual movements. This hypothesis is supported by the analysis of a model of two motor cortical networks, coupled with sparse random interhemispheric projections that reproduce the main features observed in the data. Finally, we show that the modification of the ipsilateral arm representation reduces the interference between the movements of both arms.

Directional tuning of single motor units

The directional activity of whole muscles has been shown to be broadly and often multimodally tuned, raising the question of how this tuning is subserved at the level of single motor units (SMUs). Previously defined rules of SMU activation would predict that units of the same muscle (or at least of the same neuromuscular compartment) are activated homogeneously with activity peaks in the same "best" direction(s). In the present study, the best directions of SMUs in human biceps (both heads) and deltoid (anterior, medial, and posterior portions) were determined by measuring the firing rate and threshold force of units for recruitment during isometric force ramps in many different directions. For all muscles studied, neighboring motor units could have significantly different best directions, suggesting that each muscle receives multiple directional commands. Furthermore, 17% of the units sampled clearly had a second-best direction, consistent with a convergence of different directional commands onto the same motoneuron. The best directions of the units changed gradually with location in the muscle. Best directions did not cluster into separate groups, thus, not supporting the existence of clearly distinguished neuromuscular compartments. Instead, the results reveal a more gradually distributed activation of the biceps and deltoid motoneuron pools. A model is proposed in which the central control mechanism optimizes the fulfillment of the continuously changing directional force requirements of a movement by gradually recruiting and derecruiting those units ideally suited for the production of the required force vector at any given time.

Variability and correlated noise in the discharge of neurons in motor and parietal areas of the primate cortex

We analyzed the magnitude and interneuronal correlation of the variability in the activity of single neurons that were recorded simultaneously using a multielectrode array in the primary motor cortex and parietal areas 2/5 in rhesus monkeys. The animals were trained to move their arms in one of eight directions as instructed by a visual target. The relationship between variability (SD) and mean of the discharge rate was described by a power function with a similar exponent ( approximately 0.57), regardless of the cortical area or the behavioral condition. We examined whether the deviation from mean activity between target onset and the end of the movement was correlated on a trial-by-trial basis with variability in activity during the hold period before target onset. In both cortical areas, for about a quarter of the neurons, the neuronal noise of these two periods was positively correlated, whereas significant negative correlations were seldom observed. Overall, neurons with higher signal correlation (i.e., similar directional pattern) showed higher noise correlation in both cortical areas. On the other hand, when the data were divided according to the distance between the electrode tips from which the neurons were recorded, a consistent relationship between the signal and noise correlations was found only for pairs of neurons recorded through the same electrode. These results suggest that nearby neurons with similar directional tuning carry primarily redundant messages, whereas neurons in separate cortical columns perform more independent processing.