Abstract
Adults exposed to blast and blunt impact often experience mild traumatic brain injury, affecting neural functions related to sensory, cognitive, and motor function. In this perspective article, we will review the effects of impact and blast exposure on functional performance that requires the integration of these sensory, cognitive, and motor control systems. We describe cognitive-motor integration and how it relates to successfully navigating skilled activities crucial for work, duty, sport, and even daily life. We review our research on the behavioral effects of traumatic impact and blast exposure on cognitive-motor integration in both younger and older adults, and the neural networks that are involved in these types of skills. Overall, we have observed impairments in rule-based skilled performance as a function of both physical impact and blast exposure. The extent of these impairments depended on the age at injury and the sex of the individual. It appears, however, that cognitive-motor integration deficits can be mitigated by the level of skill expertise of the affected individual, suggesting that such experience imparts resiliency in the brain networks that underly the control of complex visuomotor performance. Finally, we discuss the next steps needed to comprehensively understand the impact of trauma and blast exposure on functional movement control.
Highlights
TO THE NEURAL CONTROL OF RULE-BASEDSKILLED PERFORMANCE ImagineAt work, you operate a drone aircraft
Indirect interactions are guided by non-standard sensorimotor mapping, and rely on different neural computations that must incorporate the spatial dissociation of gaze, attention, and overt motor output [1]
We propose that widespread injury can reduce rule-based skilled performance through a failure to communicate between brain networks
Summary
You operate a drone aircraft. You have one joystick that sends the drone up or down and turns it in a circle, and another that flies it forward, back, or side to side, and all the while you look at a computer monitor showing images from the drone’s camera to allow you to direct its movement. Operating the drone and reaching for the cup are examples of visually-guided arm movement that vary widely in their complexity. Direct interactions are guided by standard sensorimotor mappings within the brain. Indirect interactions are guided by non-standard sensorimotor mapping, and rely on different neural computations that must incorporate the spatial dissociation of gaze, attention, and overt motor output [1]. Visuomotor adaptation, or “strategic control” [5] relies on a mental rotation to align the required limb movement to the spatial location of a target. It is more explicit, does not produce after-effects, and can require rule integration. The linking theme is the neural control of rulebased sensory-guided movement in health and following mild brain injury
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