Sensorimotor Cortical Areas Research Articles

Anterior Cruciate Ligament Deficiency Causes Brain Plasticity

Background The mechanoreceptors located in anterior cruciate ligament (ACL) constitute an afferent source of information toward the central nervous system. It has been proposed that ACL deficiency causes a disturbance in neuromuscular control, affects central programs and consequently the motor response resulting in serious dysfunction of the injured limb. Purpose The objective of this study was to investigate whether chronic anterior cruciate ligament injury causes plastic changes in brain activation patterns. Study Design Case control study; Level of evidence, 3. Methods Seventeen right leg–dominant male participants with chronic anterior cruciate ligament deficiency and 18 matched healthy male participants with no special sport or habitual physical activity participated in this study. Patient selection criteria comprised a complete right unilateral anterior cruciate ligament rupture ≥6 months before testing. Brain activation was examined by using functional magnetic resonance imaging technique (1.5-T scanner). Results Results show that patients with anterior cruciate ligament deficiency had diminished activation in several sensorimotor cortical areas and increased activation in 3 areas compared with controls: presupplementary motor area, posterior secondary somatosensory area, and posterior inferior temporal gyrus. Conclusion The current study reveals that anterior cruciate ligament deficiency can cause reorganization of the central nervous system, suggesting that such an injury might be regarded as a neurophysiologic dysfunction, not a simple peripheral musculoskeletal injury. This evidence could explain clinical symptoms that accompany this type of injury and lead to severe dysfunction. Understanding the pattern of brain activation after a peripheral joint injury such as anterior cruciate ligament injury lead to new standards in rehabilitation and motor control learning with a wide application in a number of clinical and research areas (eg, surgical procedures, patient re-education, athletic training, etc).

Long-Term Recordings of Multiple, Single-Neurons for Clinical Applications: The Emerging Role of the Bioactive Microelectrode

In 1999 we reported an important demonstration of a working brain-machine interface (BMI), in which recordings from multiple, single neurons in sensorimotor cortical areas of rats were used to directly control a robotic arm to retrieve a water reward. Subsequent studies in monkeys, using a similar approach, demonstrated that primates can use a BMI device to control a cursor on a computer screen and a robotic arm. Recent studies in humans with spinal cord injuries have shown that recordings from multiple, single neurons can be used by the patient to control the cursor on a computer screen. The promise is that one day it will be possible to use these control signals from neurons to re-activate the patient’s own limbs. However, the ability to record from large populations of single neurons for long periods of time has been hampered because either the electrode itself fails or the immunological response in the tissue surrounding the microelectrode produces a glial scar, preventing single-neuron recording. While we have largely solved the problem of mechanical or electrical failure of the electrode itself, much less is known about the long term immunological response to implantation of a microelectrode, its effect on neuronal recordings and, of greatest importance, how it can be reduced to allow long term single neuron recording. This article reviews materials approaches to resolving the glial scar to improve the longevity of recordings. The work to date suggests that approaches utilizing bioactive interventions that attempt to alter the glial response and attract neurons to the recording site are likely to be the most successful. Importantly, measures of the glial scar alone are not sufficient to assess the effect of interventions. It is imperative that recordings of single neurons accompany any study of glial activation because, at this time, we do not know the precise relationship between glial activation and loss of neuronal recordings. Moreover, new approaches to immobilize bioactive molecules on microelectrode surfaces while maintaining their functionality may open new avenues for very long term single neuron recording. Finally, it is important to have quantitative measures of glial upregulation and neuronal activity in order to assess the relationship between the two. These types of studies will help rationalize the study of interventions to improve the longevity of recordings from microelectrodes.

Differential effects of high‐frequency repetitive transcranial magnetic stimulation over ipsilesional primary motor cortex in cortical and subcortical middle cerebral artery stroke

Facilitation of cortical excitability of the ipsilesional primary motor cortex (M1) may improve dexterity of the affected hand after stroke. The effects of 10 Hz repetitive transcranial magnetic stimulation (rTMS) over ipsilesional M1 on movement kinematics and neural activity were examined in patients with subcortical or cortical stroke. Twenty-nine patients with impaired dexterity after stroke (16 subcortical middle cerebral artery [MCA] strokes, 13 MCA strokes involving subcortical tissue and primary or secondary cortical sensorimotor areas) received 1 session of 10 Hz rTMS (5-second stimulation, 25-second break, 1,000 pulses, 80% of the resting motor threshold) applied over: 1) ipsilesional M1 and 2) vertex (control stimulation). For behavioral testing, 29 patients performed index finger and hand tapping movements with the affected and unaffected hand prior to and following each rTMS application. For functional magnetic resonance imaging, 18 patients performed index finger tapping movements with the affected and unaffected hand before and after each rTMS application. Ten-Hz rTMS over ipsilesional M1, but not over vertex, improved movement kinematics in 14 of 16 patients with subcortical stroke, but not in patients with additional cortical stroke. Ten-Hz rTMS slightly deteriorated dexterity of the affected hand in 7 of 13 cortical stroke patients. At a neural level, rTMS over ipsilesional M1 reduced neural activity of the contralesional M1 in 11 patients with subcortical stroke, but caused a widespread bilateral recruitment of primary and secondary motor areas in 7 patients with cortical stroke. Activity in ipsilesional M1 at baseline correlated with improvement of index finger tapping frequency induced by rTMS. The beneficial effects of 10 Hz rTMS over ipsilesional M1 on motor function of the affected hand depend on the extension of MCA stroke. Neural activity in ipsilesional M1 may serve as a surrogate marker for the effectiveness of facilitatory rTMS.

Increased expression of the growth‐associated protein 43 gene in the sensorimotor cortex of the macaque monkey after lesioning the lateral corticospinal tract

To investigate the neural basis for functional recovery of the cerebral cortex following spinal cord injury, we measured the expression of growth-associated protein 43 (GAP-43), which is involved in the process of synaptic sprouting. We determined the GAP-43 mRNA expression levels in the sensorimotor cortical areas of macaque monkeys with a unilateral lesion of the lateral corticospinal tract (l-CST) at the C4/C5 level of the cervical cord and compared them with the levels in the corresponding regions of intact monkeys. Lesioned monkeys recovered finger dexterity during the first months after surgery, and the GAP-43 mRNA levels increased in layers II-III in primary motor areas (M1), bilaterally. Double-labeling analysis of the lesioned monkeys showed that GAP-43 mRNA was expressed strongly in excitatory neurons but only rarely in inhibitory interneurons. Expression also increased in the medium-sized (area, 500-1,000 microm(2)) and large pyramidal cells (area, >1,000 microm(2)) in layer V of the bilateral M1. The increased expression of GAP-43 mRNA in the M1 contralateral to the lesion was more prominent during the early recovery stage than during the late recovery stage. In addition, GAP-43 mRNA increased in layers II-III of both the contralesional ventral premotor area and the primary somatosensory area. These results suggest that GAP-43 is involved in time-dependent and brain region-specific plastic changes after l-CST lesioning. The expression patterns imply that plastic changes occur not only in M1 but also in the broad associative cortical network, including the ventral premotor and primary sensory areas.

Implementation of Spatial Transformation Rules for Goal-Directed Reaching via Gain Modulation in Monkey Parietal and Premotor Cortex

Planning goal-directed movements requires the combination of visuospatial with abstract contextual information. Our sensory environment constrains possible movements to a certain extent. However, contextual information guides proper choice of action in a given situation and allows flexible mapping of sensory instruction cues onto different motor actions. We used anti-reach tasks to test the hypothesis that spatial motor-goal representations in cortical sensorimotor areas are gain modulated by the behavioral context to achieve flexible remapping of spatial cue information onto arbitrary motor goals. We found that gain modulation of neuronal reach goal representations is commonly induced by the behavioral context in individual neurons of both, the parietal reach region (PRR) and the dorsal premotor cortex (PMd). In addition, PRR showed stronger directional selectivity during the planning of a reach toward a directly cued goal (pro-reach) compared with an inferred target (anti-reach). PMd, however, showed stronger overall activity during reaches toward inferred targets compared with directly cued targets. Based on our experimental evidence, we suggest that gain modulation is the computational mechanism underlying the integration of spatial and contextual information for flexible, rule-driven stimulus-response mapping, and thereby forms an important basis of goal-directed behavior. Complementary contextual effects in PRR versus PMd are consistent with the idea that posterior parietal cortex preferentially represents sensory-driven, "automatic" motor goals, whereas frontal sensorimotor areas are stronger engaged in the representation of rule-based, "inferred" motor goals.

Primary afferent plasticity following deafferentation of the trigeminal brainstem nuclei in the adult rat

Alpha-tyrosinated tubulin is a cytoskeletal protein that is involved in axonal growth and is considered a marker of neuronal plasticity in adult mammals. In adult rats, unilateral ablation of the left facial sensorimotor cortical areas induces degeneration of corticotrigeminal projections and marked denervation of the contralateral sensory trigeminal nuclei. Western blotting and real-time-PCR of homogenates of the contralateral trigeminal ganglion (TG) revealed consistent overexpression of growth proteins 15 days after left decortication in comparison with the ipsilateral side. Immunohistochemical analyses indicated marked overexpression of α-tyrosinated tubulin in the cells of the ganglion on the right side. Cytoskeletal changes were primarily observed in the small ganglionic neurons. Application of HRP-CT, WGA-HRP, and HRP to infraorbital nerves on both sides 15 days after left decortication showed a significant degree of terminal sprouting and neosynaptogenesis from right primary afferents at the level of the right caudalis and interpolaris trigeminal subnuclei. These observations suggest that the adaptive response of TG neurons to central deafferentation, leading to overcrowding and rearrangement of the trigeminal primary afferent terminals on V spinal subnuclei neurons, could represent the anatomical basis for distortion of facial modalities, perceived as allodynia and hyperalgesia, despite nerve integrity.

Functional correlates of incoordination in patients with spinocerebellar ataxia 1: A preliminary fMRI study

The neural (blood oxygenation level dependent) correlates of motor coordination of both hands were studied in adult right-handed volunteers and patients with spinocerebellar ataxia 1 (SCA1), using functional magnetic resonance imaging (fMRI) of the entire brain. Each experimental condition consisted of five sets of alternate pronation and supination tasks for either hand in a prescribed sequence as the active phase followed by a period of rest. An intricate network consisting of sensorimotor cortex, supplementary motor area (SMA), cingulate motor area (CMA), putamina and cerebellum, was identified when the task was performed in healthy volunteers. However, cerebellar activity was largely absent with additional activity in contralateral cortices and in thalami in patients with SCA1. This apparent decoupling of sensorimotor cortical and cerebellar areas during coordinated movement in patients with SCA1, suggests that cortico-cerebellar loops may be malfunctioning in SCA1.

Neural correlates of simple unimanual discrete and continuous movements: a functional imaging study at 3 T

The cerebral and cerebellar network involved in unimanual continuous and discrete movements was studied in blood oxygenation level-dependent functional magnetic resonance imaging (fMRI) at 3 T. Seven healthy right-handed volunteers were scanned (1) while drawing a circle with the tip of the right index finger (continuous motor task), and (2) while drawing a triangle with the tip of the right index finger (discrete motor task). In both motor tasks, extensive activations were observed in the sensorimotor (M1/S1), parietal, prefrontal, insular, lateral occipital (LOC) and anterior cerebellar cortices. Subcortical activations within red, thalamic and lentiform nuclei were also detected. However, discrete movements were specifically followed by the recruitment of the left orbitofrontal cortex, right dentate nucleus and the second cerebellar homunculus (HVIII), and bilateral and stronger activation of the sensorimotor cortical areas, whereas continuous movements specifically activated the right prefrontal cortex and the lateral hemispherical part of the neocerebellum (crus 1). We confirm the findings of previous studies showing partly distinct neural networks involved in monitoring continuous and discrete movements, but we found new differential neural relays within the prefrontal, insular and neocerebellar cortices.

What is the role of neurotransmitter systems in cortical seizures?

Epileptic afterdischarges (ADs) elicited by electrical stimulation of sensorimotor cortical area were used as a model to study the role of neurotransmitter systems in cortical seizures in three age groups of developing rats. Drugs augmenting inhibition mediated by GABAA receptors were found to suppress ADs in all age groups, their activity was usually more marked in younger than in 25-day-old rat pups. Drugs potentiating GABAB receptors exhibit lower efficacy and more complicated developmental profile than GABAA-ergic drugs. Effects of an antagonist of GABAB receptor--marked prolongation of ADs in all three age groups--suggest an important role of GABAB receptors in arrest of cortical seizures. Drugs affecting glutamate receptors exhibit variable effects, usually better expressed in older animals than in 12-day-old ones. No specific role for ionotropic as well as metabotropic glutamate receptors could be predicted. Activation of adenosinergic inhibitory modulatory system also exhibited anticonvulsant action in the present model. All three neurotransmitter systems probably participate in mechanisms of generation, maintenance and arrest of cortical seizures.

Simultaneous EMG‐functional MRI recordings can directly relate hyperkinetic movements to brain activity

To apply and validate the use of electromyogram (EMG) recorded during functional magnetic resonance imaging (fMRI) in patients with movement disorders, to directly relate involuntary movements to brain activity. Eight "familial cortical myoclonic tremor with epilepsy" (FCMTE) patients, with tremor-like cortical myoclonus and cerebellar Purkinje cell degeneration, and nine healthy controls performed hand posture and movement in an on/off fashion (block design). Superfluous movements were quantified as deviations in EMG power, positive and negative, with respect to the average EMG per session. This measure, "residual EMG" (r-EMG), was derived by Gram-Schmidt orthogonalization. Activation maps resulting from conventional block regressors and novel r-EMG regressors were compared. In healthy participants, the block posture regressor identified mainly cerebellar activity and some activity in other areas belonging to motor circuitry. In FCMTE patients, no cerebellar activity was seen with the block posture regressor, compatible with cerebellar Purkinje cell changes in FCMTE. EMG power showed little variation during posture in healthy controls. Therefore, the r-EMG regressor was almost constant and revealed no brain activity as expected. In contrast, in FCMTE patients the r-EMG posture regressor was highly variable due to continuous myoclonic jerks. It identified sensorimotor cortical areas, compatible with cortical hyperexcitability in FCMTE patients. Conventional block regressors can be used to identify neuronal circuitry associated with a specific motor task, whereas r-EMG regressors can help identify brain activation directly related to involuntary movements. Simultaneous EMG-fMRI is complementary to conventional fMRI and will facilitate studies of hyperkinetic movement disorders.

Proprio-tactile integration for kinesthetic perception: An fMRI study

This study aims to identify the cerebral networks involved in the integrative processing of somesthetic inputs for kinesthetic purposes. In particular, we investigated how muscle proprioceptive and tactile messages can result in a unified percept of one's own body movements. We stimulated either separately or conjointly these two sensory channels in order to evoke kinesthetic illusions of a clockwise rotation of 10 subjects’ right hand in an fMRI environment.Results first show that, whether induced by a tactile or a proprioceptive stimulation, the kinesthetic illusion was accompanied by the activation of a very similar cerebral network including cortical and subcortical sensorimotor areas, which are also classically found in passive or imagined movement tasks.In addition, the strongest kinesthetic illusions occurred under the congruent proprio-tactile co-stimulation condition. They were specifically associated to brain area activations distinct from those evidenced under the unimodal stimulations: the inferior parietal lobule, the superior temporal sulcus, the insula-claustrum region, and the cerebellum.These findings support the hypothesis that heteromodal areas may subserve multisensory integrative mechanisms at cortical and subcortical levels. They also suggest the integrative processing might consist of detection of the spatial coherence between the two kinesthetic messages involving the inferior parietal lobule activity and of a detection of their temporal coincidence via a subcortical relay, the insula structure, usually linked to the relative synchrony of different stimuli. Finally, the involvement of the superior temporal sulcus in the feeling of biological movement and that of the cerebellum in the movement timing control are also discussed.

Effects of subthalamic nucleus stimulation on spontaneous sensorimotor MEG activity in a Parkinsonian patient

Abstract Abnormal low-frequency entrainment in sensorimotor cortical areas of Parkinson's disease (PD) patients has been observed in MEG recordings. Efficacy of high-frequency stimulation of subthalamic nucleus (STN) in treating PD may result from blocking such abnormal oscillations. Artifacts elicited by stimulation have precluded MEG study of such patients. We recorded spontaneous MEG activity with a 306-channel Elekta Neuromag® instrument from a Parkinsonian patient with an implanted neurostimulator, with electrodes in both subthalamic nuclei when 130-Hz STN stimulation was on and off. Auditory evoked fields (AEFs) were recorded as well. Brain activity was revealed by applying temporally extended signal space separation on the signals strongly contaminated by stimulation-related artifacts. Bipolar STN stimulation decreased spontaneous activity in the 3–20 Hz range over the right sensorimotor cortex both when eyes were open and closed. Less systematic changes were observed over the left hemisphere where monopolar stimulation was associated with an increase of the low-frequency activity. Suppression of occipital alpha activity in eyes open condition as well as AEF source locations corresponded with those in normal subjects. The results suggest that STN stimulation modifies spontaneous activity over the sensorimotor cortices.

Sensorimotor Cortical Plasticity During Recovery Following Spinal Cord Injury: A Longitudinal fMRI Study

Background. Although the consequences of spinal cord injury (SCI) within the spinal cord and peripheral nervous system have been studied extensively, the influence of SCI on supraspinal structures during recovery remains largely unexplored. Objective. To assess temporal changes in cortical sensorimotor representations beginning in the subacute phase following SCI and determine if an association exists between the plastic changes within cortical sensorimotor areas and recovery of movement postinjury. Methods. Functional magnetic resonance imaging (fMRI) was used to study 6 SCI patients for 1 year, beginning shortly postinjury, and 10 healthy control individuals. During fMRI, individuals performed a simple self-paced wrist extension motor task. Recovery of movement was assessed using the American Spinal Injury Association (ASIA) Standard Neurological Classification of SCI. Results. In the subacute period post-SCI, during impaired movement, little task-related activation within the primary motor cortex (M1) was present, whereas activation in associated cortical sensorimotor areas was more extensive than in controls. During motor recovery, a progressive enlargement in the volume of movement-related M1 activation and decreased activation in associated cortical sensorimotor areas was seen. When movement was performed with little to no impairment, the overall pattern of cortical activation was similar to that observed in control individuals. Conclusions . This study provides the first report of the temporal progression of cortical sensorimotor representational plasticity during recovery following traumatic SCI in humans and suggests an association between movement-related fMRI activation and motor recovery postinjury. These findings have implications on current and future rehabilitative interventions for patients with SCI.

Complete Correction of Enzymatic Deficiency and Neurochemistry in the GM1-gangliosidosis Mouse Brain by Neonatal Adeno-associated Virus–mediated Gene Delivery

GM1-gangliosidosis is a glycosphingolipid (GSL) lysosomal storage disease caused by autosomal recessive deficiency of lysosomal acid beta-galactosidase (betagal), and characterized by accumulation of GM1-ganglioside and GA1 in the brain. Here we examined the effect of neonatal intracerebroventricular (i.c.v.) injection of an adeno-associated virus (AAV) vector encoding mouse betagal on enzyme activity and brain GSL content in GM1-gangliosidosis (betagal(-/-)) mice. Histological analysis of betagal distribution in 3-month-old AAV-treated betagal(-/-) mice showed that enzyme was present at high levels throughout the brain. Biochemical quantification showed that betagal activity in AAV-treated brains was 7- to 65-fold higher than in wild-type controls and that brain GSL levels were normalized. Cerebrosides and sulfatides, which were reduced in untreated betagal(-/-) mice, were restored to normal levels by AAV treatment. In untreated betagal(-/-) brains, cholesterol was present at normal levels but showed abnormal cellular distribution consistent with endosomal/lysosomal localization. This feature was also corrected in AAV-treated mice. The biochemical and histological parameters analyzed in this study showed that normal brain neurochemistry was achieved in AAV-treated betagal(-/-) mice. Therefore we show for the first time that neonatal AAV-mediated gene delivery of lysosomal betagal to the brain may be an effective approach for treatment of GM1-gangliosidosis.

Different effects of nonNMDA and NMDA receptor antagonists (NBQX and dizocilpine) on cortical epileptic afterdischarges in rats

Excitatory amino acids play an important role in generation of epileptic seizures. To study the participation of different types of their receptors in cortical epileptic afterdischarges, a noncompetitive NMDA receptor antagonist dizocilpine and a competitive AMPA receptor antagonist NBQX were used. Adult rats with implanted epidural stimulation and registration electrodes were pretreated either with NBQX (30 or 60 mg/kg i.p.) or with dizocilpine (0.1 or 0.5 mg/kg i.p.) and low-frequency stimulation of sensorimotor cortical area was repeatedly applied with stepwise increased current intensities. Lower dose of NBQX unexpectedly decreased thresholds for elicitation of spike-and-wave afterdischarges (ADs), clonic seizures accompanying this type of ADs and for transition into the second, limbic type of ADs. Lower dose of dizocilpine increased these three thresholds. Higher doses of either drug did not significantly change threshold intensities. Duration of ADs was also influenced by the two antagonists in opposite directions: higher dose of NBQX resulted in prolongation of ADs mainly due to an increased duration of the spike-and-wave part of ADs whereas dizocilpine shortened ADs in a dose-dependent manner affecting both types of ADs. In addition, NBQX did not influence interhemispheric responses meanwhile dizocilpine moderately suppressed these evoked potentials. According to our results, NMDA receptors are important for generation of cortical epileptic afterdischarges meanwhile the role of AMPA receptors is not clear and has to be analyzed.

P35.4 Effects of interictal epileptiform discharges on heart rate variability during sleep in patients with benign epilepsy with centrotemporal spikes

SSRs. Results: SSRs could be evoked by stimulation through electrodes over the primary sensorimotor and temporal cortices. Stimulation of the motor areas (M1) for face, tongue and eye movement or the sensory areas (S1) for face and tongue as well as M1 and S1 areas for the hand and foot could produce SSRs. SSRs could also be evoked by stimulation of the M1 for the hand and temporal cortex even at subthreshold intensities which did not produce any positive motor or psychic responses during the stimulation train. Conclusion: Sensorimotor and temporal cortical areas have an excitatory influence on mental sweating in humans.

Structural and functional plasticity in the somatosensory cortex of chronic stroke patients

Animal studies have demonstrated that motor recovery after hemiparetic stroke is associated with functional and structural brain plasticity. While studies in stroke patients have revealed functional plasticity in sensorimotor cortical areas in association with motor recovery, corresponding structural plasticity has not been shown. We sought to test the hypothesis that chronic hemiparetic stroke patients exhibit structural plasticity in the same sensorimotor cortical areas that exhibit functional plasticity. Functional MRI during unilateral tactile stimulation and structural MRI was conducted in chronic stroke patients and normal subjects. Using recently developed computational methods for high-resolution analysis of MRI data, we evaluated for between-group differences in functional activation responses, and cortical thickness of areas that showed an enhanced activation response in the patients. We found a significant (P < 0.005) increase in the activation response in areas of the ventral postcentral gyrus (POG) in the patients relative to controls. These same ventral POG areas showed a significant (P < 0.05) increase in cortical thickness in the patients. Control cortical areas did not show a significant between-group difference in thickness or activation response. These results provide the first evidence of structural plasticity co-localized with areas exhibiting functional plasticity in the human brain after stroke.

The basal ganglia are hyperactive during the discrimination of tactile stimuli in writer's cramp

Writer's cramp is a focal hand dystonia that specifically affects handwriting. Though writer's cramp has been attributed to a dysfunction of the basal ganglia, the role of the basal ganglia in the pathogenesis of writer's cramp remains to be determined. Seventeen patients with writer's cramp (nine females; age range: 24-71 years) and 17 healthy individuals (six females; age range: 27-68 years) underwent functional MRI (fMRI) while they discriminated the orientation of gratings delivered to the tip of the right index finger. Statistical parametric mapping was used to analyse the fMRI data. The significance level was set at a corrected P-value of 0.05. Relative to healthy controls, patients with writer's cramp showed a widespread bilateral increase in task-related activity in the putamen, caudate nucleus, internal globus pallidus and lateral thalamus. In these areas, hyperactivity was more pronounced in patients who had recently developed writer's cramp. The enhanced response of the basal ganglia to tactile input from the affected hand is compatible with the concept of impaired centre-surround inhibition within the basal ganglia-thalamic circuit and may lead to an excessive activation of sensorimotor cortical areas during skilled movements affected by dystonia. Outside the basal ganglia, dystonic patients showed task-related overactivity in visual cortical areas, left anterior insula and right intraparietal sulcus, but not in the primary or secondary sensory cortex. In addition, task-related activity in the cerebellar nuclei, posterior vermis, right paramedian cerebellar hemisphere and dorsal pons was inversely related with the severity of hand dystonia. Regional activity in these areas may reflect secondary adaptive reorganization at the systems level to compensate for the dysfunction in the basal ganglia-thalamic loop.

Explicit Information Interferes with Implicit Motor Learning of Both Continuous and Discrete Movement Tasks After Stroke

A large portion of the rehabilitation experience after stroke relies on implicit learning. However, our understanding of how best to facilitate motor learning after stroke is limited by a paucity of research that has explored the interaction between explicit information and implicit learning across various task domains. Previously we reported that the delivery of explicit instructions disrupted implicit motor learning after stroke that involved the sensorimotor cortical areas or basal ganglia. The purpose of this study was to determine the robustness of these findings by determining whether they could be replicated with 2 motor tasks, one discrete and one continuous, employed by the same group of participants. Ten individuals with stroke in the sensorimotor cortical areas (SMC), 10 with stroke in the basal ganglia (BG), and 10 age-matched healthy controls (HC) participated in this study. Each completed 3 days of practice of both a discrete implicit motor task (the serial reaction time task) and a continuous motor task (the continuous tracking task); all returned on a fourth day for retention tests. By random designation, participants were divided into either the explicit information (EI) or no explicit information (No-EI) groups. Consistent with previous results, we found that the response to explicit information after stroke was uniformly negative regardless of task or lesion location; both stroke groups demonstrated an interference effect of explicit information while the healthy control group did not. Strengthening these findings is the fact that the interference effect of explicit information was not task dependent. This point is particularly important for rehabilitation scientists as they instruct clients during various therapeutic tasks after stroke. Our data suggest that certain forms of explicit information delivered before task practice may not be as useful for learning as discovering the solution to the motor task with practice alone, and this is regardless of the type of task being learned.

Cortical short-term fatigue effects assessed via rhythmic brain–muscle coherence

This study is aimed at assessing the short-term effects of muscular fatigue on the sensorimotor areas organization in the left and right hemispheres. Magnetoencephalographic (MEG) and electromyographic (EMG) activities were simultaneously recorded during the execution of a non-fatiguing motor task, performed before and after a task known to induce muscle fatigue (Fatigue). Coherence between cerebral and muscular rhythms as well as cerebral and muscular rhythms spectral densities were estimated during this non-fatiguing task and at rest. The MEG-EMG coherence in the beta band (13-32 Hz) was higher after than before Fatigue. The background activity reduction during contraction with respect to rest (i.e. the cerebral reactivity) was less evident after than before Fatigue in the gamma (33-45 Hz) and beta bands. When differentiating subjects on the base of Fatigue endurance times, while a huge inter-subject variability was found, an evident intra-subject similarity was observed for left and right arms, suggesting that resistance to fatigue is more an individual ability than a motor skill differentiated for the dominant and non-dominant side. In conclusion, signs of a more selective neural recruitment, more coupled with muscular activity, appeared as short-term effects of muscular fatigue in primary sensorimotor cortical areas. Evidence suggested that the reduction of cortical recruitment and the increased cortico-muscular coupling are distinct mechanisms.