Hand Representation Research Articles

Interhemispheric symmetry of \xb5-rhythm phase-dependency of corticospinal excitability

Oscillatory activity in the µ-frequency band (8–13 Hz) determines excitability in sensorimotor cortex. In humans, the primary motor cortex (M1) in the two hemispheres shows significant anatomical, connectional, and electrophysiological differences associated with motor dominance. It is currently unclear whether the µ-oscillation phase effects on corticospinal excitability demonstrated previously for the motor-dominant M1 are also different between motor-dominant and motor-non-dominant M1 or, alternatively, are similar to reflect a ubiquitous physiological trait of the motor system at rest. Here, we applied single-pulse transcranial magnetic stimulation to the hand representations of the motor-dominant and the motor-non-dominant M1 of 51 healthy right-handed volunteers when electroencephalography indicated a certain µ-oscillation phase (positive peak, negative peak, or random). We determined resting motor threshold (RMT) as a marker of corticospinal excitability in the three µ-phase conditions. RMT differed significantly depending on the pre-stimulus phase of the µ-oscillation in both M1, with highest RMT in the positive-peak condition, and lowest RMT in the negative-peak condition. µ-phase-dependency of RMT correlated directly between the two M1, and interhemispheric differences in µ-phase-dependency were absent. In conclusion, µ-phase-dependency of corticospinal excitability appears to be a ubiquitous physiological trait of the motor system at rest, without hemispheric dominance.

Combination of Simultaneous Artificial Sensory Percepts to Identify Prosthetic Hand Postures: A Case Study

Multiple sources of sensory information are combined to develop hand posture percepts in the intact system, but the combination of multiple artificial somatosensory percepts by human prosthesis users has not been studied. Here, we report on a case study in which a person with transradial amputation identified prosthetic hand postures using artificial somatosensory feedback. He successfully combined five artificial somatosensory percepts to achieve above-chance performance of 95.0% and 75.7% in identifying four and seven postures, respectively. We studied how artificial somatosensation and the extant hand representation are combined in the decision-making process by providing two mappings between the prosthetic sensor and the location of the sensory percept: (1) congruent, and (2) incongruent. The participant’s ability to combine and engage with the sensory feedback significantly differed between the two conditions. The participant was only able to successfully generalize prior knowledge to novel postures in the congruent mapping. Further, he learned postures more accurately and quickly in the congruent mapping. Finally, he developed an understanding of the relationships between postures in the congruent mapping instead of simply memorizing each individual posture. These experimental results are corroborated by a Bayesian decision-making model which tracked the participant’s learning.

Using Action-congruent Language Facilitates the Motor Response during Action Observation: A Combined Transcranial Magnetic Stimulation and Eye-tracking Study.

There is evidence that action observation (AO) and the processing of action-related words are associated with increased activity in cortical motor regions. Research has examined the effects of AO and action verb processing on activity in the motor system independently. The aim of this experiment was to investigate, for the first time, the modulation of corticospinal excitability and visual attention during the concurrent processing of action verbs and AO stimuli. Twenty participants took part in an integrated transcranial magnetic stimulation and eye-tracking protocol. Single-pulse transcranial magnetic stimulation was delivered to the hand representation of the left motor cortex during (i) observation of a static hand, (ii) AO of a hand squeezing a sponge, (iii) AO of the same action with an audio recording of the word "squeeze," and (iv) AO of the same action with an audio recording of the word "green". Motor evoked potentials were recorded from the abductor pollicis brevis and abductor digiti minimi muscles of the right hand. Eye gaze was recorded throughout the four conditions as a proxy for visual attention. Interviews were conducted to discuss participants' preferences and imagery use for each condition. The AO and action verb condition resulted in significantly increased motor evoked potential amplitudes in the abductor pollicis brevis muscle; participants also made significantly more fixations on the sponge and reported wanting to move their hand more in the action verb condition. The inclusion of auditory action verbs, alongside AO stimuli, in movement simulation interventions could have implications for the delivery of AO interventions for motor (re)learning.

Hand sign language recognition using multi-view hand skeleton

Hand sign language recognition from video is a challenging research area in computer vision, which performance is affected by hand occlusion, fast hand movement, illumination changes, or background complexity, just to mention a few. In recent years, deep learning approaches have achieved state-of-the-art results in the field, though previous challenges are not completely solved. In this work, we propose a novel deep learning-based pipeline architecture for efficient automatic hand sign language recognition using Single Shot Detector (SSD), 2D Convolutional Neural Network (2DCNN), 3D Convolutional Neural Network (3DCNN), and Long Short-Term Memory (LSTM) from RGB input videos. We use a CNN-based model which estimates the 3D hand keypoints from 2D input frames. After that, we connect these estimated keypoints to build the hand skeleton by using midpoint algorithm. In order to obtain a more discriminative representation of hands, we project 3D hand skeleton into three views surface images. We further employ the heatmap image of detected keypoints as input for refinement in a stacked fashion. We apply 3DCNNs on the stacked features of hand, including pixel level, multi-view hand skeleton, and heatmap features, to extract discriminant local spatio-temporal features from these stacked inputs. The outputs of the 3DCNNs are fused and fed to a LSTM to model long-term dynamics of hand sign gestures. Analyzing 2DCNN vs. 3DCNN using different number of stacked inputs into the network, we demonstrate that 3DCNN better capture spatio-temporal dynamics of hands. To the best of our knowledge, this is the first time that this multi-modal and multi-view set of hand skeleton features are applied for hand sign language recognition. Furthermore, we present a new large-scale hand sign language dataset, namely RKS-PERSIANSIGN, including 10′000 RGB videos of 100 Persian sign words. Evaluation results of the proposed model on three datasets, NYU, First-Person, and RKS-PERSIANSIGN, indicate that our model outperforms state-of-the-art models in hand sign language recognition, hand pose estimation, and hand action recognition.

Differential effects of the mode of touch, active and passive, on experience-driven plasticity in the S1 cutaneous digit representation of adult macaque monkeys.

This study compared the receptive field (RF) properties and firing rates of neurons in the cutaneous hand representation of primary somatosensory cortex (areas 3b, 1, and 2) of 9 awake, adult macaques that were intensively trained in a texture discrimination task using active touch (fingertips scanned over the surfaces using a single voluntary movement), passive touch (surfaces displaced under the immobile fingertips), or both active and passive touch. Two control monkeys received passive exposure to the same textures in the context of a visual discrimination task. Training and recording extended over 1-2 yr per animal. All neurons had a cutaneous receptive field (RF) that included the tips of the stimulated digits (D3 and/or D4). In area 3b, RFs were largest in monkeys trained with active touch, smallest in those trained with passive touch, and intermediate in those trained with both; i.e., the mode of touch differentially modified the cortical representation of the stimulated fingers. The same trends were seen in areas 1 and 2, but the changes were not significant, possibly because a second experience-driven influence was seen in areas 1 and 2, but not in area 3b: smaller RFs with passive exposure to irrelevant tactile inputs compared with recordings from one naive hemisphere. We suggest that added feedback during active touch and higher cortical firing rates were responsible for the larger RFs with behavioral training; this influence was tempered by periods of more restricted sensory feedback during passive touch training in the active + passive monkeys.NEW & NOTEWORTHY We studied experience-dependent sensory cortical plasticity in relation to tactile discrimination of texture using active and/or passive touch. We showed that neuronal receptive fields in primary somatosensory cortex, especially area 3b, are largest in monkeys trained with active touch, smallest in those trained with passive touch, and intermediate in those trained using both modes of touch. Prolonged, irrelevant tactile input had the opposite influence in areas 1 and 2, favoring smaller receptive fields.

Abstract TMP26: Extracellular Vesicles and Myelin Plasticity After Cortical Injury in Non-Human Primates

Introduction: Our laboratory demonstrated that monkeys treated after cortical injury with extracellular vesicles (EVs) derived from Mesenchymal Stem Cell (MSC) had enhanced recovery compared to controls. To identify the EV-mediated neuroplastic changes involved in improved recovery, we assessed markers of myelin damage and plasticity in brain and cerebrospinal fluid (CSF) of monkeys treated with EVs or vehicle. Hypothesis: MSC derived EVs enhance behavioral plasticity by reducing the post injury cascade of myelin damage and stimulating remyelination. Methods: Monkeys were given a unilateral cortical injury in the hand representation of M1. EVs were delivered IV 24 hours and 14 days later. Monkeys were tested on motor tasks for 14 weeks, and brains were harvested at completion. To quantify myelinated axons, we first used Spectral Confocal Reflectance (SCoRe) microscopy. To assess myelin damage, we measured accumulation of Myelin Basic Protein (MBP) in CSF from 24 hours to 14 weeks after injury. To assess myelin related gene expression changes, we used qPCR to assess MBP, BCAS1 as a marker of oligodendroglia engaged in new myelination, and Myelin Regulatory Factor (MyRF) a marker of oligodendrocyte regulation and differentiation. Additionally, we used IHC and stereology to quantify densities of BCAS1 and CC1 positive oligodendroglia. Results: Preliminary results show that EV treatment is associated with greater density of myelinated axons. In addition, longitudinal MBP levels in CSF gradually declined over 6 weeks, suggesting that EV treatment limited ongoing damage . PCR studies of perilesional brain tissue demonstrated a 4-fold increase in MyRF, as well as a 1.5-fold increase for BCAS1 and MBP in EV-treated monkeys relative to vehicle. Finally, increased densities of CC1+ and BCAS1+ cells approached significance in EV treated subjects. Conclusions and Future Directions: Our data suggests that MSC-EVs likely reduce the post injury cascade of myelin damage and promote remyelination, thus enhancing plasticity. (Supported by R21-NS102991 & R21-NS111174).

Neurosurgical lesions to sensorimotor cortex do not impair action verb processing

There is ongoing debate regarding the role that sensorimotor regions play in conceptual processing, with embodied theories supporting their direct involvement in processing verbs describing body part movements. Patient lesion studies examining a causal role for sensorimotor activation in conceptual task performance have suffered the caveat of lesions being largely diffuse and extensive beyond sensorimotor cortices. The current study addresses this limitation in reporting on 20 pre-operative neurosurgical patients with focal lesion to the pre- and post-central area corresponding to somatotopic representations. Patients were presented with a battery of neuropsychological tests and experimental tasks tapping into motor imagery and verbal conceptual verb processing in addition to neurophysiological measures including DTI, fMRI, and MEP being measured. Results indicated that left tumor patients who presented with a lesion at or near somatotopic hand representations performed significantly worse on the mental rotation hand task and that performance correlated with MEP amplitudes in the upper limb motor region. Furthermore, performance on tasks of verbal processing was within the normal range. Taken together, while our results evidence the involvement of the motor system in motor imagery processes, they do not support the embodied view that sensorimotor regions are necessary to tasks of action verb processing.

Motor control drives visual bodily judgements

The ‘embodied cognition’ framework proposes that our motor repertoire shapes visual perception and cognition. But recent studies showing normal visual body representation in individuals born without hands challenges the contribution of motor control on visual body representation. Here, we studied hand laterality judgements in three groups with fundamentally different visual and motor hand experiences: two-handed controls, one-handers born without a hand (congenital one-handers) and one-handers with an acquired amputation (amputees). Congenital one-handers, lacking both motor and first-person visual information of their missing hand, diverged in their performance from the other groups, exhibiting more errors for their intact hand and slower reaction-times for challenging hand postures. Amputees, who have lingering non-visual motor control of their missing (phantom) hand, performed the task similarly to controls. Amputees’ reaction-times for visual laterality judgements correlated positively with their phantom hand’s motor control, such that deteriorated motor control associated with slower visual laterality judgements. Finally, we have implemented a computational simulation to describe how a mechanism that utilises a single hand representation in congenital one-handers as opposed to two in controls, could replicate our empirical results. Together, our findings demonstrate that motor control is a driver in making visual bodily judgments.

The motor system (partially) deceives body representation biases in absence of visual correcting cues

The internal models of our body dimensions are prone to bias, but little evidence exists to explain how the motor system achieves fine-grained control despite these distortions. Previous work showed that the hand representation, assessed in a dynamic task (Proprioceptive Matching Task), was less distorted compared to that measured through a static body representation task (Localization Task), suggesting that either the hand representation was updated or the motor trajectory was adjusted during movement. The present study set out to shed light on this phenomenon by administering the Localization Task before and after either the Proprioceptive Matching Task or a control condition in a within-subjects design. Our results showed that hand map biases decreased during the Proprioceptive Matching Task, but that this increase in accuracy did not carry over to the Localization Task. In other words, more accurate performance in the dynamic body representation task does not reflect a change in how the hand is represented. Rather, it likely reflects a refinement of the motor trajectory, due to the integration of multisensory information, providing interesting insights into how the motor system partially overcomes biases in body representations.

Is Human Brain Activity During Driving Operations Modulated by the Viscoelastic Characteristics of a Steering Wheel?: An fMRI Study

To date, a neuroscientific investigation of drivers’ steering behavior has never been performed because the reaction forces generated by the mechanical characteristics of a steering wheel have been difficult to assess in a magnetic resonance imaging (MRI) environment. In this study, using our previously developed MRI-compatible unit for steering reaction force generation, we investigated changes in human brain activity induced by varying the viscoelastic characteristics associated with manipulating a car steering wheel. Participants performed a simulated driving task with three levels of stiffness and viscosity. An amplitude effect of reaction forces on the measured brain activity due to varying stiffness was found in the primary motor cortex (M1) associated with hand representation. Conversely, the changes in the brain activity induced by varying viscosity were found more dorsally in the premotor cortex and the M1 than in regions associated with hand representation. These results are the first to demonstrate that various viscoelastic characteristics activate different motor regions; more specifically, stiffness and viscosity of the steering wheel mainly affected the motor control of the distal and proximal muscles, respectively.

Follow, select and assemble method FSAM for VE and re assembly

We modified the methods by Ballard et al. [1]. They sought to study eye-hand coordination strategies and created both a real world and a virtual model copying task consisting of three different areas: model, source, and workspace. Participants followed a pickup and place exercise and used a mouse to control stimuli presented on a computer monitor in the virtual task. We also considered the method presented by Hayhoe et al. [2] and Aivar et al. [3] who designed a similar model copying task in a 3D virtual environment. Stimuli were displayed in a head mounted display and participants held a motion sensor to select and move virtual objects in 3D space. Moreover, Aivar et al. [3] also included extra assembly pieces and a variation in the position of the assembly pieces located in the resource area.• It proposes an assembly task designed at a 1:1 scale for two environments, real and virtual environments.• It introduces a reading sequence for the model that is being replicated and it also introduces distractor assembly blocks with similar colors and shapes as the required assembly blocks, and a change in the location for all assembly blocks in the resource area.• It modifies the interaction for the VR environment by using hand gestures to select, move and position virtual assembly blocks. This was possible by incorporating a LEAP® motion controller which although it does not provide haptic feedback, it provides a virtual representation of the participant's hand. Our VE also includes visual and auditory feedback to guide depth perception and virtual control.The software used for this research study is available at: http://virtualete.com/research/fsam.php

Rigged hand model for the Blender Game Engine

In a lot of virtual reality applications, it is necessary to display and animate the user's hand in the virtual world. In game engines, armatures are often used for modeling parts or the whole of the human body. The process of creating the armature and assigning parts of the mesh representing flesh and skin to the “bones” of the armature is called rigging. After performing rigging, moving the armature will result in the movement of the mesh, thus the virtual hand (or other object) is animated. The Blender Game Engine (BGE) is one of the few open-source game engines available. The paper gives a detailed description of the process of successfully building a complex rigged hand model for the BGE and gives guidance for driving this hand model with input data from the Leap Motion hand movement detector. The rigged hand model has been implemented, using the hand mesh from the LibHand library and an armature specifically built to match the hand representation of the Leap Motion. The model will be used for navigation and interaction in the virtual model of a power plant control room.

Two Distinct Systems Represent Contralateral and Ipsilateral Sensorimotor Processes in the Human Premotor Cortex: A Dense TMS Mapping Study.

Animal brains contain behaviorally committed representations of the surrounding world, which integrate sensory and motor information. In primates, sensorimotor mechanisms reside in part in the premotor cortex (PM), where sensorimotor neurons are topographically clustered according to functional specialization. Detailed functional cartography of the human PM is still under investigation. We explored the topographic distribution of spatially dependent sensorimotor functions in healthy volunteers performing left or right, hand or foot, responses to visual cues presented in the left or right hemispace, thus combining independently stimulus side, effector side, and effector type. Event-related transcranial magnetic stimulation was applied to single spots of a dense grid of 10 points on the participants' left hemiscalp, covering the whole PM. Results showed: (1) spatially segregated hand and foot representations, (2) focal representations of contralateral cues and movements in the dorsal PM, and (3) distributed representations of ipsilateral cues and movements in the ventral and dorso-medial PM. The present novel causal information indicates that (1) the human PM is somatotopically organized and (2) the left PM contains sensory-motor representations of both hemispaces and of both hemibodies, but the hemispace and hemibody contralateral to the PM are mapped on a distinct, nonoverlapping cortical region compared to the ipsilateral ones.

Hand, foot and lip representations in primary sensorimotor cortex: a high-density electroencephalography study

The primary sensorimotor cortex plays a major role in the execution of movements of the contralateral side of the body. The topographic representation of different body parts within this brain region is commonly investigated through functional magnetic resonance imaging (fMRI). However, fMRI does not provide direct information about neuronal activity. In this study, we used high-density electroencephalography (hdEEG) to map the representations of hand, foot, and lip movements in the primary sensorimotor cortex, and to study their neural signatures. Specifically, we assessed the event-related desynchronization (ERD) in the cortical space. We found that the performance of hand, foot, and lip movements elicited an ERD in beta and gamma frequency bands. The primary regions showing significant beta- and gamma-band ERD for hand and foot movements, respectively, were consistent with previously reported using fMRI. We observed relatively weaker ERD for lip movements, which may be explained by the fact that less fine movement control was required. Overall, our study demonstrated that ERD based on hdEEG data can support the study of motor-related neural processes, with relatively high spatial resolution. An interesting avenue may be the use of hdEEG for deeper investigations into the pathophysiology of neuromotor disorders.

Electrophysiological correlates of action observation treatment in children with cerebral palsy: A pilot study.

Action Observation Treatment (AOT) has been shown to be effective in the functional recovery of several clinical populations. However, little is known about the neural underpinnings of the clinical efficacy of AOT in children with Cerebral Palsy (CP). Using electroencephalography (EEG), we recorded µ rhythm desynchronization as an index of sensorimotor cortex modulation during a passive action observation task before and after AOT. The relationship between sensorimotor modulation and clinical outcomes was also assessed. Eight children with CP entered the present randomized controlled crossover pilot study in which the experimental AOT preceded or followed a control Videogame Observation Treatment (VOT). Results provide further evidence of the clinical efficacy of AOT for improving hand motor function in CP, as assessed with the Assisting Hand Assessment (AHA) and Melbourne Assessment of Unilateral Upper Limb Function Scale (MUUL). The novel finding is that AOT increases µ rhythm desynchronization at scalp locations corresponding to the hand representation areas. This effect is associated to functional improvement assessed with the MUUL. These preliminary findings, although referred to as a small sample, suggest that AOT may affect upper limb motor recovery in children with CP and modulate the activation of sensorimotor areas, offering a potential neurophysiological correlate to support the clinical utility of AOT.

Interhemispheric transfer of post-amputation cortical plasticity within the human somatosensory cortex

Animal models reveal that deafferenting forelimb injuries precipitate reorganization in both contralateral and ipsilateral somatosensory cortices. The functional significance and duration of these effects are unknown, and it is unclear whether they also occur in injured humans. We delivered cutaneous stimulation during functional magnetic resonance imaging (fMRI) to map the sensory cortical representation of the intact hand and lower face in a group of chronic, unilateral, upper extremity amputees (N = 19) and healthy matched controls (N = 29). Amputees exhibited greater activity than controls within the deafferented former sensory hand territory (S1f) during stimulation of the intact hand, but not of the lower face. Despite this cortical reorganization, amputees did not differ from controls in tactile acuity on their intact hands. S1f responses during hand stimulation were unrelated to tactile acuity, pain, prosthesis usage, or time since amputation. These effects appeared specific to the deafferented somatosensory modality, as fMRI visual mapping paradigm failed to detect any differences between groups. We conclude that S1f becomes responsive to cutaneous stimulation of the intact hand of amputees, and that this modality-specific reorganizational change persists for many years, if not indefinitely. The functional relevance of these changes, if any, remains unknown.

Hand Motor Cortex Excitability During Speaking in Persistent Developmental Stuttering.

Persistent developmental stuttering (PDS) is a speech fluency disorder characterized by intermittent involuntary breakdowns of speech motor control, possibly related to motor cortex excitability. Whether motor cortex dysfunction extends into hand representations is unclear. We here studied task-dependent modulations of hand motor cortex excitability in 10 right-handed adults who stutter (AWS) and 13 age- and sex-matched fluent speaking control participants (ANS), covering a wide range of tasks in an exploratory study. Before, during and after a null speech/rest task, spontaneous speech, solo reading, chorus reading, singing, and non-verbal orofacial movements, transcranial magnetic stimulation was applied over the primary motor cortex and motor evoked potentials (MEPs) were recorded from the abductor digiti minimi muscle of either hand. In both groups, motor threshold was lower in the left than in the right motor cortex. During task performance, MEP amplitudes increased in both groups. A post hoc comparison of spontaneous speech and non-verbal orofacial movements yielded an interaction of group by task with AWS showing larger than ANS MEP amplitude increase in spontaneous speech, but a smaller than ANS MEP amplitude increase in non-verbal orofacial movements. We conclude that hemispheric specialization of hand motor representation is similar for both groups. Spontaneous speech as well as non-verbal orofacial movements are the orofacial tasks that merit further study. The excessive motor cortex facilitation could be reflecting a stronger activation of non-speech muscles during AWS’s speech.

Fine-Grained Mapping of Cortical Somatotopies in Chronic Complex Regional Pain Syndrome.

It has long been thought that severe chronic pain conditions, such as complex regional pain syndrome (CRPS), are not only associated with, but even maintained by a reorganization of the somatotopic representation of the affected limb in primary somatosensory cortex (S1). This notion has driven treatments that aim to restore S1 representations in CRPS patients, such as sensory discrimination training and mirror therapy. However, this notion is based on both indirect and incomplete evidence obtained with imaging methods with low spatial resolution. Here, we used fMRI to characterize the S1 representation of the affected and unaffected hand in humans (of either sex) with unilateral CRPS. The cortical area, location, and geometry of the S1 representation of the CRPS hand were largely comparable with those of both the unaffected hand and healthy controls. We found no differential relation between affected versus unaffected hand map measures and clinical measures (pain severity, upper limb disability, disease duration). Thus, if any map reorganization occurs, it does not appear to be directly related to pain and disease severity. These findings compel us to reconsider the cortical mechanisms underlying CRPS and the rationale for interventions that aim to “restore” somatotopic representations to treat pain.SIGNIFICANCE STATEMENT This study shows that the spatial map of the fingers in somatosensory cortex is largely preserved in chronic complex regional pain syndrome (CRPS). These findings challenge the treatment rationale for restoring somatotopic representations in complex regional pain syndrome patients.

Organized Toe Maps in Extreme Foot Users

SummaryAlthough the fine-grained features of topographic maps in the somatosensory cortex can be shaped by everyday experience, it is unknown whether behavior can support the expression of somatotopic maps where they do not typically occur. Unlike the fingers, represented in all primates, individuated toe maps have only been found in non-human primates. Using 1-mm resolution fMRI, we identify organized toe maps in two individuals born without either upper limb who use their feet to substitute missing hand function and even support their profession as foot artists. We demonstrate that the ordering and structure of the artists’ toe representation mimics typical hand representation. We further reveal “hand-like” features of activity patterns, not only in the foot area but also similarly in the missing hand area. We suggest humans may have an innate capacity for forming additional topographic maps that can be expressed with appropriate experience.

Assessment of the effect of continuous theta burst stimulation of the motor cortex on manual dexterity in non-human primates in a direct comparison with invasive intracortical pharmacological inactivation.

Non-invasive reversible perturbation techniques of brain output such as continuous theta burst stimulation (cTBS), commonly used to modulate cortical excitability in humans, allow investigation of possible roles in functional recovery played by distinct intact cortical areas following stroke. To evaluate the potential of cTBS, the behavioural effects of this non-invasive transient perturbation of the hand representation of the primary motor cortex (M1) in non-human primates (two adult macaques) were compared with an invasive focal transient inactivation based on intracortical microinfusion of GABA-A agonist muscimol. The effects on the contralateral arm produced by cTBS or muscimol were directly compared based on a manual dexterity task performed by the monkeys, the "reach and grasp" drawer task, allowing quantitative assessment of the grip force produced between the thumb and index finger and exerted on the drawer's knob. cTBS only induced modest to moderate behavioural effects, with substantial variability on manual dexterity whereas the intracortical muscimol microinfusion completely impaired manual dexterity, producing a strong and clear cortical inhibition of the M1 hand area. In contrast, cTBS induced mixed inhibitory and facilitatory/excitatory perturbations of M1, though with predominant inhibition. Although cTBS impacted on manual dexterity, its effects appear too limited and variable in order to use it as a reliable proof of cortical vicariation mechanism (cortical area replacing another one) underlying functional recovery following a cortical lesion in the motor control domain, in contrast to potent pharmacological block generated by muscimol infusion, whose application is though limited to an animal model such as non-human primate.