Hand Area Of Primary Motor Cortex Research Articles

Imagined paralysis reduces motor cortex excitability.

Mental imagery is a powerful capability that engages similar neurophysiological processes that underlie real sensory and motor experiences. Previous studies show that motor cortical excitability can increase during mental imagery of actions. In this study, we focused on possible inhibitory effects of mental imagery on motor functions. We assessed whether imagined arm paralysis modulates motor cortical excitability in healthy participants, as measured by motor evoked potentials (MEPs) of the hand induced by near‐threshold transcranial magnetic stimulation (TMS) over the primary motor cortex hand area. We found lower MEP amplitudes during imagined arm paralysis when compared to imagined leg paralysis or baseline stimulation without paralysis imagery. These results show that purely imagined bodily constraints can selectively inhibit basic motor corticospinal functions. The results are discussed in the context of motoric embodiment/disembodiment.

The Myelin Content of the Human Precentral Hand Knob Reflects Interindividual Differences in Manual Motor Control at the Physiological and Behavioral Level.

The primary motor cortex hand area (M1HAND) and adjacent dorsal premotor cortex (PMd) form the so-called motor hand knob in the precentral gyrus. M1HAND and PMd are critical for dexterous hand use and are densely interconnected via corticocortical axons, lacking a sharp demarcating border. In 24 young right-handed volunteers, we performed multimodal mapping to delineate the relationship between structure and function in the right motor hand knob. Quantitative structural magnetic resonance imaging (MRI) at 3 tesla yielded regional R1 maps as a proxy of cortical myelin content. Participants also underwent functional MRI (fMRI). We mapped task-related activation and temporal precision, while they performed a visuomotor synchronization task requiring visually cued abduction movements with the left index or little finger. We also performed sulcus-aligned transcranial magnetic stimulation of the motor hand knob to localize the optimal site (hotspot) for evoking a motor evoked potential (MEP) in two intrinsic hand muscles. Individual motor hotspot locations varied along the rostrocaudal axis. The more rostral the motor hotspot location in the precentral crown, the longer were corticomotor MEP latencies. “Hotspot rostrality” was associated with the regional myelin content in the precentral hand knob. Cortical myelin content also correlated positively with task-related activation of the precentral crown and temporal precision during the visuomotor synchronization task. Together, our results suggest a link among cortical myelination, the spatial cortical representation, and temporal precision of finger movements. We hypothesize that the myelination of cortical axons facilitates neuronal integration in PMd and M1HAND and, hereby, promotes the precise timing of movements.SIGNIFICANCE STATEMENT Here we used magnetic resonance imaging and transcranial magnetic stimulation of the precentral motor hand knob to test for a link among cortical myelin content, functional corticomotor representations, and manual motor control. A higher myelin content of the precentral motor hand knob was associated with more rostral corticomotor presentations, with stronger task-related activation and a higher precision of movement timing during a visuomotor synchronization task. We propose that a high precentral myelin content enables fast and precise neuronal integration in M1 (primary motor cortex) and dorsal premotor cortex, resulting in higher temporal precision during dexterous hand use. Our results identify the degree of myelination as an important structural feature of the neocortex that is tightly linked to the function and behavior supported by the cortical area.

Functional interaction between human dorsal premotor cortex and the ipsilateral primary motor cortex for grasp plans: a dual-site TMS study.

Recent findings suggest that the dorsal premotor cortex (PMd), a cortical area in the dorsomedial pathway, is involved in grasp control. It is unclear, however, whether human PMd transfers grasp-related information to the primary motor cortex hand area (M1HAND) during action preparation. The present study tested whether ipsilateral cortico-cortical connections between PMd and M1HAND in the left hemisphere are modulated during grasp preparation. Ten participants performed object-directed grasps and reaches with the right hand. Functional connectivity between left PMd and ipsilateral M1HAND was probed with dual-site transcranial magnetic stimulation. We found that PMd-M1HAND functional interactions were facilitated selectively for the muscles involved in the preparation of the upcoming grasps. The PMd-M1HAND interaction was facilitated for first dorsal interosseous muscle for both precision grip and whole-hand grasps and for abductor digiti minimi muscle for whole-hand grasps. We conclude that human dorsomedial PMd-M1HAND circuit encodes handgrip formation during grasp preparation.

How are the motor system activity and functional connectivity between the cognitive and sensorimotor systems modulated by athletic expertise?

Expertise offers a unique insight into how our brain functions. The purpose of this experiment was to determine if motor system activity and functional connectivity between the cognitive system and sensorimotor system is differentially modulated by an individual's level of expertise. This goal was achieved through the acquisition of functional neuroimaging data in 10 expert volleyball players and 10 novice individuals who were presented with a series of sentences describing possible technical volleyball-specific motor acts and acts that cannot be performed as positive (“Do …!”) or negative (“Don't …”) commands, while they were silently reading them and deciding whether the actions were technically feasible or not. Compared with novices, experts' activity in the left primary motor cortex hand area (M1) and in the left premotor cortex (Pm) was decreased by impossible actions presented as positive commands. Sensorimotor activation in response to action-related stimuli is not that automatic as held since we found that these areas were deactivated during the task, and their functional connectivity to the primary visual cortex was strengthened for possible actions presented as positive commands, reflecting the neural processes underlying the interaction between motor and visual imagery. These results suggest that the neural activity within the key areas implicitly triggered by motor simulation is a function of the expertise, action feasibility, and context.

The activity of primary motor cortex corticospinal neurons during tool use by macaque monkeys.

It has been suggested that the distinctive capacity of some nonhuman primates to use tools may reflect a well-developed corticospinal system and, in particular, direct cortico-motoneuronal (CM) connections to hand muscles. We investigated the activity of corticospinal neurons in the primary motor cortex hand area during the use of a tool by two adult macaque monkeys. They used a light rake to retrieve food rewards placed in their extrapersonal space. An analysis of EMG activity showed that the rake task involved a complex interaction of muscles acting on the digits, hand, and arm. Sixty-nine corticospinal neurons were identified antidromically as pyramidal tract neurons (PTNs). When tested on the rake task, most (64 of 69; 93%) showed a significant modulation of their discharge during at least one of three task periods: grasping the rake, projecting it beyond the food reward, and then pulling it back to retrieve the reward. Discharge patterns were heterogeneous, and many PTNs showed significant suppression of discharge during raking. Seventeen of the 69 PTNs recorded during the rake task were further identified as CM cells, exerting clear postspike facilitation on digit muscles, demonstrating that the CM system contributes to the skilled use of tools. We compared the activity of each PTN on the rake task with that during precision grip. Most PTNs (90%) modulated their activity significantly for both tasks, demonstrating that PTNs activated by a task involving fractionated movements of the digits are also recruited during rake use, although there were often contrasting patterns of PTN recruitment and muscle activity for the two tasks.

A novel dual-site transcranial magnetic stimulation paradigm to probe fast facilitatory inputs from ipsilateral dorsal premotor cortex to primary motor cortex

The dorsal premotor cortex (PMd) plays an import role in action control, sensorimotor integration and motor recovery. Animal studies and human data have demonstrated direct connections between ipsilateral PMd and primary motor cortex hand area (M1(HAND)). In this study we adopted a multimodal approach combining highly focal dual-site TMS (dsTMS) and diffusion tensor imaging (DTI) to probe ipsilateral effective and structural connectivity between PMd and M1(HAND) in humans. A suprathreshold test stimulus (TS) was applied to left M1(HAND) producing a motor evoked potential (MEP) and a subsequent conditioning stimulus (CS) to ipsilateral rostromedial PMd at short latencies ranging from of 0.8 to 2.0 ms. At an interstimulus interval of 1.2 ms, dsTMS of the left M1(HAND) and PMd facilitated MEP amplitudes relative to unconditioned TMS of M1(HAND). This PMd to M1(HAND) facilitation was absent during voluntary contraction of the target muscle. During a two-choice reaction time task, PMd-M1(HAND) facilitation was only observed when dsTMS was given 125 ms after presentation of the cue and subjects responded with their right hand, but not for left hand responses. Our results reveal a short-latency PMd to M1(HAND) connection which modulates excitability of ipsilateral M1(HAND) in a task and effector specific manner. DTI revealed that individual increases in PMd to M1(HAND) facilitation were correlated with fractional anisotropy and axial diffusivity in the juxtacortical white matter underlying the caudal portion of the left superior frontal gyrus. This finding shows that the functional strength of this connection from medial PMd to M1(HAND) has a microstructural correlate in the underlying subcortical white matter. This novel dsTMS paradigm can be used to non-invasively probe effective PMd to M1(HAND) connectivity in healthy individuals and patients with impaired hand function.

Botulinum toxin injections reduce associative plasticity in patients with primary dystonia

Botulinum toxin injections ameliorate dystonic symptoms by blocking the neuromuscular junction and weakening dystonic contractions. We asked if botulinum toxin injections in dystonia patients might also affect the integrity of sensorimotor cortical plasticity, one of the key pathophysiological features of dystonia. We applied a paired associative stimulation protocol, known to induce long-term potentiation-like changes in the primary motor cortex hand area to 12 patients with cervical dystonia before and 1 and 3 months after botulinum toxin injections to the neck muscles. Primary motor cortex excitability was probed by measuring transcranial magnetic stimulation-evoked motor evoked potentials before and after paired associative stimulation. We also measured the input-output curve, short-interval intracortical inhibition, intracortical facilitation, short afferent inhibition, and long afferent inhibition in hand muscles and the clinical severity of dystonia. Before botulinum toxin injections, paired associative stimulation significantly facilitated motor evoked potentials in hand muscles. One month after injections, this effect was abolished, with partial recovery after 3 months. There were significant positive correlations between the facilitation produced by paired associative stimulation and (1) the time elapsed since botulinum toxin injections and (2) the clinical dystonia score. One effect of botulinum toxin injection treatment is to modulate afferent input from the neck. We propose that subsequent reorganization of the motor cortex representation of hand muscles may explain the effect of botulinum toxin on motor cortical plasticity. © 2011 Movement Disorder Society.

Somatotopic representation of finger in human primary motor cortex hand area

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98. Isolated ring finger palsy due to cortical infarction of the primary motor cortex hand area

98. Isolated ring finger palsy due to cortical infarction of the primary motor cortex hand area

Safety and Behavioral Effects of High-Frequency Repetitive Transcranial Magnetic Stimulation in Stroke

Electromagnetic brain stimulation might have value to reduce motor deficits after stroke. Safety and behavioral effects of higher frequencies of repetitive transcranial magnetic stimulation (rTMS) require detailed assessment. Using an active treatment-only, unblinded, 2-center study design, patients with chronic stroke received 20 minutes of 20 Hz rTMS to the ipsilesional primary motor cortex hand area. Patients were assessed before, during the hour after, and 1 week after rTMS. The 12 patients were 4.7+/-4.9 years poststroke (mean+/-SD) with moderate-severe arm motor deficits. In terms of safety, rTMS was well tolerated and did not cause new symptoms; systolic blood pressure increased from pre- to immediately post-rTMS by 7 mm Hg (P=0.043); and none of the behavioral measures showed a decrement. In terms of behavioral effects, modest improvements were seen, for example, in grip strength, range of motion, and pegboard performance, up to 1 week after rTMS. The strongest predictor of these motor gains was lower patient age. A single session of high-frequency rTMS to the motor cortex was safe. These results require verification with addition of a placebo group and thus blinded assessments across a wide spectrum of poststroke deficits and with larger doses of 20 Hz rTMS.

Pronounced Reduction of Digit Motor Responses Evoked from Macaque Ventral Premotor Cortex after Reversible Inactivation of the Primary Motor Cortex Hand Area

In common with other secondary motor areas, the macaque ventral premotor cortex (PMv) gives rise to corticospinal projections; it also makes numerous reciprocal corticocortical connections with the primary motor cortex (M1). Repetitive intracortical microstimulation (rICMS) of the PMv gives rise to movements of the hand and digits. To investigate whether these motor effects are dependent on the corticocortical interactions with M1, the effect of reversible inactivation of the M1 hand area was tested in three macaque monkeys with chronically implanted intracortical electrodes in the hand representations of M1 and PMv (rostral division, area F5). Monkeys were lightly sedated. Test EMG responses to rICMS were recorded from intrinsic hand muscles before and after microinjection of the GABA agonist muscimol in the M1 hand area. This not only greatly reduced EMG responses evoked from M1, but also reduced or abolished responses from F5, over a similar time course (20-50 min). Muscimol in M1 reduced the level of background EMG activity in the contralateral hand, which was paretic for several hours after injection. However, because EMG responses to direct activation of the corticospinal tract were significantly less affected than the responses to F5 stimulation, it is unlikely that reduced motoneuronal excitability explained the loss of the evoked responses from F5. Finally, muscimol injections in M1 greatly reduced the corticospinal volleys evoked by rICMS in F5. The results suggest that the motor effects evoked from F5 depend, at least in part, on corticocortical interactions with M1, leading to activation of M1 corticospinal outputs to hand muscles.

Isolated ring finger palsy due to cortical infarction of the primary motor cortex hand area

Isolated ring finger palsy due to cortical infarction of the primary motor cortex hand area

Dynamics of cortical neurovascular coupling analyzed by simultaneous DC-magnetoencephalography and time-resolved near-infrared spectroscopy

Functional magnetic resonance imaging (fMRI) visualizes activated brain areas with a high spatial resolution. The activation signal is determined by the local change of cerebral blood oxygenation, blood volume and blood flow which serve as surrogate marker for the neuronal signal itself. Here, the complex coupling between these parameters and the electrophysiologic activity is characterized non-invasively in humans during a simple motor task using simultaneously DC-magnetoencephalography (DC-MEG), for the detection of neuronal signals, and time-resolved near-infrared spectroscopy (trNIRS), for cortical metabolic/vascular responses: over the left primary motor cortex hand area of healthy subjects DC-fields and trNIRS parameters followed closely the 30 s motor task cycles, i.e., finger movements of the right hand alternating with rest. In subjects showing a sufficient signal-to-noise ratio the analysis of variance of photon time of flight proved that the task-related trNIRS changes originated from the cortex. While onset and relaxation started simultaneously, trNIRS signals reached 50% of the maximum level 1–4 s later than the DC-MEG-signals. The non-invasive ‘dual’ setup helps to characterize simultaneously the two complementary aspects of the ‘hemodynamic inverse problem’, i.e., the coupling of neuronal and vascular/metabolic signals, in healthy subjects and provides a new analysis perspective for pathophysiological coupling concepts in diverse diseases, e.g., in stroke, hypertension and Alzheimer’s disease.

Neurovascular Coupling Non-Invasively Characterized by Simultaneous DC-Magnetoencephalography and Time-Resolved Near-Infrared Spectroscopy

Functional brain imaging methods map neuronal activations indirectly through the accompanying neurovascular response. However, awareness is increasing that the link between neuronal and vascular task-related responses is all but a simple linear transform. Recently, we have shown that in a technically complementary approach neurovascular coupling can be analyzed non-invasively in the human brain in principle by simultaneous DC-magnetoencephalography (DC-MEG with brain-to-sensor modulation) and near-infrared spectroscopy (NIRS). As an extension to the first non-selective NIRS and DC-MEG recordings, we demonstrate here that time-resolved multichannel NIRS in combination with DC-MEG permits us to analyze neurovascular coupling in the human cortex. Simultaneously, DC-MEG signals and time-resolved multichannel NIRS at three wavelengths (687 nm, 803 nm, 826 nm) allowing for depth-selective analysis of absorption changes were recorded over the left primary motor cortex hand area in healthy subjects during finger movements of the right hand (30s followed by 30s rest; n=25 periods). DC fields and NIRS parameters (deoxy-Hb and oxy-Hb) followed closely the motor task cycles revealing statistically significant differences between periods of finger movements and rest. Analysis of variance of distributions of photon times of flight demonstrated changes of hemoglobin concentration originating from a deeper compartment of the head, i.e., the cortex. Notably, the leading slope of the DC-MEG response was found to be steeper and correspondingly the 50% level of its maximum was reached about 1s to 3s earlier compared to the NIRS responses. These results indicate that the vascular response, analyzed here in a simple motor task, is slower compared to the neuronal activation. Taken together, this dual approach provides a new opportunity to analyse non-invasively the “hemodynamic inverse problem“ which refers to the challenge of making valid and precise estimates of underlying cortical neuronal activity from measured hemodynamic responses, e.g., in NIRS and fMRI.

Partial Inactivation of the Primary Motor Cortex Hand Area: Effects on Individuated Finger Movements

After large lesions of the primary motor cortex (M1), voluntary movements of affected body parts are weak and slow. In addition, the relative independence of moving one body part without others is lost; attempts at individuated movements of a given body part are accompanied by excessive, unintended motion of contiguous body parts. The effects of partial inactivation of the M1 hand area are comparatively unknown, however. If the M1 hand area contains the somatotopically ordered finger representations implied by the classic homunculus or simiusculus, then partial inactivation might produce weakness, slowness, and loss of independence of one or two adjacent digits without affecting other digits. But if control of each finger movement is distributed in the M1 hand area as many studies suggest, then partial inactivation might produce dissociation of weakness, slowness, and relative independence of movement, and which fingers movements are impaired might be unrelated to the location of the inactivation along the central sulcus. To investigate the motoric deficits resulting from partial inactivation of the M1 hand area, we therefore made single intracortical injections of muscimol as trained monkeys performed visually cued, individuated flexion-extension movements of the fingers and wrist. We found little if any evidence that which finger movements were impaired after each injection was related to the injection location along the central sulcus. Unimpaired fingers could be flanked on both sides by impaired fingers, and the flexion movements of a given finger could be unaffected even though the extension movements were impaired, or vice versa. Partial inactivation also could produce dissociated weakness and slowness versus loss of independence in a given finger movement. These findings suggest that control of each individuated finger movement is distributed widely in the M1 hand area.

Postnatal Development of Corticospinal Projections from Motor Cortex to the Cervical Enlargement in the Macaque Monkey

The postnatal development of corticospinal projections was investigated in 11 macaques by means of the anterograde transport of wheat germ agglutin-horseradish peroxidase injected into the primary motor cortex hand area. Although the fibers of the corticospinal tract reached all levels of the spinal cord white matter at birth, their penetration into the gray matter was far from complete. At birth, as in the adult, corticospinal projections were distributed to the same regions of the intermediate zone, although they showed marked increases in density during the first 5 months. The unique feature of the primate corticospinal tract, namely direct cortico-motoneuronal projections to the spinal motor nuclei innervating hand muscles, was not present to a significant extent at birth. The density of these cortico-motoneuronal projections increased rapidly during the first 5 months, followed by a protracted period extending into the second year of life. The densest corticospinal terminations occupied only 40% of the hand motor nuclei in the first thoracic segment at 1 month, 73% at 5 months, and 75.5% at 3 years. A caudo-rostral gradient of termination density within the hand motor nuclei was present throughout development and persisted into the adult. As a consequence, the more caudal the segment within the cervical enlargement, the earlier the adult pattern of projection density was reached. No transitory corticospinal projections were found. The continuous postnatal expansion of cortico-motoneuronal projections to hand motor nuclei in primates is in marked contrast to the retraction of exuberant projections that characterizes the development of other sensory and motor pathways in subprimates.