Sensorimotor Integration Processes Research Articles

Temporary Nerve Block at Selected Digits Revealed Hand Motor Deficits in Grasping Tasks.

Peripheral sensory feedback plays a crucial role in ensuring correct motor execution throughout hand grasp control. Previous studies utilized local anesthesia to deprive somatosensory feedback in the digits or hand, observations included sensorimotor deficits at both corticospinal and peripheral levels. However, the questions of how the disturbed and intact sensory input integrate and interact with each other to assist the motor program execution, and whether the motor coordination based on motor output variability between affected and non-affected elements (e.g., digits) becomes interfered by the local sensory deficiency, have not been answered. The current study aims to investigate the effect of peripheral deafferentation through digital nerve blocks at selective digits on motor performance and motor coordination in grasp control. Our results suggested that the absence of somatosensory information induced motor deficits in hand grasp control, as evidenced by reduced maximal force production ability in both local and non-local digits, impairment of force and moment control during object lift and hold, and attenuated motor synergies in stabilizing task performance variables, namely the tangential force and moment of force. These findings implied that individual sensory input is shared across all the digits and the disturbed signal from local sensory channel(s) has a more comprehensive impact on the process of the motor output execution in the sensorimotor integration process. Additionally, a feedback control mechanism with a sensation-based component resides in the formation process for the motor covariation structure.

Neurorehabilitation strategies for poststroke oropharyngeal dysphagia: from compensation to the recovery of swallowing function.

Oropharyngeal dysphagia (OD) is very prevalent among poststroke patients, causing severe complications but lacking specific neurorehabilitation treatment. This review covers advances in the pathophysiology, diagnosis, and physiologically based neurorehabilitation strategies for poststroke OD. The pathophysiology of oropharyngeal biomechanics can be assessed by videofluoroscopy, as delayed laryngeal vestibule closure is closely associated with aspiration. Stroke may affect afferent or efferent neuronal circuits participating in deglutition. The integrity of oropharyngeal-cortical afferent pathways can be assessed by electroencephalography through sensory-evoked potentials by pharyngeal electrical stimulation, while corticopharyngeal efferent pathways can be characterized by electromyography through motor-evoked potentials by transcranial magnetic stimulation. Dysfunction in both cortico-mediated evoked responses is associated with delayed swallow response and aspiration. Studies have reported hemispherical asymmetry on motor control of swallowing and the relevance of impaired oropharyngeal sensitivity on aspiration. Advances in treatment include improvements in compensatory strategies but are mainly focused on (1) peripheral stimulation strategies and (2) central, noninvasive stimulation strategies with evidence of their clinical benefits. Characterization of poststroke OD is evolving from the assessment of impaired biomechanics to the sensorimotor integration processes involved in deglutition. Treatment is also changing from compensatory strategies to promoting brain plasticity, both to recover swallow function and to improve brain-related swallowing dysfunction.

Editorial: A Hand at Work: Effects of Aging.

Editorial: A Hand at Work: Effects of Aging.

Perceptual conflict during sensorimotor integration processes - a neurophysiological study in response inhibition.

A multitude of sensory inputs needs to be processed during sensorimotor integration. A crucial factor for detecting relevant information is its complexity, since information content can be conflicting at a perceptual level. This may be central to executive control processes, such as response inhibition. This EEG study aims to investigate the system neurophysiological mechanisms behind effects of perceptual conflict on response inhibition. We systematically modulated perceptual conflict by integrating a Global-local task with a Go/Nogo paradigm. The results show that conflicting perceptual information, in comparison to non-conflicting perceptual information, impairs response inhibition performance. This effect was evident regardless of whether the relevant information for response inhibition is displayed on the global, or local perceptual level. The neurophysiological data suggests that early perceptual/ attentional processing stages do not underlie these modulations. Rather, processes at the response selection level (P3), play a role in changed response inhibition performance. This conflict-related impairment of inhibitory processes is associated with activation differences in (inferior) parietal areas (BA7 and BA40) and not as commonly found in the medial prefrontal areas. This suggests that various functional neuroanatomical structures may mediate response inhibition and that the functional neuroanatomical structures involved depend on the complexity of sensory integration processes.

The Cortical Processing of Sensorimotor Sequences is Disrupted in Writer's Cramp.

Evidence for pre-existing abnormalities in the sensory and motor systems has been previously reported in writer's cramp (WC). However, the processing of somatosensory information during motor planning has received little attention. We hypothesized that sensorimotor integration processes might be impaired partly due to a disruption in the parieto-premotor network. To test this assumption, we designed 2 nonwriting motor tasks in which subjects had to perform a 4-finger motor sequence either on the basis of sensory stimuli previously memorized (SM task) or freely generated (SG task). Brain activity was measured by combining event-related functional magnetic resonance imaging and coherency electroencephalography in 15 WC patients and 15 normal controls. The bold signal was decreased in patients in both tasks during sensory stimulation but not during movement execution. However, the EEG study showed that coherency was decreased in patients compared with controls, during the delay of the SM task and during the execution of the SG task, on both the whole network and for specific couples of electrodes. Overall, these results demonstrate an endophenotypic impairment in the synchronization of cortical areas within the parieto-premotor network during somatosensory processing and motor planning in WC patients.

62. Sensory Tricks in cervical dystonia: A neurophysiological study with short latency afferent inhibition

A classic hallmark of cervical dystonia (CD) is the improvement of dystonic symptoms during a specific maneuver, defined ‘sensory trick’ (ST). Even if the mechanism by which ST improves dystonia is not well understood, it is likely that cortical sensorimotor integration processes are involved. In a previous preliminary study, we evaluated the short latency afferent inhibition (SAI) in a group of CD patients and the effects of ST on the SAI profile. To date, we have increased our sample including 28 patients with primary CD (18 with ST, CD+, and 10 without ST, CD-) and 11 controls. The analysis of variance showed no significant differences between CD- patients and controls. On the contrary, a remarkable trend toward a reduced SAI was observed in CD+ patients when they did not perform ST. Interestingly, SAI was further reduced in CD+ patients when they performed ST, reaching a strong statistical relevance. Our results show the presence of an abnormal sensorimotor integration in CD+ patients. Furthermore, they prove that ST acts by modulating the abnormal link between sensory input and motor output.

Low-frequency rTMS over the Parieto–frontal network during a sensorimotor task: The role of absolute beta power in the sensorimotor integration

Several studies have demonstrated that Repetitive Transcranial Magnetic Stimulation (rTMS) promotes alterations in the Central Nervous System circuits and networks. The focus of the present study is to examine the absolute beta power patterns in the Parieto–frontal network. We hypothesize that rTMS alters the mechanisms of the sensorimotor integration process during a visuomotor task. Twelve young healthy volunteers performed a visuomotor task involving decision making recorded (Catch a ball in a free fall) by Electroencephalography. rTMS was applied on the Superior Parietal Cortex (SPC; Brodmann area [BA] 7) with low-frequency (1Hz – 15min – 80% Resting Motor Threshold). For each Frontal and Parietal region, a two-way ANOVA was used to compare the absolute beta power before and after TMS for each condition of the study (Rest 1, Task and Rest 2). The results demonstrated interactions (TMS vs. Condition) for the Frontal electrodes: Fp1, Fp2 and F7 and an effect of TMS (before and after) for F4.The results for the Parietal region showed a main effect of Condition for the P3, PZ and P4 electrodes. Thus, our paradigm was useful to better understand the reorganization and neural plasticity mechanisms in the parieto–frontal network during the sensorimotor integration process.

Interacting sources of interference during sensorimotor integration processes

Every day, a multitude of interfering sensory inputs needs to be integrated and adequately processed using response selection processes. Interference effects are typically investigated using classical paradigms like the Flanker and Simon task. The sources of interference for Flanker and Simon effect are known to be different and according to dual process accounts, two distinct functional pathways are involved in resolving these types of interference. It is an open question how far these sources of interference are related to each other and interact. We investigated this question in a system neurophysiological study utilizing a hybrid paradigm combining both Flanker effect-like and Simon effect-like features. We focus on event-related theta oscillations and use beamforming methods to examine functional neuroanatomical networks. The results show that Simon and Flanker interference interacted in a non-additive fashion by modulating theta band activity, probably reflecting the recruitment of cognitive control processes. Beamforming source reconstruction revealed that theta band activity was related to a broad neuronal network comprising prefrontal and cerebellar regions, including the MFG, SFG, IFG, and SMA. These regions were connected to interference processing and conflict resolution, but differed in the amount of specificity for different sources of interference.

Trigeminal nerve stimulation modulates brainstem more than cortical excitability in healthy humans.

Multiple sites in the central nervous system (CNS) have been hypothesized to explain the beneficial effects of transcutaneous trigeminal nerve stimulation (TNS) on several disorders. This work investigated the acute effects of TNS on the excitability of brainstem and intracortical circuits, as well as on sensorimotor integration processes at cortical level in physiological conditions. Brainstem excitability was evaluated in seventeen healthy subjects measuring the R1 and R2 areas of the blink reflex (BR) and its recovery cycle, with cortical excitability and sensorimotor integration assessed by probing short-interval (SICI) and long-interval (LICI) intracortical inhibition, with short-interval (SICF), intracortical facilitation (ICF), short-latency (SAI) and long-latency (LAI) inhibition measuring motor potentials evoked in the first dorsal interosseous muscle by TMS of the contralateral motor cortex. Neurophysiological parameters were assessed, in seventeen healthy subjects, before and after cyclic 20-min TNS delivered bilaterally to the infraorbital nerve. After TNS, the area of the R2 was significantly reduced (p=0.018). By contrast, R1 area and R2 recovery cycle were unaffected. Similarly, SICI, ICF, LICI, SICF, SAI and LAI appeared unaltered after TNS. These data suggest that, in normal subjects, TNS mainly acts on brainstem polysynaptic circuits mediating the R2 component of the BR and plays a minor role in modifying the activity of higher-level structures involved in the R2 recovery cycle and in modulation of cortical excitability. A further investigation of a chronic TNS-induced effect may disclose a higher potential for TNS in producing measurable after effects on its CNS targets.

A functional tracking task to assess frontal plane motor control in post stroke gait

The ability to execute appropriate medio-lateral foot placements during gait is thought to require active frontal plane control and to be critical in maintaining upright posture during gait. The aggregate frontal plane metrics of step width and step width variability have been assessed for post-stroke populations, but only under normal walking conditions. However, in the case of stroke, limb specific differences in sensory-motor control are likely. Thus, an investigation of limb specific motor control characteristics under tracking task conditions is needed to appropriately characterize frontal plane sensory-motor control post-stroke. Chronic stroke subjects (n=15) and age matched control subjects (n=10) tracked static, bilateral foot placement targets at self-selected walking speeds and completed a free walking trial. Variability and error of tracking performance were analyzed for step width and foot placement. Stroke subjects demonstrated reduced ability to control step width variability and foot placement variability, compared to control subjects. Step width variability and affected limb foot placement variability were sensitive to task complexity, increasing significantly in response to a decrease in step width target size. These results show that stroke mediated changes in the sensory-motor integration processes are manifested as inter-limb differences in frontal plane motor variability during a gait tracking task, with an additional sensitivity to task complexity. Additionally, the proposed step width tracking paradigm presents a clinically reproducible motor control metric that can be used for diagnostic assessment or as a potential outcome for a gait training regimen.

The magnitude of the somatosensory cortical activity is related to the mobility and strength impairments seen in children with cerebral palsy.

The noted disruption of thalamocortical connections and abnormalities in tactile sensory function has resulted in a new definition of cerebral palsy (CP) that recognizes the sensorimotor integration process as central to the motor impairments seen in these children. Despite this updated definition, the connection between a child's motor impairments and somatosensory processing remains almost entirely unknown. In this investigation, we explored the relationship between the magnitude of neural activity within the somatosensory cortices, the strength of the ankle plantarflexors, and the gait spatiotemporal kinematics of a group of children with CP and a typically developing matched cohort. Our results revealed that the magnitude of somatosensory cortical activity in children with CP had a strong positive relationship with the ankle strength, step length, and walking speed. These results suggest that stronger activity within the somatosensory cortices in response to foot somatosensations was related to enhanced ankle plantarflexor strength and improved mobility in the children with CP. These results provide further support for the notion that children with CP exhibit, not only musculoskeletal deficits, but also somatosensory deficits that potentially contribute to their overall functional mobility and strength limitations.

Post-Stroke Rehabilitation: Importance of Neuroplasticity and Sensorimotor Integration Processes

Questions of the neurorehabilitation of strokes patients are addressed. The importance of the phenomenon of neuroplasticity, which underlies recovery processes after brain lesions, is emphasized. Particular attention is paid to the question of sensorimotor integration in health and CNS pathology, as well as to the role of afferentation in the processes underlying the recovery of motor impairments. The principles of rehabilitation therapy for stroke patients are discussed.

Diffuse decreased gray matter in patients with idiopathic craniocervical dystonia: a voxel-based morphometry study.

Background: Recent studies have addressed the role of structures other than the basal ganglia in the pathophysiology of craniocervical dystonia (CCD). Neuroimaging studies have attempted to identify structural abnormalities in CCD but a clear pattern of alteration has not been established. We performed whole-brain evaluation using voxel-based morphometry (VBM) to identify patterns of gray matter (GM) changes in CCD.Methods: We compared 27 patients with CCD matched in age and gender to 54 healthy controls. VBM was used to compare GM volumes. We created a two-sample t-test corrected for subjects’ age, and we tested with a level of significance of p < 0.001 and false discovery rate (FDR) correction (p < 0.05).Results: Voxel-based morphometry demonstrated significant reductions of GM using p < 0.001 in the cerebellar vermis IV/V, bilaterally in the superior frontal gyrus, precuneus, anterior cingulate and paracingulate, insular cortex, lingual gyrus, and calcarine fissure; in the left hemisphere in the supplementary motor area, inferior frontal gyrus, inferior parietal gyrus, temporal pole, supramarginal gyrus, rolandic operculum, hippocampus, middle occipital gyrus, cerebellar lobules IV/V, superior, and middle temporal gyri; in the right hemisphere, the middle cingulate and precentral gyrus. Our study did not report any significant result using the FDR correction. We also detected correlations between GM volume and age, disease duration, duration of botulinum toxin treatment, and the Marsden–Fahn dystonia scale scores.Conclusion: We detected large clusters of GM changes chiefly in structures primarily involved in sensorimotor integration, motor planning, visuospatial function, and emotional processing.

Morphological patterns of the intraparietal sulcus and the anterior intermediate parietal sulcus of Jensen in the human brain.

Distinct parts of the intraparietal sulcal cortex contribute to sensorimotor integration and visual spatial attentional processing. A detailed examination of the morphological relations of the different segments of the complex intraparietal sulcal region in the human brain in standard stereotaxic space, which is a prerequisite for detailed structure-to-function studies, is not available. This study examined the intraparietal sulcus (IPS) and the related sulcus of Jensen in magnetic resonance imaging brain volumes registered in the Montreal Neurological Institute stereotaxic space. It was demonstrated that the IPS is divided into two branches: the anterior ramus and the posterior ramus of the IPS, often separated by a submerged gyral passage. The sulcus of Jensen emerges between the anterior and posterior rami of the IPS, and its ventral end is positioned between the first and second caudal branches of the superior temporal sulcus. In a small number of brains, the sulcus of Jensen may merge superficially with the first caudal branch of the superior temporal sulcus. The above morphological findings are discussed in relation to previously reported functional neuroimaging findings and provide the basis for future exploration of structure-to-function relations in the posterior parietal region of individual subjects.

77. Effect of sensory tricks on brain excitability in cervical dystonia: Sensory afferent inhibition study

Sensory trick (ST), i.e. the improvement of dystonic posture by application of a sensory stimulus, is a typical Cervical Dystonia (CD) feature. Though its exact mechanism is still unknown, cortical sensorimotor integration processes are likely to be involved. Short latency afferent inhibition (SAI), the physiological inhibition of motor evoked potentials (MEP) mediated by somatosensory stimulation, could potentially help to understand this phenomenon. We evaluated by means of SAI whether the inhibitory effect of somatosensory afferent volley is preserved in CD patients; Moreover, we assessed if sensory trick may change SAI profile in patients with CD. We performed SAI at rest and during ST performance in 2 groups of CD patients: group 1 ( n = 13), patients high-responsive to ST and group 2 ( n = 8), patients no- or slightly responsive to ST. Results: We found an overall SAI impairment in both CD groups at rest; rather unexpectedly, SAI was less effective and MEP amplitude increased with ST in group 1, while just slight or no effect was observed in group 2. The physiological inhibition of sensory stimuli over motor cortex, measured with SAI, is decreased in our CD patients. The trick-related dystonia relief seems to occur through a paradoxical enhancement of the sensorimotor circuitry, at least in high-responsive ST patients.

Neglect following stroke: The role of sensory sensitivity in visuo-spatial performance

Both proprioceptive and visual manipulations have led to some improvement of the spatial neglect syndrome. Until now, their effects on visuo-spatial behaviour have never been compared simultaneously. The objective of this study was to determine their influence, as a function of the presence of neglect and the side of the brain damage. 19 stroke patients with right and 14 with left brain damage, without or with neglect; realized the Bells test in 5 conditions: a reference condition and 4 sensory conditions, defined according to the side of application (contralesional vs ipsilesional) and the type of perturbation (visual vs proprioceptive). The visuo-spatial behaviour was analyzed for global and spatial aspects and for individual extreme performances. For the neglect group, the restriction of the visual field to the ipsilesional hemi-field significantly diverted the centre of exploration towards the ipsilesional side compared to all other conditions. The weighting of visual cues from the ipsilesional hemi-field seems to be increased in sensory-motor integration processes in neglect patients. In all the groups, although some improvements in performance did occur with sensory manipulation, they were dependent on the individual, particularly for neglect patients. A same performance can be achieved through the use of different sensory-motor strategies, which are individual-related. It is thus important to consider the sensory sensitivity and the responsiveness of each patient before beginning any sensory therapies.

Obsessive-compulsive disorder: A “sensory-motor” problem?

Obsessive–compulsive disorder (OCD) is a clinically heterogeneous condition. Although its pathophysiology is not completely understood, neurophysiologic and neuroimaging data have disclosed functional abnormalities in the networks linking frontal cortex, supplementary motor and premotor areas, striatum, globus pallidus, and thalamus (CSPT circuits). By means of transcranial magnetic stimulation (TMS) it is possible to test inhibitory and excitatory circuits within motor cortex.Previous studies on OCD patients under medication have demonstrated altered cortical inhibitory circuits as tested by TMS. On the other hand there is growing evidence suggesting an alteration of sensory-motor integration. Therefore, the aim of the present study was to evaluate sensory-motor integration (SAI and LAI), intracortical inhibition, and facilitation in drug-naïve OCD patients, using TMS. In our sample, we have demonstrated a significant SAI reduction in OCD patients when compared to a cohort of healthy individuals. SAI abnormalities may be related to a dysfunction of CSPT circuits which are involved in sensory-motor integration processes. Thus, it can be speculated that hypofunctioning of such system might impair the ability of OCD patients to suppress internally triggered intrusive and repetitive movements and thoughts. In conclusion, our data suggest that OCD may be considered as a sensory motor disorder where a dysfunction of sensory-motor integration may play an important role in the release of motor compulsions.

Changes in the theta band coherence during motor task after hand immobilization.

Many different factors can temporarily or permanently impair movement and impairs cortical organization, e.g. hand immobilization. Such changes have been widely studied using electroencephalography. Within this context, we have investigated the immobilization effects through the theta band coherence analysis, in order to find out whether the immobilization period causes any changes in the inter and intra-hemispheric coherence within the cerebral cortex, as well as to observe whether the theta band provides any information about the neural mechanisms involved during the motor act. We analyzed the cortical changes that occurred after 48 hours of hand immobilization. The theta band coherence was study through electroencephalography in 30 healthy subjects, divided into two groups (control and experimental). Within both groups, the subjects executed a task involving flexion and extension of the index finger, before and after 48 hours. The experimental group, however, was actually submitted to hand immobilization. We were able to observe an increase in the coupling within the experimental group in the frontal, parietal and temporal regions, and a decrease in the motor area. In order to execute manual tasks after some time of movement restriction, greater coherence is present in areas related to attention, movement preparation and sensorimotor integration processes. These results may contribute to a detailed assessment of involved neurophysiological mechanism in motor act execution.

Perceptual errors increase with movement duration and may contribute to hypokinesia in Parkinson’s disease

People with Parkinson’s disease (PD) perceive that their movement amplitude is greater than what they actually perform. The neural mechanisms underlying one’s perception of movement are believed to involve the sensorimotor integration process (SIP). How PD affects the SIP is not well understood. A previous study interrogating the SIP showed healthy adults (HAs) overestimated their limb position in the direction of movement and the error and its variance (VOE) depended on movement duration. We asked if PDs showed errors in perceived limb position and if the dependence on movement duration was different from HAs. We used an existing computational model of the SIP to explore mechanisms for the error and VOE as a function of movement duration. Twenty PDs, off medication, and 20 age-matched HAs were asked to estimate the position of their hand after performing 50, slow, non-visually guided wrist flexion or extension movements for a random period of time (<4.0s). Both groups overestimated the amount they moved; however, the PDs’ error and VOE were larger (p<0.001). HAs showed increasing error/VOE for small movement durations that reduced/stabilized for longer movement durations. PDs however showed increasing error/VOE with increasing movement duration that did not significantly improve/stabilize. The model suggested that the basis for such perceptual deficits may be abnormal proprioceptive feedback and/or processing of an abnormal internal impression (prediction) that underestimates movement amplitude. Simulation results imply that the PD’s SIP could no longer effectively access sensory (proprioceptive) feedback to correct errors in other components of the SIP due to the abnormal processing of sensory feedback. We suggest from this study that an impaired perception of movement amplitude and sensory processing deficits contribute to hypokinesia in PD.

Effects of Carpal Tunnel Syndrome on Dexterous Manipulation Are Grip Type-Dependent

Carpal tunnel syndrome (CTS) impairs sensation of a subset of digits. Although the effects of CTS on manipulation performed with CTS-affected digits have been studied using precision grip tasks, the extent to which CTS affects multi-digit force coordination has only recently been studied. Whole-hand manipulation studies have shown that CTS patients retain the ability to modulate multi-digit forces to object mass, mass distribution, and texture. However, CTS results in sensorimotor deficits relative to healthy controls, including significantly larger grip force and lower ability to balance the torques generated by the digits. Here we investigated the effects of CTS on multi-digit force modulation to object weight when manipulating an object with a variable number of fingers. We hypothesized that CTS patients would be able to modulate digit forces to object weight. However, as different grip types involve the exclusive use of CTS-affected digits (‘uniform’ grips) or a combination of CTS-affected and non-affected digits (‘mixed’ grips), we addressed the question of whether ‘mixed’ grips would reduce or worsen CTS-induced force coordination deficits. The former scenario would be due to adding digits with intact tactile feedback, whereas the latter scenario might occur due to a potentially greater challenge for the central nervous system of integrating ‘noisy’ and intact tactile feedback. CTS patients learned multi-digit force modulation to object weight regardless of grip type. Although controls exerted the same total grip force across all grip types, patients exerted significantly larger grip force than controls but only for manipulations with four and five digits. Importantly, this effect was due to CTS patients’ inability to change the finger force distribution when adding the ring and little fingers. These findings suggest that CTS primarily challenges sensorimotor integration processes for dexterous manipulation underlying the coordination of CTS-affected and non-affected digits.