Unilateral Motor Task Research Articles

Motor demand-dependent activation of ipsilateral motor cortex.

The role of ipsilateral primary motor cortex (M1) in hand motor control during complex task performance remains controversial. Bilateral M1 activation is inconsistently observed in functional (f)MRI studies of unilateral hand performance. Two factors limit the interpretation of these data. As the motor tasks differ qualitatively in these studies, it is conceivable that M1 contributions differ with the demand on skillfulness. Second, most studies lack the verification of a strictly unilateral execution of the motor task during the acquisition of imaging data. Here, we use fMRI to determine whether ipsilateral M1 activity depends on the demand for precision in a pointing task where precision varied quantitatively while movement trajectories remained equal. Thirteen healthy participants used an MRI-compatible joystick to point to targets of four different sizes in a block design. A clustered acquisition technique allowed simultaneous fMRI/EMG data collection and confirmed that movements were strictly unilateral. Accuracy of performance increased with target size. Overall, the pointing task revealed activation in contralateral and ipsilateral M1, extending into contralateral somatosensory and parietal areas. Target size-dependent activation differences were found in ipsilateral M1 extending into the temporal/parietal junction, where activation increased with increasing demand on accuracy. The results suggest that ipsilateral M1 is active during the execution of a unilateral motor task and that its activity is modulated by the demand on precision.

Lateralization and localization of epilepsy related hemodynamic foci using presurgical fMRI

ObjectiveThe aim was to develop a method for the purpose of localizing epilepsy related hemodynamic foci for patients suffering intractable focal epilepsy using task-free fMRI alone. MethodsWe studied three groups of subjects: patients with intractable focal epilepsy, healthy volunteers performing motor tasks, and healthy volunteers in resting state. We performed spatial independent component analysis (ICA) on the fMRI alone data and developed a set of IC selection criteria to identify epilepsy related ICs. The method was then tested in the two healthy groups. ResultsIn seven out of the nine surgery patients, identified ICs were concordant with surgical resection. Our results were also consistent with presurgical evaluation of the remaining one patient without surgery and may explain why she was not suitable for resection treatment. In the motor task study of ten healthy subjects, our method revealed components with concordant spatial and temporal features as expected from the unilateral motor tasks. In the resting state study of seven healthy subjects, the method successfully rejected all components in four out of seven subjects as non-epilepsy related components. ConclusionThese results suggest the lateralization and localization value of fMRI alone in presurgical evaluation for patients with intractable unilateral focal epilepsy. SignificanceThe proposed method is noninvasive in nature and easy to implement. It has the potential to be incorporated in current presurgical workup for treating intractable focal epilepsy patients.

Role of the Mirror-Neuron System in Cross-Education

The present review proposes the untested hypothesis that cross-education performed with a mirror increases the transfer of motor function to the resting limb compared with standard cross-education interventions without a mirror. The hypothesis is based on neuroanatomical evidence suggesting an overlap in activated brain areas when a unilateral motor task is performed with and without a mirror in the context of cross-education of the upper extremities. The review shows that the mirror-neuron system (MNS), connecting sensory neurons responding to visual properties of an observed action and motor neurons that discharge action potentials during the execution of a similar action, has the potential to enhance cross-education.

Homologous Muscle Contraction during Unilateral Movement Does Not Show a Dominant Effect on Leg Representation of the Ipsilateral Primary Motor Cortex

Co-activation of homo- and heterotopic representations in the primary motor cortex (M1) ipsilateral to a unilateral motor task has been observed in neuroimaging studies. Further analysis showed that the ipsilateral M1 is involved in motor execution along with the contralateral M1 in humans. Additionally, transcranial magnetic stimulation (TMS) studies have revealed that the size of the co-activation in the ipsilateral M1 has a muscle-dominant effect in the upper limbs, with a prominent decline of inhibition within the ipsilateral M1 occurring when a homologous muscle contracts. However, the homologous muscle-dominant effect in the ipsilateral M1 is less clear in the lower limbs. The present study investigates the response of corticospinal output and intracortical inhibition in the leg representation of the ipsilateral M1 during a unilateral motor task, with homo- or heterogeneous muscles. We assessed functional changes within the ipsilateral M1 and in corticospinal outputs associated with different contracting muscles in 15 right-handed healthy subjects. Motor tasks were performed with the right-side limb, including movements of the upper and lower limbs. TMS paradigms were measured, consisting of short-interval intracortical inhibition (SICI) and recruitment curves (RCs) of motor evoked potentials (MEPs) in the right M1, and responses were recorded from the left rectus femoris (RF) and left tibialis anterior (TA) muscles. TMS results showed that significant declines in SICI and prominent increases in MEPs of the left TA and left RF during unilateral movements. Cortical activations were associated with the muscles contracting during the movements. The present data demonstrate that activation of the ipsilateral M1 on leg representation could be increased during unilateral movement. However, no homologous muscle-dominant effect was evident in the leg muscles. The results may reflect that functional coupling of bilateral leg muscles is a reciprocal movement.

Transfer of ballistic motor skill between bilateral and unilateral contexts in young and older adults: neural adaptations and behavioral implications

Bilateral movement rehabilitation is gaining popularity as an approach to improve the recovery not only of bimanual function but also of unilateral motor tasks. While the neural mechanisms mediating the transfer of bilateral training gains into unimanual contexts are not fully understood, converging evidence from behavioral, neurophysiological, and imaging studies suggests that bimanual movements are not simply the superposition of unimanual tasks undertaken with both (upper) limbs. Here we investigated the neural responses in both hemispheres to bilateral ballistic motor training and the extent to which performance improvements transferred to a unimanual task. Since aging influences interhemispheric interactions during movement production, both young (n = 9; mean age 19.4 yr; 6 women, 3 men) and older (n = 9; 66.3 yr; 7 women, 2 men) adults practiced a bilateral motor task requiring simultaneous "fast-as-possible" abductions of their left and right index fingers. Changes in bilateral and unilateral performance, and in corticospinal excitability and intracortical inhibition, were assessed. Strong transfer was observed between bimanual and unimanual contexts for both age groups. However, in contrast to previous reports of substantial bilateral cortical adaptations following unilateral training, increases in corticospinal excitability following bilateral training were not statistically reliable, and a release of intracortical inhibition was only observed for older adults. The results indicate that the neural mechanisms of motor learning for bilateral ballistic tasks differ from those that underlie unimanual ballistic performance improvement but that aging results in a greater overlap of the neural mechanisms mediating bilateral and unilateral ballistic motor performance.

Co-activation of primary motor cortex ipsilateral to muscles contracting in a unilateral motor task

ObjectiveThis study aims to investigate the role of the primary motor cortex ipsilateral to the movement (ipsilateral M1) in unilateral motor execution. MethodsFifteen right-handed healthy subjects underwent functional magnetic resonance imaging (fMRI) and transcranial magnetic stimulation (TMS) experiments. Motor tasks were performed with the right-side limb. Subjects followed visual cues to execute movements in the scanner and independent component analysis (ICA) was applied to analyse the data. Interhemispheric inhibition (IHI), short-interval intracortical inhibition (SICI) and recruitment curves (RCs) of motor-evoked potentials (MEPs) in right M1 were measured by TMS and responses were recorded from the left flexor carpi radialis (FCR) and left anterior deltoid (AD). ResultsGroup ICA showed activations of bilateral M1s highly related to motor tasks. Additionally, TMS results showed significant increases of MEP RCs on the left FCR and left AD during right wrist flexion and right shoulder flexion. Prominent decreases of IHI and SICI were also observed under the same conditions. ConclusionsDuring unilateral muscle contraction, co-activation of the ipsilateral M1 involves additional processes modulated by intra- and interhemispheric interactions and its size of activations is specifically enhanced on the homotopic representation. SignificanceThe ipsilateral M1 plays a central role in unilateral motor executions.

Mirror training to augment cross-education during resistance training: a hypothesis

Resistance exercise has been shown to be a potent stimulus for neuromuscular adaptations. These adaptations are not confined to the exercising muscle and have been consistently shown to produce increases in strength and neural activity in the contralateral, homologous resting muscle; a phenomenon known as cross-education. This observation has important clinical applications for those with unilateral dysfunction given that cross-education increases strength and attenuates atrophy in immobilized limbs. Previous evidence has shown that these improvements in the transfer of strength are likely to reside in areas of the brain, some of which are common to the mirror neuron system (MNS). Here we examine the evidence for the, as yet, untested hypothesis that cross-education might benefit from observing our own motor action in a mirror during unimanual resistance training, thereby activating the MNS. The hypothesis is based on neuroanatomical evidence suggesting brain areas relating to the MNS are activated when a unilateral motor task is performed with a mirror. This theory is timely because of the growing body of evidence relating to the efficacy of cross-education. Hence, we consider the clinical applications of mirror training as an adjuvant intervention to cross-education in order to engage the MNS, which could further improve strength and reduce atrophy in dysfunctional limbs during rehabilitation.

Visualization of Altered Neurovascular Coupling in Chronic Stroke Patients using Multimodal Functional MRI

Evaluation of cortical reorganization in chronic stroke patients requires methods to accurately localize regions of neuronal activity. Blood oxygenation level-dependent (BOLD) functional magnetic resonance imaging (fMRI) is frequently employed; however, BOLD contrast depends on specific coupling relationships between the cerebral metabolic rate of oxygen (CMRO(2)), cerebral blood flow (CBF), and volume (CBV), which may not exist following stroke. The aim of this study was to understand whether CBF-weighted (CBFw) and CBV-weighted (CBVw) fMRI could be used in sequence with BOLD to characterize neurovascular coupling mechanisms poststroke. Chronic stroke patients (n=11) with motor impairment and age-matched controls (n=11) performed four sets of unilateral motor tasks (60 seconds/30 seconds off/on) during CBFw, CBVw, and BOLD fMRI acquisition. While control participants elicited mean BOLD, CBFw, and CBVw responses in motor cortex (P<0.01), patients showed only mean changes in CBF (P<0.01) and CBV (P<0.01), but absent mean BOLD responses (P=0.20). BOLD intersubject variability was consistent with differing coupling indices between CBF, CBV, and CMRO(2). Thus, CBFw and/or CBVw fMRI may provide crucial information not apparent from BOLD in these patients. A table is provided outlining distinct vascular and metabolic uncoupling possibilities that elicit different BOLD responses, and the strengths and limitations of the multimodal protocol are summarized.

Abstract P289: Therapist-Based and Robot-Assisted Physical Training Have Differential Effects on Motor Control of Upper Limb and Quality of Life after Chronic Stroke

Introduction: Compensatory strategies for stroke-related motor impairment may cause a pattern of disuse that might limit the improvement of upper limb (UL) motor function, and incomplete UL motor recovery might detrimentally impact quality of life. Previous studies showed that bilateral arm physical training (BAT) can improve UL function after stroke and improves trunk stabilization. However, it remains uncertain that whether BAT can reduce trunk compensation during reaching. Furthermore, there is no study investigating therapist-guided bilateral arm training (TBAT) versus robot-assisted bilateral arm training (RBAT). Hypothesis: We tested the hypothesis that TBAT and RBAT, compared with control treatment (CT), would result in the better outcomes on movement control in the affected UL and less trunk compensation in reaching tasks and would improve quality of life. In addition, TBAT and RBAT may have differential effects on motor control and quality of life. Methods: Forty-two community dwelling chronic stroke survivors (54 years old; 18 months after stroke) were randomized to TBAT (N=14), RBAT (N=14), or CT (N=14) groups. Each group received a 90- to 105-minute training session, 5 days/week, for 4 weeks. The TBAT participants practiced a variety of bilateral functional tasks with each arm simultaneously under one-on-one supervision of therapists. In the RBAT, the robot-assisted arm trainer, Bi-Manu-Track, was introduced. The CT group involved some conventional therapeutic activities on the paretic arms, unilateral and bilateral fine motor tasks, and compensatory practice on functional tasks. Outcome measures consisted of kinematic analyses for motor control in unilateral and bilateral reaching tasks, and the Stroke Impact Scale for quality of life. Results: The kinematic results indicated that the TBAT group experienced better temporal efficiency and smoothness in unilateral reaching than the CT group. The TBAT group demonstrated less compensatory trunk movement than the CT or RBAT groups in both unilateral and bilateral tasks. In contrast, the RBAT engendered a larger improvement in shoulder flexion than the other groups. The RBAT demonstrated improved quality of life than the CT group characterized by better strength, physical function, and total scores of Stroke Impact Scale. Conclusions: TBAT and RBAT engendered differential effects on outcome measures than CT. TBAT may have better results on temporal efficiency, smoothness, and trunk control. In contrast, RBAT may experience the improved shoulder flexion and quality of life.

Corticomuscular coherence with and without additional task in the elderly

Aging and dual-task paradigms often degrade fine motor performance, but the effects of aging on correlated neural activity between motor cortex and contracting muscle are unknown during dual tasks requiring fine motor performance. The purpose of this study was to compare corticomuscular coherence between young and elderly adults during the performance of a unilateral fine motor task and concurrent motor and cognitive tasks. Twenty-nine healthy young (18-38 yr) and elderly (61-75 yr) adults performed unilateral motor, bilateral motor, concurrent motor-cognitive, and cognitive tasks. Peak corticomuscular coherence between the electroencephalogram from the primary motor cortex and surface electromyogram from the first dorsal interosseous muscle was compared during steady abduction of the index finger with visual feedback. In the alpha-band (8-14 Hz), corticomuscular coherence was greater in elderly than young adults especially during the motor-cognitive task. The beta-band (15-32 Hz) corticomuscular coherence was higher in elderly than young adults across unilateral motor and dual tasks. In addition, beta-band corticomuscular coherence in the motor-cognitive task was negatively correlated with motor output error across young but not elderly adults. The results suggest that 1) corticomuscular coherence was increased in senior age with a greater influence of an additional cognitive task in the alpha-band and 2) individuals with greater beta-band corticomuscular coherence may exhibit more accurate motor output in young, but not elderly adults, during steady contraction with visual feedback.

Transient and state modulation of beta power in human subthalamic nucleus during speech production and finger movement

Signs of Parkinson's disease (PD) are augmented by speech and repetitive motor tasks. The neurophysiological basis for this phenomenon is unknown, but may involve augmentation of β (13–30 Hz) oscillations within the subthalamic nucleus (STN). We hypothesized that speech and motor tasks increase β power in STN and propose a mechanism for clinical observations of worsening motor state during such behaviors. Subjects undergoing deep brain stimulation (DBS) surgery performed tasks while STN local field potential (LFP) data were collected. Power in the β frequency range was analyzed across the entire recording to observe slow shifts related to block design and during time epochs synchronized to behavior to evaluate immediate fluctuations related to task execution. Bilaterally symmetric β event related desynchronization was observed in analysis time-locked to subject motor and speech tasks. We also observed slow shifts of β power associated with blocks of tasks. Repetitive combined speech and motor, and isolated motor blocks were associated with the highest bilateral β power state. Overt speech alone and imagined speech were associated with a low bilateral β power state. Thus, changing behavioral tasks is associated with bilateral switching of β power states. This offers a potential neurophysiologic correlate of worsened PD motor signs experienced during clinical examination with provocative tasks: switching into a high β power state may be responsible for worsening motor states in PD patients when performing unilateral repetitive motor tasks and combined speech and motor tasks. Beta state changes could be chronically measured and potentially used to control closed loop neuromodulatory devices in the future.

Attenuation of corticomuscular coherence with additional motor or non-motor task

Objective The study aimed to compare beta (15–30 Hz) band corticomuscular coherence between a unilateral hand motor task and concurrent motor or non-motor tasks. Additionally, we examined the potential associations between corticomuscular coherence and fine motor performance. Methods Ten healthy young right-handed adults performed unilateral, bilateral, concurrent motor–cognitive, and cognitive tasks. Electroencephalogram and electromyogram were recorded from the primary motor cortex and the first dorsal interosseous muscle, respectively, during steady contractions. Results Corticomuscular beta band coherence decreased ( P < 0.05) from the unilateral motor task with the right hand to the same extent in both the bilateral motor and motor–cognitive tasks. A decrease in corticomuscular coherence with concurrent tasks was also observed for the left hand ( P < 0.05). Beta band coherence was not associated with motor output steadiness or accuracy. Conclusions Beta band coherence decreased during concurrent tasks irrespective of the additional task, most likely due to divided attention. There was no association between beta band coherence and fine motor performance during steady contractions. Significance This study supports that attention divided by an additional motor or non-motor task influences beta band corticomuscular coherence that was not associated with fine motor performance. The results suggest clinical relevance to identify what might occur in clinical distracter tasks.

Function lateralization via measuring coherence laterality

A data-driven approach for lateralization of brain function based on the spatial coherence difference of functional MRI (fMRI) data in homologous regions-of-interest (ROI) in each hemisphere is proposed. The utility of using coherence laterality (CL) to determine function laterality was assessed first by examining motor laterality using normal subjects' data acquired both at rest and with a simple unilateral motor task and subsequently by examining mesial temporal lobe memory laterality in normal subjects and patients with temporal lobe epilepsy. The motor task was used to demonstrate that CL within motor ROI correctly lateralized functional stimulation. In patients with unilateral epilepsy studied during a scene-encoding task, CL in a hippocampus–parahippocampus–fusiform (HPF) ROI was concordant with lateralization based on task activation, and the CL index (CLI) significantly differentiated the right side group to the left side group. By contrast, normal controls showed a symmetric HPF CLI distribution. Additionally, similar memory laterality prediction results were still observed using CL in epilepsy patients with unilateral seizures after the memory encoding effect was removed from the data, suggesting the potential for lateralization of pathological brain function based on resting fMRI data. A better lateralization was further achieved via a combination of the proposed approach and the standard activation based approach, demonstrating that assessment of spatial coherence changes provides a complementary approach to quantifying task-correlated activity for lateralizing brain function.

Putamen coactivation during motor task execution

Models of corticostriatal motor circuitry have focused on the role of the circuit in the hemisphere of the motor cortex providing primary control (contralateral to the movement). We used functional magnetic resonance imaging and functional connectivity analyses to study circuit function in both the controlling and noncontrolling hemispheres. During the completion of a unilateral motor task with either hand, each putamen nucleus demonstrated strong coactivation with structures in both hemispheres. The putamen in the noncontrolling hemisphere (ipsilateral to the movement) coactivated more strongly with the controlling motor cortex than with the noncontrolling cortex. These findings suggest that the two corticostriatal circuits are functionally integrated. New circuit models based on functional connectivity may need to be developed.

Comparison of unilateral and bilateral complex finger tapping‐related activation in premotor and primary motor cortex

Sixteen healthy right-handed subjects performed a complex finger-tapping task that broadly activates the motor and premotor regions, including primary motor (M1), ventral premotor (PMv), and dorsal premotor (PMd) cortex. This task was performed with the right hand only, left hand only and both hands simultaneously. Behavioral performance and the possibility of mirror movements were controlled through the use of MRI-compatible gloves to monitor finger movements. Using spatially normalized ROIs from the Human Motor Area Template (HMAT), comparisons were made of the spatial extent and location of activation in the left and right motor regions between all three tasks. During unilateral right and left hand tapping, ipsilateral precentral gyrus activation occurred in all subjects, mainly in the PMv and PMd. Ipsilateral M1 activation was less consistent and shifted anteriorly within M1, towards the border of M1 and premotor cortex. Regions of ipsilateral activation were also activated during contralateral and bilateral tasks. Overall, 83%/70%/58% of the ipsilaterally activated voxels in M1/PMd/PMv were also activated during contralateral and bilateral tapping. The mean percent signal change of spatially overlapping activated voxels was similar in PMv and PMd between all three tasks. However, the mean percent signal change of spatially overlapping M1 activation was significantly less during ipsilateral tapping compared with contra- or bilateral tapping. Results suggest that the ipsilateral fMRI activation in unilateral motor tasks may not be inhibitory in nature, but rather may reflect part of a bilateral network involved in the planning and/or execution of tapping in the ipsilateral hand.

Combining fMRI and DTI: A framework for exploring the limits of fMRI-guided DTI fiber tracking and for verifying DTI-based fiber tractography results

A powerful, non-invasive technique for estimating and visualizing white matter tracts in the human brain in vivo is white matter fiber tractography that uses magnetic resonance diffusion tensor imaging. The success of this method depends strongly on the capability of the applied tracking algorithm and the quality of the underlying data set. However, DTI-based fiber tractography still lacks standardized validation. In the present work, a combined fMRI/DTI study was performed, both to develop a setup for verifying fiber tracking results using fMRI-derived functional connections and to explore the limitations of fMRI based DTI fiber tracking. Therefore, a minor fiber bundle that features several fiber crossings and intersections was examined: The striatum and its connections to the primary motor cortex were examined by using two approaches to derive the somatotopic organization of the striatum. First, an fMRI-based somatotopic map of the striatum was reconstructed, based on fMRI activations that were provoked by unilateral motor tasks. Second, fMRI-guided DTI fiber tracking was performed to generate DTI-based somatotopic maps, using a standard line propagation and an advanced fast marching algorithm. The results show that the fiber connections reconstructed by the advanced fast marching algorithm are in good agreement with known anatomy, and that the DTI-revealed somatotopy is similar to the fMRI somatotopy. Furthermore, the study illustrates that the combination of fMRI with DTI can supply additional information in order to choose reasonable seed regions for generating functionally relevant networks and to validate reconstructed fibers.

Brain activity during a motor learning task: An fMRI and skin conductance study

Measuring electrodermal activity (EDA) during fMRI is an effective means of studying the influence of task-related arousal, inferred from autonomic nervous system activity, on brain activation patterns. The goals of this study were: (1) to measure reliable EDA from healthy individuals during fMRI involving an effortful unilateral motor task, (2) to explore how EDA recordings can be used to augment fMRI data analysis. In addition to conventional hemodynamic modeling, skin conductance time series data were used as model waveforms to generate activation images from fMRI data. Activations from the EDA model produced significantly different brain regions from those obtained with a standard hemodynamic model, primarily in the insula and cingulate cortices. Onsets of the EDA changes were synchronous with the hemodynamic model, but EDA data showed additional transient features, such as a decrease in amplitude with time, and helped to provide behavioral evidence suggesting task difficulty decreased with movement repetition. Univariate statistics also confirmed that several brain regions showed early versus late session effects. Partial least squares (PLS) multivariate analysis of EDA and fMRI data provided complimentary, additional insight on how the motor network varied over the course of a single fMRI session. Brain regions identified in this manner included the insula, cingulate gyrus, pre- and postcentral gyri, putamen and parietal cortices. These results suggest that recording EDA during motor fMRI experiments provides complementary information that can be used to improve the fMRI analysis, particularly when behavioral or task effects are difficult to model a priori.

Exhaustive stretch‐shortening cycle exercise: no contralateral effects on muscle activity in maximal motor performances

Minor cross-over effects of unilateral muscle fatigue have been reported after isometric exercises. The present study re-examined this possibility after an exhaustive stretch-shortening cycle (SSC)-type exercise. Twenty-five subjects performed on a sledge apparatus a unilateral exhaustive rebound exercise involving mostly the triceps surae muscle group. Ipsilateral vs contralateral fatigue effects were compared in uni- and bilateral tests that included a maximal isometric voluntary contraction (MVC) and a series of 10 maximal drop jumps (DJ). These tests were carried out just before and after (POST) the exhaustive SSC exercise, and were repeated 2 days later (D2), at the expected time of major inflammation and pain. The exercised (fatigued) leg analysis revealed significant declines in MVC and DJ performances at POST and D2, the latter ones being associated with significant decreases in voluntary muscle activity. In contrast, no significant change was found for the non-fatigued leg. These results do not support the existence of cross-over effects after exhaustive SSC exercise, at least when tested in maximal static and dynamic unilateral motor tasks.

Recruitment of the Sensorimotor Cortex - A Developmental fMRI Study

The growing mastery of motor tasks is one of the most visible changes in the developing child. The cortex is known to play a central role in learning, planning, and performance of motor tasks. We investigated the age dependency of motor cortex activation using functional magnetic resonance imaging (fMRI). Thirty-two right-handed subjects were studied: 11 children (median age 9 years, range 6 - 10 years), 10 adolescents (median age 13 years, range 11 - 15 years), and 11 adults (median age 27 years, range 23 - 42 years). The subjects performed a simple, paced unilateral motor task (repetitive squeezing of a ball with the right hand). Also, we set up a control experiment (visual stimulation using an alternating checkerboard pattern) in which no age-related differences were expected. Compared to children, adults showed significantly increased activation of the bilateral sensorimotor cortex, parietal areas, the supplementary motor area, and the cerebellum. In the visual stimulation experiment there were no age-related differences. Children show a significant difference in the degree of cortical activation compared to adults when performing a simple motor task. The change in fMRI activation patterns may reflect a maturation process of primary and secondary motor areas.

Hemodynamic and metabolic responses to activation, deactivation and epileptic discharges

To investigate the coupling between the hemodynamic and metabolic changes following functional brain activation as well as interictal epileptiform discharges (IEDs), blood oxygenation level dependent (BOLD), perfusion and oxygen consumption responses to a unilateral distal motor task and interictal epileptiform discharges (IEDs) were examined via continuous EEG-fMRI. Seven epilepsy patients performed a periodic (1 Hz) right-hand pinch grip using ∼8% of their maximum voluntary contraction, a paradigm previously shown to produce contralateral MI neuronal excitation and ipsilateral MI neuronal inhibition. A multi-slice interleaved pulsed arterial spin labeling and T2*-weighted gradient echo sequence was employed to quantify cerebral blood flow (CBF) and BOLD changes. EEG was recorded throughout the imaging session and reviewed to identify the IEDs. During the motor task, BOLD, CBF and cerebral metabolic rate of oxygen consumption (CMRO2) signals increased in the contra- and decreased in the ipsilateral primary motor cortex. The relative changes in CMRO2 and CBF were linearly related, with a slope of 0.46 ± 0.05. The ratio of contra- to ipsilateral CBF changes was smaller in the present group of epilepsy patients than in the healthy subjects examined previously. IEDs produced both increases and decreases in BOLD and CBF signals. In the two case studies for which the estimation criteria were met, the coupling ratio between IED-induced CMRO2 and CBF changes was estimated at 0.48 ± 0.17. These findings provide evidence for a preserved coupling between hemodynamic and metabolic changes in response to both functional activation and, for the two case studies available, in response to interictal epileptiform activity.