Disrupting somatosensory processing impairs motor execution but not motor imagery.

While motor imagery (MI) is thought to be 'functionally equivalent' with motor execution (ME), the equivalence of feedforward and feedback mechanisms between the two modalities is unexplored. Here, we tested the equivalence of these mechanisms between MI and ME via two experiments designed to probe the role of somatosensory processing (Exp 1), and cognitive processing (Exp 2). All participants were engaged in a previously established force-matching task adapted for MI. A reference force was applied (on scale of 1-10, with higher numbers indicative of greater force) to one index finger while participants matched the force with their opposite index finger via ME or MI (control conditions). Participants then rated the force on the same scale of 1-10. Exp 1: Participants (N = 27) performed the task with tactile stimulation (ME+TAC, MI+TAC) in addition to control conditions. Exp 2: Participants (N = 26) performed the task in dual-task conditions (ME+COG, MI+COG) in addition to control conditions. Results indicate that (Exp 1) tactile stimulation impaired performance in ME but not MI. Dual-task conditions (Exp 2) were not shown to impair performance in either practice modality. Findings suggest that while somatosensory processing is critical for ME, it is not for MI. Overall we indicate a functional equivalence between feedforward/back mechanisms in MI and ME may not exist.

Influence of acute beetroot juice supplementation on cold-induced vasodilation and fingertip rewarming.

PURPOSE: Vasoactive ingredients in beetroot (BR) such as nitrate are known to induce vasodilation in temperate conditions. This study investigated the effect of BR ingestion on cold induced vasodilation (CIVD) and rewarming of finger skin temperature (Tfing) during and after hand immersion in cold water. METHODS: Twenty healthy males (mean ± SD; age 22.2 ± 0.7 years, height 172.6 ± 6.0 cm, body mass 61.3 ± 11.7 kg) repeated a hand cold water immersion test twice with prior BR or water beverage ingestion (randomised order). They rested for 2 h in thermoneutral conditions (27 °C, 40% relative humidity) after consuming the beverage, then immersed their non-dominant hand in 8 °C water for 30 min. They then rewarmed their hand in the ambient air for 20 min. Skin temperature at seven body sites, Tfing, finger skin blood flow (SkBFfing), and blood pressure were measured. RESULTS: During hand immersion parameters of CIVD (Tfing and SkBFfing) were not different between BR and water conditions although skin temperature gradient from proximal to distal body sites was significantly smaller with BR (P < 0.05). During rewarming, SkBFfing and cutaneous vascular conductance were significantly higher with BR than with water (P < 0.05). The rewarming speed in Tfing and SkBFfing was significantly faster with BR at 15- (BR 1.24 ± 0.22 vs water 1.11 ± 0.26 °C/min) and 20-min rewarming (P < 0.05). Additionally, individuals with slower rewarming speed with water demonstrated accelerated rewarming with BR supplementation. CONCLUSION: BR accelerated rewarming in Tfing and SkBFfing after local cold stimulus, whereas, CIVD response during hand cold immersion was not affected by BR ingestion.

Comparison of the on-line effects of different motor simulation conditions on corticospinal excitability in healthy participants.

In healthy participants, corticospinal excitability is known to increase during motor simulations such as motor imagery (MI), action observation (AO) and mirror therapy (MT), suggesting their interest to promote plasticity in neurorehabilitation. Further comparing these methods and investigating their combination may potentially provide clues to optimize their use in patients. To this end, we compared in 18 healthy participants abductor pollicis brevis (APB) corticospinal excitability during MI, AO or MT, as well as MI combined with either AO or MT. In each condition, 15 motor-evoked potentials (MEPs) and three maximal M-wave were elicited in the right APB. Compared to the control condition, mean normalized MEP amplitude (i.e. MEP/M) increased during MI (P = .003), MT (P < .001) and MT + MI (P < .001), without any difference between the three conditions. No MEP modulation was evidenced during AO or AO + MI. Because MI provided no additional influence when combined with AO or MT, our results may suggest that, in healthy subjects, visual feedback and unilateral movement with a mirror may provide the greatest effects among all the tested motor simulations.

Fingertip Whole Blood as an Indicator of Omega-3 Long-Chain Polyunsaturated Fatty Acid Changes during Dose-Response Supplementation in Women: Comparison with Plasma and Erythrocyte Fatty Acids.

The sensitivity of fingertip whole blood to reflect habitual dietary and dose-dependent supplemental omega-3 long-chain polyunsaturated fatty acid (n-3 LCPUFA) intake in premenopausal women was compared to that of venous erythrocytes and plasma fatty acids. Samples were obtained from women in a randomised, double-blind, placebo-controlled trial in which premenopausal women (n = 53) were supplemented with DHA-rich tuna oil capsules and/or placebo (Sunola oil) capsules (6 capsules per day) for 8 weeks to achieve doses of either 0, 0.35, 0.7 or 1.05 g/day n-3 LCPUFA. All blood biomarkers were very similar in their ability to reflect dietary n-3 LCPUFA intake (r = 0.38-0.46 for EPA and DHA intake), and in their dose-dependent increases in n-3 LCPUFA levels after supplementation (R2 = 0.41-0.51 for dose effect on biomarker EPA and DHA levels (mol %)). Fingertip whole blood is an effective alternative to erythrocytes and plasma as a biomarker n-3 LCPUFA intake in premenopausal women.

Differential neural plasticity of individual fingers revealed by fMRI neurofeedback.

Previous work has shown that functional magnetic resonance imaging (fMRI) activity patterns associated with individual fingers can be shifted by temporary impairment of the hand. Here, we investigated whether these neural activity patterns could be modulated endogenously and whether any behavioral changes result from this modulation. We used decoded neurofeedback in healthy individuals to encourage participants to shift the neural activity pattern in sensorimotor cortex of the middle finger toward the index finger, and the ring finger toward the little finger. We first mapped the neural activity patterns for all fingers of the right hand in an fMRI pattern localizer session. Then, in three subsequent neurofeedback sessions, participants were rewarded after middle/ring finger presses according to their activity pattern overlap during each trial. A force-sensitive keyboard was used to ensure that participants were not altering their physical finger coordination patterns. We found evidence that participants could learn to shift the activity pattern of the ring finger but not of the middle finger. Increased variability of these activity patterns during the localizer session was associated with the ability of participants to modulate them using neurofeedback. Participants also showed an increased preference for the ring finger but not for the middle finger in a postneurofeedback motor task. Our results show that neural activity and behaviors associated with the ring finger are more readily modulated than those associated with the middle finger. These results have broader implications for rehabilitation of individual finger movements, which may be limited or enhanced by individual finger plasticity after neurological injury.NEW & NOTEWORTHY It may be possible to remobilize fingers after neurological injury by altering neural activity patterns. Toward this end, we examined whether finger-related neural activity patterns could be modified in healthy individuals without physical intervention, using fMRI neurofeedback. Our findings show that greater variability of neural patterns at baseline predicted a participant's ability to successfully shift these patterns. Because neural variability is common in individuals poststroke, this illustrates a potential clinical benefit of this procedure.

Cognitive processes and a centre-of-pressure error-based moving light-touch biofeedback.

Lightly touching an earth-fixed external surface with the forefinger provides somatosensory information that reduces the center of pressure (CoP) oscillations. If this surface were to move slowly, the central nervous system (CNS) would misinterpret its movement as body self-motion, and involuntary compensatory sway responses would appear, resulting in a significant coupling between finger and CoP motions. We designed a forefinger moving light-touch biofeedback based on this finding, which controls the surface velocity to drive the CoP towards a target position. Here, we investigate this biofeedback resistance to cognitive processes. In addition to a baseline, the experimental protocol includes four main conditions. In the first, participants were utterly naive about the feedback. Then, they received additional reliable sensory information. The third condition ensured their full awareness of the external nature of the surface motion. Finally, the experimenter notified them that the external motion drives their balance and asked them to reject its influence. Our investigation shows that despite the robustness of the proposed biofeedback, light-touch remains penetrable by cognitive processes. For participants to dramatically reduce the existing coupling between the finger and CoP motions, they should be aware of the external motion, how it impacts sway, and actively reject its influence. The main implication of our findings is that light-touch exhibits the same cognitive flexibility as vision when artificially stimulated. This could be interpreted as a defense mechanism to re-weight these two sensory inputs in a moving environment.

Towards a common template for neural reinforcement of finger individuation.

The inability to individuate finger movements is a common impairment following stroke. Conventional physical therapy ignores underlying neural changes with recovery, leaving it unclear why sensorimotor function often remains impaired. Functional MRI neurofeedback can monitor neural activity and reinforce it towards a healthy template to restore function. However, identifying an individualized training template may not be possible depending on the severity of impairment. In this study, we investigated the use of functional alignment of brain data across healthy participants to create an idealized neural template to be used as a training target for new participants. We employed multi-voxel pattern analyses to assess the prediction accuracy and robustness to missing data of pre-trained functional templates corresponding to individual finger presses. We found a significant improvement in classification accuracy (p < 0.001) of individual finger presses when group data was aligned based on function (88%) rather than anatomy (46%). Importantly, we found no significant drop in performance when aligning a new participant to a pre-established template as compared to including this new participant in the creation of a new template. These results indicate that functionally aligned templates could provide an effective surrogate training target for patients following neurological injury.

Biocultural evidence of precise manual activities in an Early Holocene individual of the high-altitude Peruvian Andes.

OBJECTIVES: Cuncaicha, a rockshelter site in the southern Peruvian Andes, has yielded archaeological evidence for human occupation at high elevation (4,480 masl) during the Terminal Pleistocene (12,500-11,200 cal BP), Early Holocene (9,500-9,000 cal BP), and later periods. One of the excavated human burials (Feature 15-06), corresponding to a middle-aged female dated to ~8,500 cal BP, exhibits skeletal osteoarthritic lesions previously proposed to reflect habitual loading and specialized crafting labor. Three small tools found in association with this burial are hypothesized to be associated with precise manual dexterity. MATERIALS AND METHODS: Here, we tested this functional hypothesis through the application of a novel multivariate methodology for the three-dimensional analysis of muscle attachment surfaces (entheses). This original approach has been recently validated on both lifelong-documented anthropological samples as well as experimental studies in nonhuman laboratory samples. Additionally, we analyzed the three-dimensional entheseal shape and resulting moment arms for muscle opponens pollicis. RESULTS: Results show that Cuncaicha individual 15-06 shows a distinctive entheseal pattern associated with habitual precision grasping via thumb-index finger coordination, which is shared exclusively with documented long-term precision workers from recent historical collections. The separate geometric morphometric analysis revealed that the individual's opponens pollicis enthesis presents a highly projecting morphology, which was found to strongly correlate with long joint moment arms (a fundamental component of force-producing capacity), closely resembling the form of Paleolithic hunter-gatherers from diverse geo-chronological contexts of Eurasia and North Africa. DISCUSSION: Overall, our findings provide the first biocultural evidence to confirm that the lifestyle of some of the earliest Andean inhabitants relied on habitual and forceful precision grasping tasks.

Development and evaluation of a novel music-based therapeutic device for upper extremity movement training: A pre-clinical, single-arm trial.

Restoration of upper limb motor function and patient functional independence are crucial treatment targets in neurological rehabilitation. Growing evidence indicates that music-based intervention is a promising therapeutic approach for the restoration of upper extremity functional abilities in neurologic conditions such as cerebral palsy, stroke, and Parkinson's Disease. In this context, music technology may be particularly useful to increase the availability and accessibility of music-based therapy and assist therapists in the implementation and assessment of targeted therapeutic goals. In the present study, we conducted a pre-clinical, single-arm trial to evaluate a novel music-based therapeutic device (SONATA) for upper limb extremity movement training. The device consists of a graphical user interface generated by a single-board computer displayed on a 32" touchscreen with built-in speakers controlled wirelessly by a computer tablet. The system includes two operational modes that allow users to play musical melodies on a virtual keyboard or draw figures/shapes whereby every action input results in controllable sensory feedback. Four motor tasks involving hand/finger movement were performed with 21 healthy individuals (13 males, aged 26.4 ± 3.5 years) to evaluate the device's operational modes and main features. The results of the functional tests suggest that the device is a reliable system to present pre-defined sequences of audiovisual stimuli and shapes and to record response and movement data. This preliminary study also suggests that the device is feasible and adequate for use with healthy individuals. These findings open new avenues for future clinical research to further investigate the feasibility and usability of the SONATA as a tool for upper extremity motor function training in neurological rehabilitation. Directions for future clinical research are discussed.

Bimanual but not unimanual finger movements are triggered by a startling acoustic stimulus: evidence for increased reticulospinal drive for bimanual responses.

The relative contributions of reticulospinal versus corticospinal pathways for movement production are thought to be dependent on the type of response involved. For example, unilateral distal movements involving the hand and finger have been thought to be primarily driven by corticospinal output, whereas bilateral responses are considered to have greater reticulospinal drive. The current study investigated whether a difference in the relative contribution of reticulospinal drive to a bimanual versus unimanual finger movement could be assessed using a StartReact protocol. The StartReact effect refers to the early and involuntary initiation of a prepared movement when a startle reflex is elicited. A decreased response latency on loud stimulus trials where a startle reflex is observed in sternocleidomastoid (SCM+ trials) confirms the StartReact effect, which is attributed to increased reticulospinal drive associated with engagement of the startle reflex circuitry. It was predicted that a StartReact effect would be absent for the predominantly corticospinal-mediated unimanual finger movement but present for the bimanual finger movement due to stronger reticulospinal drive. Results supported both predictions as reaction time was statistically equivalent for SCM+ and SCM- trials during unimanual finger movements but significantly shorter for SCM+ trials during bimanual finger movements. These results were taken as strong and novel evidence for increased reticulospinal output for bimanual finger movements.NEW & NOTEWORTHY The relative contributions of reticulospinal and corticospinal pathways to movement initiation are relatively unknown but appear to depend on the involved musculature. Here, we show that unimanual finger movements, which are predominantly initiated via corticospinal pathways, are not triggered at short latency by a startling acoustic stimulus (SAS), while bimanual finger movements are triggered by the SAS. This distinction is attributed to increased reticulospinal drive for bilateral responses.

Effect of Calcium-Channel Blockade on the Cold-Induced Vasodilation Response.

INTRODUCTION: Cold-induced vasodilation (CIVD) is seen in the extremities during exposure to cold. A strong vasodilation response has been associated with a decreased risk of cold injury. Increasing CIVD might further decrease this risk. The calcium-channel blocker nifedipine causes vasodilation and is used to treat Raynaud's syndrome and chilblains. Nifedipine is also used for high altitude pulmonary edema and could potentially serve a dual purpose in preventing frostbite. The effects of nifedipine on CIVD have not been studied. METHODS: A double-blind crossover study comparing nifedipine (30 mg SR (sustained release) orally twice daily) to placebo was designed using 2 sessions of 4 finger immersion in 5°C water, with 24 h of medication pretreatment before each session. Finger temperatures were measured via nailbed thermocouples. The primary outcome was mean finger temperature; secondary outcomes were mean apex and nadir temperatures, first apex and nadir temperatures, subjective pain ranking, and time of vasodilation onset (all presented as mean±SD). RESULTS: Twelve volunteers (age 29±3 [24-34] y) completed the study. No significant difference in finger temperature (9.2±1.1°C nifedipine vs 9.0±0.7°C placebo, P=0.38) or any secondary outcome was found. Pain levels were similar (2.8±1.6 nifedipine vs 3.0±1.5 placebo, P=0.32). The most common adverse event was headache (32% of nifedipine trials vs 8% placebo). CONCLUSIONS: Pretreatment with 30 mg of oral nifedipine twice daily does not affect the CIVD response in healthy individuals under cold stress.

Agent-dependent modulation of corticospinal excitability during painful transcutaneous electrical stimulation.

Pain has an inhibitory effect on the corticospinal excitability that has been interpreted as an evolutionary mechanism, directed to down-regulate cortical activity in order to facilitate rapid protective spinal reflexes. Here, we focused on the link between defensive mechanisms and motor system and we asked whether voluntary actions can modulate the corticospinal excitability during painful stimulations. To this aim, we manipulated the volition-related aspects of our paradigm by comparing conditions in which either the participant (self-generated action) or the experimenter (other-generated action) pressed the button to deliver painful high-intensity transcutaneous electric shocks to the right digit V. MEPs to TMS were recorded from the FDI and APB muscles of the stimulated hand. A compelling agent-dependent modulation of the corticospinal excitability was found, showing, in self-generated compared to other-generated actions, a significantly lower inhibitory effect, as measured by greater MEP amplitude. This finding suggests a top-down modulation of volitional actions on defensive mechanisms, promoting the view that predictive information from the motor system attenuates the responses to the foreseeable adverse events generated by one's own actions as compared to unpredictable events generated by someone else's actions.

The Rhythmic Finger Focus Hypnotic Technique: Multilevel Application of Ericksonian Utilization.

This paper presents a hypnotic technique that starts with a suggested focus on one's fingertips, and movement of the hands in a self-determined rhythm. The technique involves the use of the utilization principle of Milton Erickson in multiple ways. This includes utilizing psychomotor agitation characteristic of psychophysiological arousal, directing it toward movement that generates the sensations upon which to focus. It utilizes the sensitivity of the fingertips, the high degree of representation of the hands in the somatosensory cortex, and the tendency of the brain to orient to novelty to help facilitate focused absorption. It generates counter stimulation for pain management, and emotionally self- soothing tactile sensations. The technique is further designed to activate and utilize prior sensorimotor learning and sensory experiences associated with the hands to access feelings of mastery, creativity, flow, self-efficacy, and other positive emotional experiences. It is hypothesized that multisystem coherence is generated through activating prior positive motor, behavioral and affective experiential learning. It is further hypothesized that the rhythmic movement and sensory input simultaneously generated by and processed in the right and left hemispheres, entrains the hemispheres toward greater sympathetic/parasympathetic balance.

Auditory-induced body distortions in children and adults.

Recent studies have shown that body-representations can be altered by dynamic changes in sound. In the so-called "auditory Pinocchio illusion" participants feel their finger to be longer when the action of pulling their finger is paired with a rising pitch. Here, we investigated whether preschool children - an age group in which multisensory body-representations are still fine-tuning - are also sensitive to this illusion. In two studies, sixty adult and sixty child participants heard sounds rising or falling in pitch while the experimenter concurrently pulled or pressed their index finger on a vertical (Experiment 1) or horizontal axis (Experiment 2). Results showed that the illusion was subjected to axis and age: both adults and children reported their finger to be longer in Experiment 1, but not in Experiment 2. However, while in adults the feeling of finger elongation corresponded to a recalibration of the fingertip's felt position upwards, this was not the case in children, who presented a dissociation between the feeling of finger elongation and the perceived fingertip position. Our results reveal that the 'auditory Pinocchio illusion' is constrained to the vertical dimension and suggest that multisensory interactions differently contribute to subjective feelings and sense of position depending on developmental stage.

Object Shape and Surface Topology Recognition Using Tactile Feedback Evoked through Transcutaneous Nerve Stimulation.

Tactile feedback is critical for distinguishing different object properties. In this article, we determined if tactile feedback evoked by transcutaneous nerve stimulation can be used to detect objects of different shape and surface topology. To evoke tactile sensation at different fingers, a 2x8 electrode grid was placed along the subject's upper arm, and two concurrent electrical stimulation trains targeted the median and ulnar nerve bundles, which evoked individually modulated sensations at different fingers. Fingertip forces of the prosthetic hand were transformed to stimulation current amplitude. Object shape was encoded based on finger-object contact timing. Surface topology represented by ridge height and spacing was encoded through current amplitude and stimulation time interval, respectively. The elicited sensation allowed subjects to determine object shape with success rates >84%. Surface topology recognition resulted in success rates >81%. Our findings suggest that tactile feedback evoked from transcutaneous nerve stimulation allows the recognition of object shape and surface topology. The ability to recognize these properties may help improve object manipulation and promote fine control of a prosthetic hand.

Deep grey matter involvement and altered sensory gating in multiple sclerosis.

BACKGROUND: Somatosensory temporal discrimination threshold (STDT) is altered in multiple sclerosis (MS). In healthy subjects (HS), voluntary movement modulates the STDT through mechanisms of subcortical sensory gating. OBJECTIVE: With neurophysiological and magnetic resonance imaging (MRI) techniques, we investigated sensory gating and sensorimotor integration in MS. METHODS: We recruited 38 relapsing-remitting multiple sclerosis (RR-MS) patients with no-to-mild disability and 33 HS. We tested STDT at rest and during index finger abductions and recorded the movement kinematics. Participants underwent a 3T MRI protocol. RESULTS: Patients exhibited higher STDT values and performed slower finger movements than HS. During voluntary movement, STDT values increased in both groups, albeit to a lesser extent in patients, while the mean angular velocity of finger movements decreased in patients alone. Patients had a smaller volume of the thalamus, pallidum and caudate nucleus, and displayed higher mean diffusivity in the putamen, pallidum and thalamus. STDT correlated with thalamic volume while mean angular velocity correlated with putaminal volume. Changes in mean angular velocity during sensorimotor integration inversely correlated with mean diffusivity in the thalamus and pallidum. Changes in STDT and velocity were associated with fatigue score. CONCLUSION: Altered STDT and sensorimotor integration are related to structural damage in the thalamus and basal ganglia in MS and likely to affect motor performance.

The effects of visual distractors on cognitive load in a motor imagery brain-computer interface.

A brain-computer interface (BCI) is a system that translates neural activity into a practical output. Its functionality, therefore, depends not only on the computer itself, but also on the cognitive system of the user. Distractors have the potential to capture attention, increase cognitive load, and may therefore impact BCI use. The purpose of the current study is to determine the effects of small visual distractors on the cognitive load of users of a motor imagery-BCI, and to examine whether these distractor-mediated effects can be improved by modifying the task interface. Sixteen typically-developed participants completed two sessions of online motor imagery to control an EEG-BCI, under conditions of no distractors, visual distractors, and cognitive strategies (intended to mitigate cognitive load) amid distractors. Cognitive load for each session was assessed through both a ratio of theta to alpha power and the NASA-Task Load Index (NASA-TLX). Task-irrelevant visual stimuli were found to significantly increase the objective measure of cognitive load, particularly for parietal channels. Subjective cognitive load as indexed by the NASA-TLX was predictive of a decrease in BCI performance for participants with below 0.75 classification accuracy (R2 = 0.32, p < 0.001), which may indicate a differential susceptibility to changes in workload for "low"-performing participants. Quantifying and addressing the increased cognitive load imparted by distractors on BCI users can aid in the future applicability of the technology in real-world settings.

Differential contributions of the two human cerebral hemispheres to action timing.

Rhythmic actions benefit from synchronization with external events. Auditory-paced finger tapping studies indicate the two cerebral hemispheres preferentially control different rhythms. It is unclear whether left-lateralized processing of faster rhythms and right-lateralized processing of slower rhythms bases upon hemispheric timing differences that arise in the motor or sensory system or whether asymmetry results from lateralized sensorimotor interactions. We measured fMRI and MEG during symmetric finger tapping, in which fast tapping was defined as auditory-motor synchronization at 2.5 Hz. Slow tapping corresponded to tapping to every fourth auditory beat (0.625 Hz). We demonstrate that the left auditory cortex preferentially represents the relative fast rhythm in an amplitude modulation of low beta oscillations while the right auditory cortex additionally represents the internally generated slower rhythm. We show coupling of auditory-motor beta oscillations supports building a metric structure. Our findings reveal a strong contribution of sensory cortices to hemispheric specialization in action control.

Multichannel Nerve Stimulation for Diverse Activation of Finger Flexors.

OBJECTIVE: Neuromuscular electrical stimulation (NMES) is a common approach to restore muscle strength of individuals with a neurological injury but restoring hand dexterity is still a challenge. This study sought to quantify the diversity of finger movements elicited by a multichannel nerve stimulation technique. METHODS: A 2 × 8 stimulation grid, placed on the upper arm along the ulnar and median nerves, was used to activate different finger flexors by automatically switching between randomized bipolar electrodes. The forces from each individual finger as well as the high-density electromyogram (HDEMG) of the intrinsic and extrinsic flexors were recorded. The elicited finger forces were categorized using hierarchical clustering, and the 2D correlation of the spatial patterns of muscle activation was also calculated. RESULTS: A wide range of movement patterns were identified, including multi-finger and single-digit movements. Additionally, a number of electrode pairs elicited similar finger movements. The muscle activation patterns showed similar and distinct spatial patterns, signifying activation redundancy. CONCLUSION: These results revealed the diversity of elicitable finger movements and muscle activations. The system redundancy can be explored to compensate for system instability due to fatigue or electrode shift. The outcomes can also enable the development of an automatic calibration of the stimulation.

Elicited Finger and Wrist Extension Through Transcutaneous Radial Nerve Stimulation.

Individuals with neurological disorders, such as stroke or spinal cord injury, often have weakness and/or spasticity in their hand and wrist muscles, which can lead to impaired ability to extend their fingers and wrists. Functional electrical stimulation can help to restore these motor functions. However, the conventional stimulation method can lead to fast muscle fatigue and limited movements due to a non-physiological recruitment of motor units and a limited recruitment of deep muscles. In this paper, we investigated the feasibility of eliciting various hand opening and wrist extension movement patterns through a transcutaneous electrical stimulation array, which targeted the proximal segment of the radial nerve bundle proximal to the elbow. The wrist and finger joint kinematics were used to classify the different movement patterns through a cluster analysis, and electromyogram signals from the wrist and finger extensors were recorded to investigate the muscle activation patterns. The results showed that the finger and wrist motions can be elicited both independently and in a coordinated manner, by changing the stimulation intensity and stimulation location. H-reflex activity was also observed, which demonstrated the potential of recruiting motor units in a physiological order. Our approach could be further developed into a rehabilitative/assistive tool for individuals with impaired hand opening and/or wrist extension.