Comparison of uni- and multimodal motion stimulation on visual neglect: A proof-of-concept study.

Spatial neglect is characterized by the failure to attend stimuli presented in the contralesional space. Typically, the visual modality is more severely impaired than the auditory one. This dissociation offers the possibility of cross-modal interactions, whereby auditory stimuli may have beneficial effects on the visual modality. A new auditory motion stimulation method with music dynamically moving from the right to the left hemispace has recently been shown to improve visual neglect. The aim of the present study was twofold: a) to compare the effects of unimodal auditory against visual motion stimulation, i.e., smooth pursuit training, which is an established therapeutical approach in neglect therapy and b) to explore whether a combination of auditory + visual motion stimulation, i.e., multimodal motion stimulation, would be more effective than unimodal auditory or visual motion stimulation. 28 patients with left-sided neglect due to a first-ever, right-hemispheric subacute stroke were included. Patients either received auditory, visual, or multimodal motion stimulation. The between-group effect of each motion stimulation condition as well as a control group without motion stimulation was investigated by means of a one-way ANOVA with the patient's visual exploration behaviour as an outcome variable. Our results showed that unimodal auditory motion stimulation is equally effective as unimodal visual motion stimulation: both interventions significantly improved neglect compared to the control group. Multimodal motion stimulation also significantly improved neglect, however, did not show greater improvement than unimodal auditory or visual motion stimulation alone. Besides the established visual motion stimulation, this proof-of-concept study suggests that auditory motion stimulation seems to be an alternative promising therapeutic approach to improve visual attention in neglect patients. Multimodal motion stimulation does not lead to any additional therapeutic gain. In neurorehabilitation, the implementation of either auditory or visual motion stimulation seems therefore reasonable.

Hemispheric asymmetry of auditory oddball detection: An MEG study.

The capacity of the human brain to detect unattended deviant information from frequent information in our environment shows a hemispheric asymmetry, with stronger brain activation in the right temporal area. This lateralization is distinct from the functional left-ward asymmetry of auditory information processing.

Clinical standardization for the detection of hemispheric dominance for steady-state auditory evoked fields in normal hearing.

BACKGROUND: Steady-state auditory evoked responses (SSAERs) are promising indicators of major auditory function. The improvement in accessibility in the clinical setting depends on the standardization and definition of the characteristics of SSAERs. There have been some insights into the changes in the interhemispheric dominance of SSAERs in some clinical entities. However, the hemispheric asymmetry of SSAERs in healthy controls remains inconclusive. METHODS: Twelve right-handed healthy volunteers with normal hearing were recruited. Steady-state auditory evoked fields (SSAEFs) were measured binaurally using magnetoencephalography (MEG) under pure-tone auditory stimuli at 1000 Hz with an amplitude modulation frequency of 43 Hz. The laterality index, based on the ratio of SSAEF strength over the right hemisphere to that over the left hemisphere, was also analyzed. RESULTS: The SSAEFs source was localized bilaterally on the superior temporal plane, with an orientation centripetal to the auditory cortex. The laterality index ranged from 1.1 to 2.3, and there were no sex differences. In all subjects, the strength of the SSAEFs was significantly weaker in the left hemisphere than in the right hemisphere ( p = 0.014). CONCLUSION: Right-sided dominance of the SSAEFs was verified in subjects with normal hearing. Acoustic sources clinically available in audiometric tests were used as stimuli. Such a simplification of parameters would be helpful for the standardization of precise production and the definition of the characteristics of SSAERs. Because MEG is still not easily accessible clinically, further studies using electroencephalography with larger sample sizes are necessary to address these issues.

Spatially bivariate EEG-neurofeedback can manipulate interhemispheric inhibition.

Human behavior requires inter-regional crosstalk to employ the sensorimotor processes in the brain. Although external neuromodulation techniques have been used to manipulate interhemispheric sensorimotor activity, a central controversy concerns whether this activity can be volitionally controlled. Experimental tools lack the power to up- or down-regulate the state of the targeted hemisphere over a large dynamic range and, therefore, cannot evaluate the possible volitional control of the activity. We addressed this difficulty by using the recently developed method of spatially bivariate electroencephalography (EEG)-neurofeedback to systematically enable the participants to modulate their bilateral sensorimotor activities. Here, we report that participants learn to up- and down-regulate the ipsilateral excitability to the imagined hand while maintaining constant contralateral excitability; this modulates the magnitude of interhemispheric inhibition (IHI) assessed by the paired-pulse transcranial magnetic stimulation (TMS) paradigm. Further physiological analyses revealed that the manipulation capability of IHI magnitude reflected interhemispheric connectivity in EEG and TMS, which was accompanied by intrinsic bilateral cortical oscillatory activities. Our results show an interesting approach for neuromodulation, which might identify new treatment opportunities, e.g., in patients suffering from a stroke.

Mental rotation of hands and objects in ageing and Parkinson's disease: differentiating motor imagery and visuospatial ability.

Motor imagery supports motor learning and performance and has the potential to be a useful strategy for neurorehabilitation. However, motor imagery ability may be impacted by ageing and neurodegeneration, which could limit its therapeutic effectiveness. Motor imagery can be assessed implicitly using a hand laterality task (HLT), whereby laterality judgements are slower for stimuli corresponding to physically more difficult postures, as indicated by a "biomechanical constraint" effect. Performance is also found to differ between back and palm views of the hand, which may differentially recruit visual and sensorimotor processes. Older adults and individuals with Parkinson's disease (PD) have shown altered performance on the HLT; however, the effects of both ageing and PD on laterality judgements for the different hand views (back and palm) have not been directly examined. The present study compared healthy younger, healthy older, and PD groups on the HLT, an object-based mental rotation task, and an explicit motor imagery measure. The older and PD groups were slower than the younger group on the HLT, particularly when judging laterality from the back view, and exhibited increased biomechanical constraint effects for the palm. While response times were generally similar between older and PD groups, the PD group showed reduced accuracy for the back view. Letter rotation was slower and less accurate only in the PD group, while explicit motor imagery ratings did not differ significantly between groups. These results suggest that motor imagery may be slowed but relatively preserved in both typical ageing and neurodegeneration, while a PD-specific impairment in visuospatial processing may influence task performance. The findings have implications for the use of motor imagery in rehabilitation protocols.

Attentional modulations of alpha power are sensitive to the task-relevance of auditory spatial information.

The topographical distribution of oscillatory power in the alpha band is known to vary depending on the current focus of spatial attention. Here, we investigated to what extend univariate and multivariate measures of post-stimulus alpha power are sensitive to the required spatial specificity of a task. To this end, we varied the perceptual load and the spatial demand in an auditory search paradigm. A centrally presented sound at the beginning of each trial indicated the to-be-localized target sound. This spatially unspecific pre-cue was followed by a sound array, containing either two (low perceptual load) or four (high perceptual load) simultaneously presented lateralized sound stimuli. In separate task blocks, participants were instructed either to report whether the target was located on the left or the right side of the sound array (low spatial demand) or to indicate the exact target location (high spatial demand). Univariate alpha lateralization magnitude was neither affected by perceptual load nor by spatial demand. However, an analysis of onset latencies revealed that alpha lateralization emerged earlier in low (vs high) perceptual load trials as well as in low (vs high) spatial demand trials. Finally, we trained a classifier to decode the specific target location based on the multivariate alpha power scalp topography. A comparison of decoding accuracy in the low and high spatial demand conditions suggests that the amount of spatial information present in the scalp distribution of alpha-band power increases as the task demands a higher degree of spatial specificity. Altogether, the results offer new insights into how the dynamic adaption of alpha-band oscillations in response to changing task demands is associated with post-stimulus attentional processing.

Cerebral perfusion mediated by thalamo-cortical functional connectivity in non-dominant thalamus affects naming ability in aphasia.

Naming is a commonly impaired language domain in various types of aphasia. Emerging evidence supports the cortico-subcortical circuitry subserving naming processing, although neurovascular regulation of the non-dominant thalamic and basal ganglia subregions underlying post-stroke naming difficulty remains unclear. Data from 25 subacute stroke patients and 26 age-, sex-, and education-matched healthy volunteers were analyzed. Region-of-interest-wise functional connectivity (FC) was calculated to measure the strength of cortico-subcortical connections. Cerebral blood flow (CBF) was determined to reflect perfusion levels. Correlation and mediation analyses were performed to identify the relationship between cortico-subcortical connectivity, regional cerebral perfusion, and naming performance. We observed increased right-hemispheric subcortical connectivity in patients. FC between the right posterior superior temporal sulcus (pSTS) and lateral/medial prefrontal thalamus (lPFtha/mPFtha) exhibited significantly negative correlations with total naming score. Trend-level increased CBF in subcortical nuclei, including that in the right lPFtha, and significant negative correlations between naming and regional perfusion of the right lPFtha were observed. The relationship between CBF in the right lPFtha and naming was fully mediated by the lPFtha-pSTS connectivity in the non-dominant hemisphere. Our findings suggest that perfusion changes in the right thalamic subregions affect naming performance through thalamo-cortical circuits in post-stroke aphasia. This study highlights the neurovascular pathophysiology of the non-dominant hemisphere and demonstrates thalamic involvement in naming after stroke.

A comparison of directed functional connectivity among fist-related brain activities during movement imagery, movement execution, and movement observation.

Brain-computer interface (BCI) has been widely used in sports training and rehabilitation training. It is primarily based on action simulation, including movement imagery (MI) and movement observation (MO). However, the development of BCI technology is limited due to the challenge of getting an in-depth understanding of brain networks involved in MI, MO, and movement execution (ME). To better understand the brain activity changes and the communications across various brain regions under MO, ME, and MI, this study conducted the fist experiment under MO, ME, and MI. We recorded 64-channel electroencephalography (EEG) from 39 healthy subjects (25 males, 14 females, all right-handed) during fist tasks, obtained intensities and locations of sources using EEG source imaging (ESI), computed source activation modes, and finally investigated the brain networks using spectral Granger causality (GC). The brain regions involved in the three motor conditions are similar, but the degree of participation of each brain region and the network connections among the brain regions are different. MO, ME, and MI did not recruit shared brain connectivity networks. In addition, both source activation modes and brain network connectivity had lateralization advantages.

Neurophysiological modulations in the (pre)motor-motor network underlying age-related increases in reaction time and the role of GABA levels - a bimodal TMS-MRS study.

It has been argued that age-related changes in the neurochemical and neurophysiological properties of the GABAergic system may underlie increases in reaction time (RT) in older adults. However, the role of GABA levels within the sensorimotor cortices (SMC) in mediating interhemispheric interactions (IHi) during the processing stage of a fast motor response, as well as how both properties explain interindividual differences in RT, are not yet fully understood. In this study, edited magnetic resonance spectroscopy (MRS) was combined with dual-site transcranial magnetic stimulation (dsTMS) for probing GABA+ levels in bilateral SMC and task-related neurophysiological modulations in corticospinal excitability (CSE), and primary motor cortex (M1)-M1 and dorsal premotor cortex (PMd)-M1 IHi, respectively. Both CSE and IHi were assessed during the preparatory and premotor period of a delayed choice RT task. Data were collected from 25 young (aged 18-33 years) and 28 older (aged 60-74 years) healthy adults. Our results demonstrated that older as compared to younger adults exhibited a reduced bilateral CSE suppression, as well as a reduced magnitude of long latency M1-M1 and PMd-M1 disinhibition during the preparatory period, irrespective of the direction of the IHi. Importantly, in older adults, the GABA+ levels in bilateral SMC partially accounted for task-related neurophysiological modulations as well as individual differences in RT. In contrast, in young adults, neither task-related neurophysiological modulations, nor individual differences in RT were associated with SMC GABA+ levels. In conclusion, this study contributes to a comprehensive initial understanding of how age-related differences in neurochemical properties and neurophysiological processes are related to increases in RT.

Implicit motor imagery using laterality recognition in functional movement disorders.

Functional movement disorder (FMD) presents as disabling motor symptoms that cannot be explained by organic processes. Despite the lack of lesion or known central nervous system dysfunction, distortion in sensorimotor processing in movement generation and execution is often observed. A person's capacity to judge laterality of a body part requires processing of sensorimotor information. This prospective observational study compared reaction time (RT) and accuracy (ACC) of hand laterality recognition between 30 people diagnosed with FMD and 30 age-matched healthy control participants. The association of RT and ACC with severity of FMD as measured by the Simplified Functional Movement Disorders Rating Scale (SFMDRS) was also explored. RT was on average 0.6 s slower (95% CI 0.4 - 0.8 s, p < 0.001) in patients with FMD (mean 2.2 s, standard deviation (SD) 0.5) than controls (mean 1.7 s, SD 0.3). ACC was on average 8.9% lower (95% CI -15.7 - -2.2, p = 0.01) in patients with FMD (mean 79.6%, SD 16.6) than controls (mean 88.5%, SD 8.1). When adjusted for SFMDRS using robust regression, RT was 0.3 s slower (95% CI 0.01 - 0.5, p = 0.04) in cases than in controls, but ACC was no longer different between groups. There was a moderate negative correlation between RT and ACC in FMD patients (ρ -0.58, p < 0.001 but not in controls (ρ -0.26, p = 0.17). People with FMD had significantly slower RT and lower ACC compared to the control group. These results provide new insights into underlying sensorimotor processing deficits in those with FMD.

Direct Interhemispheric Cortical Communication via Thalamic Commissures: A New White-Matter Pathway in the Rodent Brain.

The corpus callosum (CC), the anterior (AC), and the posterior (PC) commissures are the principal axonal fiber bundle pathways that allow bidirectional communication between the brain hemispheres. Here, we used the Allen mouse brain connectivity atlas and high-resolution diffusion-weighted MRI (DWI) to investigate interhemispheric fiber bundles in C57bl6/J mice, the most commonly used wild-type mouse model in biomedical research. We identified 1) commissural projections from the primary motor area through the AC to the contralateral hemisphere; and 2) intrathalamic interhemispheric fiber bundles from multiple regions in the frontal cortex to the contralateral thalamus. This is the first description of direct interhemispheric corticothalamic connectivity from the orbital cortex. We named these newly identified crossing points thalamic commissures. We also analyzed interhemispheric connectivity in the Balb/c mouse model of dysgenesis of the corpus callosum (CCD). Relative to C57bl6/J, Balb/c presented an atypical and smaller AC and weaker interhemispheric corticothalamic communication. These results redefine our understanding of interhemispheric brain communication. Specifically, they establish the thalamus as a regular hub for interhemispheric connectivity and encourage us to reinterpret brain plasticity in CCD as an altered balance between axonal reinforcement and pruning.

Multiple Visuotopically Organized Subdivisions of the Lateral Pulvinar/Central Lateral Inferior Pulvinar Project into Thin and Thick Stripe Compartments of V2 in Macaques.

The lateral and central lateral inferior pulvinar (PL/PIcl) of primates has been implicated in playing an important role in visual processing, but its physiological and anatomical characteristics remain to be elucidated. It has been suggested that there are two complete visuotopic maps in the PL/PIcl, each of which sends afferents into V2 and V4 in primates. Given that functionally distinct thin and thick stripes of V2 both receive inputs from the PL/PIcl, this raises the possibility of a presence of parallel segregated pathways within the PL/PIcl. To address this question, we selectively injected three types of retrograde tracers (CTB-488, CTB-555, and BDA) into thin or thick stripes in V2 and examined labeling in the PL/PIcl in macaques. As a result, we found that every cluster of retrograde labeling in the PL/PIcl included all three types of signals next to each other, suggesting that thin stripe- and thick stripe-projecting compartments are not segregated into domains. Unexpectedly, we found at least five topographically organized retrograde labeling clusters in the PL/PIcl, indicating the presence of more than two V2-projecting maps. Our results suggest that the PL/PIcl exhibits greater compartmentalization than previously thought. They may be functionally similar but participate in multiple cortico-pulvinar-cortical loops.

GABA levels are differentially associated with bimanual motor performance in older as compared to young adults.

Although gamma aminobutyric acid (GABA) is of particular importance for efficient motor functioning, very little is known about the relationship between regional GABA levels and motor performance. Some studies suggest this relation to be subject to age-related differences even though literature is scarce. To clarify this matter, we employed a comprehensive approach and investigated GABA levels within young and older adults across multiple motor tasks as well as multiple brain regions. Specifically, 30 young and 30 older adults completed a task battery of three different bimanual tasks. Furthermore, GABA levels were obtained within bilateral primary sensorimotor cortex (SM1), bilateral dorsal premotor cortex, the supplementary motor area and bilateral dorsolateral prefrontal cortex (DLPFC) using magnetic resonance spectroscopy. Results indicated that older adults, as compared to their younger counterparts, performed worse on all bimanual tasks and exhibited lower GABA levels in bilateral SM1 only. Moreover, GABA levels across the motor network and DLPFC were differentially associated with performance in young as opposed to older adults on a manual dexterity and bimanual coordination task but not a finger tapping task. Specifically, whereas higher GABA levels related to better manual dexterity within older adults, higher GABA levels predicted poorer bimanual coordination performance in young adults. By determining a task-specific and age-dependent association between GABA levels across the cortical motor network and performance on distinct bimanual tasks, the current study advances insights in the role of GABA for motor performance in the context of aging.

Bilateral difference between lower limbs in children practicing laterally dominant vs. non-laterally dominant sports.

Bilateral asymmetry in lower-limb power and dynamic balance has been associated with increased risk of sport injury, whereas there is a lack of research examining this asymmetry for child athletes. Twenty-eight fencers (19 boys and 9 girls, aged 9.71 ± 1.08 years) and 28 Taekwondo athletes (19 boys and 9 girls, aged 9.71 ± 1.08 years) were examined on the single-leg jump and Star Excursion Balance Test (SEBT) performance. A mixed model design ANOVA (2 [Sex: Boys, Girls] × 2 [Sport group: Fencing, Taekwondo] × 2 [Limb: Dominant, Non-dominant Leg]) was conducted to examine for difference for each test. There was a significant main effect of limb on hop and triple hop distance (p < 0.05). A significant limb by sex interaction (p = 0.000) was shown for the single-leg countermovement jump (CMJ) performance, wherein a bilateral difference was only shown in boys. In SEBT, a main effect (p = 0.007) of limb was identified for posterolateral (PL) reach distance. A limb by sex interaction (p = 0.009) was also shown for posteromedial (PM) reach distance, wherein a bilateral difference was only shown in girls. These findings suggest that child athletes in both laterally dominant and non-laterally dominant sports showed inter-limb asymmetry of leg power and dynamic balance. Sex should be an important consideration when evaluating bilateral difference of leg power and dynamic balance for child athletes.

Age, Sex, Body Mass Index, and Laterality in the Foot Posture of Adolescents: A Cross Sectional Study.

OBJECTIVE: To investigate the relationship between the right and left foot posture in terms of body mass index (BMI), sex, and age in adolescents aged 10 to 14. METHODS: A total of 1400 adolescents were included. For assessment, the Foot Posture Index (FPI-6) was used. Each foot was assessed and ranked as supinated, normal, or pronated by the sum of the FPI-6 criteria. Each criterion was scored on a scale of -2 to +2, with negative for supinated and positive for pronated posture. A linear mixed model with repeated measures was used for statistical analysis. RESULTS: Sex, BMI, and right and left foot are associated with FPI-6. The total score attributed for male sex (ß = 0.29, P = .04) and the left foot (ß = 0.73, P < .001) was higher (male right foot: mean ± standard deviation [SD], 3.09 ± 2.84, male left foot: 3.76 ± 2.80; female right foot: mean ± SD, 2.28 ± 2.61, female left foot: 3.45 ± 2.66; laterality for left foot: mean ± SD, 3.55 ± 2.71, laterality for right foot: mean ± SD, 2.82 ± 2.7). On the other hand, the correlation coefficient for the BMI was negative (ß = -0.08, P = < .001), which means that the higher the BMI the lower the score attributed to the FPI-6. CONCLUSIONS: The FPI-6 is positively related to the male sex and the left foot-that is, the predicted score is higher, so the feet tend to present with a tendency to pronation. Although BMI is associated with FPI-6, it was not possible to establish a relationship between high BMI and pronation of the feet.

Differential contributions of the two cerebral hemispheres to temporal and spectral speech feedback control.

Proper speech production requires auditory speech feedback control. Models of speech production associate this function with the right cerebral hemisphere while the left hemisphere is proposed to host speech motor programs. However, previous studies have investigated only spectral perturbations of the auditory speech feedback. Since auditory perception is known to be lateralized, with right-lateralized analysis of spectral features and left-lateralized processing of temporal features, it is unclear whether the observed right-lateralization of auditory speech feedback processing reflects a preference for speech feedback control or for spectral processing in general. Here we use a behavioral speech adaptation experiment with dichotically presented altered auditory feedback and an analogous fMRI experiment with binaurally presented altered feedback to confirm a right hemisphere preference for spectral feedback control and to reveal a left hemisphere preference for temporal feedback control during speaking. These results indicate that auditory feedback control involves both hemispheres with differential contributions along the spectro-temporal axis.

Telling right from right: the influence of handedness in the mental rotation of hands.

BACKGROUND: This study investigated the impact of handedness on a common spatial abilities task, the mental rotation task (MRT). The influence of a right-handed world was contrasted with people's embodied experience with their own hands by testing both left- and right-handed people on an MRT of right- and left-hand stimuli. An additional consideration is the influence of matching the shape of the hand stimuli with the proprioception of one's own hands. Two orthogonal hypothesis axes were crossed to yield four competing hypotheses. One axis contrasted (i) embodied experience versus (ii) world knowledge; the other axis contrasted (a) the match between the visual image of a hand on the screen and one's own hand versus (b) the resemblance of the shape outline information from the hand stimuli with the proprioception of one's own hands. RESULTS: Among people with mixed handedness, right-handers performed more accurately for left-hand stimuli, while left-handers had a trend for higher accuracy for right-hand stimuli. For people with extreme handedness, right-handers outperformed left-handers. Regardless of group, there was no significant variation in performance for left-hand stimuli, with only right-hand stimuli producing significant variation. CONCLUSIONS: No hypothesis fully aligned with all the data. For left-hand stimuli, the consistent performance across groups does not provide support for embodied experience, while world knowledge might influence all groups similarly. Alternatively, the within-group variation for mixed-handed people supports embodied experience in the hand MRT, likely processed through visual-proprioceptive integration.

The effects of traditional massage on spasticity of children with cerebral palsy: a randomized controlled trial.

OBJECTIVE: To examine the effects of traditional massage on spasticity of children with cerebral palsy. METHODS: The randomised control trial was conducted at the National Institute of Rehabilitation Medicine, Islamabad, Pakistan, from September 2016 to August 2018, and comprised children with spastic cerebral palsy aged 2-10 years who were randomly allocated to control and intervention groups. Both the groups received routine physical therapy once daily, five times a week for three months. The intervention group additionally received traditional massage. Spasticity was evaluated using the Modified Ashworth Scale at baseline, and after 6th and 12th weeks of intervention. Data analysed using SPSS 20.. RESULTS: Of the 86 subjects enrolled, 75(87.2%) completed the study; 37(49.3%) in the control group with a mean age of 6.81±2.31 years, and 38(50.6%) in the intervention group with a mean age of 7.05±2.47 years. There were 25(68%) boys among the controls and 22(58%) in the intervention group. There was no statistically significant difference in baseline scores between the groups (p>0.05). At 6th week, reduction in scores was statistically significant in the right upper limb (p<0.05), and in the right lower limb (p<0.05) after the 12th week. CONCLUSIONS: Traditional massage was found to have significant effect on the right side compared to the routine physical therapy for reduction of spasticity in children with cerebral palsy.

Deep Brain Stimulation for Spasmodic Dysphonia: A Blinded Comparison of Unilateral and Bilateral Stimulation in Two Patients.

Deep brain stimulation (DBS) is a promising new therapy for patients with spasmodic dysphonia (SD). The preliminary results from our randomized controlled trial showed good clinical effects with unilateral left thalamic stimulation in 6 right- handed patients. This suggests that the pathological process underpinning SD may have a "hemisphere dominant" pathway. We describe 2 patients with concurrent essential tremor and SD who had previously undergone bilateral thalamic DBS for their limb tremor. Both patients experienced an unanticipated improvement of their SD symptoms. One patient was right-handed, and the other was mixed left-handed. To investigate the amount of SD improvement following DBS therapy in each hemisphere, 4 different settings were tested: both sides on, left side on, right side on, and both sides off. Both patients most improved following bilateral stimulation. There was, however, a powerful unilateral benefit in both patients with only a small additional benefit from bilateral stimulation. The right-handed patient improved most with left-hemisphere stimulation whereas the mixed left-handed patient improved most with right hemisphere stimulation. There was some discrepancy between the two tests applied in the second patient reflecting the known difficulties to evaluate vocal symptom improvement in SD. We discuss the possible correlation of handedness and speech hemisphere dominance as well as the need for more reliable tests to measure SD severity. Ultimately, we recommend a bilateral approach for future studies, using a patient perception test as the primary outcome and functional imaging to further investigate the correlation of handedness and the amount of hemisphere dominance in SD.

Neurofeedback-Linked Suppression of Cortical ß Bursts Speeds Up Movement Initiation in Healthy Motor Control: A Double-Blind Sham-Controlled Study.

Abnormally increased ß bursts in cortical-basal ganglia-thalamic circuits are associated with rigidity and bradykinesia in patients with Parkinson's disease. Increased ß bursts detected in the motor cortex have also been associated with longer reaction times (RTs) in healthy participants. Here we further hypothesize that suppressing ß bursts through neurofeedback training can improve motor performance in healthy subjects. We conducted a double-blind sham-controlled study on 20 human volunteers (10 females) using a sequential neurofeedback-behavior task with the neurofeedback reflecting the occurrence of ß bursts over sensorimotor cortex quantified in real time. The results show that neurofeedback training helps healthy participants learn to volitionally suppress ß bursts in the sensorimotor cortex, with training being accompanied by reduced RT in subsequent cued movements. These changes were only significant in the real feedback group but not in the sham group, confirming the effect of neurofeedback training over simple motor imagery. In addition, RTs correlated with the rate and accumulated duration of ß bursts in the contralateral motor cortex before the go-cue, but not with averaged ß power. The reduced RTs induced by neurofeedback training positively correlated with reduced ß bursts across all tested hemispheres. These results strengthen the link between the occurrence of ß bursts in the sensorimotor cortex before the go-cue and slowed movement initiation in healthy motor control. The results also highlight the potential benefit of neurofeedback training in facilitating voluntary suppression of ß bursts to speed up movement initiation.SIGNIFICANCE STATEMENT This double-blind sham-controlled study suggested that neurofeedback training can facilitate volitional suppression of ß bursts in sensorimotor cortex in healthy motor control better than sham feedback. The training was accompanied by reduced reaction time (RT) in subsequent cued movements, and the reduced RT positively correlated with the level of reduction in cortical ß bursts before the go-cue, but not with average ß power. These results provide further evidence of a causal link between sensorimotor ß bursts and movement initiation and suggest that neurofeedback training could potentially be used to train participants to speed up movement initiation.