Parietofrontal integrity determines neural modulation associated with grasping imagery after stroke.

Chronic stroke patients with heterogeneous lesions, but no direct damage to the primary sensorimotor cortex, are capable of longitudinally acquiring the ability to modulate sensorimotor rhythms using grasping imagery of the affected hand. Volitional modulation of neural activity can be used to drive grasping functions of the paralyzed hand through a brain-computer interface. The neural substrates underlying this skill are not known. Here, we investigated the impact of individual patient's lesion pathology on functional and structural network integrity related to this volitional skill. Magnetoencephalography data acquired throughout training was used to derive functional networks. Structural network models and local estimates of extralesional white matter microstructure were constructed using T(1)-weighted and diffusion-weighted magnetic resonance imaging data. We employed a graph theoretical approach to characterize emergent properties of distributed interactions between nodal brain regions of these networks. We report that interindividual variability in patients' lesions led to differential impairment of functional and structural network characteristics related to successful post-training sensorimotor rhythm modulation skill. Patients displaying greater magnetoencephalography global cost-efficiency, a measure of information integration within the distributed functional network, achieved greater levels of skill. Analysis of lesion damage to structural network connectivity revealed that the impact on nodal betweenness centrality of the ipsilesional primary motor cortex, a measure that characterizes the importance of a brain region for integrating visuomotor information between frontal and parietal cortical regions and related thalamic nuclei, correlated with skill. Edge betweenness centrality, an analogous measure, which assesses the role of specific white matter fibre pathways in network integration, showed a similar relationship between skill and a portion of the ipsilesional superior longitudinal fascicle connecting premotor and posterior parietal visuomotor regions known to be crucially involved in normal grasping behaviour. Finally, estimated white matter microstructure integrity in regions of the contralesional superior longitudinal fascicle adjacent to primary sensorimotor and posterior parietal cortex, as well as grey matter volume co-localized to these specific regions, positively correlated with sensorimotor rhythm modulation leading to successful brain-computer interface control. Thus, volitional modulation of ipsilesional neural activity leading to control of paralyzed hand grasping function through a brain-computer interface after longitudinal training relies on structural and functional connectivity in both ipsilesional and contralesional parietofrontal pathways involved in visuomotor information processing. Extant integrity of this structural network may serve as a future predictor of response to longitudinal therapeutic interventions geared towards training sensorimotor rhythms in the lesioned brain, secondarily improving grasping function through brain-computer interface applications.

Kinesthetic imagery and tool-specific modulation of corticospinal representations in expert tennis players.

Specific physical or mental practice may induce short- and long-term neuroplastic changes in the motor system and cause tools to become part of one's own body representation. Athletes who use tools as part of their practice may be an excellent model for assessing the neural correlates of possible bodily representation changes that are specific to extensive practice. We used single-pulse transcranial magnetic stimulation to measure corticospinal excitability in forearm and hand muscles of expert tennis players and novices while they mentally practiced a tennis forehand, table tennis forehand, and a golf drive. The muscles of expert tennis players showed increased corticospinal facilitation during motor imagery of tennis but not golf or table tennis. Novices, although athletes, were not modulated across sports. Subjective reports indicated that only in the tennis imagery condition did experts differ from novices in the ability to form proprioceptive images and to consider the tool as an extension of the hand. Neurophysiological and subjective data converge to suggest a key role of long-term experience in modulating sensorimotor body representations during mental simulation of sports.

Think to move: a neuromagnetic brain-computer interface (BCI) system for chronic stroke.

BACKGROUND AND PURPOSE: Stroke is a leading cause of long-term motor disability among adults. Present rehabilitative interventions are largely unsuccessful in improving the most severe cases of motor impairment, particularly in relation to hand function. Here we tested the hypothesis that patients experiencing hand plegia as a result of a single, unilateral subcortical, cortical or mixed stroke occurring at least 1 year previously, could be trained to operate a mechanical hand orthosis through a brain-computer interface (BCI). METHODS: Eight patients with chronic hand plegia resulting from stroke (residual finger extension function rated on the Medical Research Council scale=0/5) were recruited from the Stroke Neurorehabilitation Clinic, Human Cortical Physiology Section of the National Institute for Neurological Disorders and Stroke (NINDS) (n=5) and the Clinic of Neurology of the University of Tübingen (n=3). Diagnostic MRIs revealed single, unilateral subcortical, cortical or mixed lesions in all patients. A magnetoencephalography-based BCI system was used for this study. Patients participated in between 13 to 22 training sessions geared to volitionally modulate micro rhythm amplitude originating in sensorimotor areas of the cortex, which in turn raised or lowered a screen cursor in the direction of a target displayed on the screen through the BCI interface. Performance feedback was provided visually in real-time. Successful trials (in which the cursor made contact with the target) resulted in opening/closing of an orthosis attached to the paralyzed hand. RESULTS: Training resulted in successful BCI control in 6 of 8 patients. This control was associated with increased range and specificity of mu rhythm modulation as recorded from sensors overlying central ipsilesional (4 patients) or contralesional (2 patients) regions of the array. Clinical scales used to rate hand function showed no significant improvement after training. CONCLUSIONS: These results suggest that volitional control of neuromagnetic activity features recorded over central scalp regions can be achieved with BCI training after stroke, and used to control grasping actions through a mechanical hand orthosis.

Influence of imagined posture and imagery modality on corticospinal excitability.

Single pulse transcranial magnetic stimulation (TMS) was used to test the assumption that kinesthetic imagery of action is more 'motor' than visual imagery of action. We assessed corticospinal excitability during motor imagery of a thumb-palm opposition movement by recording potentials evoked by TMS from two hand muscles that would (opponens pollicis, OP, target) or would not (abductor digiti minimi, ADM, control) be activated during actual performance of the very same movement. Participants were asked to imagine the thumb-palm opposition movement while maintaining first person imagery that was either purely visual or predominately kinesthetic. The motor imagery task was performed in two conditions in which the imagined and the actual hand could be either congruent or incongruent. Facilitation of potentials recorded from OP was higher during imagery carried out in mentally congruent than incongruent postures. This effect was largely due to lack of excitability recorded during incongruent kinesthetic imagery, which was indistinguishable from baseline imagery of the static hand. All other conditions differed from static imagery regardless of position. No significant effects were found in a control muscle (ADM) thus indicating that the effect was not related to spatial coding. Subjective reports obtained after the experiment indicate that the results cannot be ascribed to qualitative differences in the imagery experienced. For relatively simple motor tasks requiring no 'expertise' we found no detectable difference in the motor cortex due to imagery modality.

Online versus offline processing of visual feedback in the control of movement amplitude.

Researchers have suggested that visual feedback not only plays a role in the correction of errors during movement execution but that visual feedback from a completed movement is processed offline to improve programming on upcoming trials. In the present study, we examined the potential contribution of online and offline processing of visual feedback by analysing spatial variability at various kinematic landmarks in the limb trajectory (peak acceleration, peak velocity, peak negative acceleration and movement end). Participants performed a single degree of freedom video aiming task with and without vision of the cursor under four criterion movement times (225, 300, 375 and 450 ms). For movement times of 225 and 300 ms, the full vision condition was less variable than the no vision condition. However, the form of the variability profiles did not differ between visual conditions suggesting that the contribution of visual feedback was due to offline processes. In the 375 and 450 ms conditions, there was evidence for both online and offline control as the form of the variability profiles differed significantly between visual conditions.

Egocentric and object-based transformations in the laterality judgement of human and animal faces and of non-corporeal objects.

Mental rotation of body parts is influenced by specific sensory-motor information, and may be performed using an egocentric (subject-based) or an object-based mental transformation. Neurologically healthy volunteers were asked to verbally judge the laterality of visually presented human face, owl face and front of a car with a black patch over one eye/headlight, presented in one of eight orientations. Subjects may or may not have their head held in a head brace. The transformation used to solve the task was assessed with a questionnaire. Response times were non-monotonical at 180 degrees for the object-based group, but not for the group using egocentric transformation. Having head movement constrained by the use of a head brace ("fixed") or not ("moving") did not influence performance. Within the two groups, no differences were found between the three types of stimuli. Hence, the response profile for mental rotation of human faces and face-like stimuli depended on the type of mental spatial transformation used to solve the task, independently from the possibility to move the head and from the kind of stimuli processed.

The influence of hands posture on mental rotation of hands and feet.

Behavioural and functional neuroanatomy studies demonstrate that mental rotation of body parts is carried out through a sort of inner motor simulation. Here we examined whether changes of hands posture influence the mental rotation of hands and feet. Twenty healthy subjects were asked to verbally judge the laterality of hands and feet pictures in two different postural conditions. In one condition, subjects kept hands on their knees in anatomical position; in the other, their hands were kept in an unusual posture with intertwined fingers, behind the back. Results show that mental rotation of hands but not of feet was influenced by changes in hands posture. Indeed, while mental rotation of hands was faster in the front than in the back hands position, no similar effect was found when mentally rotating feet. Thus, sensory-motor and postural information coming from the body may influence mental rotation of body parts according to specific, somatotopic rules.

Corticospinal facilitation during first and third person imagery.

Motor imagery can be defined as the covert rehearsal of movement. Previous research with transcranial magnetic stimulation (TMS) has demonstrated that motor imagery increases the corticospinal excitability of the primary motor cortex in the area corresponding to the representation of the muscle involved in the imagined movement. This research, however, has been limited to imagery of oneself in motion. We extend the TMS research by contrasting first person imagery and third person imagery of index finger abduction-adduction movements. Motor evoked potentials were recorded from first dorsal interosseous (FDI) and abductor digiti minimi (ADM) during single pulse TMS. Participants performed first and third person motor imagery, visual imagery, and static imagery. Visual imagery involved non biological motion while static imagery involved a first person perspective of the unmoving hand. Relative to static imagery, excitability during imagined movement increased in FDI but not ADM. The facilitation in first person imagery adds to previous findings. A greater facilitation of MEPs recorded from FDI was found in third person imagery where the action was clearly attributable to another person. We interpret this novel result in the context of observed action and imagined observation of self action, and attribute the result to activation of mirror systems for matching the imagined action with an inner visuo-motor template.

Guiding movements with internal representations: a reach-and-grasp task.

We investigated participants' ability to use internal representations of the environment to guide prehensile movements, when visual feedback was not available. Reaching and grasping performed with concurrent visual feedback was compared to conditions in which participants actively formed spatial images and passively encoded images from visual presented information. Movement times, the proportion of time spent after peak velocity and peak apertures, were greater when concurrent visual feedback was unavailable. Movement times increased as a function of premovement occlusion length, with passively encoded images resulting in shorter movement durations than actively formed images. The findings indicated that participants adapted their movement trajectories to compensate for the degradation of stored spatial information, when concurrent visual feedback was not available.

Conflicting sources of spatial information in a distance-reproduction task.

Previous research has shown that the reproduction of a criterion distance is biased towards previously coded endpoints. The purpose of this research was to illustrate that, in addition to the retention of endpoint information, the presence of conflicting sources of spatial information within a trial causes systematic response biases in distance reproduction. Three experiments were conducted in which participants performed rapid aiming movements on a digitising tablet that translated to movement of a cursor on a computer monitor. The required movement amplitude in all three experiments was 20 cm. In experiment 1, the location of the home and target positions on the monitor was fixed, but the initial position of the hand was varied randomly from trial to trial. In experiment 2, the change in position of the limb was matched by a corresponding change in the location of the monitor display. In experiment 3, the initial position of the limb was fixed, but the location of the display on the monitor varied from trial to trial. The results of experiments 1 and 2 showed that error varied as a function of the initial position of the limb. However, this effect was greater in experiment 1, where the mapping between the location of the monitor display and limb position varied from trial to trial. There was also an effect of varying the location of the monitor display in experiment 3, but this was smaller than varying initial limb position in experiment 1. These findings suggest that both the retrieval of previously specified endpoints and conflicts in the coding of spatial information contributed to the observed response biases in distance reproduction.