scholarly journals Bimanual Movements and Chronic Stroke Rehabilitation: Looking Back and Looking Forward

2021 ◽  
Vol 11 (22) ◽  
pp. 10858
Author(s):  
James H. Cauraugh ◽  
Nyeonju Kang
Keyword(s):  
Neural Plasticity ◽  
Stroke Rehabilitation ◽  
Primary Motor Cortex ◽  
Supplementary Motor Area ◽  
Chronic Stroke ◽  
Upper Extremities ◽  
Bimanual Movement ◽  
Movement Coordination ◽  
Bimanual Movements ◽  
Motor Actions

Executing voluntary motor actions in the upper extremities after a stroke is frequently challenging and frustrating. Although spontaneous motor recovery can occur, reorganizing the activation of the primary motor cortex and supplementary motor area takes a considerable amount of time involving effective rehabilitation interventions. Based on motor control theory and experience-dependent neural plasticity, stroke protocols centered on bimanual movement coordination are generating considerable evidence in overcoming dysfunctional movements. Looking backward and forward in this comprehensive review, we discuss noteworthy upper extremity improvements reported in bimanual movement coordination studies including force generation. Importantly, the effectiveness of chronic stroke rehabilitation approaches that involve voluntary interlimb coordination principles look promising.

scholarly journals Anterior corpus callosum modulates symmetric forelimb movements during spontaneous food handling behavior of rats

2019 ◽  
Author(s):  
Masakazu Igarashi ◽  
Yumiko Akamine ◽  
Jeffery R Wickens
Keyword(s):  
Corpus Callosum ◽  
Bimanual Coordination ◽  
Anterior Part ◽  
Bimanual Movement ◽  
Food Handling ◽  
Axonal Conduction ◽  
Bimanual Movements ◽  
Electrophysiological Recordings ◽  
Neural Transmission ◽  
Motor Actions

AbstractBimanual motor actions, such as threading a needle, require coordination of the movements of each hand according to the state of the other hand. By connecting homologous cortical regions between the two cerebral hemispheres, the corpus callosum is thought to play a key role in such bimanual coordination. However, direct experimental evidence of the contribution of the corpus callosum to natural behaviors requiring bimanual coordination, such as feeding, is lacking. We investigated the hypothesis that the corpus callosum mediates bimanual movements during food-handling behavior. We first traced the forelimb-related components of the motor corpus callosum in Long-Evans rats, and found that the callosal fiber bundle from the forelimb motor areas passes through the anterior part of the corpus callosum. We then confirmed by electrophysiological recordings that blocking the axonal conduction of fibers in the anterior corpus callosum reduced neural transmission between cortical forelimb areas. The causal role of corpus callosum in bimanual coordination was then tested by analyzing forelimb kinematics during object manipulation, before and after blocking axonal conduction in the anterior corpus callosum. We found the frequency of occurrence of symmetric bimanual movements was reduced by inhibition of anterior corpus callosum. In contrast, asymmetric bimanual movement was increased. Our findings suggest that the anterior corpus callosum coordinates the direction of bimanual movement.

scholarly journals Free will and neurosurgical resections of the supplementary motor area: a critical review

2021 ◽  
Vol 163 (5) ◽  
pp. 1229-1237 ◽  
Author(s):  
Rickard L Sjöberg
Keyword(s):  
Executive Function ◽  
Free Will ◽  
Corticospinal Tract ◽  
Supplementary Motor Area ◽  
Personal Responsibility ◽  
Motor Area ◽  
Simple Motor ◽  
Motor Actions ◽  
Intense Debate

Abstract Background Research suggests that unconscious activity in the supplementary motor area (SMA) precedes not only certain simple motor actions but also the point at which we become aware of our intention to perform such actions. The extent to which these findings have implications for our understanding of the concepts of free will and personal responsibility has been subject of intense debate during the latest four decades. Methods This research is discussed in relation to effects of neurosurgical removal of the SMA in a narrative review. Results Removal of the SMA typically causes a transient inability to perform non-stimulus-driven, voluntary actions. This condition, known as the SMA syndrome, does not appear to be associated with a loss of sense of volition but with a profound disruption of executive function/cognitive control. Conclusions The role of the SMA may be to serve as a gateway between the corticospinal tract and systems for executive function. Such systems are typically seen as tools for conscious decisions. What is known about effects of SMA resections would thus seem to suggest a view that is compatible with concepts of personal responsibility. However, the philosophical question whether free will exists cannot be definitely resolved on the basis of these observations.

Corticospinal Tract Microstructure Correlates With Beta Oscillatory Activity in the Primary Motor Cortex After Stroke

Stroke ◽  
2021 ◽  
Author(s):  
Robert Schulz ◽  
Marlene Bönstrup ◽  
Stephanie Guder ◽  
Jingchun Liu ◽  
Benedikt Frey ◽  
...  
Keyword(s):  
Motor Cortex ◽  
Fractional Anisotropy ◽  
Primary Motor Cortex ◽  
Supplementary Motor Area ◽  
Premotor Cortex ◽  
Motor Impairment ◽  
Motor Area ◽  
Oscillatory Activity ◽  
Premotor Area ◽  
Beta Power

Background and Purpose: Cortical beta oscillations are reported to serve as robust measures of the integrity of the human motor system. Their alterations after stroke, such as reduced movement-related beta desynchronization in the primary motor cortex, have been repeatedly related to the level of impairment. However, there is only little data whether such measures of brain function might directly relate to structural brain changes after stroke. Methods: This multimodal study investigated 18 well-recovered patients with stroke (mean age 65 years, 12 males) by means of task-related EEG and diffusion-weighted structural MRI 3 months after stroke. Beta power at rest and movement-related beta desynchronization was assessed in 3 key motor areas of the ipsilesional hemisphere that are the primary motor cortex (M1), the ventral premotor area and the supplementary motor area. Template trajectories of corticospinal tracts (CST) originating from M1, premotor cortex, and supplementary motor area were used to quantify the microstructural state of CST subcomponents. Linear mixed-effects analyses were used to relate tract-related mean fractional anisotropy to EEG measures. Results: In the present cohort, we detected statistically significant reductions in ipsilesional CST fractional anisotropy but no alterations in EEG measures when compared with healthy controls. However, in patients with stroke, there was a significant association between both beta power at rest ( P =0.002) and movement-related beta desynchronization ( P =0.003) in M1 and fractional anisotropy of the CST specifically originating from M1. Similar structure-function relationships were neither evident for ventral premotor area and supplementary motor area, particularly with respect to their CST subcomponents originating from premotor cortex and supplementary motor area, in patients with stroke nor in controls. Conclusions: These data suggest there might be a link connecting microstructure of the CST originating from M1 pyramidal neurons and beta oscillatory activity, measures which have already been related to motor impairment in patients with stroke by previous reports.

scholarly journals 2190 Longitudinal changes in EEG power envelope connectivity are proportional to motor recovery in chronic stroke patients

2018 ◽  
Vol 2 (S1) ◽  
pp. 17-17
Author(s):  
Joseph B. Humphries ◽  
David T. Bundy ◽  
Eric C. Leuthardt ◽  
Thy N. Huskey
Keyword(s):  
Motor Cortex ◽  
Motor Imagery ◽  
Stroke Rehabilitation ◽  
Brain Computer Interface ◽  
Chronic Stroke ◽  
Motor Recovery ◽  
Stroke Recovery ◽  
Computer Interface ◽  
Beta Band ◽  
Stroke Patients

OBJECTIVES/SPECIFIC AIMS: The objective of this study is to determine the degree to which the use of a contralesionally-controlled brain-computer interface for stroke rehabilitation drives change in interhemispheric motor cortical activity. METHODS/STUDY POPULATION: Ten chronic stroke patients were trained in the use of a brain-computer interface device for stroke recovery. Patients perform motor imagery to control the opening and closing of a motorized hand orthosis. This device was sent home with patients for 12 weeks, and patients were asked to use the device 1 hour per day, 5 days per week. The Action Research Arm Test (ARAT) was performed at 2-week intervals to assess motor function improvement. Before the active motor imagery task, patients were asked to quietly rest for 90 seconds before the task to calibrate recording equipment. EEG signals were acquired from 2 electrodes—one each centered over left and right primary motor cortex. Signals were preprocessed with a 60 Hz notch filter for environmental noise and referenced to the common average. Power envelopes for 1 Hz frequency bands (1–30 Hz) were calculated through Gabor wavelet convolution. Correlations between electrodes were then calculated for each frequency envelope on the first and last 5 runs, thus generating one correlation value per subject, per run. The chosen runs approximately correspond to the first and last week of device usage. These correlations were Fisher Z-transformed for comparison. The first and last 5 run correlations were averaged separately to estimate baseline and final correlation values. A difference was then calculated between these averages to determine correlation change for each frequency. The relationship between beta-band correlation changes (13–30 Hz) and the change in ARAT score was determined by calculating a Pearson correlation. RESULTS/ANTICIPATED RESULTS: Beta-band inter-electrode correlations tended to decrease more in patients achieving greater motor recovery (Pearson’s r=−0.68, p=0.031). A similar but less dramatic effect was observed with alpha-band (8–12 Hz) correlation changes (Pearson’s r=−0.42, p=0.22). DISCUSSION/SIGNIFICANCE OF IMPACT: The negative correlation between inter-electrode power envelope correlations in the beta frequency band and motor recovery indicates that activity in the motor cortex on each hemisphere may become more independent during recovery. The role of the unaffected hemisphere in stroke recovery is currently under debate; there is conflicting evidence regarding whether it supports or inhibits the lesioned hemisphere. These findings may support the notion of interhemispheric inhibition, as we observe less in common between activity in the 2 hemispheres in patients successfully achieving recovery. Future neuroimaging studies with greater spatial resolution than available with EEG will shed further light on changes in interhemispheric communication that occur during stroke rehabilitation.

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