Effects of Noisy Galvanic Vestibular Stimulation During a Bimanual Tracking Robotic Task.
ABSTRACT: Background:Noisy galvanic vestibular stimulation (nGVS) has been shown to improve motor performance in people with and without disabilities. Previous investigations on the use of nGVS to improve upper-limb motor performance have focused on unimanual fine motor movements, nevertheless, bimanual gross movements are also essential for conducting activities of daily living and can be affected as a result of cerebral dysfunction. Consequently, in this study we investigated the effects of nGVS on bimanual gross motor performance. Methods:Twelve healthy participants completed a visuomotor task in which they performed bimanual upper-limb movements using two robots. During the task, participants tracked a target that oscillated following a sinusoidal amplitude-modulated trajectory. In half of the trials, participants received subthreshold nGVS, in the other half, they received sham stimulation. Primary outcome measure: percent improvement in root mean square error (RMSE) between the target's and cursors' trajectories. Secondary outcome measures: percent improvement in lag between the cursors and target; and percent improvement in RMSE between the cursors' trajectories. A post-test questionnaire was administered to evaluate the experience of participants. Results:Tracking error was not affected by nGVS: left -2.6(5.5)%, p = 0.128; right -0.9(6.2)%, p = 0.639; nor was bimanual coordination -1.5(9.6)%, p = 0.590. When comparing if one hand was affected more than the other, we did not find a statistically significant difference (-1.7(3.3)%, p = 0.098). Similar results were found for the lag. Questionnaire results indicated that the robotic devices did not limit participants' movements, did not make participants feel unsafe, nor were they difficult to control. Furthermore, participants did not feel unsafe with the nGVS device, nor did they report any discomfort due to nGVS. Conclusion:Results suggest that nGVS applied to people without disabilities do not affect bimanual gross motor performance. However, as this was the first study to investigate such effects, stimulation parameters were based on previous unimanual fine motor studies. Future studies should investigate optimal stimulation parameters for improving upper-limb gross motor performance. Overall, participants felt safe using the robotic devices and receiving the noisy electrical stimulation. As such, a similar setup could potentially be employed for subsequent studies investigating the relation between upper-limb performance and nGVS.
Project description:Music training programs have been shown to enhance executive functions in aging adults; however, little is known regarding the extent to which different types of bimanual coordination (i.e., fine and gross motor) in music instruction contribute to these outcomes. The aim of this study was to examine the effects of bimanual coordination in music interventions on cognitive performance in healthy older adults (60-80 years). Participants (N = 135) completed motor measures and battery of standardized cognitive measures, before and after a 16-week music training program with a 3 h practice requirement. All participants were matched by age, education, and estimate of intelligence to one of three training programs: piano training (fine motor); percussion instruction (gross motor), and music listening instruction (MLI) (no motor control condition). Results of a Repeated Measures ANOVA revealed significant enhancements in bimanual synchronization and visual scanning/working memory abilities for fine and gross motor training groups as compared to MLI. Pairwise comparisons revealed that piano training significantly improved motor synchronization skills as compared to percussion instruction or music listening. Results suggest that active music performance may benefit working memory, the extent of these benefits may depend upon coordination demands.
Project description:BACKGROUND:Few options exist for training arm movements in participants with severe post-stroke hemiparesis who have little active range of motion. The purpose of this study was to test the safety and feasibility of training with a non-powered device, the Bimanual Arm Trainer (BAT), to facilitate motor recovery in individuals with severe hemiparesis. The BAT enabled coupled bimanual training of shoulder external rotation, which is reduced in individuals with severe post-stroke hemiplegia. The rationale for bimanual training was to harness contralesional cortical activity to drive voluntary movement in the affected arm in patients who could barely perform unimanual movements. METHODS:Nine participants with post-stroke hemiparesis, preserved passive range of motion and Modified Ashworth score of <3 in the shoulder and elbow joints, trained with the device for 45 minutes, twice a week for six weeks, and were assessed pre- and post-training. RESULTS:All participants tolerated the training and no adverse events were reported. Participants showed significant improvement in the upper extremity Fugl-Meyer score post-training with an effect size of 0.89. Changes in the flexor synergy pattern accounted for 64.7% of the improvement. Improvement in active range of motion in the paretic limb occurred for both trained and untrained movements. Some participants showed improvement in the time taken to perform selected tasks on the Wolf Motor Function Test post-training. CONCLUSION:The results demonstrate the safety and feasibility of using the Bimanual Arm Trainer to facilitate motor recovery in individuals with severe hemiparesis.
Project description:Motor control is associated with synchronized oscillatory activity at alpha (8-12 Hz) and beta (12-30 Hz) frequencies in a cerebello-thalamo-cortical network. Previous studies demonstrated that transcranial alternating current stimulation (tACS) is capable of entraining ongoing oscillatory activity while also modulating motor control. However, the modulatory effects of tACS on both motor control and its underlying electro- and neurophysiological mechanisms remain ambiguous. Thus, the purpose of this study was to contribute to gathering neurophysiological knowledge regarding tACS effects by investigating the after-effects of 10 Hz tACS and 20 Hz tACS at parietal brain areas on bimanual coordination and its concurrent oscillatory and hemodynamic activity. Twenty-four right-handed healthy volunteers (12 females) aged between 18 and 30 (M = 22.35 ± 3.62) participated in the study and performed a coordination task requiring bimanual movements. Concurrent to bimanual motor training, participants received either 10 Hz tACS, 20 Hz tACS or a sham stimulation over the parietal cortex (at P3/P4 electrode positions) for 20 min via small gel electrodes (3,14 cm2 Ag/AgCl, amperage = 1 mA). Before and three time-points after tACS (immediately, 30 min and 1 day), bimanual coordination performance was assessed. Oscillatory activities were measured by electroencephalography (EEG) and hemodynamic changes were examined using functional near-infrared spectroscopy (fNIRS). Improvements of bimanual coordination performance were not differently between groups, thus, no tACS-specific effect on bimanual coordination performance emerged. However, physiological measures during the task revealed significant increases in parietal alpha activity immediately following 10 Hz tACS and 20 Hz tACS which were accompanied by significant decreases of Hboxy concentration in the right hemispheric motor cortex compared to the sham group. Based on the physiological responses, we conclude that tACS applied at parietal brain areas provoked electrophysiological and hemodynamic changes at brain regions of the motor network which are relevant for bimanual motor behavior. The existence of neurophysiological alterations immediately following tACS, especially in the absence of behavioral effects, are elementary for a profound understanding of the mechanisms underlying tACS. The lack of behavioral modifications strengthens the need for further research on tACS effects on neurophysiology and behavior using combined electrophysiological and neuroimaging methods.
Project description:Dyslexia and Attention deficit disorder (AD) are prevalent neurodevelopmental conditions in children and adolescents. They have high comorbidity rates and have both been associated with motor difficulties. Little is known, however, about what is shared or differentiated in dyslexia and AD in terms of motor abilities. Even when motor skill problems are identified, few studies have used the same measurement tools, resulting in inconstant findings. The present study assessed increasingly complex gross motor skills in children and adolescents with dyslexia, AD, and with both Dyslexia and AD. Our results suggest normal performance on simple motor-speed tests, whereas all three groups share a common impairment on unimanual and bimanual sequential motor tasks. Children in these groups generally improve with practice to the same level as normal subjects, though they make more errors. In addition, children with AD are the most impaired on complex bimanual out-of-phase movements and with manual dexterity. These latter findings are examined in light of the Multiple Deficit Model.
Project description:Motor imagery and motor execution share similar processes. However, only some factors that affect motor execution affect motor imagery in the same way. We investigated whether bimanual coordination constraints (parallel movements are performed slower than symmetric movements) are observed in motor imagery and whether the way of implementing the mental chronometry paradigm, which is used to investigate motor imagery, influences the results. Participants imagined and executed repetitive symmetric and parallel bimanual movements in three different tasks. Participants performed a certain number of movement repetitions (number task), repeated movements for a fixed duration (duration task), and performed movements in synchrony with pacing sounds (synchronization task). In both, imagination and execution, inter-response intervals were longer with parallel movements than with symmetric movements (number task and duration task), and the percentage of correct movements was lower with parallel than with symmetric movements (synchronization task). Performance of imagined and executed movements was correlated in all tasks. However, imagination took longer or was rated as less accurate than execution, and in the synchronization task the coordination constraint affected accuracy more in execution than in imagination. Thus, motor imagery and overt execution involve shared and unique processes. The synchronization task offers a promising alternative to investigate motor imagery, because the speed-accuracy trade-off is taken into account, different tempi can be used, and psychometric functions can be calculated.
Project description:Reaching and grasping (prehension) is one of the earliest developing motor skills in humans, but continued prehension development in childhood and adolescence enables the performance of increasingly complex manual tasks. In individuals with autism spectrum disorder (ASD) atypical unimanual reaching and grasping has been reported, but to date, no studies have investigated discrete bimanual movements. We examined unimanual and bimanual reach to grasp tasks in youth with ASD to better understand how motor performance might change with increasing complexity. Twenty youth with ASD (10.1 ± 2.4 years) and 17 youth with typical development (TD) (9.6 ± 2.6 years) were instructed to reach and grasp cubes that became illuminated. Participants were asked to reach out with the right and/or left hands to grasp and lift targets located at near (18 cm) and/or far (28 cm) distances. For the unimanual (simplest) condition, participants grasped one illuminated cube (with either the left or right hand). For the bimanual conditions, participants grasped two illuminated cubes located at the same distance from the start position (bimanual symmetric condition) or two illuminated cubes located at different distances (bimanual asymmetric condition). Significant interactions among diagnostic group, task complexity, and age were found for initiation time (IT) and movement time (MT). Specifically, the older children in both groups initiated and performed their movements faster in the unimanual condition than in the bimanual conditions, although the older children with ASD produced slower ITs and MTs compared to typically developing peers across all three conditions. Surprisingly, the younger children with ASD had similar ITs and MTs as their peers for the unimanual condition but did not considerably slow these times to adjust for the complexity of the bimanual tasks. We hypothesize that they chose to re-use the motor plans that were generated for the unimanual trials rather than generate more appropriate motor plans for the bimanual tasks. An atypical spatiotemporal relationship between MT and peak aperture (PA) was also found in the ASD group. Together, our results suggest deficits in motor planning that result in subtle effects on performance in younger children with ASD that become more pronounced with age.
Project description:Background Intensive bimanual therapy can improve hand function in children with unilateral spastic cerebral palsy (USCP). We compared the effects of structured bimanual skill training versus unstructured bimanual practice on motor outcomes and motor map plasticity in children with USCP. Objective We hypothesized that structured skill training would produce greater motor map plasticity than unstructured practice. Methods Twenty children with USCP (average age 9.5; 12 males) received therapy in a day camp setting, 6 h/day, 5 days/week, for 3 weeks. In structured skill training (n = 10), children performed progressively more difficult movements and practiced functional goals. In unstructured practice (n = 10), children engaged in bimanual activities but did not practice skillful movements or functional goals. We used the Assisting Hand Assessment (AHA), Jebsen-Taylor Test of Hand Function (JTTHF), and Canadian Occupational Performance Measure (COPM) to measure hand function. We used single-pulse transcranial magnetic stimulation to map the representation of first dorsal interosseous and flexor carpi radialis muscles bilaterally. Results Both groups showed significant improvements in bimanual hand use (AHA; P < .05) and hand dexterity (JTTHF; P < .001). However, only the structured skill group showed increases in the size of the affected hand motor map and amplitudes of motor evoked potentials (P < .01). Most children who showed the most functional improvements (COPM) had the largest changes in map size. Conclusions These findings uncover a dichotomy of plasticity: the unstructured practice group improved hand function but did not show changes in motor maps. Skill training is important for driving motor cortex plasticity in children with USCP.
Project description:Previously, transcranial direct current stimulation (tDCS) over the primary motor cortex (M1) has resulted in improved performance in simple motor tasks. For a complex bimanual movement, studies using functional magnetic resonance imaging and transcranial magnetic stimulation indicated the involvement of the left dorsolateral prefrontal cortex (DLPFC) as well as left M1. Here we investigated the relative effect of up-regulating the cortical function in left DLPFC and left M1 with tDCS. Participants practised a complex bimanual task over four days while receiving either of five stimulation protocols: anodal tDCS applied over M1, anodal tDCS over DLPFC, sham tDCS over M1, sham tDCS over DLPFC, or no stimulation. Performance was measured at the start and end of each training day to make a distinction between acquisition and consolidation. Although task performance improved over days, no significant difference between stimulation protocols was observed, suggesting that anodal tDCS had little effect on learning the bimanual task regardless of the stimulation sites and learning phase (acquisition or consolidation). Interestingly, cognitive performance as well as corticomotor excitability did not change following stimulation. Accordingly, we found no evidence for behavioural or neurophysiological changes following tDCS over left M1 or left DLPFC in learning a complex bimanual task.
Project description:Movements of the upper limb are controlled mostly through the contralateral hemisphere. Although overall activity changes in the ipsilateral motor cortex have been reported, their functional significance remains unclear. Using human functional imaging, we analyzed neural finger representations by studying differences in fine-grained activation patterns for single isometric finger presses. We demonstrate that cortical motor areas encode ipsilateral movements in 2 fundamentally different ways. During unimanual ipsilateral finger presses, primary sensory and motor cortices show, underneath global suppression, finger-specific activity patterns that are nearly identical to those elicited by contralateral mirror-symmetric action. This component vanishes when both motor cortices are functionally engaged during bimanual actions. We suggest that the ipsilateral representation present during unimanual presses arises because otherwise functionally idle circuits are driven by input from the opposite hemisphere. A second type of representation becomes evident in caudal premotor and anterior parietal cortices during bimanual actions. In these regions, ipsilateral actions are represented as nonlinear modulation of activity patterns related to contralateral actions, an encoding scheme that may provide the neural substrate for coordinating bimanual movements. We conclude that ipsilateral cortical representations change their informational content and functional role, depending on the behavioral context.
Project description:Motor learning in unimanual and bimanual planar reaching movements has been intensively investigated. Although distinct theoretical frameworks have been proposed for each of these reaching movements, the relationship between these movements remains unclear. In particular, the generalization of motor learning effects (transfer of learning effects) between unimanual and bimanual movements has yet to be successfully explained. Here, by extending a motor primitive framework, we analytically proved that the motor primitive framework can reproduce the generalization of learning effects between unimanual and bimanual movements if the mean activity of each primitive for unimanual movements is balanced to the mean for bimanual movements. In this balanced condition, the activity of each primitive is consistent with previously reported neuronal activity. The unimanual-bimanual balance leads to the testable prediction that generalization between unimanual and bimanual movements is more widespread to different reaching directions than generalization within respective movements. Furthermore, the balanced motor primitive can reproduce another previously reported phenomenon: the learning of different force fields for unimanual and bimanual movements.