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Stretch reflex adaptation in elbow flexors during repeated passive movements in unilateral brain-injured patients.

OBJECTIVE: To evaluate the effects of repeated, externally imposed, flexion-extension movements of the elbow on the resulting stretch reflex response in hemiparetic spastic brain-injured patients. These effects were compared within a recording session and across sessions for the same subject to determine the impact of movement history on the quantification of spastic hypertonia using the stretch reflex response. DESIGN: Twenty to 30 sequential, constant velocity flexion-extension movements were applied to the impaired elbow of our cohort, with a 10-second hold interposed between flexion and extension. Movements were applied regularly at 1-minute intervals. Changes in stretch reflex responses were monitored during the applied movements. PARTICIPANTS: We examined a convenience sample of seven hemiparetic brain-injured subjects between the ages of 26 and 60 yrs, with moderate-to-severe spastic hypertonia of elbow muscles (Ashworth score 2-4/4). Subjects participated in 2 to 9 sessions. MEASURES: Elbow torque, position, velocity, and electromyograms of the biceps, brachioradialis, and triceps muscles were recorded for each flexion and extension movement. Stretch reflex torque was calculated by subtracting passive torque from total elbow torque, recorded over large amplitude movements. A linear regression analysis quantified both the initial torque response of the stretch reflex and the ensuing adaptation of the stretch reflex during sequential movements. Intersession variability was characterized both for spastic hypertonia measures and for stretch reflex adaptation. RESULTS: Repeated, externally imposed, sequential flexion-extension movements of the elbow decreased the elbow flexor stretch reflex in six of seven subjects. The mean reduction in reflex torque after 30 movements was 50% of the initial torque values (p = .001, t test vs. 0% change). Intersession stretch reflex responses for each subject were found to vary greatly (SDs of reflex torque ranged from 0.1 to 4.0 Nm), and there were also significant variations in the degree of adaptation between subjects. CONCLUSIONS: Stretch reflex adaptation must be taken into consideration when spastic hypertonia is quantified using repeated joint motion, as is often the case. The magnitude of intersession variation in spastic hypertonia measures suggests that ideally, such measurements should be made across multiple sessions before conclusions are made regarding the efficacy of spastic hypertonia interventions. This study provides quantitative evidence that repeated joint movements may have a significant short-term beneficial effect on spastic hypertonia.

Adaptation, Physiological↗

Functional properties of the primary motor cortex and ventral premotor cortex in the monkey during a visually guided jaw-movement task with a delay period.

This study investigated single neuronal activity in the face area of the primary motor cortex (MI) and ventral part of the premotor cortex (PMv) while a monkey performed a visually guided jaw-movement task with a delay period. When the monkey executed the jaw movements, 48 MI and 53 PMv neurons showed statistically significant activities time-locked to jaw movements and were defined as movement-related neurons. The activities of movement-related neurons could be classified into phasic, phasic-tonic and tonic patterns based on the changes in discharge rate. Most of the neurons exhibiting phasic and phasic-tonic activities probably contributed to the initiation of jaw movements, since they exhibited transient responses immediately after the onset of the go-cue indicating the jaw movement. In contrast, the sustained activity of the movement-related neurons exhibiting phasic-tonic and tonic activities may be involved in controlling and/or maintaining jaw position. Sustained activity was also detected during the delay period in 4 MI and 29 PMv neurons and these neurons were defined as set-related neurons. It is thought that these set-related neurons are involved in the preparation for the subsequent jaw movement, since the masticatory muscles showed no significant changes during the delay period. These findings suggest that the MI may be involved predominantly in the initiation and control of jaw movements, and that the PMv may be involved in motor preparation, and may play a role as a higher-order motor area related to the initiation and control of jaw movements.

Animals↗

The effect of transcranial magnetic stimulation over the cerebellum on the synkinesis of coordinated eye and head movements.

We made a study of coordinated saccadic eye and head movements following random and predictable horizontal visual targets by applying transcranial magnetic stimulation (TMS) over the cerebellum before the start of the gaze movement. We have found three effects of TMS on eye/head movements under these conditions. SACCADIC LATENCY-EFFECT: When stimulation took place shortly before movements commenced, significantly shorter latencies were found between target presentation and commencement of saccades: For predictable, to a lesser extent for random targets and TMS up to 75 ms before start of the saccade, latencies were significantly decreased when compared with no application of TMS. Without stimulation, latencies to random targets were within a range of 120-200 ms. EYE-HEAD INTERACTION-EFFECT: Without TMS, for amplitudes greater than 25 degrees, head movements usually preceded eye movements, as expected, especially for predictive responses. With the application of TMS shortly after the target display, the number of eye movements which preceded head movements, was significantly increased (p<0.001), and the delay between eye and head movements was reduced or reversed (p<0.001), compared with gaze movements without the use of TMS. SACCADIC PEAK VELOCITY-EFFECT: Applying transcranial magnetic stimulation at 5-25 ms after the position change of the 60 degrees target, and 50-5 s before the start of eye movement, mean peak velocity of synkinetic saccades increased up to 600 degrees/s, compared with 350-400 degrees/s without the use of TMS. We conclude that transient functional cerebellar deficits caused by the application of TMS can change the central synkinesis of eye-head coordination.

Adult↗

Head movement during sudden base translations as a measure of risks for falls in the elderly.

OBJECTIVE: To determine whether head movement in response to a sudden platform translation differs between healthy young subjects and healthy elderly with and without, bipedal sensory loss. DESIGN: A cross-sectional study with four-way comparison on subject grouping and three test conditions. BACKGROUND: Head movement has been used as a measure of balance in the elderly during voluntary movements. Studies during involuntary movement, however, are limited. Moreover, it is not clear how head movement during involuntary activities relates to postural balance and susceptibility to falls. METHODS: Head movement during a sudden base translation was measured in three subject groups: 9 healthy young, 10 healthy elderly adults and 10 elderly adults with vibratory sensation loss under the feet. The surface compliance of the supporting base, the direction of the base translation and the visual condition were all varied. RESULTS: There were significant differences among the three groups in head range of excursion (5 degrees, 9 degrees, 13 degrees for the young, elderly, and elderly with severe vibratory sensation loss, respectively), onset time (120, 150, 180 ms), and the time from peak to peak (38, 29, 25 ms). A backward base movement increased the head movement more than a forward base movement. CONCLUSIONS: During sudden base translation balance tasks, head movement is significantly increased in the elderly, especially in those elderly adults who are susceptible to falls. The results suggest that an increased head movement in the elderly might be an indication of increased risks for falls.

Accidental Falls↗

Interactions between cholinergic and GABAergic neurotransmitters in and around the locus coeruleus for the induction and maintenance of rapid eye movement sleep in rats.

The noradrenergic "REM-off" neurons in the locus coeruleus cease firing, whereas some cholinergic and non-cholinergic "REM-on" neurons increase firing during rapid eye movement sleep. A reciprocal interaction between these neurons was proposed. However, acetylcholine did not inhibit neurons in the locus coeruleus. Nevertheless, since GABA levels increase during rapid eye movement sleep and picrotoxin injections into the locus coeruleus reduced rapid eye movement sleep, it was hypothesized that GABA in the locus coeruleus might play an intermediary inhibitory role for rapid eye movement sleep regulation. Therefore, the effects of GABA or carbachol (a mixed cholinergic agonist receptor) alone, as well as an agonist of one in presence of an antagonist of the other, in the locus coeruleus were investigated on sleep-wakefulness and rapid eye movement sleep. The cholinergic agonist carbachol increased, while the muscarinic antagonist receptor scopolamine decreased, the frequency of induction of rapid eye movement sleep per hour. In contrast, GABA and picrotoxin increased and decreased, respectively, the duration of rapid eye movement sleep per episode. However, when carbachol was injected in the presence of picrotoxin or GABA was injected in the presence of scopolamine, the effect of GABA or picrotoxin was dominant. Microinjection of both scopolamine and picrotoxin in combination reduced both the frequency of initiation as well as the duration per episode of rapid eye movement sleep. From these results we suggest that in the locus coeruleus cholinergic input modulates the frequency of induction of rapid eye movement sleep and this action is mediated through GABA interneurons, whereas the length of rapid eye movement sleep per episode is maintained by the presence of an optimum level of GABA. A model of neural connections for initiation and maintenance of rapid eye movement sleep is proposed and discussed.

Acetylcholine↗

Three-dimensional intrafractional movement of prostate measured during real-time tumor-tracking radiotherapy in supine and prone treatment positions.

PURPOSE: To quantify three-dimensional (3D) movement of the prostate gland with the patient in the supine and prone positions and to analyze the movement frequency for each treatment position. METHODS AND MATERIALS: The real-time tumor-tracking radiotherapy (RTRT) system was developed to identify the 3D position of a 2-mm gold marker implanted in the prostate 30 times/s using two sets of fluoroscopic images. The linear accelerator was triggered to irradiate the tumor only when the gold marker was located within the region of the planned coordinates relative to the isocenter. Ten patients with prostate cancer treated with RTRT were the subjects of this study. The coordinates of the gold marker were recorded every 0.033 s during RTRT in the supine treatment position for 2 min. The patient was then moved to the prone position, and the marker was tracked for 2 min to acquire data regarding movement in this position. Measurements were taken 5 times for each patient (once a week); a total of 50 sets for the 10 patients was analyzed. The raw data from the RTRT system were filtered to reduce system noise, and the amplitude of movement was then calculated. The discrete Fourier transform of the unfiltered data was performed for the frequency analysis of prostate movement. RESULTS: No apparent difference in movement was found among individuals. The amplitude of 3D movement was 0.1-2.7 mm in the supine and 0.4-24 mm in the prone positions. The amplitude in the supine position was statistically smaller in all directions than that in the prone position (p < 0.0001). The amplitude in the craniocaudal and AP directions was larger than in the left-right direction in the prone position (p < 0.0001). No characteristic movement frequency was detected in the supine position. The respiratory frequency was detected for all patients regarding movement in the craniocaudal and AP directions in the prone position. The results of the frequency analysis suggest that prostate movement is affected by the respiratory cycle and is influenced by bowel movement in the prone position. CONCLUSION: The results of this study have confirmed that internal organ motion is less frequent in the supine position than in the prone position in the treatment of prostate cancer. RTRT would be useful in reducing uncertainty due to the effects of the respiratory cycle, especially in the prone position.

Fluoroscopy↗

Bladder movement during radiation therapy for bladder cancer: implications for treatment planning.

PURPOSE: To describe and quantify bladder movement during radical radiation therapy (RT). To attempt to identify factors that predict for excessive alterations in bladder position. To use the above information to assist in defining the "adequate" planning target volume margin. METHODS AND MATERIALS: Thirty patients with bladder cancer suitable for radical courses of RT were followed prospectively. Patients had an initial planning computerized tomography (CT) scan of the pelvis and three subsequent scans performed weekly during the treatment period. The following measurements were made on each scan in the midbladder slice: maximum anteroposterior (AP) and lateral bladder dimensions, AP rectal diameter, and the distance (margin) between the bladder walls (anterior, posterior, right, and left lateral) and the 95% isodose line. Various patient and tumor data, including bladder and bowel symptoms, were recorded to attempt correlation with bladder movement. RESULTS: Bladder size: the median bladder size (area) over all scans in all patients was 36.9 cm2 (range: 16.2 to 80.9 cm2). The change in bladder area across each sequence varied from 3.3 to 29.1 cm2 (7-55% change in area between scans). Patients with bladders of larger than the median size on the planning scan (despite emptying) were more likely to have alteration in size than those with small bladders, and this change was in the direction of contraction (p = 0.01). Bladder displacement: bladder wall movement of > 1.5 cm was defined as "significant." Eighteen of 30 patients (60%) demonstrated "significant" movement of at least one bladder wall relative to the original isodose plot. Movement resulting in margin reduction occurred in 10 patients (33%). Two patients required treatment replanning due to consistently altered bladder position. There was no pattern to displacement through RT, and all walls were at approximately equal risk of movement. Factors influencing bladder movement: posterior bladder wall movement appeared to relate to "marked" (>2 cm) rectal diameter change. There was a trend for patients with larger amounts of residual bladder tumor (greater than the median) to exhibit more bladder movement; 11 of 14 "moved" compared with 7 of 16 patients with less residual tumor. Other clinical factors including age, sex, body size, acute RT reaction, and tumor stage did not appear to relate to bladder movement. CONCLUSION: Bladder movement during RT is clinically relevant and is random with respect to both time and direction. We recommend, at least with respect to tumor-bearing regions of the bladder, that no less than a 2.0 cm margin should be allowed.

Aged↗

Internal vs external generation of movements: differential neural pathways involved in bimanual coordination performed in the presence or absence of augmented visual feedback.

It is commonly agreed that a functional dissociation with respect to the internal vs external control of movements exists for several brain regions. This has, however, only been tested in relation to the timing and preparation of motor responses, but not to ongoing movement control. Using functional magnetic resonance imaging (fMRI), the present study addressed the neuroanatomical substrate of the internal-external control hypothesis by comparing regional brain activation for cyclical bimanual movements performed in the presence or absence of augmented visual feedback. Subjects performed a bimanual movement pattern, either with the help of on-line visual feedback of the movements (externally guided coordination) or with the eyes closed on the basis of an internal representation of the movement pattern (internally generated coordination). Visual control and baseline rest conditions were also added. Results showed a clear functional dissociation within the network involved in movement coordination. The hMT/V5+, the superior parietal cortex, the premotor cortex, the thalamus, and cerebellar lobule VI showed higher activation levels when movements were guided by visual feedback. Conversely, the basal ganglia, the supplementary motor area, cingulate motor cortex, the inferior parietal, frontal operculum, and cerebellar lobule IV-V/dentate nucleus showed higher involvement when movements were internally generated. Consequently, the present findings suggest the existence of distinct cortico-cortical and subcortico-cortical neural pathways for externally (augmented feedback) and internally guided cyclical bimanual movements. This provides a neurophysiological account for the beneficial effect of providing augmented visual feedback to optimize movements in normal and motor disordered patients.

Adult↗

Impairment of post-movement beta synchronisation in parkinson's disease is related to laterality of tremor.

OBJECTIVE: Post-movement beta synchronisation (PMBS) is a physiological indicator of the activity of movement related neural networks. To investigate the pathophysiology of this phenomenon, we examined its characteristics in patients with unilateral tremor-dominant Parkinson's disease (PD). METHODS: Movement duration and PMBS was measured after self-paced movement of the thumb at movement-reactive beta frequencies, over the supplementary motor area in 10 PD patients and 8 control subjects. RESULTS: Movement duration in PD patients was longer than in controls. In left hand tremor patients, movement of the left hand was significantly longer compared to the right hand. When PD patients moved their non-affected hand, similarly to the controls, PMBS was higher contralateral to the movement. After movement of the tremulous hand, the contralateral PMBS decreased significantly and the contralateral preponderance disappeared. In the same hemisphere, PMBS was higher after contralateral to the non-affected hand movement, than after ipsilateral to the tremulous hand after movement. CONCLUSIONS: PMBS in PD is affected by the activity of tremor related neural networks, suggesting that both cortical and subcortical sources are responsible for its generation. Examination of PMBS in various neurological diseases might provide further data on its physiological significance.

Aged↗

Patterned electromyographic activity in the sit-to-stand movement.

OBJECTIVES: Postural activity is an essential part of any voluntary movement. In movements involving all body parts such as in the sit-to-stand maneuver (STS), postural activity becomes intermingled with the activity required to perform the actual movement, and is usually difficult to recognize. METHODS: In this paper, we have analyzed the electromyographic activity of muscles of the leg, thigh, trunk and neck in 20 healthy volunteers who performed the STS maneuver. In order to identify the postural and the executional EMG activity, subjects were requested to perform the movement according to 6 predefined experimental conditions. Our hypothesis was that changing the conditions or the strategies of the movement would modify the postural activity, without significantly altering the EMG pattern required for performing the movement itself. RESULTS: Tibialis anterior (TA), abdominal (ABD) and sternocleidomastoid (SCM) were the muscles activated first in the most natural condition for the movement (reference), but their activity and that of the trapezius (TRA) was suppressed or greatly diminished in other conditions. Conversely, lumbar paraspinal (LPS), quadriceps (QUA), and hamstrings (HMS) were activated in a patterned sequence that was invariable in all conditions, and time locked to the moment of take-off from the seat. The soleus (SOL) was the last muscle activated and, together with QUA and HMS, remained active during standing. CONCLUSIONS: We conclude that TA, SOL, ABD, SCM and TRA are involved in preparatory and accompanying postural movements, while LPS, QUA, and HMS are activated in a consistent patterned sequence and can be considered the executional muscles for the STS movement. Recognition of the role of each muscle in the STS movement can contribute to a better understanding of the movement deficits of certain patients, and help to devise adaptive motor strategies in neurorehabilitation.

Adult↗

Effects of age on distally and proximally generated drawing movements: a kinematic analysis of school children and adults.

The effects of age on basic fine motor functions were assessed using a kinematic analysis of simple repetitive drawing movements in a sample of 53 right-handed children aged 7 to 14 years 11 months and 16 adults aged 27 to 54 years with no detectable abnormality with neurological examination. Lines, circles, and half-circles were drawn at a self-chosen and maximum velocity with a pressure-sensitive pen on a computer graphics tablet. Patterns generated by finger, wrist, and arm movements, and those generated by combined finger-wrist movements with and without a change in the drawing direction were analysed. The frequencies of all movement patterns increased until adulthood: 0.1 Hz per year for half-circles, 0.15 to 0.2 Hz per year for circles and lines generated by arm and wrist movements. The greatest increase (0.35 Hz per year) was observed for lines produced by finger movements. Differences in movement frequencies between finger versus wrist or arm movements when drawing lines decreased from about 3 Hz in 7- to 8-year-olds to 0.5 to 1 Hz in adolescents. In adults the difference between maximum finger, wrist, and arm movement frequencies decreased to almost zero. In contrast, the differences in movement patterns with and without change in direction remained stable until adulthood. Based on these results it is hypothesized that the differential effects of finger and more proximally generated movements on age reflect maturation of distinct neuronal sites of the corticostriatal-cerebellar circuit rather than acquisition of motor skills or myelinization of corticospinal pathways.

Adolescent↗

Neural coding of finger and wrist movements.

Previous work (Schieber and Hibbard, 1993) has shown that single motor cortical neurons do not discharge specifically for a particular flexion-extension finger movement but instead are active with movements of different fingers. In addition, neuronal populations active with movements of different fingers overlap extensively in their spatial locations in the motor cortex. These data suggested that control of any finger movement utilizes a distributed population of neurons. In this study we applied the neuronal population vector analysis (Georgopoulos et al., 1983) to these same data to determine (1) whether single cells are tuned in an abstract, three-dimensional (3D) instructed finger and wrist movement space with hand-like geometry and (2) whether the neuronal population encodes specific finger movements. We found that the activity of 132/176 (75%) motor cortical neurons related to finger movements was indeed tuned in this space. Moreover, the population vector computed in this space predicted well the instructed finger movement. Thus, although single neurons may be related to several disparate finger movements, and neurons related to different finger movements are intermingled throughout the hand area of the motor cortex, the neuronal population activity does specify particular finger movements.

Finger Joint↗

Kinematic analyses of speech, orofacial nonspeech, and finger movements in stuttering and nonstuttering adults.

This work investigated the hypothesis that neuromotor differences between individuals who stutter and individuals who do not stutter are not limited to the movements involved in speech production. Kinematic data were obtained from gender- and age-matched stuttering (n = 10) and nonstuttering (n = 10) adults during speech movements, orofacial nonspeech movements, and finger movements. All movements were performed in 4 conditions differing in sequence length and location of the target movement within the sequence. Results revealed statistically significant differences between the stuttering and nonstuttering individuals on several measures of lip and jaw closing (but not opening) movements during perceptually fluent speech. The magnitude of these differences varied across different levels of utterance length (larger differences during shorter utterances) and across different locations of the target movement within an utterance (larger differences close to the beginning). Results further revealed statistically significant differences between the stuttering and nonstuttering groups in finger flexion (but not extension) movement duration and peak velocity latency. Overall, findings suggest that differences between stuttering and nonstuttering individuals are not confined to the sensorimotor processes underlying speech production or even movements of the orofacial system in general. Rather, it appears that the groups show generalized differences in the duration of certain goal-directed movements across unrelated motor systems.

Adult↗

Highly reproducible spatiotemporal patterns of mammalian embryonic movements at the developmental stage of the earliest spontaneous motility.

The principles underlying the variations in patterns of mammalian embryonic movements have not been established. In an attempt to clarify the mechanism that is responsible for the variations in motor patterns, we carried out a precise quantitative spatiotemporal analysis of movements in mouse embryos, using a transplacental perfusion method for the in vitro maintenance of live mammalian embryos. Episodes of spontaneous movements at the inception of motility, at embryonic day 12.5, occurred once every few minutes, lasted for several seconds and consisted of successive movements of body regions, the spatiotemporal patterns of which varied from episode to episode. By analysing and categorizing the patterns of these movements, we found that embryonic movements follow relatively few restricted patterns with respect to the order of the movements of body regions. A further analysis of episodes at high spatiotemporal resolution revealed that most of the episodes in a major category could be classified into two distinct subtypes. Each of these subtypes had its own highly reproducible spatiotemporal patterns of movement. Overall, these results show that early embryonic movements follow relatively few rather stereotyped patterns, and random local fluctuations have little effect on such movement patterns. The appearance of one pattern out of several rather stereotyped patterns may be the main cause of apparent variations in patterns of early embryonic movements. The stereotyped patterns may represent important orderly characteristics of spontaneous embryonic activities that may be involved in the development of orderly structures and functions in higher animals.

Animals↗

Neuronal populations in primary motor cortex encode bimanual arm movements.

Previous studies have shown that activity of neuronal populations in the primary motor cortex (MI), processed by the population vector method, faithfully predicts upcoming movements. In our previous studies we found that single neurons responded differently during movements of one arm vs. combined movements of the two arms. It was, therefore, not clear whether the population vector approach could produce reliable movement predictions also for bimanual movements. This study tests this question by comparing the predictive quality of population vectors for unimanual and bimanual arm movements. We designed a bimanual motor task that requires coordinated movements of the two arms, in which each arm may move in eight directions, and recorded single unit activity in the MI of two rhesus (Macaca mulatta) monkeys during the performance of unimanual and bimanual arm movements. We analysed the activity of 212 MI cells from both hemispheres and found that, despite bimanual related activity, the directional tuning and preferred directions of most cells were preserved in unimanual and bimanual movements. We demonstrate that population vectors, constructed from the activity of MI cells, predict accurately the direction of movement both for unimanual and for bimanual movements even when the two arms move simultaneously in different directions.

Action Potentials↗

Interjoint coordination during pointing movements is disrupted in spastic hemiparesis.

Approaches to the rehabilitation of movement in spastic hemiparetic patients depend on knowledge of the underlying mechanisms of movement deficits. The goals of this study were to characterize end-point trajectories and interjoint coordination of arm pointing movements to different targets on a horizontal planar surface and to correlate disruptions in motor control in the affected arm of hemiparetic subjects with the level of spasticity and the degree of functional impairment measured clinically. Arm movements were studied in six normal and 10 hemiparetic subjects. Data from the affected arms of hemiparetic subjects were compared with those from their non-affected arms and to data from the arms of normal subjects. Subjects were seated in front of a horizontal surface adjusted to the height of the sternal notch with the trunk stabilized. They made planar arm reaching movements (20 and 40 cm) to four different targets located directly in front of them and in the ipsilateral and contralateral workspace. Kinematic data from the finger, wrist, elbow and shoulder were recorded with a three-dimensional optical tracking system. Results showed that movement amplitudes were lower and movement times were significantly prolonged in the affected arms. Although trajectories were marked by deviations from smooth straight lines and characterized by increased dispersion and segmentation, even those subjects with the most severe spasticity could reach into all parts of the workspace with both their affected and non-affected arms. This indicated that movement planning in terms of extrapersonal space was unaffected in these subjects. On the other hand, the interjoint coordination of movements made into or out of the typical extensor or flexor synergies was equally disrupted. These findings suggest a bi-level control organization of pointing movements in both normal and hemiparetic subjects: the level of trajectory planning in extrapersonal space and the level specifying interjoint coordination according to the trajectory plan. Deficits in motor performance in stroke patients may be associated with problems at the second control level. This implies some strategies for the rehabilitation of stroke patients with motor disorders. Treatment aimed at improving arm function should be oriented toward restoring the normal sensorimotor relationships between the joints. We also found that while clinical spasticity scores were correlated with some aspects of motor performance, they provided little information about the movement deficit itself.

Adult↗

Single-joint rapid arm movements in normal subjects and in patients with motor disorders.

In normal subjects the execution of single rapid one-joint movements is characterized by an electromyographic (EMG) pattern composed of three discrete bursts of activity; two bursts (first and second agonist bursts, or AG1 and AG2) are present in the agonist muscle separated by an almost complete period of electrical silence. During this pause, another burst (antagonist burst, or ANT) occurs in the antagonist muscle. If a rapid movement is executed during tonic activation of the agonist muscle, tonic activity is inhibited just prior to AG1 onset (agonist inhibition). Similarly, if the movement is performed during tonic activation of the antagonist muscle, such activity is also inhibited prior to AG1 onset (antagonist inhibition). Antagonist inhibition also starts prior to AG1 onset and lasts until ANT onset. A general descriptor of the kinematic features related to the EMG pattern described above is a symmetrical and unimodal velocity profile that is bell-shaped and shows an acceleration time roughly equal to the deceleration time. This holds true for movements performed under low accuracy constraints; as accuracy demands become stricter and stricter, the peak velocity decreases but, as long as the movement is made with one continuous trajectory, the velocity profile remains roughly symmetrical. In general terms, the function of AG1 is to provide the impulsive force to start the movement; the function of ANT is to halt the movement at the desired end-point; and the function of AG2 is to dampen out the oscillations which might occur at the end of the movement. The timing and size of the bursts vary according to the speed and amplitude of the movement. The origin of the EMG pattern is a central programme, but afferent inputs can modulate the voluntary activity. In this paper, we also review the EMG and kinematic abnormalities that are present during the execution of single-joint, rapid arm movements in patients with Parkinson's disease, Huntington's disease, Sydenham's chorea, dystonia, athetosis, cerebellar deficits, upper motor neuron syndrome, essential tremor and large-fibre sensory neuropathy. The data from these studies lead us to the following conclusions: (i) the basal ganglia have a role in scaling the size of AG1, reinforcing the voluntary command and inhibiting inappropriate EMG activity; (ii) the cerebellum has a role in timing the voluntary bursts and probably in implementing muscle force phasically; (iii) the corticospinal tract has a role in determining spatial and temporal recruitment of motor units; (iv) proprioceptive feedback is not necessary to produce the triphasic pattern but it contributes to the accuracy of both the trajectory and the end-point of rapid movements.

Arm↗

Watching your foot move--an fMRI study of visuomotor interactions during foot movement.

The objective of this study was to investigate brain areas involved in distinguishing sensory events caused by self-generated movements from similar sensory events caused by externally generated movements using functional magnetic resonance imaging. Subjects performed 4 types of movements: 1) self-generated voluntary movement with visual feedback, 2) externally generated movement with visual feedback, 3) self-generated voluntary movement without visual feedback, and 4) externally generated movement without visual feedback, this design. This factorial design makes it possible to study which brain areas are activated during self-generated ankle movements guided by visual feedback as compared with externally generated movements under similar visual and proprioceptive conditions. We found a distinct network, comprising the posterior parietal cortex and lateral cerebellar hemispheres, which showed increased activation during visually guided self-generated ankle movements. Furthermore, we found differential activation in the cerebellum depending on the different main effects, that is, whether movements were self- or externally generated regardless of visual feedback, presence or absence of visual feedback, and activation related to proprioceptive input.

Adolescent↗