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Biomedical subjects

J W Krakauer

Publications and source records attributed to J W Krakauer.

6 recordsLinked to original sources

Reversible leukoencephalopathy associated with cerebral amyloid angiopathy.

The authors describe three patients with reversible leukoencephalopathy associated with cerebral amyloid angiopathy (CAA). Rapid progression of neurologic symptoms was followed by dramatic clinical and radiographic improvement. Pathologically, CAA was associated with varying degrees of inflammation ranging from none to transmural granulomatous infiltration. In the appropriate clinical context, the MRI finding of lobar white matter edema with evidence of prior hemosiderin deposition may indicate the presence of a reversible CAA leukoencephalopathy.

Aged↗

Learning of visuomotor transformations for vectorial planning of reaching trajectories.

The planning of visually guided reaches is accomplished by independent specification of extent and direction. We investigated whether this separation of extent and direction planning for well practiced movements could be explained by differences in the adaptation to extent and directional errors during motor learning. We compared the time course and generalization of adaptation with two types of screen cursor transformation that altered the relationship between hand space and screen space. The first was a gain change that induced extent errors and required subjects to learn a new scaling factor. The second was a screen cursor rotation that induced directional errors and required subjects to learn new reference axes. Subjects learned a new scaling factor at the same rate when training with one or multiple target distances, whereas learning new reference axes took longer and was less complete when training with multiple compared with one target direction. After training to a single target, subjects were able to transfer learning of a new scaling factor to previously unvisited distances and directions. In contrast, generalization of rotation adaptation was incomplete; there was transfer across distances and arm configurations but not across directions. Learning a rotated reference frame only occurred after multiple target directions were sampled during training. These results suggest the separate processing of extent and directional errors by the brain and support the idea that reaching movements are planned as a hand-centered vector whose extent and direction are established via learning a scaling factor and reference axes.

Adaptation, Physiological↗

Evolution of cortical activation during recovery from corticospinal tract infarction.

BACKGROUND AND PURPOSE: Recovery from hemiparesis due to corticospinal tract infarction is well documented, but the mechanism of recovery is unknown. Functional MRI (fMRI) provides a means of identifying focal brain activity related to movement of a paretic hand. Although prior studies have suggested that supplementary motor regions in the ipsilesional and contralesional hemisphere play a role in recovery, little is known about the time course of cortical activation in these regions as recovery proceeds. METHODS: Eight patients with first-ever corticospinal tract lacunes causing hemiparesis had serial fMRIs within the first few days after stroke and at 3 to 6 months. Six healthy subjects were used as controls. Statistically significant voxels during a finger-thumb opposition task were identified with an automated image processing program. An index of ipsilateral versus contralateral activity was used to compare relative contributions of the 2 hemispheres to motor function in the acute and chronic phases after stroke. RESULTS: Controls showed expected activation in the contralateral sensorimotor cortex (SMC), premotor, and supplementary motor areas. Stroke patients differed from control patients in showing greater activation in the ipsilateral SMC, ipsilateral posterior parietal, and bilateral prefrontal regions. Compared with the nonparetic hand, the ratio of contralateral to ipsilateral SMC activity during movement of the paretic hand increased significantly over time as the paretic hand regained function. CONCLUSIONS: The evolution of activation in the SMC from early contralesional activity to late ipsilesional activity suggests that a dynamic bihemispheric reorganization of motor networks occurs during recovery from hemiparesis.

Adult↗

Independent learning of internal models for kinematic and dynamic control of reaching.

Psychophysical studies of reaching movements suggest that hand kinematics are learned from errors in extent and direction in an extrinsic coordinate system, whereas dynamics are learned from proprioceptive errors in an intrinsic coordinate system. We examined consolidation and interference to determine if these two forms of learning were independent. Learning and consolidation of two novel transformations, a rotated spatial reference frame and altered intersegmental dynamics, did not interfere with each other and consolidated in parallel. Thus separate kinematic and dynamic models were constructed simultaneously based on errors computed in different coordinate frames, and possibly, in different sensory modalities, using separate working-memory systems. These results suggest that computational approaches to motor learning should include two separate performance errors rather than one.

Adult↗

Stimulus context in hemineglect.

Rightward deviation on bisection of a horizontal line is well described in patients with right brain injury and left hemineglect. Because of the observation that hemineglect patients may bisect very short lines to the left of the true midpoint (the so-called crossover effect), additional models have been proposed to incorporate this finding into existing theories of hemineglect. We investigated a line-length effect in six patients with left hemineglect. When presented with any set of lines of uniform (reference) length, percentage rightward deviation on line bisection remained constant across different line lengths. When lines of a second length were mixed into any uniform set of lines, bisection performance on the reference lines changed. A rightward shift in the perceived midpoint of the reference line occurred if the added lines were shorter than the reference lines; a leftward shift occurred if the added lines were longer. Leftward shifts included shifts across the true midpoint, reproducing the crossover effect. Shifts in the perceived midpoint occurred both on a manual line bisection task and on a line bisection discrimination task in which no manual response was required. We propose that the crossover effect may be part of a more general stimulus-context effect in which the perceived midpoint of a line is related not to absolute length, but to the line's length relative to other lines with which it is presented. Such a context effect has not hitherto been described in the neglect syndrome. A possible mechanism for the effect is a generalization of length estimation produced by the combined influence of the focal stimulus and all stimuli that precede it.

Adult↗

Learning of scaling factors and reference axes for reaching movements.

TO further understand visuomotor transformations in reaching, we compared adaptation to display rotation and altered gain in planar movements. Healthy subjects moved a cursor on a screen by moving an indicator on a horizontal digitizing tablet with their unseen hand. Adaptation to rotation was less complete and was accompanied by markedly increased directional variability. Adaptation training on a single target generalized broadly for gain change, but poorly for rotation. We propose that the difficulty in adapting to rotation arises from the substantial demands on short-term working memory imposed by the need to determine the new reference direction. Adaptation to gain change makes more modest demands on short-term memory to recalibrate the visuomotor scaling factor.

Adaptation, Physiological↗