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Convergent inputs from thalamic motor nuclei and frontal cortical areas to the dorsal striatum in the primate.

Current models of basal ganglia circuitry primarily associate the ventral thalamic nuclei with relaying basal ganglia output to the frontal cortex. However, some studies have demonstrated projections from the ventral anterior (VA) and ventral lateral (VL) thalamic nuclei to the striatum, suggesting that these nuclei directly modulate the striatum. VA/VL nuclei have specific connections with primary, supplementary, premotor, and cingulate motor cortices indicating their involvement in motor function. These areas mediate different aspects of motor control such as movement execution, motor learning, and sensorimotor integration. Increasing evidence indicates that functionally related motor areas have convergent projections to the dorsal striatum, suggesting that integration of different aspects of motor control occur at the level of the striatum. This study examines the organization of VA/VL thalamic inputs to the dorsal "motor" striatum to determine how this afferent projection is organized with respect to corticostriatal afferents from motor, premotor, and cingulate motor areas. Motor cortical projections to specific dorsal striatal regions arose from multiple areas, including components from primary motor, premotor, supplementary, and cingulate motor areas. Diverse motor cortical projections to a given dorsal striatal region indicated convergence of functionally related corticostriatal motor pathways. Most dorsal striatal sites received dense thalamic inputs from the VL pars oralis nucleus. Additional thalamostriatal projections arose from VA, VL pars caudalis, and ventral posterior lateral pars oralis nuclei and Olszewski's Area X. Our results provide evidence for convergent striatal projections from interconnected ventral thalamic and cortical motor areas, suggesting that these afferents modulate the same striatal output circuits.

Animals↗

Cerebral functional magnetic resonance imaging activation modulated by a single dose of the monoamine neurotransmission enhancers fluoxetine and fenozolone during hand sensorimotor tasks.

Fluoxetine inhibits the reuptake of serotonin, and dextroamphetamine enhances presynaptic release of monoamines. Although the excitatory effect of both noradrenaline and dopamine on motor behavior generally is accepted, the role of serotonin on motor output is under debate. In the current investigation, the authors evidenced a putative role of monoamines and, more specifically, of serotonin in the regulation of cerebral motor activity in healthy subjects. The effects on cerebral motor activity of a single dose of fluoxetine (20 mg), an inhibitor of serotonin reuptake, and fenozolone (20 mg/50 kg), an amphetamine-like drug, were assessed by functional magnetic resonance imaging. Subjects performed sensorimotor tasks with the right hand. Functional magnetic resonance imaging studies were performed in two sessions on two different days. The first session, with two scan experiments separated by 5 hours without any drug administration, served as time-effect control. A second, similar session but with drug administration after the first scan assessed drug effects. A large increase in evoked signal intensity occurred in the ipsilateral cerebellum, and a parallel, large reduction occurred in primary and secondary motor cortices (P < 10(-3)). These results are consistent with the known effects of habituation. Both drugs elicited comparable effects, that is, a more focused activation in the contralateral sensorimotor area, a greater involvement of posterior supplementary motor area, and a widespread decrease of bilateral cerebellar activation (P < 10(-3)). The authors demonstrated for the first time that cerebral motor activity can be modulated by a single dose of fluoxetine or fenozolone in healthy subjects. Drug effects demonstrated a direct or indirect involvement of monoamines and serotonin in the facilitation of cerebral motor activity.

Adult↗

The role of the sensorimotor system in the athletic shoulder.

OBJECTIVE: To discuss the role of the sensorimotor system as it relates to functional stability, joint injury, and muscle fatigue of the athletic shoulder and to provide clinicians with the necessary tools for restoring functional stability to the athletic shoulder after injury. DATA SOURCES: We searched MEDLINE, SPORT Discus, and CINAHL from 1965 through 1999 using the key words "proprioception," "neuromuscular control," "shoulder rehabilitation," and "shoulder stability." DATA SYNTHESIS: Shoulder functional stability results from an interaction between static and dynamic stabilizers at the shoulder. This interaction is mediated by the sensorimotor system. After joint injury or fatigue, proprioceptive deficits have been demonstrated, and neuromuscular control has been altered. To restore stability after injury, deficits in both mechanical stability and proprioception and neuromuscular control must be addressed. A functional rehabilitation program addressing awareness of proprioception, restoration of dynamic stability, facilitation of preparatory and reactive muscle activation, and implementation of functional activities is vital for returning an athlete to competition. CONCLUSIONS/RECOMMENDATIONS: After capsuloligamentous injury to the shoulder joint, decreased proprioceptive input to the central nervous system results in decreased neuromuscular control. The compounding effects of mechanical instability and neuromuscular deficits create an unstable shoulder joint. Clinicians should not only address the mechanical instability that results from joint injury but also implement both traditional and functional rehabilitation to return an athlete to competition.

Journal Article↗

Corticocortical connections of the cat sensory areas studied by means of retrograde axonal transport of horseradish peroxidase.

Afferent association connections to each functional cortex, i.e., the auditory, sensorimotor, visual, and "association" cortex, were investigated in the cat with the method of retrograde axonal transport of horseradish peroxidase (HRP). After injections of HRP in various parts of the cerebral cortex, a large number of labeled cells were found within the same functional areas, while a small number of cells were labeled in other cortical areas. This demonstrates that small parts within the functionally uniform cortical area are strongly interconnected by means of short association fibers. Labeled cells were found both in the cortex of the gyral surfaces and sulcal walls. Corticocortical neurons in the walls of some sulci were also shown to send their axons to various sensory areas. Cells of the origin of association fibers were mostly pyramidal in shape, occurring mainly in layer III of the various cortical areas (about 70% of the total number). Following injections of HRP suspension into the visual cortex, however, the majority of labeled cells (82%) were found in layers V and VI of the Clare-Bishop area, some of them were polygonal in shape. Somal diameters of the labeled cells were 15.8-17.2 micron (mean) +/- 2.5-3.0 (SD).

Afferent Pathways↗

Historical contributions to the modern understanding of function in the central area.

OBJECTIVE: To review the historical developments leading to the modern understanding of central area physiological features. METHODS: Important scientific writings related to stimulation and function of the central area were studied, beginning with the first electrolytic battery description. RESULTS: Volta's description of the electrolytic battery provided a reliable tool for mapping cortical function. However, 70 years elapsed before Fritsch and Hitzig convincingly demonstrated an excitable cortex and challenged Flourens' theories of cerebral function. The localization of sensory and motor cortical representations was hampered by difficulties in interpreting responses to stimulation in animals and in relating animal data to the human brain. Nevertheless, by the beginning of the 20th century, the evidence for a separate sensory and motor gyrus within the central area was overwhelming. Pioneering surgeons such as Keen, Krause, Foerster, Frazier, and Cushing demonstrated the motor and sensory areas in human subjects during the course of surgery. CONCLUSION: The interpretation of central area function has evolved from the 19th century view that diffuse areas of the cortex and the limbic system serve motor and sensory functions to the theories of Grünbaum, Sherrington, Campbell, and others at the beginning of the 20th century, who suggested segregated functional regions defined by sulcal and architectonic anatomic features. Subsequently, Penfield and Rasmussen supported the idea of a sensorimotor area in which central area function is not strictly separated by the central sulcus. Modern research using microelectrode recordings and functional imaging indicates localized primary sensory and motor functions defined by architectonic anatomic features.

Brain Mapping↗

Bilateral overactivation of the sensorimotor cortex in the unilateral rodent model of Parkinson's disease - a functional magnetic resonance imaging study.

Functional magnetic resonance imaging (fMRI) is used to investigate the basal ganglia (BG)-cortex circuit using a rat model of Parkinson's disease (PD). The model involves a unilateral destruction of the right substantia nigra by intranigral injection of the dopaminergic neurotoxin 6-hydroxydopamine. Volume of cortical activity was measured by the blood oxygenation level-dependent contrast method while applying electrical forepaw stimulation. The main findings are the following. (i) Contrary to the predictions of the classic model but in line with recent experimental results (positron emission tomography, fMRI and electrophysiology), an increased cortical activity in the sensorimotor cortex of PD rats compared with sham-operated or normal rats was found. (ii) A diffuse neuronal activity at large cortical areas that were not related directly to the stimulation used, was observed. (iii) No difference was found between the lesion and the nonlesion hemispheres when the left or the right forepaw was stimulated; both cortices show significant overactivation of the sensorimotor cortices in addition to diffuse cortical activation. The last finding could be explained by either corticocortical connections or by bilateral BG-cortex connections. These finding suggest that the mutual influence of the two hemispheres is important in the pathophysiology of the BG-cortex circuit and might be crucial in predicting treatments.

Animals↗

Behavioral recovery from unilateral photothrombotic infarcts of the forelimb sensorimotor cortex in rats: role of the contralateral cortex.

During sensorimotor recovery following stroke ipsi- and contralesional alterations in brain function have been characterized in patients as well as animal models of focal ischemia, but the contribution of these bilateral processes to the functional improvement is only poorly understood. Here we examined the role of the homotopic contralateral cortex for sensorimotor recovery after focal ischemic infarcts at different time periods after the insult. One group of animals received a unilateral single photothrombotic infarct in the forelimb sensorimotor cortex, while four additional groups received a second lesion in the contralateral homotopic cortex either immediately or 2 days, 7 days, or 10 days after the first infarct. The time course of functional recovery of the impaired forelimbs was assessed using different sensorimotor scores: forelimb-activity during exploratory behavior and frequency of forelimb-sliding in the glass cylinder as well as forelimb misplacement during grid walking. Focal infarcts in the forelimb sensorimotor cortex area significantly impaired the function of the contralateral forelimb in these different behavioral tests. The subsequent damage of the contralateral homotopic forelimb sensorimotor cortex only affected the forelimb opposite to the new lesion but did not reinstate the original deficit. The time course of sensorimotor recovery after bilateral sequential cortical infarcts did not significantly differ from animals with unilateral single lesions. These data indicate that following small ischemic cortical infarcts in the forelimb sensorimotor cortex the contralateral cortex homotopic to the lesion plays only a minor role for functional recovery.

Animals↗

The basal ganglia and motor control.

This paper briefly reviews the functional anatomy of the basal ganglia and their relationships with the thalamocortical system. The basal ganglia, including the striatum, pallidum, subthalamic nucleus, and substantia nigra, are involved in a number of parallel, functionally segregated cortical-subcortical circuits. These circuits support a wide range of sensorimotor, cognitive and emotional-motivational brain functions. A main role of the basal ganglia is the learning and selection of the most appropriate motor or behavioral programs. The internal functional organization of the basal ganglia is very well suited for such selection mechanisms, both in development and in adulthood. The question of whether clumsiness may be, at least in part, attributed to dysfunction of the basal ganglia is discussed in the context of the differential, complementary, or interactive roles of the basal ganglia and the cerebellum in the development of motor control.

Animals↗

Prism adaptation to a rightward optical deviation rehabilitates left hemispatial neglect.

A large proportion of right-hemisphere stroke patients show hemispatial neglect-a neurological deficit of perception, attention, representation, and/or performing actions within their left-sided space, inducing many functional debilitating effects on everyday life, and responsible for poor functional recovery and ability to benefit from treatment. The frequent parietal locus of the lesion producing neglect reflects the impairment of coordinate transformation used by the nervous system to represent extrapersonal space. Given that adaptation to a visual distortion can provide an efficient way to stimulate neural structures responsible for the transformation of sensorimotor coordinates, the aim of our study was to investigate the effect of prism adaptation on various neglect symptoms, including the pathological shift of the subjective midline to the right. All patients exposed to the optical shift of the visual field to the right were improved on their manual body-midline demonstration and on classical neuropsychological tests. Unlike other physiological manipulations used to improve neglect, this improvement lasted for at least two hours after prism removal and thus could be useful in rehabilitation programmes. The positive effect found for both sensorimotor and more cognitive spatial functions suggests that they share or depend on a common level of space representation linked to multisensory integration.

Adaptation, Ocular↗

Chronic intractable epilepsy associated with a tumor located in the central region: functional mapping data and postoperative outcome.

Out of 57 patients operated for intractable epilepsy of the central region, 8 harbored an indolent glioma (7 dysembryoplastic neuroepithelial tumors, 1 ganglioglioma). Mapping of the sensorimotor area with depth electrodes implanted for stereoelectroencephalographic exploration demonstrated no or abnormal motor responses after low-frequency stimulation, and variable sensory responses to high-frequency stimulation, suggesting reorganization of the sensorimotor cortex representation around the tumor and absence of functional tissue within the neoplastic volume. After lesionectomy (3 cases) or corticectomy including the tumor (5 cases), 6 (75%) patients were seizure-free (class I of Engel) at the time to follow-up. No permanent motor or sensory deficit was observed in 6 cases. In 2, a mild facial (in 1) and arm (in 1) deficit persisted. It is concluded that the resection of intrinsic low-grade tumors associated with long-standing epilepsy and located in the central region can be associated with excellent seizure outcome and no or minimal postoperative deficit because of functional reorganization of the sensorimotor cortex.

Adolescent↗

[Comparative analysis of the interactions between spontaneous active neurons of the sensomotor cortex of kittens and adult cats].

The character of functional interneuronal relations in the sensorimotor cortex during spontaneous neural activity in kitten and adult cats immobilized with d-tubocurarine, was studied by the method of cross-correlations of two impulse series. The data obtained by computation revealed specific age-related interneuronal connections in investigated groups of animals. In kitten aged up to 10 days, the highest percentage of the functional connections was observed which were established mainly due to the influence of a common source. In other groups of animals (kittens of 20, 30 days of postnatal life, adult cats) the common source did not play a significant role in the formation of interneuronal connections. The results showed that inhibitory connections between neurones-are established to the end of the first month of the postnatal life.

Age Factors↗

Differentiating autistic children with quantitative encephalography: a 3-month longitudinal study.

The present study used a single-channel quantitative electroencephalographic (EEG) assessment to differentiate autistic children from normal control subjects. One hundred five normal and 17 autistic children participated in the study. In addition to amplitude measures of the frequency bands of delta, theta, alpha, sensorimotor rhythm, and beta and the theta to beta ratio, intra- (6 minutes) and intersessional (3 months) consistencies were also examined. The results indicated that autistic children showed significantly higher quantitative EEG amplitudes in many of the frequency bands than normal children; furthermore, their quantitative EEG activities were found to be relatively unstable within a 6-minute session compared with normal children. Discriminant function analyses revealed that absolute sensorimotor rhythm and beta amplitudes were the best predictors that correctly differentiated autistic children from normal children in the present sample, with a high accuracy rate of 95.2%. In addition, quantitative EEG measurements of normal and autistic children were found to be generally consistent across the 3-month period.

Autistic Disorder↗

Differentiating Autistic Children With Quantitative Encephalography: A 3-Month Longitudinal Study.

The present study used a single-channel quantitative electroencephalographic (EEG) assessment to differentiate autistic children from normal control subjects. One hundred five normal and 17 autistic children participated in the study. In addition to amplitude measures of the frequency bands of delta, theta, alpha, sensorimotor rhythm, and beta and the theta to beta ratio, intra- (6 minutes) and intersessional (3 months) consistencies were also examined. The results indicated that autistic children showed significantly higher quantitative EEG amplitudes in many of the frequency bands than normal children; furthermore, their quantitative EEG activities were found to be relatively unstable within a 6-minute session compared with normal children. Discriminant function analyses revealed that absolute sensorimotor rhythm and beta amplitudes were the best predictors that correctly differentiated autistic children from normal children in the present sample, with a high accuracy rate of 95.2%. In addition, quantitative EEG measurements of normal and autistic children were found to be generally consistent across the 3-month period. (J Child Neurol 2006;21:391-399; DOI 10.2310/7010.2006.00094).

Journal Article↗

The effects of a sensorimotor training and a strength training on postural stabilisation, maximum isometric contraction and jump performance.

Previous studies revealed that adaptations following sensorimotor training, performed to improve functional joint or postural stability, were characterized by improvements in the rate of force development during maximum voluntary isometric contraction. In classical strength training studies using intense loads it has been shown that improvements in rate of force development is mainly due to adaptations in the intramuscular coordination. The purpose of the present study was to compare possible neuromuscular adaptations in two training groups following either sensorimotor or classical strength training over a period of four weeks. Additionally a control group was investigated to contrast the adaptations seen after training. Postural stability, maximum voluntary isometric contraction and performance in squat-jump and in drop-jump were measured before and after training. The results confirmed the positive effects of both training regimen on rate of force development and on maximum strength during maximum voluntary contraction as well as on jump performance, while only the improvements after the strength training were significant. Strength training reduced iMEG, while it was enhanced after sensorimotor training in most testing situations. Strength training had positive effects also on concentric contractions like squat-jump. The sensorimotor training improved performance in reactive drop-jump by enhanced neuromuscular activity immediately after ground contact. It is concluded that classical strength training with high loads basically improves the mechanical efficiency of the efferent drive on the motoneurons, whereas sensorimotor training alters the afferent input on the central nervous system. Both adaptations yield to specific effects during force development.

Adult↗

Long-term outcome after epilepsy surgery for focal cortical dysplasia.

OBJECT: Reports of outcomes for surgical treatment of cortical dysplasia associated with epilepsy are conflicting due to the inclusion of patients with a wide range of malformations of cortical development. The authors report their experience and the long-term outcome for a subgroup of patients with the histopathological diagnosis of focal cortical dysplasia of Taylor. METHODS: The records of 22 patients with focal cortical dysplasia of Taylor (15 with the balloon-cell type and seven with the nonballoon-cell type) were reviewed. There were 11 female and 11 male patients whose mean age was 26 +/- 17.6 years (mean +/- standard deviation [SD]) at surgery. The details of their epilepsy evaluation and resection were analyzed. Extent of resection was preoperatively planned using information obtained from long-term intracranial monitoring (15 patients) and/or more definitively determined by histopathologically proven clear margins during resection when feasible (12 patients). The mean duration of follow up was 6.3 +/- 5.1 years (mean +/- SD, range 0.5-15.6 years). Risk factors for epilepsy were trauma (seven patients) or meningoencephalitis (one patient); 14 patients (64%) had no obvious risk factors. The mean age at seizure onset was 9.2 years and the mean duration of their epilepsy was 16.1 +/- 9 years. In two patients there were no adverse findings on magnetic resonance (MR) imaging. In 15 patients (68%), the epileptogenic zone identified on long-term intracranial monitoring extended beyond the abnormality observed on MR images. Focal resection (lesion plus margins) was performed in 14 patients (64%), whereas eight (36%) underwent partial/tailored lobectomy. Two patients underwent multiple subpial transections in addition to partial lesionectomy because their lesions involved the sensorimotor cortex. In these two, functional MR imaging confirmed a normal functional anatomy despite the presence of the cortical dysplasia. Eleven (92%) of 12 patients who underwent resection guided by histopathologically proven clear margins and three (43%) of seven patients who underwent histopathologically proven subtotal resection have remained seizure free. Evidence of clear margins was significantly associated with an improved seizure outcome (p = 0.003). Postoperatively, expected deficits included nondisabling visual field defects, which occurred in three patients (14%), and transient sensorimotor deficits, which appeared in five (23%). Two patients had meningitis, which was successfully treated with antibiotics. Overall, 16 patients (73%) are either seizure free (13 patients), have rare nondisabling partial seizures (one patient), or had one seizure after their medication was changed (two patients). Thirteen patients (59%) have discontinued anticonvulsant medications or are being maintained on monotherapy. Of five patients (23%), two have had rare disabling seizures or significant reduction in their seizure frequency (three patients). One patient's seizures have remained the same. CONCLUSIONS: Focal cortical dysplasias are a distinct subgroup of malformations of cortical development and have a favorable outcome after resection. The epileptogenic zone often extends beyond the abnormality found on neuroimaging. Resection of the epileptogenic zone guided by histopathologically proven clear margins is associated with an improved seizure outcome.

Adolescent↗

Clinical features of argyrophilic grain disease: a retrospective survey of cases with neuropsychiatric symptoms.

OBJECTIVE: Although argyrophilic grain disease (AGD) appears common in post-mortem series, its clinical features are not widely known. The aim of this study was to explore such clinical features in neuropathologically-confirmed AGD cases. METHODS: After completing a neuropathological assessment of 386 patients, 33 cases (8.5%) were diagnosed as having AGD; 10 were diagnosed as "pure" cases. These subjects had been admitted to geriatric wards of mental hospitals because of behavioral or neuropsychiatric symptoms requiring medical management. Assessment of the clinical features of the pure cases was based on the evaluations in medical records. RESULTS: The average age at onset was 82.2 years. Amnesia was the most common initial symptom; irritability and agitation were also common as initial symptoms. During the course of the illness, irritability was the most frequently observed, followed by delusions (mostly delusions of persecution), dysphoria, and then agitation, and apathy. In contrast to the severity of amnesia, other cognitive functions were relatively spared, and the sensorimotor symptoms were not remarkable. CONCLUSIONS: AGD is a late-onset dementing disorder clinically characterized by amnesia, with other cognitive functions relatively spared, and prominent neuropsychiatric features. These features may correlate with the high level of AGD seen in limbic structures. Future studies are needed to elucidate whether these features are common to all AGD patients or to a clinical subtype with neuropsychiatric symptoms.

Aged↗

Effects of pallidal deep brain stimulation and levodopa treatment on reaction-time performance in Parkinson's disease.

Basal ganglia-thalamocortical circuits play an important role in movement preparation and execution. Tracer, single-cell, and lesion studies in monkeys suggest the existence of topologically segregated motor and nonmotor basal ganglia cortical circuits. In this study we used deep brain stimulation (DBS) of the posteroventrolateral globus pallidus internus (GPi) in patients with Parkinson's disease to elucidate the function of the GPi in human sensorimotor behavior. This question was investigated by comparing the influence of DBS on patients' performance in various reaction-time tasks that differed with respect to cognitive but not motor requirements. As a main result, DBS improved performance on the different tasks independently of the complexity of the involved cognitive processing functions. Furthermore, the observed effects did not depend on the modality of the processed information. These results suggest that the functional state of the posteroventrolateral GPi selectively affects the motor stage in simple sensorimotor acts, because this stage was the only stage involved in all investigated tasks. In addition to DBS, we manipulated the levodopa medication state of the PD patients. In contrast to DBS, levodopa effects on reaction times were less consistent. Levodopa improved reaction times in choice reaction tasks significantly, while affecting reaction times in a simple reaction task to a lesser extent. Error analysis revealed that the medication-dependent reaction-time improvement in the choice reaction tasks was accompanied by an increase in errors, suggesting a shift of the speed-accuracy criteria of the patients. A similar pattern of results was not observed for the DBS effects. Taken together, our data are in agreement with recent findings in monkeys that indicate a topological organization of the GPi in which motor functions are localized in posterolateral regions apart from cognitive regions. Furthermore, our data show a way to uncover the subcortical-cortical circuitry serving human sensorimotor behavior.

Acoustic Stimulation↗