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Abstract Background We hypothesized that postural instability observed in individuals with Parkinson's disease (PD) can be classified as distinct subtypes based on comprehensive analyses of various evaluated parameters obtained from time-series of center of pressure (CoP) data during quiet standing. The aim of this study was to characterize the postural control patterns in PD patients by performing an exploratory factor analysis and subsequent cluster analysis using CoP time-series data during quiet standing. Methods 127 PD patients, 47 aged 65 years or older healthy older adults, and 71 healthy young adults participated in this study. Subjects maintain quiet standing for 30 s on a force platform and 23 variables were calculated from the measured CoP time-series data. Exploratory factor analysis and cluster analysis with a Gaussian mixture model using factors were performed on each variable to classify subgroups based on differences in characteristics of postural instability in PD. Results The factor analysis identified five factors (magnitude of sway, medio-lateral frequency, anterio-posterior frequency, component of high frequency, and closed-loop control). Based on the five extracted factors, six distinct subtypes were identified, which can be considered as subtypes of distinct manifestations of postural disorders in PD patients. Factor loading scores for the clinical classifications (younger, older, and PD severity) overlapped, but the cluster classification scores were clearly separated. Conclusions The cluster categorization clearly identifies symptom-dependent differences in the characteristics of the CoP, suggesting that the detected clusters can be regarded as subtypes of distinct manifestations of postural disorders in patients with PD.

Abstract Walking with pulling force fields acting at the body center of mass (in the forward or backward directions) is compatible with inclined walking and is used in clinical practice for gait training. From the perspective of known differences in the motor strategies that underlie walking with the respective force fields, the present study elucidated whether the adaptation acquired by walking on a split-belt treadmill with either one of the force fields affects subsequent walking in a force field in the opposite directions. Walking with the force field induced an adaptive and de-adaptive behavior of the subjects, with the aspect evident in the braking and propulsive impulses of the ground reaction force (difference in the peak value between the left and right sides for each stride cycle) as parameters. In the parameters, the adaptation acquired during walking with a force field acting in one direction was transferred to that in the opposite direction only partially. Furthermore, the adaptation that occurred while walking in a force field in one direction was rarely washed out by subsequent walking in a force field in the opposite direction and thus was maintained independently of the other. These results demonstrated possible independence in the neural functional networks capable of controlling walking in each movement task with an opposing force field.

Forearm amputees can use body-powered hooks and myoelectric hands for their daily activities. The body-powered hooks are suitable for delicate manipulation. However, their appearance is not always preferred by amputees, and a harness to pull a control cable is not easy to wear. Although the myoelectric hands have a natural appearance similar to the human hand and can be intuitively controlled by a myoelectric control system, they are not easy to try out and are heavy. This paper reports on the Finch, a prosthetic arm with three opposing fingers controlled by a muscle bulge. The aim of developing the Finch is to realize a lightweight prosthetic arm that is easy to wear and use. Three opposing fingers are controlled according to the degree of muscle bulge measured with a muscle bulge sensor on the user’s forearm caused by muscle contraction. A supporter socket, consisting of a resin socket frame and a fabric supporter, allows easy fitting. A simple design using a linear actuator and 3D-printed parts achieved light weight (330 g) and low cost. Six functional tests and user tests using Southampton Hand Assessment Procedure showed that the Finch had a practical function that could be used in daily activities.

Summary: Muscular control during walking is believed to be simplified by the coactivation of muscles called muscle synergies. Although significant corticomuscular connectivity during walking has been reported, the level at which the cortical activity is involved in muscle activity (muscle synergy or individual muscle level) remains unclear. Here we examined cortical correlates of muscle activation during walking by brain decoding of activation of muscle synergies and individual muscles from electroencephalographic signals. We demonstrated that the activation of locomotor muscle synergies was decoded from slow cortical waves. In addition, the decoding accuracy for muscle synergies was greater than that for individual muscles and the decoding of individual muscle activation was based on muscle-synergy-related cortical information. These results indicate the cortical correlates of locomotor muscle synergy activation. These findings expand our understanding of the relationships between brain and locomotor muscle synergies and could accelerate the development of effective brain-machine interfaces for walking rehabilitation. : Human Physiology; Neuroscience; Biomechanics Subject Areas: Human Physiology, Neuroscience, Biomechanics

Summary: Visuospatial neglect (VSN) is a neurological syndrome of higher brain functions in which an individual fails to detect stimuli on a space that is contralateral to a hemispheric lesion. We performed a comprehensive multivariate analysis based on the principal component analysis (PCA) and cluster analysis in patients with right hemisphere stroke and then performed a determination of different elements of VSN. PCA-based cluster analysis detected distinct aspects of VSN as follows: cluster 1: low arousal and attention state, cluster 2: exogenous neglect, cluster 3: spatial working memory (SWM) deficit. Lesion analysis revealed neural correlates for each cluster and highlighted “disturbance of the ventral attention network” for the stagnation of exogenous attention and “parietal damage” for SWM deficit. Our results reveal a pathological structure of VSN as multiple components of an attention network deficit, and they contribute to the understanding of the mechanisms underlying VSN.

The prediction of upcoming perturbation modulates postural responses in the ankle muscles. The effects of this prediction on postural responses vary according to predictable factors. When the amplitude of perturbation can be predicted, the long-latency response is set at an appropriate size for the required response, whereas when the direction of perturbation can be predicted, there is no effect. The neural mechanisms underlying these phenomena are poorly understood. Here, we examined how the corticospinal excitability of the ankle muscles [i.e., the tibialis anterior (TA), the soleus (SOL), and the medial gastrocnemius (MG), with a focus on the TA], would be modulated in five experimental conditions: (1) No-perturbation; (2) Low (anterior translation with small amplitude); (3) High (anterior translation with large amplitude); (4) Posterior (posterior translation with large amplitude); and (5) Random (Low, High, and Posterior in randomized order). We measured the motor-evoked potentials (MEPs) induced by transcranial magnetic stimulation (TMS) at 50 ms before surface-translation in each condition. The electromyographic (EMG) responses evoked by surface-translations were also measured. The results showed that the TA-MEP amplitude was greater in the High condition (where the largest TA-EMG response was evoked among the five conditions) compared to that in the No-perturbation, Low, and Posterior conditions (High vs. No-perturbation, p < 0.001; High vs. Low, p = 0.001; High vs. Posterior, p = 0.001). In addition, the MEP amplitude in the Random condition was significantly greater than that in the No-perturbation and Low conditions (Random vs. No-perturbation, p = 0.002; Random vs. Low, p = 0.002). The EMG response in the TA evoked by perturbation was significantly smaller when a perturbation can be predicted (predictable vs. unpredictable, p < 0.001). In the SOL and MG muscles, no prominent modulations of the MEP amplitude or EMG response were observed, suggesting that the effects of prediction on corticospinal excitability differ between the dorsiflexor and plantar flexor muscles. These findings suggest that the corticospinal excitability in the TA is scaled in parallel with the prediction of the direction and magnitude of an upcoming perturbation in advance.

Recent studies demonstrated that the corticospinal pathway is one of the key nodes for the feedback control of human standing and that the excitability is flexibly changed according to the current state of posture. However, it has been unclear whether this pathway is also involved in a predictive control of human standing. Here, we investigated whether the corticospinal excitability of the soleus (SOL) and tibialis anterior (TA) muscles during standing would be modulated anticipatorily when perturbation was impending. We measured the motor-evoked potential (MEP) induced by transcranial magnetic stimulation over the motor cortex at six stimulus intensities. Three experimental conditions were set depending on predictabilities about perturbation occurrence and onset: No perturbation, No Cue, and Cue conditions. In the Cue condition, an acoustic signal was given as timing information of perturbation. The slope of the stimulus–response relation curve revealed that the TA-MEP was enhanced when postural perturbation was expected compared to when the perturbation was not expected (No Perturbation vs. No Cue, 0.023 ± 0.004 vs. 0.042 ± 0.007; No Perturbation vs. Cue, 0.023 ± 0.004 vs. 0.050 ± 0.009; Bonferroni correction, p = 0.01, respectively). In addition, two-way analysis of variance (intensity × condition) revealed the main effect of condition (F(1,13) = 6.31, p = 0.03) but not intensity and interaction when the MEP amplitude of the Cue and No Cue conditions was normalized by that in No Perturbation, suggesting the enhancement more apparent when timing information was given. The SOL-MEP was not modulated even when perturbation was expected, but it slightly reduced due to the timing information. The results of an additional experiment confirmed that the acoustic cue by itself did not affect the TA- and SOL-MEPs. Our findings suggest that a prediction of a future state of standing balance modulates the corticospinal excitability in the TA, and that the additional timing information facilitates this modulation. The corticospinal pathway thus appears to be involved in mechanisms of the predictive control as well as feedback control of standing posture.

The adaptability of human bipedal locomotion has been studied using split-belt treadmill walking. Most of previous studies utilized experimental protocol under remarkably different split ratios (e.g. 1:2, 1:3, or 1:4). While, there is limited research with regard to adaptive process under the small speed ratios. It is important to know the nature of adaptive process under ratio smaller than 1:2, because systematic evaluation of the gait adaptation under small to moderate split ratios would enable us to examine relative contribution of two forms of adaptation (reactive feedback and predictive feedforward control) on gait adaptation. We therefore examined a gait behavior due to on split-belt treadmill adaptation under five belt speed difference conditions (from 1:1.2 to 1:2). Gait parameters related to reactive control (stance time) showed quick adjustments immediately after imposing the split-belt walking in all five speed ratios. Meanwhile, parameters related to predictive control (step length and anterior force) showed a clear pattern of adaptation and subsequent aftereffects except for the 1:1.2 adaptation. Additionally, the 1:1.2 ratio was distinguished from other ratios by cluster analysis based on the relationship between the size of adaptation and the aftereffect. Our findings indicate that the reactive feedback control was involved in all the speed ratios tested and that the extent of reaction was proportionally dependent on the speed ratio of the split-belt. On the contrary, predictive feedforward control was necessary when the ratio of the split-belt was greater. These results enable us to consider how a given split-belt training condition would affect the relative contribution of the two strategies on gait adaptation, which must be considered when developing rehabilitation interventions for stroke patients.

Human locomotion is flexible in meeting the requirements of given environmental or task demands. Hence, in everyday life, we can walk, run, and skip in environmental surroundings that vary from hour to hour and even from second to second. In making such flexible adjustments, a sense of “adaptability” attained by the central nervous system plays an important role. In the literature, adaptation studies focusing on locomotion have attracted a great deal of attention in recent years for their potential application to the designing of gait training programs, and as a useful method for revealing the specific mechanisms underlying human locomotion. In this review article, to address how locomotor adaptation is related to social locomotion, the authors introduce knowledge accumulated in recent decades, particularly that related to two different types of locomotor adaptation studies: first, studies that address the general features of locomotor adaptation including underlying neural mechanisms, and second, those that use experimental paradigms of locomotor adaptation to reveal the context-dependency of locomotion. It should be noted that, although knowledge of locomotor adaptation has been increasing, the field is still largely unexplored, and further intensive research in the future is necessary.

While previous studies have shown that muscle stretching suppresses monosynaptic spinal reflex excitability in stretched muscles, its effects on non-stretched muscles is still largely unknown. The purpose of this study was to examine the effects of muscle stretching on monosynaptic spinal reflex in non-stretched muscles. Ten healthy male subjects participated in this study. Muscle stretching of the right triceps surae muscle was performed using a motor torque device for 1 minute. Three different dorsiflexion torques (at approximately 5, 10, and 15 Nm) were applied during muscle stretching. Spinal reflexes evoked by transcutaneous spinal cord stimulation were recorded in both the lower-limb muscles before, during, and at 0 and 5 min following muscle stretching. The amplitudes of the spinal reflexes in both the stretched and non-stretched muscles in the right (ipsilateral) leg were smaller during stretching compared to before, and at 0 and 5 min after stretching. Furthermore, the degree of reduction in the amplitude of the spinal reflexes in the right (ipsilateral) leg muscles increased significantly as the dorsiflexion torque (i.e., stretching of the right triceps surae muscles) increased. In contrast, reduction in the amplitude of the spinal reflexes with increasing dorsiflexion torque was not seen in the left (contralateral) leg muscles. Our results clearly indicate that muscle stretching has inhibitory effects on monosynaptic spinal reflexes, not only in stretched muscles, but also in non-stretched muscles of the ipsilateral leg.

Chronic smoking has been shown to have deleterious effects on brain function and is an important risk factor for ischemic stroke. Reduced cortical excitability has been shown among chronic smokers compared with non-smokers to have a long-term effect and so far no study has assessed the effect of smoking on short-term motor learning. Paired associative stimulation (PAS) is a commonly used method for inducing changes in excitability of the motor cortex (M1) in a way that simulates short-term motor learning. This study employed PAS to investigate the effect of chronic cigarette smoking on plasticity of M1. Stimulator output required to elicit a motor-evoked potential (MEP) of approximately 1 mV was similar between the groups prior to PAS. MEP response to single pulse stimuli increased in the control group and remained above baseline level for at least 30 min after the intervention, but not in the smokers who showed no significant increase in MEP size. The silent period was similar between groups at all time points of the experiment. This study suggests that chronic smoking may have a negative effect on the response to PAS and infers that chronic smoking may have a deleterious effect on the adaptability of M1.

The purpose of the present study was to investigate how stretch reflex (SR) responses in the ankle extensor (soleus: SOL) and flexor (tibialis anterior: TA) muscles would be modulated with temporal and/or spatial predictions of external perturbations and whether their effects are specific to the standing posture. SR responses in the SOL/TA were elicited by imposing quick ankle toes-up/toes-down rotations while standing upright and in the supine position. We designed four experimental conditions based on pre-information about perturbations: no information (No Cue), the timing of the perturbation onset (TIM), the direction of the perturbation (DIR), and both the timing and direction of the perturbation (TIM/DIR). Each condition was separated and its order was counterbalanced. In the SR of TA evoked by toes-down rotation, integrated electromyography activities of the late component were significantly reduced in the TIM and TIM/DIR conditions as compared with those in the No Cue and DIR conditions. The occurrence rate of late SR components that reflects how often the reflex response was observed was also lower in the TIM and TIM/DIR conditions as compared with that in the No Cue and DIR conditions. On the other hand, no significant changes were seen among the four conditions in the early SR component in the TA and both SR components in the SOL. The same results in the occurrence rate were found in the supine position. The present results suggest (1) only temporal predictions have a remarkable effect on the SR excitability of the TA, and (2) this effect is independent of posture.

A phantom limb is the sensation that an amputated limb is still attached to the body and is moving together with other body parts. Phantom limb phenomenon is often described on the basis of the patient's subjective sense, for example as represented using a visual analog scale (VAS). The aim of this study was to propose a novel quantification method for behavioral aspect of phantom limb by psychophysics. Twelve unilateral forearm amputees were asked to perform phantom wrist motion with various motion frequencies (60, 80, 100, 120, 140, 160, 180, 200, 220, 240% of preferred speed). The attainment of phantom limb motion in each session was rated by the VAS ranging from 0 (hard) to 10 (easy). The relationship between the VAS and motion frequency was mathematically fitted by quadric function, and the value of shift and the degree of steepness were obtained as evaluation variables for the phantom limb movement. In order to test whether the proposed method can reasonably quantify the characteristics of phantom limb motion, we compared the variables among three different phantom limb movement conditions: (1) unilateral (phantom only), (2) bimanual, and (3) bimanual wrist movement with mirror reflection-induced visual feedback (MVF). While VAS rating showed a larger extent of inter- and intra-subject variability, the relationship of the VAS in response to motion frequency could be fitted by quadric curve, and the obtained parameters based on quadric function well characterize task-dependent changes in phantom limb movement. The present results suggest the potential usefulness of psychophysical evaluation as a validate assessment tool of phantom limb condition.

The aim of the present study was to elucidate the adaptive and de-adaptive nature of human running on a split-belt treadmill. The degree of adaptation and de-adaptation was compared with those in walking by calculating the antero-posterior component of the ground reaction force (GRF). Adaptation to walking and running on a split-belt resulted in a prominent asymmetry in the movement pattern upon return to the normal belt condition, while the two components of the GRF showed different behaviors depending on the gaits. The anterior braking component showed prominent adaptive and de-adaptive behaviors in both gaits. The posterior propulsive component, on the other hand, exhibited such behavior only in running, while that in walking showed only short-term aftereffect (lasting less than 10 seconds) accompanied by largely reactive responses. These results demonstrate a possible difference in motor strategies (that is, the use of reactive feedback and adaptive feedforward control) by the central nervous system (CNS) for split-belt locomotor adaptation between walking and running. The present results provide basic knowledge on neural control of human walking and running as well as possible strategies for gait training in athletic and rehabilitation scenes.

OBJECTIVE: To test whether the phantom limb awareness could be altered by observing mirror reflection-induced visual feedback (MVF) in unilateral forearm amputees. METHODS: Ten unilateral forearm amputees were asked to perform bilateral (intact and phantom) synchronous wrist motions with and without MVF. During wrist motion, electromyographic activities in the extensor digitorum longus (EDL) and flexor carpi radialis muscles (FCR) were recorded with bipolar electrodes. Degree of wrist range of motion (ROM) was also recorded by electrogoniometry attached to the wrist joint of intact side. Subjects were asked to answer the degree of attainment of phantom limb motion using a visual analog scale (VAS: ranging from 0 (hard) to 10 (easy)). RESULTS: VAS and ROM were significantly increased by utilizing MVF, and the extent of an enhancement of the VAS and wrist ROM was positively correlated (r = 0.72, p

The two major modes of locomotion in humans, walking and running, may be regarded as a function of different speed (walking as slower and running as faster). Recent results using motor learning tasks in humans, as well as more direct evidence from animal models, advocate for independence in the neural control mechanisms underlying different locomotion tasks. In the current study, we investigated the possible independence of the neural mechanisms underlying human walking and running. Subjects were tested on a split-belt treadmill and adapted to walking or running on an asymmetrically driven treadmill surface. Despite the acquisition of asymmetrical movement patterns in the respective modes, the emergence of asymmetrical movement patterns in the subsequent trials was evident only within the same modes (walking after learning to walk and running after learning to run) and only partial in the opposite modes (walking after learning to run and running after learning to walk) (thus transferred only limitedly across the modes). Further, the storage of the acquired movement pattern in each mode was maintained independently of the opposite mode. Combined, these results provide indirect evidence for independence in the neural control mechanisms underlying the two locomotive modes.