Long-term forced-use therapy after sensorimotor cortex lesions restores contralesional hand function and promotes its preference in Macaca mulatta.

Injury to one cerebral hemisphere can result in paresis of the contralesional hand and subsequent preference of the ipsilesional hand in daily activities. However, forced use therapy in humans can improve function of the contralesional paretic hand and increase its use in daily activities, although the ipsilesional hand may remain preferred for fine motor activities. Studies in monkeys have shown that minimal forced use of the contralesional hand, which was the preferred hand prior to brain injury, can produce remarkable recovery of function.

Proprioceptive acuity for locating and controlling movements of a hand-held tool.

We investigated proprioceptive acuity for location and motion of a never seen hand-held tool (30 cm long rod) and the accuracy of movements to place tool parts in the location of remembered visual targets. Ten blindfolded right-handed subjects (5 females) reached with the tool held in the right hand to touch the tip and midpoint to the stationary and moving left index-tip, to the right and left ear lobes and to remembered visual target locations. We also tested accuracy of left hand rod reaches to the ear lobes to determine if rod dimensions and control of tool movements experienced during right hand tool use could be used to accurately localize the rod parts when held in the left hand.

Proprioceptive acuity for landmarks on the hand and digits.

Previous work using visually guided reaches to localize landmarks on a hidden hand has suggested that proprioceptive acuity for hand targets is low and representation of hand dimensions is highly distorted (e.g., hand width estimated to be 60% wider than actual hand width).

Terminal organization of the corticospinal projection from the arm/hand region of the rostral primary motor cortex (M1r or old M1) to the cervical enlargement (C5-T1) in rhesus monkey.

High-resolution anterograde tracers and stereology were used to study the terminal organization of the corticospinal projection (CSP) from the rostral portion of the primary motor cortex (M1r) to spinal levels C5-T1. Most of this projection (90%) terminated contralaterally within laminae V-IX, with the densest distribution in lamina VII. Moderate bouton numbers occurred in laminae VI, VIII, and IX with few in lamina V.

Diet-induced changes in functional disability are mediated by fatigue in relapsing-remitting multiple sclerosis: A secondary analysis of the WAVES randomized parallel-arm trial.

Background: People with multiple sclerosis (MS) often report dietary modifications; however, evidence on functional outcomes remains sparse.

Objective: Evaluate the impact of the low-saturated fat (Swank) and modified Paleolithic elimination (Wahls) diets on functional disability among people with relapsing-remitting MS.

Methods: Baseline-referenced MS functional composite (MSFC) scores were calculated from nine-hole peg-test (NHPT), timed 25-foot walk, and oral symbol digit modalities test (SDMT-O) collected at four study visits: (a) run-in, (b) baseline, (c) 12 weeks, and (d) 24 weeks.

Acuity of Proprioceptive Localization Varies with Body Region.

We accurately sense locations of objects touching various points on the body and, if they are irritants, make accurate rapid movements to remove them. Such movements require accurate proprioception of orientation and motion of the reaching limb and of the target. However, it is unknown whether acuity of these sensations is similar for different points on the body.

High proprioceptive acuity in slow and fast hand movements.

We can accurately reach to touch our index fingertip to various points on the body without vision. Awareness of location/motion of the index fingertip and other body parts through proprioception is required for such movements. Proprioception involves processing sensory information, but it is also debated whether internal model estimates of body state from motor commands improve proprioception.

Cerebellar Contributions to Motor Impairments in People with Multiple Sclerosis.

Although Charcot characterized classic cerebellar symptoms in people with multiple sclerosis (PwMS) in 1877, the impact of cerebellar dysfunction on MS symptoms has predominately been evaluated in the last two decades. Recent studies have clearly demonstrated the association between cerebellar pathology, including atrophy and reduced fractional anisotropy in the peduncles, and motor impairments, such as reduced gait velocity and time to complete walking tasks. However, future studies using novel imaging techniques are needed to elucidate all potential pathophysiology that is associated with disability in PwMS.

Impact of the Swank and Wahls elimination dietary interventions on fatigue and quality of life in relapsing-remitting multiple sclerosis: The WAVES randomized parallel-arm clinical trial.

Objective: To compare the effect of the modified Paleolithic elimination (Wahls) and low-saturated fat (Swank) diets in relapsing-remitting MS (RRMS).

Methods: Individuals (n = 87) with RRMS were randomized to the Swank or Wahls diets in a parallel group clinical trial consisting of four timepoints: 1) run-in, 2) baseline, 3) 12-weeks, and 4) 24-weeks.

Results: 77 participants completed 12 weeks and 72 completed 24 weeks.

Simultaneous Recording of Motor Evoked Potentials in Hand, Wrist and Arm Muscles to Assess Corticospinal Divergence.

The purpose of this study was to further develop methods to assess corticospinal divergence and muscle coupling using transcranial magnetic stimulation (TMS). Ten healthy right-handed adults participated (7 females, age 34.0 ± 12.

Proprioceptive Acuity is Enhanced During Arm Movements Compared to When the Arm is Stationary: A Study of Young and Older Adults.

Proprioception in old age is thought to be poorer due to degeneration of the central (CNS) and peripheral nervous systems (PNS). We tested whether community-dwelling older adults (65-83 years) make larger proprioceptive errors than young adults (18-22 years) using a natural reaching task. Subjects moved the right arm to touch the index fingertip to the stationary or moving left index fingertip.

Greater Reduction in Contralesional Hand Use After Frontoparietal Than Frontal Motor Cortex Lesions in .

We previously reported that rhesus monkeys recover spontaneous use of the more impaired (contralesional) hand following neurosurgical lesions to the arm/hand representations of primary motor cortex (M1) and lateral premotor cortex (LPMC) (F2 lesion) when tested for reduced use (RU) in a fine motor task allowing use of either hand. Recovery occurred without constraint of the less impaired hand and with occasional forced use of the more impaired hand, which was the preferred hand for use in fine motor tasks before the lesion. Here, we compared recovery of five F2 lesion cases in the same RU test to recovery after unilateral lesions of M1, LPMC, S1 and anterior portion of parietal cortex (F2P2 lesion - four cases).

Changes in ipsilesional hand motor function differ after unilateral injury to frontal versus frontoparietal cortices in Macaca mulatta.

We tested the hypothesis that injury to frontoparietal sensorimotor areas causes greater initial impairments in performance and poorer recovery of ipsilesional dexterous hand/finger movements than lesions limited to frontal motor areas in rhesus monkeys. Reaching and grasping/manipulation of small targets with the ipsilesional hand were assessed for 6-12 months post-injury using two motor tests. Initial post-lesion motor skill and long-term recovery of motor skill were compared in two groups of monkeys: (1) F2 group-five cases with lesions of arm areas of primary motor cortex (M1) and lateral premotor cortex (LPMC) and (2) F2P2 group-five cases with F2 lesions + lesions of arm areas of primary somatosensory cortex and the anterior portion of area 5.

Terminal organization of the corticospinal projection from the lateral premotor cortex to the cervical enlargement (C5-T1) in rhesus monkey.

High-resolution tract tracing and stereology were used to study the terminal organization of the corticospinal projection (CSP) from the ventral (v) and dorsal (d) regions of the lateral premotor cortex (LPMC) to spinal levels C5-T1. The LPMCv CSP originated from the postarcuate sulcus region, was bilateral, sparse, and primarily targeted the dorsolateral and ventromedial sectors of contralateral lamina VII. The convexity/lateral part of LPMCv did not project below C2.

New Corticopontine Connections in the Primate Brain: Contralateral Projections From the Arm/Hand Area of the Precentral Motor Region.

The ipsilateral corticopontine projection (iCPP) represents a massive descending axon system terminating in the pontine nuclei (PN). In the primate, this projection is well known for its dominant influence on contralateral upper limb movements through the classical cerebrocerebellar circuity system. Although a much weaker contralateral corticopontine projection (cCPP) from motor cortex to the paramedian region has been reported in the non-human primate brain, we provide the first comprehensive description of the cCPP from the lateral motor cortex using high resolution anterograde tract tracing in .

Effects of a multimodal intervention on gait and balance of subjects with progressive multiple sclerosis: a prospective longitudinal pilot study.

Purpose: To investigate the effects of a multimodal intervention including a modified Paleolithic diet, nutritional supplements, stretching, strengthening exercises with electrical stimulation of trunk and lower limb muscles, meditation and massage on walking performance and balance of subjects with progressive multiple sclerosis (MS).

Materials And Methods: Twenty subjects with mean (standard deviation) age of 51.7 (6.

Hand Motor Recovery Following Extensive Frontoparietal Cortical Injury Is Accompanied by Upregulated Corticoreticular Projections in Monkey.

We tested the hypothesis that arm/hand motor recovery after injury of the lateral sensorimotor cortex is associated with upregulation of the corticoreticular projection (CRP) from the supplementary motor cortex (M2) to the gigantocellular reticular nucleus of the medulla (Gi). Three groups of rhesus monkeys of both genders were studied: five controls, four cases with lesions of the arm/hand area of the primary motor cortex (M1) and the lateral premotor cortex (LPMC; F2 lesion group), and five cases with lesions of the arm/hand area of M1, LPMC, S1, and anterior parietal cortex (F2P2 lesion group). CRP strength was assessed using high-resolution anterograde tracers injected into the arm/hand area of M2 and stereology to estimate of the number of synaptic boutons in the Gi.

Pointing to One's Moving Hand: Putative Internal Models Do Not Contribute to Proprioceptive Acuity.

We can easily and without sight bring our fingertip to our nose, or swat a mosquito on our arm. These actions rely on proprioception, also known as kinesthesia, which classically has been attributed to processing of sensory inflow by the CNS. However, internal model theories of sensorimotor neuroscience propose that proprioceptive localization also involves a contribution from estimates of limb kinematics derived from motor commands.

Dietary approaches to treat MS-related fatigue: comparing the modified Paleolithic (Wahls Elimination) and low saturated fat (Swank) diets on perceived fatigue in persons with relapsing-remitting multiple sclerosis: study protocol for a randomized controlled trial.

Background: Fatigue is one of the most disabling symptoms of multiple sclerosis (MS) and contributes to diminishing quality of life. Although currently available interventions have had limited success in relieving MS-related fatigue, clinically significant reductions in perceived fatigue severity have been reported in a multimodal intervention pilot study that included a Paleolithic diet in addition to stress reduction, exercise, and electrical muscle stimulation. An optimal dietary approach to reducing MS-related fatigue has not been identified.

The Acute Effects of Aerobic Exercise on the Functional Connectivity of Human Brain Networks.

Although there is promising evidence that regular physical activity could counteract age-related decline in cognitive and brain function, the mechanisms for this neuroprotection remain unclear. The acute effects of exercise can provide insight into the mechanisms by which the brain adapts to habitual exercise by reflecting transient modulations of systems that would subsequently accumulate long-term adaptations through repeated training sessions. However, methodological limitations have hindered the mechanistic insight gained from previous studies examining acute exercise effects on the human brain.

Randomized control trial evaluation of a modified Paleolithic dietary intervention in the treatment of relapsing-remitting multiple sclerosis: a pilot study.

Background/objective: A Paleolithic diet may improve fatigue and quality of life in progressive multiple sclerosis (MS) patients, but past research has evaluated the effects of this dietary intervention in combination with other treatments such as exercise. Thus, the purpose of this pilot study was to evaluate a modified Paleolithic dietary intervention (MPDI) in the treatment of fatigue and other symptoms in relapsing-remitting MS (RRMS).

Methods: We measured the effects of a MPDI in 17 individuals with RRMS.