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Author |
Lowenthal-Raz, J.; Liebermann, D.G.; Friedman, J.; Soroker, N. |
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Title |
Kinematic descriptors of arm reaching movement are sensitive to hemisphere-specific immediate neuromodulatory effects of transcranial direct current stimulation post stroke |
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Journal Article |
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Year |
2024 |
Publication |
Scientific Reports |
Abbreviated Journal |
Sci Rep |
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Volume |
14 |
Issue |
1 |
Pages |
11971 |
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Keywords |
Humans; *Transcranial Direct Current Stimulation/methods; Male; Female; Middle Aged; *Stroke/physiopathology/therapy; Biomechanical Phenomena; Aged; *Arm/physiopathology; *Movement/physiology; *Stroke Rehabilitation/methods; Single-Blind Method; Cross-Over Studies |
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Abstract |
Transcranial direct current stimulation (tDCS) exerts beneficial effects on motor recovery after stroke, presumably by enhancement of adaptive neural plasticity. However, patients with extensive damage may experience null or deleterious effects with the predominant application mode of anodal (excitatory) stimulation of the damaged hemisphere. In such cases, excitatory stimulation of the non-damaged hemisphere might be considered. Here we asked whether tDCS exerts a measurable effect on movement quality of the hemiparetic upper limb, following just a single treatment session. Such effect may inform on the hemisphere that should be excited. Using a single-blinded crossover experimental design, stroke patients and healthy control subjects were assessed before and after anodal, cathodal and sham tDCS, each provided during a single session of reaching training (repeated point-to-point hand movement on an electronic tablet). Group comparisons of endpoint kinematics at baseline-number of peaks in the speed profile (NoP; smoothness), hand-path deviations from the straight line (SLD; accuracy) and movement time (MT; speed)-disclosed greater NoP, larger SLD and longer MT in the stroke group. NoP and MT revealed an advantage for anodal compared to sham stimulation of the lesioned hemisphere. NoP and MT improvements under anodal stimulation of the non-lesioned hemisphere correlated positively with the severity of hemiparesis. Damage to specific cortical regions and white-matter tracts was associated with lower kinematic gains from tDCS. The study shows that simple descriptors of movement kinematics of the hemiparetic upper limb are sensitive enough to demonstrate gain from neuromodulation by tDCS, following just a single session of reaching training. Moreover, the results show that tDCS-related gain is affected by the severity of baseline motor impairment, and by lesion topography. |
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Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel. nachum@soroker.online |
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2045-2322 |
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PMID:38796610; PMCID:PMC11127956 |
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125 |
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Frenkel-Toledo, S.; Liebermann, D.G.; Bentin, S.; Soroker, N. |
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Title |
Dysfunction of the Human Mirror Neuron System in Ideomotor Apraxia: Evidence from Mu Suppression |
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Journal Article |
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Year |
2016 |
Publication |
Journal of Cognitive Neuroscience |
Abbreviated Journal |
J Cogn Neurosci |
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Stroke patients with ideomotor apraxia (IMA) have difficulties controlling voluntary motor actions, as clearly seen when asked to imitate simple gestures performed by the examiner. Despite extensive research, the neurophysiological mechanisms underlying failure to imitate gestures in IMA remain controversial. The aim of the current study was to explore the relationship between imitation failure in IMA and mirror neuron system (MNS) functioning. Mirror neurons were found to play a crucial role in movement imitation and in imitation-based motor learning. Their recruitment during movement observation and execution is signaled in EEG recording by suppression of the lower (8-10 Hz) mu range. We examined the modulation of EEG in this range in stroke patients with left (n = 21) and right (n = 15) hemisphere damage during observation of video clips showing different manual movements. IMA severity was assessed by the DeRenzi's standardized diagnostic test. Results showed that failure to imitate observed manual movements correlated with diminished mu suppression in patients with damage to the right inferior parietal lobule and in patients with damage to the right inferior frontal gyrus pars opercularis-areas where major components of the human MNS are assumed to reside. Voxel-based lesion symptom mapping revealed a significant impact on imitation capacity for the left inferior and superior parietal lobules and the left post central gyrus. Both left and right hemisphere damages were associated with imitation failure typical of IMA, yet a clear demonstration of relationship to the MNS was obtained only in the right hemisphere damage group. Suppression of the 8-10 Hz range was stronger in central compared with occipital sites, pointing to a dominant implication of mu rather than alpha rhythms. However, the suppression correlated with De Renzi's apraxia test scores not only in central but also in occipital sites, suggesting a multifactorial mechanism for IMA, with a possible impact for deranged visual attention (alpha suppression) beyond the effect of MNS damage (mu suppression). |
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Loewenstein Hospital, Ra'anana, Israel |
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0898-929X |
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PMID:26942323 |
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82 |
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Author |
Liebermann, D.G.; Goodman, D. |
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Title |
Pre-landing muscle timing and post-landing effects of falling with continuous vision and in blindfold conditions |
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Journal Article |
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Year |
2007 |
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Journal of Electromyography and Kinesiology : Official Journal of the International Society of Electrophysiological Kinesiology |
Abbreviated Journal |
J Electromyogr Kinesiol |
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17 |
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2 |
Pages |
212-227 |
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Keywords |
Adult; Analysis of Variance; Biomechanics; *Blindness; *Electromyography; Humans; Joints/physiology; Lower Extremity/physiology; Male; Movement/*physiology; Muscle, Skeletal/*physiology; Orientation; *Vision, Ocular |
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The present study examined the effect of continuous vision and its occlusion in timing of pre-landing actions during free falls. When vision is occluded, muscle activation is hypothesized to start relative to onset of the fall. However, when continuous vision is available onset of action is hypothesized to be relative to the moment of touchdown. Six subjects performed 6 randomized sets of 6 trials after becoming familiar with the task. The 36 trials were divided in 2 visual conditions (vision and blindfold) and 3 heights of fall (15, 45 and 75 cm). EMG activity was recorded from the gastrocnemius and rectus femoris muscles during the falls. The latency of onset (L(o)) and the lapse from EMG onset to touchdown (T(c)) were obtained from these muscles. Vertical forces were recorded to assess the effects of pre-landing activity on the impacts at collision with and without continuous vision. Peak amplitude (F(max)), time to peak (T(max)) and peak impulse normalized to momentum (I(norm)) were used as outcome measures. Within flight time ranges of approximately 50-400 ms, the results showed that L(o) and T(c) follow a similar linear trend whether continuous vision was available or occluded. However, the variability of T(c) for each of the muscles was larger in the vision occluded condition. Analyses of variance showed that the rectus femoris muscle started consistently earlier in no vision trials. Finally, impact forces were not different in vision or blindfold conditions, and thus, they were not affected by minor differences in the timing of muscles prior to landing. Thus, it appears that knowing the surroundings before falling may help to reduce the need for a continuous visual input. The relevance of such input cannot be ruled out for falls from high landing heights, but cognitive factors (e.g., attention to specific cues and anticipation of a fall) may play a dominant role in timing actions during short duration falls encountered daily. |
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Physical Therapy Department, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 69978, Israel. dlieberm@post.tau.ac.il <dlieberm@post.tau.ac.il> |
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1050-6411 |
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PMID:16600637 |
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37 |
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Author |
Liebermann, D.G.; Levin, M.F.; McIntyre, J.; Weiss, P.L.; Berman, S. |
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Title |
Arm path fragmentation and spatiotemporal features of hand reaching in healthy subjects and stroke patients |
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Journal Article |
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Year |
2010 |
Publication |
Conference Proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Conference |
Abbreviated Journal |
Conf Proc IEEE Eng Med Biol Soc |
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2010 |
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5242-5245 |
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Keywords |
Aged; Aged, 80 and over; Analysis of Variance; Arm/*physiology; Biomechanics/physiology; Female; Hand/*physiology; *Health; Humans; Male; Middle Aged; Movement/*physiology; Posture/physiology; Principal Component Analysis; Stroke/*physiopathology; Time Factors |
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Arm motion in healthy humans is characterized by smooth and relatively short paths. The current study focused on 3D reaching in stroke patients. Sixteen right-hemiparetic stroke patients and 8 healthy adults performed 42 reaching movements towards 3 visual targets located at an extended arm distance. Performance was assessed in terms of spatial and temporal features of the movement; i.e., hand path, arm posture and smoothness. Differences between groups and within subjects were hypothesized for spatial and temporal aspects of reaching under the assumption that both are independent. As expected, upper limb motion of patients was characterized by longer and jerkier hand paths and slower speeds. Assessment of the number of sub-movements within each movement did not clearly discriminate between groups. Principal component analyses revealed specific clusters of either spatial or temporal measures, which accounted for a large proportion of the variance in patients but not in healthy controls. These findings support the notion of a separation between spatial and temporal features of movement. Stroke patients may fail to integrate the two aspects when executing reaching movements towards visual targets. |
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Physical Therapy Dept., Sackler Faculty of Medicine, Tel Aviv University, 69978 Israel. dlieberm@post.tau.ac.il |
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1557-170X |
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PMID:21096047 |
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30 |
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Author |
Liebermann, D.G.; Goodman, D. |
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Title |
Effects of visual guidance on the reduction of impacts during landings |
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Journal Article |
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Year |
1991 |
Publication |
Ergonomics |
Abbreviated Journal |
Ergonomics |
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34 |
Issue |
11 |
Pages |
1399-1406 |
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Adult; Analysis of Variance; Biomechanics; *Cues; Humans; Male; Motor Activity/*physiology; Psychomotor Performance/physiology; Vision, Ocular/*physiology |
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While a common view is that vision is essential to motor performance, some recent studies have shown that continuous visual guidance may not always be required within certain time constraints. This study investigated a landing-related task (self-released falls) to assess the extent to which visual information enhances the ability to reduce the impacts at touchdown. Six individuals performed six blocked trials from four height categories in semi-counterbalanced order (5-10, 20-25, 60-65, and 90-95 cm) in vision and no-vision conditions randomly assigned. A series of two-way ANOVA with repeated measures were carried out separately on each dependent variable collapsed over six trials. The results indicated that vision during the flight did not produce softer landings. Indeed, in analysing the first peak (PFP) a main effect for visual condition was revealed in that the mean amplitude was slightly higher when vision was available (F(1,5) = 6.57; p less than 0.05), thus implicating higher forces at impact. The results obtained when the time to the first peak (TFP) was applied showed no significant differences between conditions (F(1,5) less than 1). As expected, in all cases, the analyses yielded significant main effects for the height categories factor. It appears that during self-initiated falls in which the environmental cues are known before the event, visual guidance is not necessary in order to adopt a softer landing strategy. |
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Research Department, Wingate Institute, Israel |
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0014-0139 |
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PMID:1800107 |
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55 |
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