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Davidowitz, I., Parmet, Y., Frenkel-Toledo, S., Banina, M. C., Soroker, N., Solomon, J. M., et al. (2019). Relationship Between Spasticity and Upper-Limb Movement Disorders in Individuals With Subacute Stroke Using Stochastic Spatiotemporal Modeling. Neurorehabil Neural Repair, 33(2), 141–152.
Abstract: BACKGROUND: Spasticity is common in patients with stroke, yet current quantification methods are insufficient for determining the relationship between spasticity and voluntary movement deficits. This is partly a result of the effects of spasticity on spatiotemporal characteristics of movement and the variability of voluntary movement. These can be captured by Gaussian mixture models (GMMs). OBJECTIVES: To determine the influence of spasticity on upper-limb voluntary motion, as assessed by the bidirectional Kullback-Liebler divergence (BKLD) between motion GMMs. METHODS: A total of 16 individuals with subacute stroke and 13 healthy aged-equivalent controls reached to grasp 4 targets (near-center, contralateral, far-center, and ipsilateral). Two-dimensional GMMs (angle and time) were estimated for elbow extension motion. BKLD was computed for each individual and target, within the control group and between the control and stroke groups. Movement time, final elbow angle, average elbow velocity, and velocity smoothness were computed. RESULTS: Between-group BKLDs were much larger than within control-group BKLDs. Between-group BKLDs for the near-center target were lower than those for the far-center and contralateral targets, but similar to that for the ipsilateral target. For those with stroke, the final angle was lower for the near-center target, and the average velocity was higher. Velocity smoothness was lower for the near-center than for the ipsilateral target. Elbow flexor and extensor passive muscle resistance (Modified Ashworth Scale) strongly explained BKLD values. CONCLUSIONS: Results support the view that individuals with poststroke spasticity have a velocity-dependent reduction in active elbow joint range and that BKLD can be used as an objective measure of the effects of spasticity on reaching kinematics.
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Liebermann, D. G., Biess, A., Friedman, J., Gielen, C. C. A. M., & Flash, T. (2006). Intrinsic joint kinematic planning. I: reassessing the Listing's law constraint in the control of three-dimensional arm movements. Exp Brain Res, 171(2), 139–154.
Abstract: This study tested the validity of the assumption that intrinsic kinematic constraints, such as Listing's law, can account for the geometric features of three-dimensional arm movements. In principle, if the arm joints follow a Listing's constraint, the hand paths may be predicted. Four individuals performed 'extended arm', 'radial', 'frontal plane', and 'random mixed' movements to visual targets to test Listing's law assumption. Three-dimensional rotation vectors of the upper arm and forearm were calculated from three-dimensional marker data. Data fitting techniques were used to test Donders' and Listing's laws. The coefficient values obtained from fitting rotation vectors to the surfaces described by a second-order equation were analyzed. The results showed that the coefficients that represent curvature and twist of the surfaces were often not significantly different from zero, particularly not during randomly mixed and extended arm movements. These coefficients for forearm rotations were larger compared to those for the upper arm segment rotations. The mean thickness of the rotation surfaces ranged between approximately 1.7 degrees and 4.7 degrees for the rotation vectors of the upper arm segment and approximately 2.6 degrees and 7.5 degrees for those of the forearm. During frontal plane movements, forearm rotations showed large twist scores while upper arm segment rotations showed large curvatures, although the thickness of the surfaces remained low. The curvatures, but not the thicknesses of the surfaces, were larger for large versus small amplitude radial movements. In conclusion, when examining the surfaces obtained for the different movement types, the rotation vectors may lie within manifolds that are anywhere between curved or twisted manifolds. However, a two-dimensional thick surface may roughly represent a global arm constraint. Our findings suggest that Listing's law is implemented for some types of arm movement, such as pointing to targets with the extended arm and during radial reaching movements.
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Frenkel-Toledoa, S., Bentin, S., Perry, A., Liebermann, D. G., & Soroker, N. (2014). Mirror-neuron system recruitment by action observation: Effects of focal brain damage on mu suppression. NeuroImage, 87, 127–137.
Abstract: Mu suppression is the attenuation of EEG power in the alpha frequency range (8-12 Hz), recorded over the sensorimotor cortex during execution and observation of motor actions. Based on this dual characteristic it is thought to signalize activation of a human analogue of the mirror neuron system (MNS) found in macaque monkeys, though much uncertainty remains concerning its specificity and full significance. To further explore the hypothesized relationship between mu suppression and MNS activation, we investigated how it is affected by damage to cortical regions, including areas where the MNS is thought to reside. EEG was recorded in 33 first-event stroke patients during observation of video-clips showing reaching and grasping hand movements. We examined the modulation of EEG oscillations at central and occipital sites, and analyzed separately the lower (8-10 Hz) and higher (10-12 Hz) segments of the alpha/mu range. Suppression was determined relative to observation of a non-biological movement. Normalized lesion data were used to investigate how damage to regions of the fronto-parietal cortex affects the pattern of suppression. The magnitude of mu suppression during action observation was significantly reduced in the affected hemisphere compared to the unaffected hemisphere. Differences between the hemispheres were significant at central (sensorimotor) sites but not at occipital (visual) sites. Total hemispheric volume loss did not correlate with mu suppression. Suppression in the lower mu range in the unaffected hemisphere (C3) correlated with lesion extent within the right inferior parietal cortex. Our lesion study supports the role of mu suppression as a marker of MNS activation, as suggested by findings gathered in previous studies in normal subjects.
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Liebermann, D. G., & Hoffman, J. R. (2005). Timing of preparatory landing responses as a function of availability of optic flow information. J Electromyogr Kinesiol, 15(1), 120–130.
Abstract: This study investigated temporal patterns of EMG activity during self-initiated falls with different optic flow information ('gaze directions'). Onsets of EMG during the flight phase were monitored from five experienced volunteers that completed 72 landings in three gaze directions (downward, mid-range and horizontal) and six heights of fall (10-130 cm). EMG recordings were obtained from the right gastrocnemius, tibialis anterior, biceps femoris and rectus femoris muscles, and used to determine the latency of onset (L(o)) and the perceived time to contact (T(c)). Impacts at touchdown were also monitored using as estimates the major peak of the vertical ground reaction forces (F(max)) normalized to body mass, time to peak (T(max)), peak impulse (I(norm)) normalized to momentum, and rate of change of force (dF(max)/dt). Results showed that L(o) was longer as heights of fall increased, but remained within a narrow time-window at >50 cm landings. No significant differences in L(o) were observed when gaze direction was changed. The relationship between T(c) and flight time followed a linear trend regardless of gaze direction. Gaze direction did not significantly affect the landing impacts. In conclusion, availability of optic flow during landing does not play a major role in triggering the preparatory muscle actions in self-initiated falls. Once a structured landing plan has been acquired, the relevant muscles respond relative to the start of the fall.
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Liebermann, D. G., & Defrin, R. (2009). Characteristics of the nociceptive withdrawal response elicited under aware and unaware conditions. J Electromyogr Kinesiol, 19(2), e114–22.
Abstract: BACKGROUND: Nociceptive withdrawal reflexes (NWR) are subject to supraspinal modulation. Therefore, awareness about a noxious stimulation may affect its characteristics. The goal of this study was to investigate the effect of different degrees of awareness on the NWR. METHOD: Eight subjects performed back and forth hand movements from a common starting point towards four visual targets during which NWR was evoked when subjects were either unaware or aware of a noxious stimulation (unaware-NWR and aware-NWR). For the comparison between the NWR under both conditions, onset latencies and kinematic variables were computed respectively from the recorded Biceps Brachii EMG and from the spatial coordinates of hand reflective markers. RESULTS: The onset latency of unaware-NWR (mean+/-SD 73.9+/-13 ms) was significantly shorter than that of the aware-NWR (91.1+/-27 ms, p<0.05). The total duration of the muscular activation was shorter in unaware-NWR than in aware-NWR. The slopes of the tangential velocity-time curves were steeper for unaware-NWR than for aware-NWR (p=0.057). CONCLUSIONS: The results suggest that supraspinal regulation of NWR under different degrees of awareness involves the re-parameterization of selected spatiotemporal aspects of a pre-structured motor response.
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