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P104. Two methods for one network: Toward an understanding of the left lateralized pathways for tool use
e100
Society Proceedings / Clinical Neurophysiology 126 (2015) e63–e170
right-hemispheric predominance for visual-spatial processing we found a complementary left-sided dominance for OKN responses in the cerebellum (Dieterich et al., 2003). Taken together, these findings should open up another chapter in our understanding of visual– vestibular interactions in the human brain. References Brandt T et al. Reciprocal inhibitory visual–vestibular interaction. Brain 1998;121(Pt 9):1749–58. Dieterich M et al. Dominance of the vestibular cortical function in the non-dominant hemisphere. Cereb Cortex 2003;13(9):994–1007.
parietal areas. The carousel benefits to test single tool use in patients and healthy participants; this fact and, in addition, the employment of this two different populations validate the findings of the project. References Goldenberg G, Spatt J. The neural basis of tool use. Brain 2009;132:1645–55. Johnson-Frey SH. The neural bases of complex tool use in humans. Trends Cogn Sci 2004;8(2):71–8. Manuel AL, Radman N, Mesot D, Chouiter L, Clarke S, Annoni J-M, et al. Inter- and intrahemispheric dissociations in ideomotor apraxia: a large-scale lesion-symptom mapping study in subacute brain-damaged patients. Cereb Cortex 2013;23(12):2781–9.
doi:10.1016/j.clinph.2015.04.145 doi:10.1016/j.clinph.2015.04.146
P104. Two methods for one network: Toward an understanding of the left lateralized pathways for tool use—E. Salazar-Lopez a, M.L. Brandi a,b, B.J. Schwaiger b, G. Goldenberg c, A. Wohlschläger b, J. Hermsdörfer a (a Technische Universität München, München, Germany, b Klinikum Rechts der Isar, Neuroradiologie, München, Germany, c Klinikum Bogenhausen, Neuropsychologie, München, Germany) Introduction: This project investigates the neural networks involved in the daily use of tools, a fundamental human activity that may be impaired in patients who have suffered strokes, particularly in the middle cerebral artery, resulting in apraxia. Previous experiments with healthy young adults and brain damaged patients have employed various paradigms to address the neural representations of manipulation and employment of tools; but important factors, such as aging or side of brain injury, have not been addressed. Our goal is test the same task, the use of individual tools, using two fundamentally different methods of brain imaging to determine the consistency of findings and to discover the nature of the different components of tool use. Method: The methodology comprised fMRI in healthy subjects and lesion analysis in brain damaged patients. Both approaches employed a similar version of the tool carousel, an apparatus built for the presentation of single tools and objects. Twelve tools in the lesion experiment and 10 in the fMRI were presented with the instruction, ‘‘Use the tool presented the way you know’’. An event-related fMRI experiment was conducted on 17 young and 17 elderly controls. In the lesion study 31 left brain damaged patients and 19 patients with right brain injuries were tested. FMRI-data was analyzed with SPM8 in a factorial design (tool vs. non-tool and use vs. transport) during the planning- and execution-phase. In the lesion study Voxel Lesion Symptom Mapping was applied to the behavioral scoring of patients and VOIs damaged to analyze the following factors: score parameter, damaged side (left, right) and tools used; in addition a ROI analysis specified the findings. Results: A left-lateralized network that includes the superior and inferior parietal lobes, the dorsal and ventral premotor cortex and the middle frontal gyrus, the temporal cortex and the lateral occipital complex is similarly involved in tool use in young and elderly controls and in left-brain damaged patients. A difference can be observed in the elderly subjects, who recruit a wider and less focused network during action planning but a smaller, weaker activation pattern during actual motion execution. Despite moderate performance errors in patients with right brain damage, these pathways were not detected, suggesting a more widely-spread distribution of responsible networks and differentsources for failure in the correct use of the tools. Conclusions: The correspondence of the areas revealed by fMRI in healthy subjects and left-side areas damaged in the patient group demonstrates the role of dorsal and ventral pathways in complex actions like tool use, with particular importance for the frontal and
P105. Network dynamics engaged in the modulation of motor behavior in chronic stroke patients—E.-M. Pool a,b, M. Kutscha b, E. Binder b, S.B. Eickhoff c,d, G.R. Fink a,b, C. Grefkes a,b (a Forschungszentrum Jülich, Institute of Neurosciences and Medicine (INM-3), Jülich, Germany, b University of Cologne, Department of Neurology, Cologne, Germany, c Forschungszentrum Jülich, Institute of Neurosciences and Medicine (INM-1), Jülich, Germany, d Heinrich Heine University, Institute of Clinical Neuroscience and Medical Psychology, Düsseldorf, Germany) Background: Affected hand movements are associated with a successive increase of neural activity in both hemispheres in the first weeks after stroke, which then return to levels observed in healthy controls, particularly in patients making full motor recovery. Little is known about the changes of the interplay of brain regions that enable the modulation of motor performance after stroke. In healthy subjects, an important feature of faster hand movements is mediated by a more effective coupling between distinct cortical and subcortical motor areas. But the mechanisms underlying the dynamic modulation of motor behavior in stroke patients related to motor impairment and recovery thereof are still unclear. Methods: We, therefore, investigated 10 chronic stroke patients with mild to moderate unilateral hand motor deficits and 10 healthy, age-matched controls by using functional magnetic resonance imaging (fMRI). Motor system activity was assessed by fist closures at different movement frequencies (0.5 Hz, 1.0 Hz, and 2.0 Hz) performed with the affected/right or unaffected/left hand. Results: When chronic stroke patients moved their affected, right hand, the fMRI data revealed a stronger frequency-dependent increase of neural activity within both the dorsolateral premotor cortex (PMd) and the superior parietal lobe (SPL), contralateral to the lesioned hemisphere as compared to healthy controls. Conclusion: Our findings suggest a critical contribution of contralateral PMd and SPL in the flexible adaption of the brain to varying motor demands in chronic stroke patients controlling temporal and spatial preciseness of recovered complex hand movements in the contralesional hemisphere. doi:10.1016/j.clinph.2015.04.147
P106. Brain connectivity in a simple motor task characterized by dynamic causal modeling of EEG FMRI signal—M. Bönstrup, R. Schulz, J. Feldheim, F. Hummel, C. Gerloff (Universitätsklinikum Hamburg-Eppendorf, Klinik für Neurologie, Brain Imaging and Neurostimulation Lab (BINS), Hamburg, Germany) Introduction: Dynamic causal modeling (DCM) based on functional magnetic resonance imaging (FMRI) and magneto-/electroencephalo
Society Proceedings / Clinical Neurophysiology 126 (2015) e63–e170
right-hemispheric predominance for visual-spatial processing we found a complementary left-sided dominance for OKN responses in the cerebellum (Dieterich et al., 2003). Taken together, these findings should open up another chapter in our understanding of visual– vestibular interactions in the human brain. References Brandt T et al. Reciprocal inhibitory visual–vestibular interaction. Brain 1998;121(Pt 9):1749–58. Dieterich M et al. Dominance of the vestibular cortical function in the non-dominant hemisphere. Cereb Cortex 2003;13(9):994–1007.
parietal areas. The carousel benefits to test single tool use in patients and healthy participants; this fact and, in addition, the employment of this two different populations validate the findings of the project. References Goldenberg G, Spatt J. The neural basis of tool use. Brain 2009;132:1645–55. Johnson-Frey SH. The neural bases of complex tool use in humans. Trends Cogn Sci 2004;8(2):71–8. Manuel AL, Radman N, Mesot D, Chouiter L, Clarke S, Annoni J-M, et al. Inter- and intrahemispheric dissociations in ideomotor apraxia: a large-scale lesion-symptom mapping study in subacute brain-damaged patients. Cereb Cortex 2013;23(12):2781–9.
doi:10.1016/j.clinph.2015.04.145 doi:10.1016/j.clinph.2015.04.146
P104. Two methods for one network: Toward an understanding of the left lateralized pathways for tool use—E. Salazar-Lopez a, M.L. Brandi a,b, B.J. Schwaiger b, G. Goldenberg c, A. Wohlschläger b, J. Hermsdörfer a (a Technische Universität München, München, Germany, b Klinikum Rechts der Isar, Neuroradiologie, München, Germany, c Klinikum Bogenhausen, Neuropsychologie, München, Germany) Introduction: This project investigates the neural networks involved in the daily use of tools, a fundamental human activity that may be impaired in patients who have suffered strokes, particularly in the middle cerebral artery, resulting in apraxia. Previous experiments with healthy young adults and brain damaged patients have employed various paradigms to address the neural representations of manipulation and employment of tools; but important factors, such as aging or side of brain injury, have not been addressed. Our goal is test the same task, the use of individual tools, using two fundamentally different methods of brain imaging to determine the consistency of findings and to discover the nature of the different components of tool use. Method: The methodology comprised fMRI in healthy subjects and lesion analysis in brain damaged patients. Both approaches employed a similar version of the tool carousel, an apparatus built for the presentation of single tools and objects. Twelve tools in the lesion experiment and 10 in the fMRI were presented with the instruction, ‘‘Use the tool presented the way you know’’. An event-related fMRI experiment was conducted on 17 young and 17 elderly controls. In the lesion study 31 left brain damaged patients and 19 patients with right brain injuries were tested. FMRI-data was analyzed with SPM8 in a factorial design (tool vs. non-tool and use vs. transport) during the planning- and execution-phase. In the lesion study Voxel Lesion Symptom Mapping was applied to the behavioral scoring of patients and VOIs damaged to analyze the following factors: score parameter, damaged side (left, right) and tools used; in addition a ROI analysis specified the findings. Results: A left-lateralized network that includes the superior and inferior parietal lobes, the dorsal and ventral premotor cortex and the middle frontal gyrus, the temporal cortex and the lateral occipital complex is similarly involved in tool use in young and elderly controls and in left-brain damaged patients. A difference can be observed in the elderly subjects, who recruit a wider and less focused network during action planning but a smaller, weaker activation pattern during actual motion execution. Despite moderate performance errors in patients with right brain damage, these pathways were not detected, suggesting a more widely-spread distribution of responsible networks and differentsources for failure in the correct use of the tools. Conclusions: The correspondence of the areas revealed by fMRI in healthy subjects and left-side areas damaged in the patient group demonstrates the role of dorsal and ventral pathways in complex actions like tool use, with particular importance for the frontal and
P105. Network dynamics engaged in the modulation of motor behavior in chronic stroke patients—E.-M. Pool a,b, M. Kutscha b, E. Binder b, S.B. Eickhoff c,d, G.R. Fink a,b, C. Grefkes a,b (a Forschungszentrum Jülich, Institute of Neurosciences and Medicine (INM-3), Jülich, Germany, b University of Cologne, Department of Neurology, Cologne, Germany, c Forschungszentrum Jülich, Institute of Neurosciences and Medicine (INM-1), Jülich, Germany, d Heinrich Heine University, Institute of Clinical Neuroscience and Medical Psychology, Düsseldorf, Germany) Background: Affected hand movements are associated with a successive increase of neural activity in both hemispheres in the first weeks after stroke, which then return to levels observed in healthy controls, particularly in patients making full motor recovery. Little is known about the changes of the interplay of brain regions that enable the modulation of motor performance after stroke. In healthy subjects, an important feature of faster hand movements is mediated by a more effective coupling between distinct cortical and subcortical motor areas. But the mechanisms underlying the dynamic modulation of motor behavior in stroke patients related to motor impairment and recovery thereof are still unclear. Methods: We, therefore, investigated 10 chronic stroke patients with mild to moderate unilateral hand motor deficits and 10 healthy, age-matched controls by using functional magnetic resonance imaging (fMRI). Motor system activity was assessed by fist closures at different movement frequencies (0.5 Hz, 1.0 Hz, and 2.0 Hz) performed with the affected/right or unaffected/left hand. Results: When chronic stroke patients moved their affected, right hand, the fMRI data revealed a stronger frequency-dependent increase of neural activity within both the dorsolateral premotor cortex (PMd) and the superior parietal lobe (SPL), contralateral to the lesioned hemisphere as compared to healthy controls. Conclusion: Our findings suggest a critical contribution of contralateral PMd and SPL in the flexible adaption of the brain to varying motor demands in chronic stroke patients controlling temporal and spatial preciseness of recovered complex hand movements in the contralesional hemisphere. doi:10.1016/j.clinph.2015.04.147
P106. Brain connectivity in a simple motor task characterized by dynamic causal modeling of EEG FMRI signal—M. Bönstrup, R. Schulz, J. Feldheim, F. Hummel, C. Gerloff (Universitätsklinikum Hamburg-Eppendorf, Klinik für Neurologie, Brain Imaging and Neurostimulation Lab (BINS), Hamburg, Germany) Introduction: Dynamic causal modeling (DCM) based on functional magnetic resonance imaging (FMRI) and magneto-/electroencephalo