Christina Schmitz

Motor control and children with autism: deficit of anticipatory function?

This study aims at investigating how do anticipatory postural adjustments develop in children with autism, during a bimanual load-lifting task that required maintaining the stabilisation of the forearm despite imposed or voluntary unloading. Elbow angle and electromyographic were recorded on the child forearm supporting the load. The forearm stabilisation was as good in children with autism as in the control group. However, in children with autism, the latencies for both kinematics and muscular events indicated an increase of the duration of unloading. These results indicate the use of a feedback rather than a feed-forward mode of control. Impairments in both the building of internal representations and the mastering of timing parameters, could explain the deficient postural anticipation reported in children with autism.

Development of Postural Control in Healthy Children: A Functional Approach

From a set of experimental studies showing how intersegmental coordination develops during childhood in various posturokinetic tasks, we have established a repertoire of equilibrium strategies in the course of ontogenesis. The experimental data demonstrate that the first reference frame used for the organization of balance control during locomotion is the pelvis, especially in young children. Head stabilization during posturokinetic activities, particularly locomotion, constitutes a complex motor skill requiring a long time to develop during childhood. When studying the emergence of postural strategies, it is essential to distinguish between results that can be explained by biomechanical reasons strictly and those reflecting the maturation of the central nervous system (CNS). To address this problem, we have studied our young subjects in situations requiring various types of adaptation. The studies dealing with adaptation of postural strategies aimed at testing short and long-term adaptation capacity of the CNS during imposed transient external biomechanical constraints in healthy children, and during chronic internal constraints in children with skeletal pathologies. In addition to maintenance of balance, another function of posture is to ensure the orientation of a body segment. It appears that the control of orientation and the control of balance both require the trunk as an initial reference frame involving a development from egocentric to exocentric postural control. It is concluded that the first step for children consists in building a repertoire of postural strategies, and the second step consists in learning to select the most appropriate postural strategy, depending on the ability to anticipate the consequence of the movement in order to maintain balance control and the efficiency of the task.

Acquisition of anticipatory postural adjustments in a bimanual load-lifting task: normal and pathological aspects.

Abstract Anticipatory adjustments of forearm posture are associated with a voluntary load-lifting movement in bimanual load-lifting tasks. Three aspects of these adjustments are analyzed: their goal, their central organization, and their acquisition. The goal of the anticipatory adjustment in this task is to minimize the perturbation of forearm posture that occurs during unloading. The central organization is based on two parallel controls responsible, respectively, for the lifting movement of the moving forearm and the anticipatory postural adjustment of the postural forearm, their coordination depending on a central timing signal. The acquisition of the anticipatory postural adjustment was tested using a paradigm where the voluntary movement performed by one hand triggered, via an electronic switch, the load release of the postural forearm. It was achieved after 40–60 trials and was not graded as a function of the voluntary movement parameters, but of the disturbance of the postural arm about to occur. The learned anticipation was not transferred when, after a first acquisition session with one forearm as the postural forearm, a second learning session was performed with the other forearm as the postural forearm. The acquisition was tested in Parkinsonian and in hemiparetic patients with capsular lesion. The highest acquisition deficit was observed in hemiparetic patients, when the contralateral forearm was the postural forearm; the deficit was less important when the ipsilateral arm was postural. Surprisingly, the anticipatory postural adjustments in hemiparetic patients were rather well preserved when the natural load-lifting task was tested. These results suggest that the basal-ganglia SMA circuit and M1 premotor areas are important in the acquisition process.

Lighter or Heavier Than Predicted: Neural Correlates of Corrective Mechanisms during Erroneously Programmed Lifts

A central concept in neuroscience is that the CNS signals the sensory discrepancy between the predicted and actual sensory consequences of action. It has been proposed that the cerebellum and parietal cortex are involved in this process. A discrepancy will trigger preprogrammed corrective responses and update the engaged sensorimotor memories. Here we use functional magnetic resonance imaging with an event-related design to investigate the neuronal correlates of such discrepancies. Healthy adults repeatedly lifted an object between their right index fingers and thumbs, and on some lifting trials, the weight of the object was unpredictably changed between light (230 g) and heavy (830 g). Regardless of whether the weight was heavier or lighter than predicted, activity was found in the right inferior parietal cortex (supramarginal gyrus). This suggests that this region is involved in the comparison of the predicted and actual sensory input and the updating of the sensorimotor memories. When the object was lighter or heavier than predicted, two different types of preprogrammed force corrections occurred. There was a slow force increase when the weight of the object was heavier than predicted. This corrective response was associated with activity in the left primary motor and somatosensory cortices. The fast termination of the excessive force when the object was lighter than predicted activated the right cerebellum. These findings show how the parietal cortex, cerebellum, and motor cortex are involved in the signaling of the discrepancy between predicated and actual sensory feedback and the associated corrective mechanisms.

Impairment of a cortical event-related desynchronisation during a bimanual load-lifting task in children with autistic disorder

In autism, the abilities of communication are affected, associated with abnormalities of cognitive, sensorial and motor development. In a previous study based on a load-lifting task, we showed impairment of anticipation in children with autism as evidenced by kinematics and eletromyographic recordings [Neurosci. Lett. 348 (2003) 17]. In the present study, we assessed the cortical counterparts of the use of anticipatory postural adjustments in a group of control children and in a group of children with autism. The tasks required maintaining a stable forearm position despite imposed or voluntary lifting of an object placed either on the controlateral forearm or on a support. We investigated the differences between the two groups of children on the Event-Related Desynchronisation (ERD) which precedes movement onset in adults [Electroencephalogr. Clin. Neurophysiol. 46 (1979) 138]. Electroencephalogram (EEG) power evolution of a 6-8-Hz frequency band was averaged before and after imposed or voluntary movement onset. EEG reactivity of control and autistic children did not differ during the imposed unloading condition, but significant differences appeared in the voluntary unloading situations. Before lifting the object, control children showed an ERD above the left motor areas. An ERD also occurred above the right motor areas when the object was placed on their forearm. This indicates that the ERD can also translate the use of anticipatory postural adjustments. By contrast, children with autism did not show an ERD in the two voluntary situations. This suggests a central deficit of anticipation in both postural and motor control in children with autism.

Development of anticipatory postural adjustments in a bimanual load-lifting task in children.

Abstract Anticipatory postural adjustments (APA) are needed to perform a movement without perturbing posture. We investigated the development of APA in 3- to 4-year-old children during a bimanual load-lifting task. The task required maintaining a stable elbow position despite imposed or voluntary unloading of the forearm. Although children can compensate the consequences of unloading by using APA, their performance did not reach an adults’ level. In addition, children showed high intra-individual variability in the voluntary situation, revealed by the coexistence of both adult-like and immature patterns in kinematic and electromyographic data. In conclusion, the present study reports that APA, associated with a bimanual load-lifting task, are still being set up in 3- to 4-year-old-children. The intra-individual variability should decrease with age and be associated with a progressive mastering of the timing parameters characterizing APA.

Use-Dependent Up- and Down-Regulation of Sensorimotor Brain Circuits in Stroke Patients

Objective. To examine whether cerebral activity during passive movements decreases with time after stroke, and if reduced activity in the representation for the upper extremity can be reversed with training. Methods. Brain activity was measured by functional magnetic resonance imaging (fMRI) during passive wrist flexion-extension in 7 patients at varying time points after stroke, in a cross-sectional design. Upper limb function was also measured in all patients. Five of the patients took part in a training program and were measured again, behaviorally and with fMRI posttraining. Healthy control individuals of comparable age were also studied. Results. In patients, reduced activity over time after stroke was found for the group in the supplementary motor area (SMA), contralateral primary motor cortex, and prefrontal and parietal association areas along with ipsilateral cerebellum. Activity in most of these areas was also reduced in the patient group as compared to the control group. After a half-hour of daily training for 4 weeks with repetitive passive and active arm movements, cerebral activation increased in the pre-SMA and SMA, ipsilateral primary sensory cortex and intraparietal sulcus, and contralateral cerebellum in parallel with functional improvements of the upper limb. Areas common to both analyses included the SMA, pre-SMA, primary sensory cortex, intraparietal sulcus, and cerebellum. Conclusions. Our findings suggest that a down-regulation of sensorimotor activity occurs progressively over time as a result of inactivity and that training may reverse the reduced brain activity.

From egocentric to exocentric spatial orientation : Development of posture control in bimanual and trunk inclination tasks

The authors investigated the emergence of independent control of body segments in bimanual tasks involving either voluntary or involuntary trunk motion by tracking the transition from an ego- to an exocentric mode of postural control during childhood (i.e., from body-referenced orientation to externally referenced action). A paradigm combining a seated manual task and various trunk manipulations described the coordination strategies used by 24 children at different ages (2 to 9 years) and by adults. The following questions were asked: (a) When do children begin to dissociate upper limb movements from those of the trunk? (b) What segmental strategies are exhibited by each age group (2-3, 4-6, and 7-9 years, and adults)? Kinematic analyses revealed that younger children (2-6 years) used either the trunk or the support surface as reference to orient the limbs. Older children (7-9 years) began to use a gravitational reference frame similar to that of adults; they uncoupled upper limb motion from the trunk in either voluntary or imposed conditions. Young children patterned the forearm trajectory after the initiating segment (support surface or the trunk), thus reducing the degrees of freedom during the dual task. Echoing previous reports, 7-9 years of age appears to be a critical period in which children master postural control and develop an internal representation of body scheme.

Developmental sequence in the acquisition of anticipation during a new co-ordination in a bimanual load-lifting task in children.

The aim of this experiment was to test the capacity of children to develop anticipation at various stages of their growth. We studied the learning process of an artificial co-ordination by means of a procedure of double unloading in two groups of children, and a group of adults. Elbow-joint angle measurement was used to assess for the improvement of the forearm stabilization through the six learning sessions. The main results report a developmental sequence of the acquisition of anticipatory postural adjustments (APA) similar to the one established for the ontogenesis of APA. A difference in learning dynamics, but also in the final level of performance, is reported between children aged 5-6 and children aged 7-8 years. The improvement occurring at the age of 7 years probably indicates maturation of internal representations, favourable to the faster setting up of operational anticipated control.

Anticipatory postural adjustments in a bimanual load-lifting task in children with developmental coordination disorder

Aim  Postural control is a fundamental component of action in which deficits have been shown to contribute to motor difficulties in children with developmental coordination disorder (DCD). The purpose of this study was to examine anticipatory postural adjustments (APAs) in children with DCD in a bimanual load‐lifting task.