Attempt-dependent decrease in skilled reaching characterizes the acute postsurgical period following a forelimb motor cortex lesion: an experimental demonstration of learned nonuse in the rat

The notion that shock or diaschisis is a distinctive stage in the recovery process following brain damage has played a formative role in the characterization of brain injury. For example, damage to the forelimb region of motor cortex results in an acute period of behavioural depression in skilled reaching and other skilled actions followed by improved performance mediated by compensatory movements. Whereas the progression of improvement and the use of compensatory movements in the chronic period of recovery is well-documented, temporal aspects of behaviour during the acute period of depression of behaviour are relatively unstudied. The present study examined the temporal scheduling of reach-attempts by rats attempting to gain single pellets of food from a shelf in a skilled reaching task. Pretrained rats received contralateral-to-the-pretrained limb forelimb motor cortex lesions. Control lesions included contralateral-to-the-pretrained limb parietal cortex lesions, or ipsilateral-to-the-pretrained limb motor cortex lesions. Frame-by-frame video analysis of behaviour showed a decrease in reaching attempts as a function of successive approaches and attempts to grasp the food over the first few postsurgical days in rats with contralateral-to-the-pretrained limb motor cortex lesions. A similar approach-dependent decrease in attempts did not occur after parietal or ipsilateral-to-the-pretrained limb motor cortex lesions. The decrease in responding occurred only during acute testing and was not observed in rats first tested after 8 days of postoperative recovery. The findings are discussed in relation to the ideas that: (1) the stroke subject is an active participant in modifying behaviour to cope with injury; (2) learned nonuse contributes to behaviour in the acute postinjury period following motor cortex injury; (3) diaschisis inadequately accounts for poststoke behaviour.     

The problem of relating plasticity and skilled reaching after motor cortex stroke in the rat

The plasticity of the nervous system is illustrated in the many new neuronal connections that are formed during the acquisition of behavioral skills, loss of function after brain injury, and subsequent recovery of function. The present review describes the acquisition of skilled reaching, the act of reaching for food with a forelimb, and the changes that take place in skilled reaching following motor cortex stroke. The review then discusses the difficulty in associating plastic changes with specific aspects of behavioral change. Skilled reaching behavior is complex and consists of a number of oppositions (stimulus response relationships), between the rat and the food target, a number of forelimb gestures (non-weight supporting movements), which are performed to obtain food, and a complex series of segmental movements (of the limb, head, and trunk), all of which influence the success of the act. Measures of these four aspects of skilled reaching behavior following motor cortex stroke reveal that there are a number of learned changes that take place at different times, including learned nonuse, learned bad-use, and forgetting. The widespread dendritic proliferation, axonal growth, and synaptic formation that take place both before and after stroke are difficult to precisely relate to these behavioral changes. Whereas plasticity is usually proposed to be associated with improved performance it is suggested that future work should attempt to better relate plastic changes to the details of behavioral changes.     

The impairments in reaching and the movements of compensation in rats with motor cortex lesions: an endpoint, videorecording, and movement notation analysis

Reaching for food by rats, with the limb contralateral to limb area motor cortex damage, was analyzed using end-point scores, videoanalysis, and Eshkol-Wachmann Movement Notation (EWMN). End point results from groups of rats with small, medium, and large lesions showed reaching success and amount of food grasped per reach decreased with increases in lesion size. Videoanalysis and EWMN showed that the impairments were attributable to: (1) an inability to pronate the paw over the food by abduction of the upper arm, and (2) an inability to supinate the paw at the wrist to orient the food to the mouth. There were no obvious impairments in locating food using olfaction, in positioning the body in order to initiate a reach, or in clasping the digits to grasp food. There were only mild impairments in lifting, aiming, and advancing the limb. In rats with medium and large lesions, loss of pronation and supination were compensated for by a variety of whole body movements. These findings are discussed in reference to neural and behavioral mechanisms underlying recovery of function and the contribution of the motor cortex to skilled movements in the rat and other species.     

Sparing of skilled forelimb reaching and corticospinal projections after neonatal motor cortex removal or hemidecortication in the rat: support for the Kennard doctrine

Skilled forelimb use in reaching for food was studied in rats with variously sized and placed unilateral cortical lesions given in adulthood or on the day of birth. Fluorescent retrograde labelling was used to document changes in corticospinal tracts. In free choice tests, preferential use of the limb ipsilateral to damage was induced by adult motor, but not parietal or occipital, cortex damage. Similar preference for the ipsilateral limb was induced by neonatal motor and parietal, but not occipital, cortex damage. In both adult and neonate groups success with the preferred limb decreased in proportion to the increase in lesion size. To force use of the non-preferred limb, a bracelet, which prevented reaching but not other movements, was attached to the forearm of the preferred forelimb. Success with the non-preferred limb was poorer than with the preferred limb and success again decreased in proportion to the increase in lesion size. Adult and neonatal rats were divided into 4 groups according to the extent of motor cortex damage. Across all lesion sizes the neonatal operates were significantly more successful than the adult operates and their reaching movements appeared more normal. Surprisingly, some rats with large adult motor cortex lesions or hemidecortications were able to reach. Slow-motion video analysis of reaching impairments in both adult and neonate groups showed that limb extension and food grasping were less impaired than limb retraction and adduction of the limb to the mouth. The results show that the integrity of a neocortical hemisphere is not essential for contralateral limb use in reaching, but contributes to successful use of the limb. Following neonatal lesions, facilitation may be promoted by the ipsilateral neocortex through an augmented ipsilateral corticofugal pathway.     

Changes in the kinematic structure and non-kinematic features of movements during skilled reaching after stroke: a Laban Movement Analysis in two case studies

The purpose of this study was to adapt a universal language for human movement, Laban Movement Analysis (LMA), to capture the kinematic and non-kinematic aspects of movement in a reach-for-food task by subjects whose movements had been affected by stroke. Two control subjects, one stroke subject with internal capsule damage, and one subject with right posterior parietal stroke were video recorded while performing the reaching task. The movements of limb advancement, grasping the food, and limb withdrawal to place the food in the mouth, were notated using LMA. A scale, the Expressive Reaching Scale (ERS), was derived from the notation. All subjects completed the task; however, the stroke subjects displayed abnormalities in both the kinematic and non-kinematic aspects of movements during reaching with either limb. The most extensive impairments were in the contralateral-to-stroke limb and were most severe in the subject with internal capsule damage. The ERS rating scale may be a useful diagnosis and assessment tool.     

Proximal movements compensate for distal forelimb movement impairments in a reach-to-eat task in Huntington's disease: new insights into motor impairments in a real-world skill

Huntington's disease (HD) causes severe motor impairments that are characterized by chorea, dystonia, and impaired fine motor control. The motor deficits include deficits in the control of the forelimb, but as yet there has been no comprehensive assessment of the impairments in arm, hand and digit movements as they are used in every-day tasks. The present study investigated the reaching of twelve HD subjects and twelve age-matched control subjects on a reach-to-eat task. The subjects were asked to reach for a small food item, with the left or the right hand, and then bring it to the mouth for eating. The task assesses the major features of skilled forelimb use, including orienting to a target, transport of the hand to a target, use of a precision grasp of the target, limb withdrawal to the mouth, and release of the food item into the mouth, and the integration of the movements into a smooth act. The movements were analyzed frame-by-frame by scoring the video record using an established movement element rating scale and by biometric analysis to describe limb trajectory. All HD subjects displayed greater reliance on more proximal movements in reaching. They also displayed overall jerkiness, a significant impairment in end point error correction (i.e. no smooth trajectories), deficits in timing and terminating motion (overshooting the target), impairments in rotation of the hand, abnormalities in grasping, and impairments in releasing the food item to the mouth. Although impairment in the control of the distal segments of the limb was common to all subjects, the intrusion of choreatic movements produced a pattern of highly variable performance between subjects. The quantification of reaching performance as measured by this analysis provides new insights into the impairments of HD subjects, allows an easily administered and inexpensive way to document the many skilled limb movement abnormalities, and relates the impairments to a real-world context. The protocol can serve as a useful clinical tool to evaluate innovative therapeutic interventions in HD such as physiotherapy, drug therapy, or functional neurosurgical procedures.     

No improvement by amphetamine on learned non-use, attempts, success or movement in skilled reaching by the rat after motor cortex stroke

Amphetamine (AMPH) has been proposed as a treatment for post-stroke motor deficits when coupled with symptom-relevant physical rehabilitation. Whereas a number of experimental studies report improvements in endpoint measures of skilled reaching for food by rats, there has been no assessment of whether beneficial effects extend to overcoming learned non-use of the limb in the acute post-stroke period or to the qualitative deficits in movement in the chronic post-stroke period. In addition to evaluating the effects of AMPH on success, these were the objectives of the present study. In three different reaching experiments, groups of rats were pre-trained in skilled reaching for food prior to receiving a motor cortex stroke via pial removal. Postoperatively the rats received periodic AMPH treatment and daily rehabilitation. In the acute post-stroke period, AMPH failed to prevent the development of learned non-use of the limb, and in the acute and chronic period failed to improve recovery of reaching success, and also failed to improve the qualitative aspects of reaching movements. Nevertheless, AMPH did enhance adjunct non-reaching movements of locomotion, rearing and turning. The results are discussed in relation to the idea that the beneficial effects of post-stroke AMPH treatment do not extend to all movements, especially the movements of a forelimb in retrieving and consuming food.     

Limits on recovery in the corticospinal tract of the rat: partial lesions impair skilled reaching and the topographic representation of the forelimb in motor cortex

Although evidence suggests that there are impairments in skilled movements following very large lesions of the pyramidal component of the corticospinal tract, the behavioral and electrophysiological effects of partial lesion has not received equal attention. Here, rats with complete lesions or partial lesions (medial, central, or lateral third) of the pyramidal tract at the medullary pyramids were evaluated for their quantitative and qualitative postsurgical performance on a skilled reaching task, following which the topographic representation of their forelimb was mapped with intracortical microstimulation (ICMS). Complete lesions impaired reaching success, impaired the qualitative features of reaching movements, and abolished ICMS evoked movement from the forelimb region of motor cortex. Although partial lesions did not impair reaching success, they did impair qualitative aspects of limb movement including forepaw aiming, supination, and food pellet release. ICMS indicated a reduction in the size of the forelimb area, especially the distal area of the caudal forelimb area (CFA), of the motor map. The behavioral and electrophysiological impairments did not vary with lesion location within the pyramidal tract. The incomplete recovery, as measured both behaviorally and electrophysiologically, demonstrates that plasticity within the corticospinal system is limited even with lesions that permit substantial sparing of pyramidal tract fibers.     

Both compensation and recovery of skilled reaching following small photothrombotic stroke to motor cortex in the rat

Large lesions produced by stroke to the forelimb region of motor cortex of the rat feature post-stroke improvement that in the main is due to compensation. The present study describes both recovery and compensation of forelimb use in a reach-to-eat (skilled reaching) task following small photothrombotic stroke. The rats were pretrained before stroke, and then assessed using endpoint measures and biometric movement analysis during rehabilitation in the acute and chronic post-stroke periods. Histological and MRI analysis indicated that the stroke consisted of a small lesion surrounded by cortex featuring scattered cell loss, likely of the large pyramidal cells that characterize the forelimb region of motor cortex. The stroke reduced reaching success, especially on the most demanding measure of success on first reach attempts, in the acute period, but with rehabilitation, performance returned to pre-stroke levels. Reach movements as assessed by biometric measures were severely impaired acutely but displayed significant recovery chronically although this recovery was not complete. The results suggest that not only do rats show post-stroke compensation in skilled reaching but they can also display functional recovery. It is suggested that recovery is mediated by the spared neurons in the peri-infarct region of forelimb motor cortex. The results demonstrate the utility of a small lesion model for studying post-stroke neural and behavioral change and support the view that optimal post-stroke treatment should be directed toward limiting tissue loss.     

Skilled reaching impairments from the lateral frontal cortex component of middle cerebral artery stroke: a qualitative and quantitative comparison to focal motor cortex lesions in rats

The classical approach to investigating brain contributions to behavior has been to localize function to a region. In clinical investigations, however, injury is frequently multifocal, raising the question of how individual brain regions contribute to a resulting behavioral syndrome. For example, middle cerebral artery (MCA) ischemia in humans can concurrently damage a number of cortical and subcortical areas and the same areas are damaged in rat models of MCA stroke. In the rat, MCA occlusion produces severe motor deficits, but the cortical area of damage is the lateral neocortex, sparing motor cortex. This anatomical finding raises the question of whether the rat lateral neocortex contributes to MCA-related motor impairments, a question that was investigated in the present study. Rats received unilateral neocortical lesions via electrocoagulation of the MCA and were compared to rats with standard motor cortex lesions produced by devascaulrization of the overlaying blood vessels. The MCA group was as impaired as the motor cortex group in skilled reaching movements as assessed by quantitative measures of the contralateral-to-lesion forelimb in a single pellet task and in a tray-reaching task. Although there was improvement in success scores over a 2-week period in both groups, the groups were characterized by distinctive and enduring qualitative impairments. The motor cortex deficit was exemplified by use of trunk musculature and head movements to assist the reaching limb while the MCA impairment included sensory abnormalities. The results are discussed in relation to the contribution of lateral frontal cortex injury to MCA stroke sensorimotor syndromes.     

Spontaneous forelimb grasping in free feeding by rats: motor cortex aids limb and digit positioning.

Forelimb use in grasping food during free feeding was studied in control and motor cortex damaged rats using videoanalysis and Eshkol-Wachmann Movement Notation (EWMN). Rats detected food using olfaction, grasped it by mouth, and then sat and reached for it with their paws. Once held in the paws, the food was eaten. A reach consists of: (1) lifting the forelimbs from the ground, (2) positioning them elbows-in, so that the paws were adjacent to the mouth, and (3) clasping the food in the digits. These movements were executed mainly with the upper arm. Limb movements were usually bilaterally symmetrical but when asymmetrical movements occurred, the forelimb least involved in weight support initiated the movement. As the limb was positioned for grasping, the aperture of the digits was adjusted to anticipate the size of the food and the food was grasped and manipulated with the tips of the digits. Following unilateral motor cortex lesions to the forelimb area: (1) the ipsilateral limb (good limb) initiated lifting, positioning, and grasping movements, (2) appropriate adjustment of the digits of the contralateral limb (bad limb) and grasping were impaired, and (3) when contact with food was lost, the bad limb adopted an extended, closed-fist spastic posture and could not be repositioned independently. The gross impairments cleared within 2 weeks, and after a few months impairments were infrequently observed. These findings show that: (1) spontaneous food grasping uses both proximal movements of the limb and distal movements of the digits, (2) digit aperture anticipates food size in reaching, and (3) motor cortex damage impairs both proximal and distal movements more profoundly when the limb is used independently than when it is used in conjunction with the good limb. The results are discussed in relation to kinematic studies on primates and humans.     

Cholinergic upregulation by optogenetic stimulation of nucleus basalis after photothrombotic stroke in forelimb somatosensory cortex improves endpoint and motor but not sensory control of skilled reaching in mice

A network of cholinergic neurons in the basal forebrain innerve the forebrain and are proposed to contribute to a variety of functions including cortical plasticity, attention, and sensorimotor behavior. This study examined the contribution of the nucleus basalis cholinergic projection to the sensorimotor cortex on recovery on a skilled reach-to-eat task following photothrombotic stroke in the forelimb region of the somatosensory cortex. Mice were trained to perform a single pellet skilled reaching task and their pre and poststroke performance, from Day 4 to Day 28 poststroke, was assessed frame-by-frame by video analysis with endpoint, movement and sensorimotor integration measures. Somatosensory forelimb lesions produced impairments in endpoint and movement component measures of reaching and increased the incidence of fictive eating, a sensory impairment in mistaking a missed reach for a successful reach. Upregulated acetylcholine (ACh) release, as measured by local field potential recording, elicited via optogenetic stimulation of the nucleus basalis improved recovery of reaching and improved movement scores but did not affect sensorimotor integration impairment poststroke. The results show that the mouse cortical forelimb somatosensory region contributes to forelimb motor behavior and suggest that ACh upregulation could serve as an adjunct to behavioral therapy for acute treatment of stroke.     

Sexually dimorphic postural adjustments are used in a skilled reaching task in the rat

Sex differences occur not only in the sexual repertoire of animals but also are evident in other aspects of movement. The present study asked whether sexually dimorphic motor behavior extends to the skilled movements used in reaching for food in the rat. Because we have previously shown that males and females are sexually dimorphic in their organization of lateral and rotatory movements and because postural adjustments are incorporated into skilled movements, both body posture and limb movements were examined during a skilled reaching task. Male and female Long-Evans rats were filmed, from both the front and ventral views and their stepping patterns, postural adjustments and forelimb movements, during a successful reach were analyzed. While males and females did not differ in forelimb movements, they were significantly different in how they approached and oriented their body to the food item during a successful reach. These results are discussed in relation to the dissociation of skilled movement from postural adjustments, sex-dependent alterations following CNS injury, and the neural and evolutionary basis of sex differences in movement organization.     

Bi-hemispheric contribution to functional motor recovery of the affected forelimb following focal ischemic brain injury in rats

In many recovering hemiparetic stroke patients, movement of the affected limb elicits ipsilateral activation of sensorimotor areas within the undamaged hemisphere, which is not observed in control subjects. Following middle cerebral artery occlusion, rats received intensive enriched-rehabilitation (ER) of the impaired forelimb for 4 weeks. Weekly assessments on a skilled reaching test demonstrated significant improvement in ischemic animals over 4 weeks of ER (P < 0.05). We hypothesized that if the undamaged forelimb motor cortex contributed to improved forelimb function, then inhibition of neural activity within this region should reinstate (at least some of) the initial motor impairment. After 3 and 4 weeks of ER, animals received a microinjection of lidocaine hydrochloride into the undamaged motor cortex and were re-assessed on reaching ability. The behavioral effect of lidocaine challenge was dependent on the size of the infarct: animals with large infarcts were rendered unable to retrieve any food pellets and had great difficulty even contacting a pellet with the affected forepaw. Small-infarct animals were only moderately affected (25% reduction in success) by lidocaine, an effect similar to that observed in control animals. Qualitative assessments of recovered reaching after 4 weeks of rehabilitation revealed that impairments in forelimb lift, advance and aim were exacerbated (P < 0.05) following lidocaine-inactivation of the undamaged motor cortex of animals with large ischemic infarcts. In animals with small infarcts, lidocaine challenge only impaired limb advance. Thus, recruitment of the undamaged hemisphere may depend on the functional integrity of the remaining sensorimotor system. These data suggest that, in the rat, the undamaged (ipsilateral) motor system may contribute to compensatory recovery of the affected forelimb.     

Dopamine and skilled limb use in the rat: more severe bilateral impairments follow substantia nigra than sensorimotor cortex 6-hydroxydopamine injection.

The experiments examined the suggestion that the dopaminergic (DA) projection to the motor cortex are involved in the motor impairments that follow complete hemitelencephalic DA depletions. The neurotoxin, 6-hydroxydopamine (6-OHDA), was injected unilaterally into the sensorimotor cortex (MCtx), the ventral tegmental area (VTA), or into the substantia nigra pars compacta (SN) of rats trained to reach for food with either forelimb. The SN injections produced large (greater than 95%) unilateral striatal dopamine (DA) depletions and severe bilateral impairments in limb use. VTA and MCtx injections did not produce impairments in limb use or severe depletions of cortical DA. An effective test of the contribution of cortical DA to skilled limb use must await a more effective technique for producing selective cortical DA depletion. Nevertheless, the results suggest that the severe impairments of skilled forelimb use that follow hemitelencephalic DA depletions may stem primarily from depletion of the nigrostriatal DA projection.     

Contralesional neural plasticity and functional changes in the less-affected forelimb after large and small cortical infarcts in rats

Some studies have found that unilateral cerebral damage produces significant deficits in the ipsilesional, "less-affected", body side. Other studies have found that such damage results in a paradoxical hyperfunctionality of the ipsilesional body side and a facilitation of learning-induced neuroplastic changes in the contralesional motor cortex. The purpose of this study was to determine whether these effects co-exist and/or vary with lesion severity. After small or large unilateral ischemic lesions of the sensorimotor cortex (SMC) or sham operations, adult male rats were trained for 20 days to acquire a motor task, skilled reaching for food, for the first time with the ipsilesional forelimb. Analyses of movement patterns indicated lesion-size-dependent ipsilesional abnormalities in grasping, retrieving and releasing food pellets. Despite these impairments, success rates were significantly increased and aiming errors reduced in lesion groups compared with sham operates. Performance was best in rats with small lesions that had more minor ipsilesional impairments. In the motor cortex contralateral to the lesion and trained limb, there were significant increases in the density of dendrites immunoreactive for microtubule-associated protein-2 (MAP2) and of N-methyl-D-aspartate receptor subunit 1 (NMDAR1) immunoreactivity compared with sham operates. These effects were correlated with reaching performance. Therefore, enhanced motor skill learning in the "less-affected" forelimb and contralesional neuroplastic changes are muted after larger lesions and co-exist with ipsilesional impairments. These effects may be related to a denervation-induced neural restructuring of the contralesional cortex that both disrupts pre-existing motor engrams and facilitates the establishment of new ones.     

Recovery of skilled reaching following motor cortex stroke: do residual corticofugal fibers mediate compensatory recovery?

Motor cortex (MC) injury impairs skilled reaching in rats, but success scores are eventually restored to approximate preoperative levels. The improvement is attributed to compensatory strategies, such as substituting trunk rotations for the chronically lost rotatory movement of the forelimb, that occur during transport and withdrawal. The present study examined the contributions of the rostral motor cortex (RMC) and the caudal motor cortex (CMC) to skilled reaching performance. The study also examined the role of the ipsilateral and the contralateral hemispheres in supporting the spontaneous recovery. Rats were trained to reach for single food pellets, and their recovery from partial or complete MC injury was documented with quantitative scores and movement element measures in three experiments: (1) devascularization of the CMC, or the RMC, or both, in the hemisphere contralateral to the reaching paw; (2) additional lesions to the CMC and RMC injuries such that the conjoint damage amounted to an MC lesion; and (3) MC lesion followed by damage in the neocortex lateral to the injury or in the opposite MC. The results showed that the CMC made the main contribution to skilled reaching performance, and that there was a lesser contribution by the RMC. MC damage was exacerbated by additional damage to the ipsilateral neocortex as compared to the contralateral neocortex. The results are discussed in relation to the idea that the involvement of the neocortical areas in skilled reaching performance and its recovery is proportional to the region from which corticospinal projections originate.