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Abstract Background In the recent past, wearable devices have been used for gait rehabilitation in patients with Parkinson’s disease. The objective of this paper is to analyze the outcome of a wearable hip orthosis whose assistance adapts in real time to the patient’s gait kinematics via adaptive oscillators. In particular, this study focuses on a metric characterizing natural gait variability, i.e., the level of long-range autocorrelations (LRA) in series of stride durations. Methods Eight patients with Parkinson’s disease (Hoehn and Yahr stages 1 $$-$$ - 2.5) performed overground gait training three times per week for four consecutive weeks, assisted by a wearable hip orthosis. Gait was assessed based on performance metrics such as the hip range of motion, speed, stride length and duration, and the level of LRA in inter-stride time series assessed using the Adaptive Fractal Analysis. These metrics were measured before, directly after, and 1 month after training. Results After training, patients increased their hip range of motion, their gait speed and stride length, and decreased their stride duration. These improvements were maintained 1 month after training. Regarding long-range autocorrelations, the population’s behavior was standardized towards a metric closer to the one of healthy individuals after training, but with no retention after 1 month. Conclusion This study showed that an overground gait training with adaptive robotic assistance has the potential to improve key gait metrics that are typically affected by Parkinson’s disease and that lead to higher prevalence of fall. Trial registration: ClinicalTrials.gov Identifer NCT04314973. Registered on 11 April 2020.

Humans consider the parameters linked to movement goal during reaching to adjust their control strategy online. Indeed, rapid changes in target structure or disturbances interfering with their initial plan elicit rapid changes in behavior. Here, we hypothesize that these changes could result from the continuous use of a decision variable combining motor and cognitive components. We combine an optimal feedback controller with a real-time evaluation of the expected cost-to-go, which considers target- and movement-related costs, in a common theoretical framework. This model reproduces human behaviors in presence of changes in the target structure occurring during movement and of online decisions to flexibly change target following external perturbations. It also predicts that the time taken to decide to select a novel goal after a perturbation depends on the amplitude of the disturbance and on the rewards of the different options, which is a direct result of the continuous monitoring of the cost-to-go. We show that this result was present in our previously collected dataset. Together our developments point towards a continuous evaluation of the cost-to-go during reaching to update control online and make efficient decisions about movement goal.

AbstractDescribing how the brain anatomical wiring contributes to the emergence of coordinated neural activity underlying complex behavior remains challenging. Indeed, patterns of remote coactivations that adjust with the ongoing task-demand do not systematically match direct, static anatomical links. Here, we propose that observed coactivation patterns, known as functional connectivity (FC), can be explained by a controllable linear diffusion dynamics defined on the brain architecture. Our model, termed structure-informed FC, is based on the hypothesis that different sets of brain regions controlling the information flow on the anatomical wiring produce state-specific functional patterns. We thus introduce a principled framework for the identification of potential control centers in the brain. We find that well-defined, sparse, and robust sets of control regions, partially overlapping across several tasks and resting state, produce FC patterns comparable to empirical ones. Our findings suggest that controllability is a fundamental feature allowing the brain to reach different states.

Sensorimotor adaptation is a central function of the nervous system, as it allows humans and other animals to flexibly anticipate their interaction with the environment. In the context of human reaching adaptation to force fields, studies have traditionally separated feedforward (FF) and feedback (FB) processes involved in the improvement of behavior. Here, we review computational models of FF adaptation to force fields and discuss them in light of recent evidence highlighting a clear involvement of feedback control. Instead of a model in which FF and FB mechanisms adapt in parallel, we discuss how online adaptation in the feedback control system can explain both trial-by-trial adaptation and improvements in online motor corrections. Importantly, this computational model combines sensorimotor control and short-term adaptation in a single framework, offering novel perspectives for our understanding of human reaching adaptation and control.

Humans perform saccadic eye movements two to three times per second. When doing so, the nervous system strongly suppresses sensory feedback for extended periods of time in comparison to movement time. Why does the brain discard so much visual information? Here we suggest that perceptual suppression may arise from efficient sensorimotor computations, assuming that perception and control are fundamentally linked. More precisely, we show theoretically that a Bayesian estimator should reduce the weight of sensory information around the time of saccades, as a result of signal dependent noise and of sensorimotor delays. Such reduction parallels the behavioral suppression occurring prior to and during saccades, and the reduction in neural responses to visual stimuli observed across the visual hierarchy. We suggest that saccadic suppression originates from efficient sensorimotor processing, indicating that the brain shares neural resources for perception and control.

Feedback delays are a major challenge for any controlled process, and yet we are able to easily control limb movements with speed and grace. A popular hypothesis suggests that the brain largely mitigates the impact of feedback delays (∼50 ms) by regulating the limb intrinsic visco-elastic properties (or impedance) with muscle co-contraction, which generates forces proportional to changes in joint angle and velocity with zero delay. Although attractive, this hypothesis is often based on estimates of limb impedance that include neural feedback, and therefore describe the entire motor system. In addition, this approach does not systematically take into account that muscles exhibit high intrinsic impedance only for small perturbations (short-range impedance). As a consequence, it remains unclear how the nervous system handles large perturbations, as well as disturbances encountered during movement when short-range impedance cannot contribute. We address this issue by comparing feedback responses to load pulses applied to the elbow of human subjects with theoretical simulations. After validating the model parameters, we show that the ability of humans to generate fast and accurate corrective movements is compatible with a control strategy based on state estimation. We also highlight the merits of delay-uncompensated robust control, which can mitigate the impact of internal model errors, but at the cost of slowing feedback corrections. We speculate that the puzzling observation of presynaptic inhibition of peripheral afferents in the spinal cord at movement onset helps to counter the destabilizing transition from high muscle impedance during posture to low muscle impedance during movement.

In every motor task, our brain must handle external forces acting on the body. For example, riding a bike on cobblestones or skating on irregular surface requires us to appropriately respond to external perturbations. In these situations, motor predictions cannot help anticipate the motion of the body induced by external factors, and direct use of delayed sensory feedback will tend to generate instability. Here, we show that to solve this problem the motor system uses a rapid sensory prediction to correct the estimated state of the limb. We used a postural task with mechanical perturbations to address whether sensory predictions were engaged in upper-limb corrective movements. Subjects altered their initial motor response in ∼60 ms, depending on the expected perturbation profile, suggesting the use of an internal model, or prior, in this corrective process. Further, we found trial-to-trial changes in corrective responses indicating a rapid update of these perturbation priors. We used a computational model based on Kalman filtering to show that the response modulation was compatible with a rapid correction of the estimated state engaged in the feedback response. Such a process may allow us to handle external disturbances encountered in virtually every physical activity, which is likely an important feature of skilled motor behaviour.

Combining individual actions into sequences is a hallmark of everyday activities. Classical theories propose that the motor system forms a single specification of the sequence as a whole, leading to the coarticulation of the different elements. In contrast, recent neural recordings challenge this idea and suggest independent execution of each element specified separately. Here, we show that separate or coarticulated sequences can result from the same task-dependent controller, without implying different representations in the brain. Simulations show that planning for multiple reaches simultaneously allows separate or coarticulated sequences depending on instructions about intermediate goals. Human experiments in a two-reach sequence task validated this model. Furthermore, in co-articulated sequences, the second goal influenced long-latency stretch responses to external loads applied during the first reach, demonstrating the involvement of the sensorimotor network supporting fast feedback control. Overall, our study establishes a computational framework for sequence production that highlights the importance of feedback control in this essential motor skill.

Gait variability of healthy adults exhibits Long-Range Autocorrelations (LRA), meaning that the stride interval at any time statistically depends on previous gait cycles; and this dependency spans over several hundreds of strides. Previous works have shown that this property is altered in patients with Parkinson’s disease, such that their gait pattern corresponds to a more random process. Here, we adapted a model of gait control to interpret the reduction in LRA that characterized patients in a computational framework. Gait regulation was modeled as a Linear-Quadratic-Gaussian control problem where the objective was to maintain a fixed velocity through the coordinated regulation of stride duration and length. This objective offers a degree of redundancy in the way the controller can maintain a given velocity, resulting in the emergence of LRA. In this framework, the model suggested that patients exploited less the task redundancy, likely to compensate for an increased stride-to-stride variability. Furthermore, we used this model to predict the potential benefit of an active orthosis on the gait pattern of patients. The orthosis was embedded in the model as a low-pass filter on the series of stride parameters. We show in simulations that, with a suitable level of assistance, the orthosis could help patients recovering a gait pattern with LRA comparable to that of healthy controls. Assuming that the presence of LRA in a stride series is a marker of healthy gait control, our study provides a rationale for developing gait assistance technology to reduce the fall risk associated with Parkinson’s disease.

Summary: Besides relying heavily on sensory and reinforcement feedback, motor skill learning may also depend on the level of motivation experienced during training. Yet, how motivation by reward modulates motor learning remains unclear. In 90 healthy subjects, we investigated the net effect of motivation by reward on motor learning while controlling for the sensory and reinforcement feedback received by the participants. Reward improved motor skill learning beyond performance-based reinforcement feedback. Importantly, the beneficial effect of reward involved a specific potentiation of reinforcement-related adjustments in motor commands, which concerned primarily the most relevant motor component for task success and persisted on the following day in the absence of reward. We propose that the long-lasting effects of motivation on motor learning may entail a form of associative learning resulting from the repetitive pairing of the reinforcement feedback and reward during training, a mechanism that may be exploited in future rehabilitation protocols.

The planning and control of motor actions requires knowledge of the dynamics of the controlled limb to generate the appropriate muscular commands and achieve the desired goal. Such planning and control imply that the CNS must be able to deal with forces and constraints acting on the limb, such as the omnipresent force of gravity. The present study investigates the effect of hypergravity induced by parabolic flights on the trajectory of vertical pointing movements to test the hypothesis that motor commands are optimized with respect to the effect of gravity on the limb. Subjects performed vertical pointing movements in normal gravity and hypergravity. We use a model based on optimal control to identify the role played by gravity in the optimal arm trajectory with minimal motor costs. First, the simulations in normal gravity reproduce the asymmetry in the velocity profiles (the velocity reaches its maximum before half of the movement duration), which typically characterizes the vertical pointing movements performed on Earth, whereas the horizontal movements present symmetrical velocity profiles. Second, according to the simulations, the optimal trajectory in hypergravity should present an increase in the peak acceleration and peak velocity despite the increase in the arm weight. In agreement with these predictions, the subjects performed faster movements in hypergravity with significant increases in the peak acceleration and peak velocity, which were accompanied by a significant decrease in the movement duration. This suggests that movement kinematics change in response to an increase in gravity, which is consistent with the hypothesis that motor commands are optimized and the action of gravity on the limb is taken into account. The results provide evidence for an internal representation of gravity in the central planning process and further suggest that an adaptation to altered dynamics can be understood as a reoptimization process. [ABSTRACT FROM AUTHOR]