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Investigating the neural correlates of goal-oriented upper extremity movements.

OBJECTIVE
To understand neural correlates of upper extremity task performance (functional vs. non-functional) and to understand their influence on neuromotor control strategies.


DESIGN
Cross-sectional descriptive study, with repeated measures.


SETTING
Medical center 1.5T MRI clinical imaging facility.


PARTICIPANTS
Neurologically intact individuals, (M=14 F=5 mean age=22.94 ± 3.1 years) all right hand dominant as determined by the Edinburgh handedness survey. Subjects performed upper extremity motor tasks of reaching and grasping in a block paradigm. Whole brain fMRI data was acquired using a 1.5T MRI scanner.


MAIN OUTCOME MEASURES
Differences in fMRI area of activation and maximum activation intensity for the whole brain were evaluated among the different upper extremity motor tasks.


RESULTS
Our results indicate (a) Activations in brain regions are task specific. (b) ANOVA results indicate functional goal oriented movements of reaching and grasping produce higher activation intensity (p < 0.0001) in more regions of the cortex (Somatosensory motor area, primary motor cortex, and parietal region) and cerebellum (p < 0.001) as compared to nonfunctional rhythmic movements of reaching only and grasping only. (c) There is some overlap in cerebellar activations, however areas of activation in the medial cerebellum were observed for reaching-and-grasping, while the grasping-only task produced activation more laterally in the cerebellum.


CONCLUSIONS
Our findings suggest that (a) neuromotor strategy for functional goal-oriented movements is different from rhythmic movements such as finger tapping or non-functional movements, (b) This difference can be quantified and mapped using fMRI. (c) There are some overlap with activation of movement execution however the cognitive component that mediates the specific movement is not just the linear combination of simple movements rather it is task and context specific. (d) The results support the concept of using goal-oriented tasks in the applications of rehabilitation and therapy for restoration of function.