Interaction of electrical stimulation and voluntary hand movement in SII and the cerebellum during simulated therapeutic functional electrical stimulation in healthy adults

Authors

  • Simona Denisia Iftime-Nielsen,

    1. Department of Health Science and Technology, Center for Sensory-Motor Interaction, Aalborg University, Denmark
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  • Mark Schram Christensen,

    1. Department of Exercise and Sport Sciences, University of Copenhagen, Denmark
    2. Department of Neuroscience and Pharmacology, University of Copenhagen, Denmark
    3. Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital Hvidovre, Denmark
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  • Rune Jersin Vingborg,

    1. Center of Functionally Integrative Neuroscience, University of Aarhus/Aarhus University Hospital, Denmark
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  • Thomas Sinkjær,

    1. Department of Health Science and Technology, Center for Sensory-Motor Interaction, Aalborg University, Denmark
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  • Andreas Roepstorff,

    1. Center of Functionally Integrative Neuroscience, University of Aarhus/Aarhus University Hospital, Denmark
    2. Department of Social Anthropology, University of Aarhus, Denmark
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  • Michael James Grey

    Corresponding author
    1. Department of Health Science and Technology, Center for Sensory-Motor Interaction, Aalborg University, Denmark
    2. Department of Exercise and Sport Sciences, University of Copenhagen, Denmark
    3. Department of Neuroscience and Pharmacology, University of Copenhagen, Denmark
    • School of Sport and Exercise Sciences, College of Life & Environmental Sciences, University of Birmingham, Edgbaston Birmingham, B15 2TT, UK
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Abstract

The therapeutic application of functional electrical stimulation (FES) has shown promising clinical results in the rehabilitation of post-stroke hemiplegia. It appears that the effect is optimal when the patterned electrical stimulation is used in close synchrony with voluntary movement, although the neural mechanisms that underlie the clinical successes reported with therapeutic FES are unknown. One possibility is that therapeutic FES takes advantage of the sensory consequences of an internal model. Here, we investigate fMRI cortical activity when FES is combined with voluntary effort (FESVOL) and we compare this activity to that produced when FES and voluntary activity (VOL) are performed alone. FESVOL revealed greater cerebellar activity compared with FES alone and reduced activity bilaterally in secondary somatosensory areas (SII) compared with VOL alone. Reduced activity was also observed for FESVOL compared with FES alone in the angular gyrus, middle frontal gyrus and inferior frontal gyrus. These findings indicate that during the VOL condition the cerebellum predicts the sensory consequences of the movement and this reduces the subsequent activation in SII. The decreased SII activity may reflect a better match between the internal model and the actual sensory feedback. The greater cerebellar activity coupled with reduced angular gyrus activity in FESVOL compared with FES suggests that the cortex may interpret sensory information during the FES condition as an error-like signal due to the lack of a voluntary component in the movement. Hum Brain Mapp, 2012. © 2011 Wiley Periodicals, Inc.

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