Bilateral upper-limb coordination in aging and stroke

Bilateral upper-limb coordination is an important ability for our living independency, since most of our daily tasks, such as lifting a box or using knife and fork, require the simultaneous use of both arms (Waller et al., 2006). However, bilateral coordination decline has been observed in both healthy aging and neurological groups (Pollock et al., 2014; Maes et al., 2017) , which often results in decreased quality of life (Broeks et al., 1999; Franceschini et al., 2010). Therefore, this dissertation sought to understand the characteristics and mechanisms of bilateral coordination and its impairments. The two fundamental bilateral movements in human upper limbs, i.e., in-phase (homologous muscles from bilateral arms activate simultaneously) and anti-phase (different muscle groups from bilateral arms activate simultaneously) movements, have been found to show different characteristics in behavioral and neural measurements (Swinnen and Wenderoth, 2004). Behaviorally, anti-phase movements are found to be performed with lower movement accuracy and higher phase variability between hands compared to in-phase movements (Wuyts et al., 1996; Byblow et al., 2000; Pollok et al., 2007). On the neural level, fMRI studies demonstrated that the left hemisphere shows larger task-related BOLD signal changes compared to the right hemisphere during in-phase movements (Aramaki et al., 2006), while the BOLD signal changes between the two hemispheres are similar during anti-phase movements (Walsh et al., 2008). These results suggest a left-dominated control of in-phase movements. However, a critical limitation in the literature is the lack of causal evidence supporting hemispherical specialization in bilateral coordination. Therefore, it is unclear whether the observed behavioral differences between anti-phase and in-phase movements were truly due to distinct hemispheric control. Another limitation of the literature is the design of existing paradigms. While most of our daily activities involve movements engaging multiple joints at the same time (Keenan et al., 2006; Murphy et al., 2006), previous studies mostly investigated single joint movements (e.g. index finger tapping, forearm pronation-supination). Contrary to single joint movements, bilateral movements engaging multiple joints require not only inter-limb coordination, but also additional intra-limb coordination. Therefore, it is unclear whether the previous findings from single joint movements could be directly applied to multiple joint movements. In this dissertation, we used a bilateral coordination paradigm involving both shoulder and elbow joints to investigate the neural mechanisms behind bilateral coordination and its decline. We designed three studies focusing on 1) the differences between bilateral in-phase and anti-phase movements from a human motion perspective, 2) how aging affects different bilateral coordination patterns and its neural correlates, as well as 3) how lesioned hemisphere affects bilateral coordination impairments and whether distinct rehabilitation treatments are needed after a left or right hemispheric stroke. In Study 1, we examined the two basic bilateral coordination modes, in-phase and anti-phase movements, in healthy young right-handed participants. We used a bilateral circle drawing task involving both shoulder and elbow joints. During the movements, we measured participants’ hand positions with high temporal and spatial precision, and developed intra-limb and inter-limb measures to differentiate movement characteristics during the two basic movement modes. For intra-limb coordination, we quantified trajectory variability of each hand during the movements. For inter-limb coordination, we computed the phase synchronization between hands. We found that intra-limb coordination was worse in the non-dominant hand during anti-phase compared to in-phase movements. In contrast, intra-limb coordination in the dominant hand did not differ between anti-phase and in-phase movements. Second, participants showed worse inter-limb synchronization during anti-phase compared to in-phase movements. Moreover, we examined the hand acceleration profile of both hands, and found that participants’ bilateral hands accelerated and decelerated in an in-phase manner during in-phase movements. In contrast, the acceleration and deceleration of the two hands were unrelated during anti-phase movements. These inter-limb acceleration profiles support the idea of differential neural mechanisms behind bilateral anti-phase and in-phase movements: during in-phase movements, the hands are governed by a common neural generator, while during anti-phase movements, the two hands are controlled by both hemispheres more independently. Taken together, Study 1 showed that the current experimental setup is able to differentiate the performance between bilateral in-phase and anti-phase movements engaging multiple joints. Therefore, we used the same paradigm combined with electroencephalography (EEG) to examine the presumed decline of bilateral coordination in aging. In Study 2, we investigated the effect of aging on the two basic bilateral movement modes. We used intra- and inter-limb measures as the behavioral measures, and EEG as a neural measure. Behaviorally, we found that older adults only showed significant impairments in anti-phase movements, but not in-phase movements, compared to young adults. On the neural level, we found that older adults showed different neural responses during anti-phase and in-phase movements compared to young adults. Specifically, during in-phase movements, young adults showed a more pronounced decrease of alpha power (8-12 Hz) over the left compared to the right hemisphere, while older adults showed similar levels of alpha power decrease over both hemispheres. Furthermore, in the older adults, we found a marginal correlation between the change in alpha power over the right hemisphere and the behavioral performance, which indicated a compensatory brain response. As for the anti-phase movements, we found that participants with stronger directional inter-hemispheric connectivity in the beta band (15-25 Hz) showed worse behavioral performance, and this effect was more pronounced in the older adults. This result implies that a balanced inter-hemispheric contribution is essential for executing a successful anti-phase movement. Our findings therefore show that the two hemispheres are differentially involved in the two basic bilateral coordination modes. These different neural characteristics may explain the distinct decline patterns of in-phase and anti-phase movements in older adults. However, causal evidence to support hemispherical specialization is needed to confirm our findings. Therefore, we conducted Study 3, where we used stroke as a lesion model to examine the influence of the lesioned hemisphere on bilateral coordination. In Study 3, we examined the bilateral coordination ability in patients with left (LHS) and right hemispheric stroke (RHS), as well as healthy controls. Given that healthy young participants show a left-dominant control in in-phase movements in Study 2 and in the previous literature (Aramaki et al., 2006; Maki et al., 2008), we expected that LHS patients would display a more pronounced impairment of in-phase movements compared to RHS patients. In contrast, since anti-phase movements require a more balanced inter-hemispheric contribution as shown in Study 2, and RHS patients show larger inter-hemispheric inhibition compared to healthy participants and LHS patients (Lewis and Perreault, 2007b), we expected that RHS patients would show more impairment in anti-phase movements compared to LHS patients. As predicted, we found that patients with RHS patients exhibited greater impairment during anti-phase movements (both intra- and inter-limb parameters) and LHS patients showed greater impairment during in-phase movements (intra-limb parameters only). Though LHS patients did not show greater impairment in inter-limb coordination during in-phase movements compared to RHS patients, our regression analysis revealed that only LHS patients swapped hand dominance during the task. We interpreted this result as a compensatory mechanism whereby bilateral in-phase movements in the LHS group switched from a left-dominated cortical control to a right-dominated cortical control. Our findings not only provide causal evidence for hemispheric specialization in bilateral movement coordination, but also characterize the differential impairments in bilateral coordination after a left or right hemispheric stroke. Taken together, this dissertation highlighted differential neural control processes involved in bilateral in-phase and anti-phase movements, and demonstrated how these distinct mechanisms lead to impaired bilateral coordination in aging and stroke. The present results could therefore advance the development of therapeutic strategies that seek to counteract bilateral coordination decline, such as differential treatment for patients with left and right hemispheric lesions, or the use of noninvasive brain stimulation at a target hemisphere.:List of abbreviations List of figures List of tables Chapter 1. General introduction 1.1. Introduction 1.2. Bilateral coordination in human upper extremities 1.3. Age-related motor decline 1.4. Stroke-induced motor impairments Chapter 2. Rationale of the Dissertation Chapter 3. Study I: Human motion characteristics during bilateral in-phase and anti-phase movements 3.1. Introduction 3.2. Materials and methods 3.3. Results 3.4. Discussion 3.5. Conclusion Chapter 4. Study II: The effect of aging on bilateral coordination 49 4.1. Introduction 4.2. Materials and methods 4.3. Results 4.4. Discussion 4.5. Conclusion Chapter 5. Study III: Effects of lesioned side on bilateral coordination after strokes 5.1. Introduction 5.2. Materials and methods 5.3. Results 5.4. Discussion 5.5. Conclusion Chapter 6. General discussion 6.1. Summary of research 6.2. Contributions and clinical implications 6.3. Outlook for future research Chapter 7. Summary of the dissertation References Appendix Appendix 1. Supplementary information for study 1 Appendix 2. Supplementary information for study 2 Appendix 3. Supplementary information for study 3 Appendix 4. Declaration of authenticit

Regulation of axon repulsion by MAX-1 SUMOylation and AP-3.

During neural development, growing axons express specific surface receptors in response to various environmental guidance cues. These axon guidance receptors are regulated through intracellular trafficking and degradation to enable navigating axons to reach their targets. In Caenorhabditis elegans, the UNC-5 receptor is necessary for dorsal migration of developing motor axons. We previously found that MAX-1 is required for UNC-5-mediated axon repulsion, but its mechanism of action remained unclear. Here, we demonstrate that UNC-5-mediated axon repulsion in C. elegans motor axons requires both max-1 SUMOylation and the AP-3 complex β subunit gene, apb-3 Genetic interaction studies show that max-1 is SUMOylated by gei-17/PIAS1 and acts upstream of apb-3 Biochemical analysis suggests that constitutive interaction of MAX-1 and UNC-5 receptor is weakened by MAX-1 SUMOylation and by the presence of APB-3, a competitive interactor with UNC-5. Overexpression of APB-3 reroutes the trafficking of UNC-5 receptor into the lysosome for protein degradation. In vivo fluorescence recovery after photobleaching experiments shows that MAX-1 SUMOylation and APB-3 are required for proper trafficking of UNC-5 receptor in the axon. Our results demonstrate that SUMOylation of MAX-1 plays an important role in regulating AP-3-mediated trafficking and degradation of UNC-5 receptors during axon guidance

Developing a neutral equilibrium device as dynamic virtual piers for an emergency relief bridge

Every year, many natural disasters strike Taiwan, destroying bridges and disrupting traffic. To allow shipping of relief provisions and salvage, fabricated steel bridges are often used to construct emergency relief bridges. This kind of bridge must meet strength and functionality requirements. Strength depends on the materials used, while functionality depends on displacement control. These two requirements affect the section design of the bridge deck. In order to quickly build a light-weight bridge for emergency relief with displacement control, a neutral equilibrium mechanism is proposed and developed to control the deflection of an emergency relief bridge. A neutral equilibrium mechanism is a system with an internal control mechanism that can actively change the internal structure. Structural transformation causes the size variation of the action force to respond to continuous changes in bridge deflection. This mechanism can expand the effective span of the bridge, maintain its strength and functionality, and increase the convenience of building and mobility. Experimental results reveal that a virtual pier at the center of a bridge with this proposed mechanism installed can control vertical deflection caused by vehicles carrying heavy loads. Test and analysis records also reveal that the vertical displacement at the center of a bridge with the neutral equilibrium mechanism installed is close to zero. The practicality of this neutral equilibrium mechanism has been verified by experiment

The Molecular Determinants of NEDD8 Specific Recognition by Human SENP8

Although neuronal-precursor-cell-expressed developmentally downregulated protein-8 (NEDD8) and ubiquitin share the highest level of sequence identity and structural similarity among several known ubiquitin-like proteins, their conjugation to a protein leads to distinct biological consequences. In the study, we first identified the NEDD8 protein of Chlamydomonas reinhardtii (CrNEDD8) and discovered that CrNEDD8 is fused at the C-terminus of a ubiquitin moiety (CrUb) in a head-to-tail arrangement. This CrUb-CrNEDD8 protein was termed CrRUB1 (related to ubiquitin 1) by analogy with a similar protein in Arabidopsis thaliana (AtRUB1). Since there is high sequence identity in comparison to the corresponding human proteins (97% for ubiquitin and 84% for NEDD8), a His-CrRUB1-glutathione S-transferase (GST) fusion construct was adopted as the alternative substrate to characterize the specificity of NEDD8-specific peptidase SENP8 for CrNEDD8. The data showed that SENP8 only cleaved the peptide bond beyond the di-glycine motif of CrNEDD8 and His-RUB1 was subsequently generated, confirming that SENP8 has exquisite specificity for CrNEDD8 but not CrUb. To further determine the basis of this specificity, site-directed mutagenesis at earlier reported putative molecular determinants of NEDD8 specific recognition by SENP8 was performed. We found that a single N51E mutation of CrNEDD8 completely inhibited its hydrolysis by SENP8. Conversely, a single E51N mutation of CrUb enabled this ubiquitin mutant to undergo hydrolysis by SENP8, revealing that a single residue difference at the position 51 contributes substantially to the substrate selectivity of SENP8. Moreover, the E51N/R72A double mutant of the CrUb subdomain can further increase the efficiency of cleavage by SENP8, indicating that the residue at position 72 is also important in substrate recognition. The E51N or R72A mutation of CrUb also inhibited the hydrolysis of CrUb by ubiquitin-specific peptidase USP2. However, USP2 cannot cleave the N51E/A72R double mutant of the CrNEDD8 subdomain, suggesting that USP2 requires additional recognition sites

United Nations Declaration on the Rights of Indigenous Peoples, 2007 * Prepared for the International Peace Research Association

Abstract This paper seeks to understand the concept, justification, and operation of co-management. Furthermore, we like to explore how indigenous peoples may take part in the management of natural resource through the mechanism of co-management. Finally, we will assess how co-management may be applied in Taiwan and what potential barriers may be in the way. Article 18 Indigenous peoples have the right to participate in decision-making in matters which would affect their rights, through representatives chosen by themselves in accordance with their own procedures, as well as to maintain and develop their own indigenous decision-making institutions. Article 32 1. Indigenous peoples have the right to determine and develop priorities and strategies for the development or use of their lands or territories and other resources. 2. States shall consult and cooperate in good faith with the indigenous peoples concerned through their own representative institutions in order to obtain their free and informed consent prior to the approval of any project affecting their lands or territories and other resources, particularly in connection with the development, utilization or exploitation of their mineral, water or other resources

A protein interaction based model for schizophrenia study

<p>Abstract</p> <p>Background</p> <p>Schizophrenia is a complex disease with multiple factors contributing to its pathogenesis. In addition to environmental factors, genetic factors may also increase susceptibility. In other words, schizophrenia is a highly heritable disease. Some candidate genes have been deduced on the basis of their known function with others found on the basis of chromosomal location. Individuals with multiple candidate genes may have increased risk. However it is not clear what kind of gene combinations may produce the disease phenotype. Their collective effect remains to be studied.</p> <p>Results</p> <p>Most pathways except metabolic pathways are rich in protein-protein interactions (PPIs). Thus, the PPI network contains pathway information, even though the upstream-downstream relation of PPI is yet to be explored. Here we have constructed a PPI sub-network by extracting the nearest neighbour of the 36 reported candidate genes described in the literature. Although these candidate genes were discovered by different approaches, most of the proteins formed a cluster. Two major protein interaction modules were identified on the basis of the pairwise distance among the proteins in this sub-network. The large and small clusters might play roles in synaptic transmission and signal transduction, respectively, based on gene ontology annotation. The protein interactions in the synaptic transmission cluster were used to explain the interaction between the NRG1 and CACNG2 genes, which was found by both linkage and association studies. This working hypothesis is supported by the co-expression analysis based on public microarray gene expression.</p> <p>Conclusion</p> <p>On the basis of the protein interaction network, it appears that the NRG1-triggered NMDAR protein internalization and the CACNG2 mediated AMPA receptor recruiting may act together in the glutamatergic signalling process. Since both the NMDA and AMPA receptors are calcium channels, this process may regulate the influx of Ca²⁺. Reducing the cation influx might be one of the disease mechanisms for schizophrenia. This PPI network analysis approach combined with the support from co-expression analysis may provide an efficient way to propose pathogenetic mechanisms for various highly heritable diseases.</p

Estrogen Augments Shear Stress–Induced Signaling and Gene Expression in Osteoblast-like Cells via Estrogen Receptor–Mediated Expression of β1-Integrin

Estrogen and mechanical forces are positive regulators for osteoblast proliferation and bone formation. We investigated the synergistic effect of estrogen and flow-induced shear stress on signal transduction and gene expression in human osetoblast-like MG63 cells and primary osteoblasts (HOBs) using activations of extracellular signal-regulated kinase (ERK) and p38 mitogen-activated protein kinase (MAPK) and expressions of c-fos and cyclooxygenase-2 (I) as readouts. Estrogen (17β-estradiol, 10 nM) and shear stress (12 dyn/cm2) alone induced transient phosphorylations of ERK and p38 MAPK in MG63 cells. Pretreating MG63 cells with 17β-estradiol for 6 hours before shearing augmented these shear-induced MAPK phosphorylations. Western blot and flow cytometric analyses showed that treating MG63 cells with 17β-estradiol for 6 hrs induced their β1-integrin expression. This estrogen-induction of β1-integrin was inhibited by pretreating the cells with a specific antagonist of estrogen receptor ICI 182,780. Both 17β-estradiol and shear stress alone induced c-fos and Cox-2 gene expressions in MG63 cells. Pretreating MG63 cells with 17β-estradiol for 6 hrs augmented the shear-induced c-fos and Cox-2 expressions. The augmented effects of 17β-estradiol on shear-induced MAPK phosphorylations and c-fos and Cox-2 expressions were inhibited by pretreating the cells with ICI 182,780 or transfecting the cells with β1-specific small interfering RNA. Similar results on the augmented effect of estrogen on shear-induced signaling and gene expression were obtained with HOBs. Our findings provide insights into the mechanism by which estrogen augments shear stress responsiveness of signal transduction and gene expression in bone cells via estrogen receptor–mediated increases in β1-integrin expression. © 2010 American Society for Bone and Mineral Research

CMOS Image Sensor with a Built-in Lane Detector

This work develops a new current-mode mixed signal Complementary Metal-Oxide-Semiconductor (CMOS) imager, which can capture images and simultaneously produce vehicle lane maps. The adopted lane detection algorithm, which was modified to be compatible with hardware requirements, can achieve a high recognition rate of up to approximately 96% under various weather conditions. Instead of a Personal Computer (PC) based system or embedded platform system equipped with expensive high performance chip of Reduced Instruction Set Computer (RISC) or Digital Signal Processor (DSP), the proposed imager, without extra Analog to Digital Converter (ADC) circuits to transform signals, is a compact, lower cost key-component chip. It is also an innovative component device that can be integrated into intelligent automotive lane departure systems. The chip size is 2,191.4 × 2,389.8 μm, and the package uses 40 pin Dual-In-Package (DIP). The pixel cell size is 18.45 × 21.8 μm and the core size of photodiode is 12.45 × 9.6 μm; the resulting fill factor is 29.7%

Volumetric intensity-modulated Arc (RapidArc) therapy for primary hepatocellular carcinoma: comparison with intensity-modulated radiotherapy and 3-D conformal radiotherapy

<p>Abstract</p> <p>Background</p> <p>To compare the RapidArc plan for primary hepatocellular carcinoma (HCC) with 3-D conformal radiotherapy (3DCRT) and intensity-modulated radiotherapy (IMRT) plans using dosimetric analysis.</p> <p>Methods</p> <p>Nine patients with unresectable HCC were enrolled in this study. Dosimetric values for RapidArc, IMRT, and 3DCRT were calculated for total doses of 45~50.4 Gy using 1.8 Gy/day. The parameters included the conformal index (CI), homogeneity index (HI), and hot spot (V_107%) for the planned target volume (PTV) as well as the monitor units (MUs) for plan efficiency, the mean dose (D_mean) for the organs at risk (OAR) and the maximal dose at 1% volume (D_1%) for the spinal cord. The percentage of the normal liver volume receiving ≥ 40, > 30, > 20, and > 10 Gy (V_{40 Gy}, V_{30 Gy}, V_{20 Gy}, and V_{10 Gy}) and the normal tissue complication probability (NTCP) were also evaluated to determine liver toxicity.</p> <p>Results</p> <p>All three methods achieved comparable homogeneity for the PTV. RapidArc achieved significantly better CI and V_107%values than IMRT or 3DCRT (<it>p </it>< 0.05). The MUs were significantly lower for RapidArc (323.8 ± 60.7) and 3DCRT (322.3 ± 28.6) than for IMRT (1165.4 ± 170.7) (<it>p </it>< 0.001). IMRT achieved a significantly lower D_meanof the normal liver than did 3DCRT or RapidArc (<it>p </it>= 0.001). 3DCRT had higher V_{40 Gy}and V_{30 Gy}values for the normal liver than did RapidArc or IMRT. Although the V_{10 Gy}to the normal liver was higher with RapidArc (75.8 ± 13.1%) than with 3DCRT or IMRT (60.5 ± 10.2% and 57.2 ± 10.0%, respectively; <it>p </it>< 0.01), the NTCP did not differ significantly between RapidArc (4.38 ± 2.69) and IMRT (3.98 ± 3.00) and both were better than 3DCRT (7.57 ± 4.36) (<it>p </it>= 0.02).</p> <p>Conclusions</p> <p>RapidArc provided favorable tumor coverage compared with IMRT or 3DCRT, but RapidArc is not superior to IMRT in terms of liver protection. Further studies are needed to establish treatment outcome differences between the three approaches.</p