A method to monitor upper limb movement direction encoding in the corticomotor pathway

Abnormal shoulder and elbow muscle coactivation patterns, or muscle synergies, are commonly present following stroke and may arise through dysfunctional descending neural control from the cortex. The authors evaluated a novel technique for examining corticomotor movement encoding of the upper limb in three dimensions. A 6-degree-of-freedom loadcell recorded arm twitch responses in healthy adults following stimulation over the cortex or over Erb's point in the periphery. Stimuli were delivered while the arm generated a 5 N preload in each of the 6 axial directions. The initial force twitch response to stimulation was used to construct twitch direction vectors for each preload direction. General linear mixed model analyses were used to determine the influence of stimulation location, preload direction, posture, and stimulation intensity on twitch direction. Cortical stimulation gave rise to arm twitch responses that were predictably modified by preload direction. Peripheral stimulation elicited stereotypical twitches that were not influenced by preload. Our stimulation, recording, and analysis techniques were able to capture movement encoding of the upper limb in three dimensions. Such techniques could be utilized in the stroke population to determine and monitor the presence of upper limb synergies during muscle activation.