Effet de la maladie de Parkinson et de la médication dopaminergique sur les mécanismes de traitement et d'intégration sensorielle et l'adaptation visuomotrice

L’intégrité de notre système sensorimoteur est essentielle aux interactions adéquates avec notre environnement. Dans la maladie de Parkinson (MP), l’efficacité des interactions quotidiennes entre le corps et l’environnement est fréquemment réduite et diminue la qualité de vie. La MP est une maladie neurodégénérative résultant prioritairement d’une perte neuronale dopaminergique dans les ganglions de la base (GB). Cette dégénérescence altère le fonctionnement normal de la circuiterie associant les GB au cortex cérébral. L’administration de médications dopaminergiques permet d’améliorer les principaux symptômes cliniques moteurs de la MP. Cette thèse porte sur les rôles des GB dans les processus de traitement et d’intégration des informations sensorielles visuelle et proprioceptive et dans les mécanismes d’adaptation visuomotrice. Elle s’intéresse également à l’influence de la médication dopaminergique sur ces fonctions sensorimotrices. Nous avons réalisé trois études comportementales, utilisant l’atteinte manuelle tridimensionnelle comme modèle expérimental. Dans chacune de ces études, nous avons comparé la performance de personnes âgées en santé à celle de personnes souffrant de la MP avec et sans leur médication antiparkinsonienne quotidienne. Ces trois études ont été réalisées à l’aide d’un système d’analyse de mouvement et une station de réalité virtuelle. Dans la première étude, nous avons évalué si les GB sont prioritairement impliqués dans l’intégration sensorimotrice ou le traitement des informations proprioceptives. Pour se faire, nous avons testé la capacité des patients MP à effectuer des atteintes manuelles tridimensionnelles précises dans quatre conditions variant la nature des informations sensorielles (visuelles et/ou proprioceptives) définissant la position de la main et de la cible. Les patients MP ont effectué, en moyenne, de plus grandes erreurs spatiales que les personnes en santé uniquement lorsque les informations proprioceptives étaient la seule source d’information sensorielle disponible. De plus, ces imprécisions spatiales étaient significativement plus grandes que celles des personnes en santé, seulement lorsque les patients étaient testés dans la condition médicamentée. La deuxième étude présentée dans cette thèse a permis de démontrer que les imprécisions spatiales des patients MP dans les conditions proprioceptives étaient le résultat de déficits dans l’utilisation en temps réel des informations proprioceptives pour guider les mouvements. Dans la troisième étude, nous avons évalué si les GB sont prioritairement impliqués dans les mécanismes d’adaptation visuomotrice explicite ou implicite. Pour se faire, nous avons testé les capacités adaptatives des patients MP dans deux tâches variant le décours temporel de l’application d’une perturbation visuomotrice tridimensionnelle. Dans la tâche explicite, la perturbation était introduite soudainement, produisant de grandes erreurs détectées consciemment. Dans la condition implicite, la perturbation était introduite graduellement ce qui engendrait de petites erreurs non détectables. Les résultats montrent que les patients MP dans les conditions médicamentée et non médicamentée présentent des déficits adaptatifs uniquement dans la tâche explicite. Dans l’ensemble, les résultats expérimentaux présentés dans cette thèse montrent que la médication dopaminergique n’améliore pas le traitement des afférences proprioceptives et l’adaptation visuomotrice des personnes souffrant de la MP. Ces observations suggèrent que les dysfonctions dans les circuits dopaminergiques dans les GB ne sont pas les seules responsables des déficits observés dans ces fonctions sensorimotrices.

Contributions des voies vestibulospinale et corticospinale au contrôle des mouvements du bras

Le contrôle des mouvements du bras fait intervenir plusieurs voies provenant du cerveau. Cette thèse, composée principalement de deux études, tente d’éclaircir les contributions des voies tirant leur origine du système vestibulaire et du cortex moteur. Dans la première étude (Raptis et al 2007), impliquant des mouvements d’atteinte, nous avons cerné l’importance des voies descendantes partant du système vestibulaire pour l’équivalence motrice, i.e. la capacité du système moteur à atteindre un but moteur donné lorsque le nombre de degrés de liberté articulaires varie. L’hypothèse émise était que le système vestibulaire joue un rôle essentiel dans l’équivalence motrice. Nous avons comparé la capacité d’équivalence motrice de sujets sains et de patients vestibulodéficients chroniques lors de mouvements nécessitant un contrôle des positions du bras et du tronc. Pendant que leur vision était temporairement bloquée, les sujets devaient soit maintenir une position de l’index pendant une flexion du tronc, soit atteindre une cible dans l’espace péri-personnel en combinant le mouvement du bras avec une flexion du tronc. Lors d’essais déterminés aléatoirement et imprévus par les participants, leur tronc était retenu par un mécanisme électromagnétique s’activant en même temps que le signal de départ. Les sujets sains ont pu préserver la position ou la trajectoire de l’index dans les deux conditions du tronc (libre, bloqué) en adaptant avec une courte latence (60-180 ms) les mouvements articulaires au niveau du coude et de l’épaule. En comparaison, six des sept patients vestibulodéficients chroniques ont présenté des déficits au plan des adaptations angulaires compensatoires. Pour ces patients, entre 30 % et 100 % du mouvement du tronc n’a pas été compensé et a été transmis à la position ou trajectoire de l’index. Ces résultats indiqueraient que les influences vestibulaires évoquées par le mouvement de la tête pendant la flexion du tronc jouent un rôle majeur pour garantir l’équivalence motrice dans ces tâches d’atteinte lorsque le nombre de degrés de liberté articulaires varie. Également, ils démontrent que la plasticité de long terme survenant spontanément après une lésion vestibulaire unilatérale complète ne serait pas suffisante pour permettre au SNC de retrouver un niveau d’équivalence motrice normal dans les actions combinant un déplacement du bras et du tronc. Ces tâches de coordination bras-tronc constituent ainsi une approche inédite et sensible pour l’évaluation clinique des déficits vestibulaires. Elles permettent de sonder une dimension fonctionnelle des influences vestibulaires qui n’était pas prise en compte dans les tests cliniques usuels, dont la sensibilité relativement limitée empêche souvent la détection d’insuffisances vestibulaires six mois après une lésion de ces voies. Avec cette première étude, nous avons donc exploré comment le cerveau et les voies descendantes intègrent des degrés de liberté articulaires supplémentaires dans le contrôle du bras. Dans la seconde étude (Raptis et al 2010), notre but était de clarifier la nature des variables spécifiées par les voies descendantes pour le contrôle d’actions motrices réalisées avec ce membre. Nous avons testé l’hypothèse selon laquelle les voies corticospinales contrôlent la position et les mouvements des bras en modulant la position-seuil (position de référence à partir de laquelle les muscles commencent à être activés en réponse à une déviation de cette référence). Selon ce principe, les voies corticospinales ne spécifieraient pas directement les patrons d’activité EMG, ce qui se refléterait par une dissociation entre l’EMG et l’excitabilité corticospinale pour des positions-seuils différentes. Dans un manipulandum, des participants (n=16) ont modifié leur angle du poignet, d’une position de flexion (45°) à une position d’extension (-25°), et vice-versa. Les forces élastiques passives des muscles ont été compensées avec un moteur couple afin que les sujets puissent égaliser leur activité EMG de base dans les deux positions. L’excitabilité motoneuronale dans ces positions a été comparée à travers l’analyse des réponses EMG évoquées à la suite d’étirements brefs. Dans les deux positions, le niveau d’EMG et l’excitabilité motoneuronale étaient semblables. De plus, ces tests ont permis de montrer que le repositionnement du poignet était associé à une translation de la position-seuil. Par contre, malgré la similitude de l’excitabilité motoneuronale dans ces positions, l’excitabilité corticospinale des muscles du poignet était significativement différente : les impulsions de stimulation magnétique transcrânienne (TMS; à 1.2 MT, sur l’aire du poignet de M1) ont provoqué des potentiels moteurs évoqués (MEP) de plus grande amplitude en flexion pour les fléchisseurs comparativement à la position d’extension et vice-versa pour les extenseurs (p<0.005 pour le groupe). Lorsque les mêmes positions étaient établies après une relaxation profonde, les réponses réflexes et les amplitudes des MEPs ont drastiquement diminué. La relation caractéristique observée entre position physique et amplitude des MEPs dans le positionnement actif s’est aussi estompée lorsque les muscles étaient relâchés. Cette étude suggère que la voie corticospinale, en association avec les autres voies descendantes, participerait au contrôle de la position-seuil, un processus qui prédéterminerait le référentiel spatial dans lequel l’activité EMG émerge. Ce contrôle de la « référence » constituerait un principe commun s’appliquant à la fois au contrôle de la force musculaire, de la position, du mouvement et de la relaxation. Nous avons aussi mis en évidence qu’il est nécessaire, dans les prochaines recherches ou applications utilisant la TMS, de prendre en compte la configuration-seuil des articulations, afin de bien interpréter les réponses musculaires (ou leurs changements) évoquées par cette technique; en effet, la configuration-seuil influencerait de manière notable l’excitabilité corticomotrice, qui peut être considérée comme un indicateur non seulement lors d’activités musculaires, mais aussi cognitives, après apprentissages moteurs ou lésions neurologiques causant des déficits moteurs (ex. spasticité, faiblesse). Considérées dans leur ensemble, ces deux études apportent un éclairage inédit sur des principes fondamentaux du contrôle moteur : nous y illustrons de manière plus large le rôle du système vestibulaire dans les tâches d’atteinte exigeant une coordination entre le bras et son « support » (le tronc) et clarifions l’implication des voies corticomotrices dans la spécification de paramètres élémentaires du contrôle moteur du bras. De plus amples recherches sont cependant nécessaires afin de mieux comprendre comment les systèmes sensoriels et descendants (e.g. vestibulo-, réticulo-, rubro-, propriospinal) participent et interagissent avec les signaux corticofugaux afin de spécifier les seuils neuromusculaires dans le contrôle de la posture et du mouvement.

Characterizing full-body reach duration across task and viewpoint modalities

The full-body control of virtual characters is a promising technique for application fields such as Virtual Prototyping. However it is important to assess to what extent the user full-body behavior is modified when immersed in a virtual environment. In the present study we have measured reach durations for two types of task (controlling a simple rigid shape vs. a virtual character) and two types of viewpoint (1st person vs. 3rd person). The paper first describes the architecture of the motion capture approach retained for the on-line full-body reach experiment. We then present reach measurement results performed in a non-virtual environment. They show that the target height parameter leads to reach duration variation of ∓25% around the average duration for the highest and lowest targets. This characteristic is highly accentuated in the virtual world as analyzed in the discussion section. In particular, the discrepancy observed for the first person viewpoint modality suggests to adopt a third person viewpoint when controling the posture of a virtual character in a virtual environment.

Teaching an Old Robot New Tricks: Learning Novel Tasks via Interaction with People and Things

As AI has begun to reach out beyond its symbolic, objectivist roots into the embodied, experientialist realm, many projects are exploring different aspects of creating machines which interact with and respond to the world as humans do. Techniques for visual processing, object recognition, emotional response, gesture production and recognition, etc., are necessary components of a complete humanoid robot. However, most projects invariably concentrate on developing a few of these individual components, neglecting the issue of how all of these pieces would eventually fit together. The focus of the work in this dissertation is on creating a framework into which such specific competencies can be embedded, in a way that they can interact with each other and build layers of new functionality. To be of any practical value, such a framework must satisfy the real-world constraints of functioning in real-time with noisy sensors and actuators. The humanoid robot Cog provides an unapologetically adequate platform from which to take on such a challenge. This work makes three contributions to embodied AI. First, it offers a general-purpose architecture for developing behavior-based systems distributed over networks of PC's. Second, it provides a motor-control system that simulates several biological features which impact the development of motor behavior. Third, it develops a framework for a system which enables a robot to learn new behaviors via interacting with itself and the outside world. A few basic functional modules are built into this framework, enough to demonstrate the robot learning some very simple behaviors taught by a human trainer. A primary motivation for this project is the notion that it is practically impossible to build an "intelligent" machine unless it is designed partly to build itself. This work is a proof-of-concept of such an approach to integrating multiple perceptual and motor systems into a complete learning agent.

Deep learning for computer vision: a comparison between convolutional neural networks and hierarchical temporal memories on object recognition tasks

In recent years, Deep Learning techniques have shown to perform well on a large variety of problems both in Computer Vision and Natural Language Processing, reaching and often surpassing the state of the art on many tasks. The rise of deep learning is also revolutionizing the entire field of Machine Learning and Pattern Recognition pushing forward the concepts of automatic feature extraction and unsupervised learning in general. However, despite the strong success both in science and business, deep learning has its own limitations. It is often questioned if such techniques are only some kind of brute-force statistical approaches and if they can only work in the context of High Performance Computing with tons of data. Another important question is whether they are really biologically inspired, as claimed in certain cases, and if they can scale well in terms of "intelligence". The dissertation is focused on trying to answer these key questions in the context of Computer Vision and, in particular, Object Recognition, a task that has been heavily revolutionized by recent advances in the field. Practically speaking, these answers are based on an exhaustive comparison between two, very different, deep learning techniques on the aforementioned task: Convolutional Neural Network (CNN) and Hierarchical Temporal memory (HTM). They stand for two different approaches and points of view within the big hat of deep learning and are the best choices to understand and point out strengths and weaknesses of each of them. CNN is considered one of the most classic and powerful supervised methods used today in machine learning and pattern recognition, especially in object recognition. CNNs are well received and accepted by the scientific community and are already deployed in large corporation like Google and Facebook for solving face recognition and image auto-tagging problems. HTM, on the other hand, is known as a new emerging paradigm and a new meanly-unsupervised method, that is more biologically inspired. It tries to gain more insights from the computational neuroscience community in order to incorporate concepts like time, context and attention during the learning process which are typical of the human brain. In the end, the thesis is supposed to prove that in certain cases, with a lower quantity of data, HTM can outperform CNN.

Preserved obstacle avoidance during reaching in patients with left visual neglect

We asked 12 patients with left visual neglect to bisect the gap between two cylinders or to reach rapidly between them to a more distal target zone. Both tasks demanded a motor response but these responses were quite different in nature. The bisection response was a communicative act whereby the patient indicated the perceived midpoint. The reaching task carried no imperative to bisect the gap, only to maintain a safe distance from either cylinder while steering to the target zone. Optimal performance on either task could only be achieved by reference to the location of both cylinders. Our analysis focused upon the relative influence of the left and right cylinders on the lateral location of the response. In the bisection task, all neglect patients showed qualitatively the same asymmetry, with the left cylinder exerting less influence than the right. In the reaching task, the neglect group behaved like normal subjects, being influenced approximately equally by the two cylinders. This was true for all bar two of the patients, who showed clear neglect in both tasks. We conclude that the visuomotor processing underlying obstacle avoidance during reaching is preserved in most patients with left visual neglect. (C) 2004 Elsevier Ltd. All rights reserved.

Selective activation of the rectus abdominis muscle during low-intensity and fatiguing tasks

In order to understand the potential selective activation of the rectus abdominis muscle, we conducted two experiments. In the first, subjects performed two controlled isometric exercises: the curl up (supine trunk raise) and the leg raise (supine bent leg raise) at low intensity (in which only a few motor units are recruited). In the second experiment, subjects performed the same exercises, but they were required to maintain a certain force level in order to induce fatigue. We recorded the electromyographic (EMG) activities of the lower and upper portions of the rectus abdominis muscle during the exercises and used spatial-temporal and frequency analyses to describe muscle activation patterns. At low-intensity contractions, the ratio between the EMG intensities of the upper and lower portions during the curl up exercise was significantly larger than during the leg raise exercise (p = 0.02). A cross-correlation analysis indicated that the signals of the abdominal portions were related to each other and this relation did not differ between the tasks (p = 0.12). In the fatiguing condition, fatigue for the upper portion was higher than for the lower portion during the curl up exercise (p = 0.008). We conclude that different exercises evoked, to a certain degree, individualized activation of each part of the rectus abdominis muscle, but different portions of the rectus abdominis muscle contributed to the same task, acting like a functional unit. These results corroborate the relevance of varying exercise to modify activation patterns of the rectus abdominis muscle.

Males still have limb asymmetries in multijoint movement tasks more than 2 years following anterior cruciate ligament reconstruction

More than 2 years after undergoing anterior cruciate ligament (ACL) reconstruction, women still present bilateral asymmetries during multijoint movement tasks. Given the well-known ACL-injury gender bias, the goal of this study was to investigate whether males also present such asymmetries more than 2 years after undergoing ACL reconstruction. This study involved 12 participants submitted to ACL reconstruction in the ACL group and 17 healthy participants in the control group. The mean postoperative period was 37 months. The participants executed bilateral countermovement jumps and load squat tasks. The kinematics and ground reaction forces on each lower limb and pelvis were recorded, and used to compute bilateral peak vertical ground reaction forces, peak knee and hip joint powers in the sagittal plane, and the ratio between these powers. For the jump task, the groups had the same performance in the jump height, but for the ACL group the peak knee joint power on the operated side was 13% lower than on the non-operated side (p = 0.02). For the squat task, the hip-knee joint power ratio on the operated side of the ACL group was 31% greater than on the non-operated side (p = 0.02). The ACL group presented a deficit in the operated knee that had its energy generation over time (joint power) partially substituted by the hip joint power of the same side. The fact that, even after more than 2 years following the ACL reconstruction and returning to regular activity, the ACL group still had neuromuscular asymmetries suggests a need for improvement in the ACL reconstruction surgery procedures and/or rehabilitation protocols.

Amplification and diffusion of manual preference from lateralized practice in children

The effect of lateralized practice on manual preference was investigated in right-handed children. Probing tasks required reaching and grasping a pencil at distinct eccentricities in the right and left hemifields (simple), and its transportation and insertion into a small hole (complex). During practice, the children experienced manipulative tasks different from that used for probing, using the left hand only. Results showed that before practice the children used almost exclusively the right hand in the right hemifield and at the midline position. Following lateralized practice frequency of use of the left hand increased in most lateral positions. A more evident effect of lateralized practice on shift of manual preference was detected in the complex task. Implications for lateralization of behavior in a developmental timescale are discussed on the basis of the proposition of amplification and diffusion of manual preference from lateralized practice. (C) 2010 Wiley Periodicals, Inc. Dev Psychobiol 52: 723-730, 2010.

On the functional integration between postural and supra-postural tasks on the basis of contextual cues and task constraint

In order to evaluate the effects of uncertainty about direction of mechanical perturbation and supra-postural task constraint on postural control young adults had their upright stance perturbed while holding a tray in a horizontal position Stance was perturbed by moving forward or backward a supporting platform contrasting situations of certainty versus uncertainty of direction of displacement Increased constraint on postural stability was Imposed by a supra-postural task of equilibrating a cylinder on the tray Performance was assessed through EMG of anterior leg muscles angular displacement of the main Joints involved in the postural reactions and displacement of the tray Results showed that both certainty on the direction of perturbation and Increased supra-postural task constraint led to decreased angular displacement of the knee and the hip Furthermore combination of certainty and high supra-postural task constraint produced shorter latency of muscular activation Such postural responses were paralleled by decreased displacement of the tray Thesi results suggest a functional integration between the tasks with central set priming reactive postural responses from contextual cues and Increased stability demand (C) 2010 Elsevier B V All rights reserved

Effects of recovery type after a judo match on blood lactate and performance in specific and non-specific judo tasks

The objective of the present study was to verify if active recovery (AR) applied after a judo match resulted in a better performance when compared to passive recovery (PR) in three tasks varying in specificity to the judo and in measurement of work performed: four upper-body Wingate tests (WT); special judo fitness test (SJFT); another match. For this purpose, three studies were conducted. Sixteen highly trained judo athletes took part in study 1, 9 in study 2, and 12 in study 3. During AR judokas ran (15 min) at the velocity corresponding to 70% of 4 mmol l(-1) blood lactate intensity (similar to 50% (V) over dotO(2) peak), while during PR they stayed seated at the competition area. The results indicated that the minimal recovery time reported in judo competitions (15 min) is long enough for sufficient recovery of WT performance and in a specific high-intensity test (SJFT). However, the odds ratio of winning a match increased ten times when a judoka performed AR and his opponent performed PR, but the cause of this phenomenon cannot be explained by changes in number of actions performed or by changes in match`s time structure.

Bimanual aiming and overt attention: one law for two hands

Reaching to interact with an object requires a compromise between the speed of the limb movement and the required end-point accuracy. The time it takes one hand to move to a target in a simple aiming task can be predicted reliably from Fitts' law, which states that movement time is a function of a combined measure of amplitude and accuracy constraints (the index of difficulty, ID). It has been assumed previously that Fitts' law is violated in bimanual aiming movements to targets of unequal ID. We present data from two experiments to show that this assumption is incorrect: if the attention demands of a bimanual aiming task are constant then the movements are well described by a Fitts' law relationship. Movement time therefore depends not only on ID but on other task conditions, which is a basic feature of Fitts' law. In a third experiment we show that eye movements are an important determinant of the attention demands in a bimanual aiming task. The results from the third experiment extend the findings of the first two experiments and show that bimanual aiming often relies on the strategic co-ordination of separate actions into a seamless behaviour. A number of the task specific strategies employed by the adult human nervous system were elucidated in the third experiment. The general strategic pattern observed in the hand trajectories was reflected by the pattern of eye movements recorded during the experiment. The results from all three experiments demonstrate that eye movements must be considered as an important constraint in bimanual aiming tasks.

Hitting a moving target: Perception and action in the timing of rapid interceptions

Different interceptive tasks and modes of interception (hitting or capturing) do not necessarily involve similar control processes. Control based on preprogramming of movement parameters is possible for actions with brief movement times but is now widely rejected; continuous perceptuomotor control models are preferred for all types of interception. The rejection of preprogrammed control and acceptance of continuous control is evaluated for the timing of rapidly executed, manual hitting actions. It is shown that a preprogrammed control model is capable of providing a convincing account of observed behavior patterns that avoids many of the arguments that have been raised against it. Prominent continuous perceptual control models are analyzed within a common framework and are shown to be interpretable as feedback control strategies. Although these models can explain observations of on-line adjustments to movement, they offer only post hoc explanations for observed behavior patterns in hitting tasks and are not directly supported by data. It is proposed that rapid manual hitting tasks make up a class of interceptions for which a preprogrammed strategy is adopted-a strategy that minimizes the role of visual feedback. Such a strategy is effective when the task demands a high degree of temporal accuracy.

A randomized and controlled trial of a participative ergonomics intervention to reduce injuries associated with manual tasks: physical risk and legislative

A participative ergonomics approach to reducing injuries associated with manual tasks is widely promoted; however only limited evidence from uncontrolled trials has been available to support the efficacy of such an approach. This paper reports on a randomized and controlled trial of PErforM, a participative ergonomics intervention designed to reduce the risks of injury associated with manual tasks. One hundred and seventeen small to medium sized food, construction, and health workplaces were audited by government inspectors using a manual tasks risk assessment tool (ManTRA). Forty-eight volunteer workplaces were then randomly assigned to Experimental and Control groups with the Experimental group receiving the PErforM program. Inspectors audited the workplaces again, 9 months following the intervention. The results showed a significant decrease in estimates of manual task risk and suggested better legal compliance in the Experimental group.

The tasks of medicine: An ideology of care; edited by Peter Baume

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