Separate Pathways for Automatic and Intentional Visuo-Manual Reach Transformations: New Perspectives for Hemiparesia Rehabilitation Using Moving Objects
- *Corresponding Author:
- Laure Pisella
INSERM, U1028, CNRS, UMR5292
Lyon Neurosciences Research Center
ImpAct, 16 avenue du doyen Lépine
69676 Bron cedex, France
E-mail: [email protected]
Received date: July 03, 2015; Accepted date: September 18, 2015; Published date: September 21, 2015
Citation: Pisella L, Gaveau V, Delporte L, Revol P, Prablanc C, et al. (2015) Separate Pathways for Automatic and Intentional Visuo-Manual Reach Transformations: New Perspectives for Hemiparesia Rehabilitation Using Moving Objects. Int J Phys Med Rehabil 3:303. doi:10.4172/2329-9096.1000303
Copyright: © 2015 Pisella L, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Reaching implies effector and target locations to be computed and updated continuously all along the visuo-motor transformation process, before and during movement execution, aiming in making these instantaneous locations coincide spatially. So instead of a neuro-anatomical dissociation between areas devoted to motor planning versus control, there might be 1) an automatic pathway of visual-to-motor transformation which relies on a comparison at the level of oculo-centric coordinates between visual target and hand locations from multimodal sources of information and 2) intentional pathways relying on the allocentric comparison between visual locations of the hand and of the target. Converging evidence from patients with optic ataxia, neuroimaging and transcranial magnetic stimulation techniques, and investigations in primates, has led to ascribe the automatic pathway to the direct connection between the medio-dorsal occipito-parietal cortex (the caudal part of the superior parietal lobule) and the dorsal premotor cortex (and further the primary motor cortex). Studies involving patients with visual agnosia (infero-temporal cortex), Parkinson disease (basal ganglia) or neglect (inferior parietal lobule) have put forward a more diffuse putative neural substrate for the intentional visual-to-motor pathway. If most strokes affect the intentional motor function while preserving the automatic pathway of visual-to-motor transformation, we propose a new rehabilitation method for hemiparesia relying on the stimulation of the automatic pathway using moving rather than stationary objects. Preliminary data are included.