Phase Dynamics in Human Visuomotor Control - Health & Disease

In this thesis, comprised of four publications, I investigated phase dynamics of visuomotor control in humans during upright stance in response to an oscillatory visual drive. For this purpose, I applied different versions of a ‘moving room’ paradigm in virtual reality while stimulating human partic...

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Bibliographic Details
Main Author: Engel, David
Contributors: Bremmer, Frank (Prof. Dr.) (Thesis advisor)
Format: Doctoral Thesis
Published: Philipps-Universität Marburg 2022
Online Access:PDF Full Text
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Summary:In this thesis, comprised of four publications, I investigated phase dynamics of visuomotor control in humans during upright stance in response to an oscillatory visual drive. For this purpose, I applied different versions of a ‘moving room’ paradigm in virtual reality while stimulating human participants with anterior-posterior motion of their visual surround and analyzed their bodily responses. Human balance control constitutes a complex interplay of interdependent processes. The main sensory contributors include vision, vestibular input, and proprioception, with a dominant role attributed to vision. The purpose of the balance control system is to keep the body’s center of mass (COM) within a certain spatial range around the current base of support. Ever-changing environmental circumstances along with sensory noise cause the body to permanently sway around its point of equilibrium. Considering this sway, the human body can be modelled as a (multi-link) inverted pendulum. To maintain balance while being exposed to perturbations of the visual environment, humans adjust their sway to counteract the perceived motion of their bodies. Neurodegenerative diseases like Parkinson’s impair balance control and thus are likely to affect these mechanisms. Hence, investigation of bodily responses to a visual drive gives insight into visuomotor control in health and disease. In my first study, I introduced inter-trial phase coherence (ITPC) as a novel method to investigate postural responses to periodical visual stimulation. I found that human participants phase-locked the motion of their center of pressure (COP) to a 3-D dot cloud which oscillated in the anterior-posterior direction. This effect was equally strong for a low frequency of visual stimulation at 0.2 Hz and a high frequency of 1.5 Hz, the latter exceeding the previously assumed frequency range associated with coherent postural sway responses to periodical oscillations of the visual environment (moving room). Moreover, I was able to show that ITPC reliably captured responses in almost all participants, thereby addressing the common problem of inter-subject variability in body sway research. Based on the results of my first study, I concluded phase locking to be an essential feature in human postural control. For the second study, I introduced a mobile and cost-effective setup to apply a visual paradigm consisting of a virtual tunnel which stretched in the anterior-posterior direction and oscillated back and forth at three distinct frequencies (0.2 Hz, 0.8 Hz, and 1.2 Hz). Because tracking of the COP alone neglects crucial information about how COM shifts are arranged across the body, I included additional full-body motion tracking here to evaluate sway of individual body segments. Using a modified measure of phase locking, the phase locking value (PLV), allowed me to find participants phase-locking not only their COP, but also additional segments of their body to the visual drive. While their COP exhibited a strong phase locking to all frequencies of visual stimulation, distribution of phase locking across the body underwent a shift as the frequency of the visual stimulation increased. For the lowest frequency of 0.2 Hz, participants phase-locked almost their entire body to the stimulus. At higher frequencies, this phase locking shifted towards the lower torso and hip, with subjects almost exclusively phase-locking their hip to the visual drive at the highest frequency of 1.2 Hz. Having introduced a novel and reliable measurement along with a mobile setup, these results allowed me to empirically confirm shifts in postural strategies previously proposed in the literature. In the third study, a collaboration with the neurology department of the Universitätsklinikum Gießen und Marburg (UKGM), I used the same setup and paradigm as in the previous study and additionally derived the trajectory of the COM from a weighted combination of certain body segments. The aim was to investigate phase locking of body sway in a group of patients suffering from Parkinson’s disease (PD) to find potential means for an early diagnosis of the illness. For this purpose, I recruited a group of PD patients, an age-matched control group, and a group of young healthy adults. Even though the sway amplitude of PD patients was significantly larger than that of both other groups, they phase-locked their COP and COM in a similar manner as the control groups. However, considering individual body segments, the shift in PLV distribution differed between groups. While young healthy adults, analogous to the participants in the second study, exhibited a shift towards exclusive phase locking of their hips as frequency of the stimulation increased, both PD patients and age-matched controls maintained a rather homogeneous phase locking across their body. This suggested increased body stiffness, although being an effect of age rather than disease. Overall, I concluded that patients of early-to-mid stage PD exhibit impaired motor control, reflected in their increased sway amplitude, but intact visuomotor processing, indicated by their ability to phase-lock the motion of their body to a visual drive. The fourth study, to which I contributed as second author, used experimental data collected from an additional visual condition in the course of the third study. This condition consisted of unpredictable back and forward motion of the simulated tunnel. Here, we investigated the velocity profiles of the COP and COM in response to the unpredictable visual motion and a baseline condition at which the tunnel remained static. We found PD patients to exhibit larger velocities of their COP and COM under both conditions when compared to the control groups. When examining the net increase that unpredictable motion had on the velocity of both parameters, we found a significantly higher increase in COP velocity for both PD patients and age-matched controls, but no increase in COM velocity in any of the groups. These results suggested that all groups successfully maintained their balance under unpredictable visual perturbations, but that PD patients and older adults required more effort to accomplish this task, as reflected by the increased velocity of their COP. Again, these results indicated an effect of age rather than disease on the observed postural responses. In summary, using innovative phase-locking techniques and simultaneously tracking multiple body sway parameters, I was able to provide novel insight into visuomotor control in humans. First, I overcame previous issues of inconsistent sway parameters in groups of participants; Second, I found phase-locking to be an essential feature of visuomotor processing, which also allowed me to empirically confirm previously established theories of postural control; Third, through studies in collaboration with the neurology department of the UKGM, I was able to uncover new aspects of visuomotor processing in Parkinson’s, contributing to a better understanding of the sensorimotor aspects of the disease.
Physical Description:126 Pages