Damage to motor areas of the brain, caused by stroke, can produce devastating motor deficits, including aberrant control of force. After stroke, reorganization of the brain’s motor system has been identified as one of the fundamental mechanisms involved in recovery of motor control after stroke. Yet, few studies have investigated how force production and modulation are encoded in the brain after stroke and how this relates to motor outcome. Thus, the purpose of this study was to (1) understand how past neuroimaging literature has contributed to establishing common patterns of brain reorganization during both relative and absolute force production after stroke, (2) examine how brain function is reorganized during force production and modulation in individuals with stroke, and (3) relate this task-related reorganization of brain function to the amount of paretic arm use after stroke. In the second chapter, we systematically reviewed all relevant literature examining brain activation during force production after stroke. The following chapters (chapters 3 and 4) applied functional magnetic resonance imaging (fMRI) to examine the neural correlates of force production and modulation after stroke. Chapter 2 supports differences in task-related brain activation dependent on features of stroke, such as severity and chronicity, as well as influence of rehabilitation. In addition, results suggest that activation of common motor areas of the brain during force production can be identified in relation to functional outcome after stroke. Results from the subsequent two chapters (3 and 4), demonstrate that brain function reorganizes in terms of absolute, and not relative force production after stroke. Specifically, stroke participants exhibit greater activation of motor areas than healthy controls when matched for absolute force production. Moreover, there is a relationship between paretic arm usage and brain activation, where stroke participants having less paretic arm use, as measured using wrist accelerometers, exhibit higher brain activation. Results of this thesis suggest that during absolute force production, brain activation may approach near maximal levels in stroke participants at lower forces than healthy controls. Furthermore, this effect may be amplified even further in subjects with less paretic arm usage, as increased activation in motor areas occurs in participants with less arm use after stroke. Ultimately, the results from this thesis will contribute to research relevant to brain reorganization in individuals with stroke and may lead to the development of new, beneficial therapeutic interventions that optimize brain reorganization and improve functional recovery after stroke.

Damage to motor areas of the brain, caused by stroke, can produce devastating motor deficits, including aberrant control of force. After stroke, reorganization of the brain’s motor system has been identified as one of the fundamental mechanisms involved in recovery of motor control after stroke. Yet, few studies have investigated how force production and modulation are encoded in the brain after stroke and how this relates to motor outcome. Thus, the purpose of this study was to (1) understand how past neuroimaging literature has contributed to establishing common patterns of brain reorganization during both relative and absolute force production after stroke, (2) examine how brain function is reorganized during force production and modulation in individuals with stroke, and (3) relate this task-related reorganization of brain function to the amount of paretic arm use after stroke. In the second chapter, we systematically reviewed all relevant literature examining brain activation during force production after stroke. The following chapters (chapters 3 and 4) applied functional magnetic resonance imaging (fMRI) to examine the neural correlates of force production and modulation after stroke. Chapter 2 supports differences in task-related brain activation dependent on features of stroke, such as severity and chronicity, as well as influence of rehabilitation. In addition, results suggest that activation of common motor areas of the brain during force production can be identified in relation to functional outcome after stroke. Results from the subsequent two chapters (3 and 4), demonstrate that brain function reorganizes in terms of absolute, and not relative force production after stroke. Specifically, stroke participants exhibit greater activation of motor areas than healthy controls when matched for absolute force production. Moreover, there is a relationship between paretic arm usage and brain activation, where stroke participants having less paretic arm use, as measured using wrist accelerometers, exhibit higher brain activation. Results of this thesis suggest that during absolute force production, brain activation may approach near maximal levels in stroke participants at lower forces than healthy controls. Furthermore, this effect may be amplified even further in subjects with less paretic arm usage, as increased activation in motor areas occurs in participants with less arm use after stroke. Ultimately, the results from this thesis will contribute to research relevant to brain reorganization in individuals with stroke and may lead to the development of new, beneficial therapeutic interventions that optimize brain reorganization and improve functional recovery after stroke.

Damage to motor areas of the brain, caused by stroke, can produce devastating motor deficits, including aberrant control of force. After stroke, reorganization of the brain’s motor system has been identified as one of the fundamental mechanisms involved in recovery of motor control after stroke. Yet, few studies have investigated how force production and modulation are encoded in the brain after stroke and how this relates to motor outcome. Thus, the purpose of this study was to (1) understand how past neuroimaging literature has contributed to establishing common patterns of brain reorganization during both relative and absolute force production after stroke, (2) examine how brain function is reorganized during force production and modulation in individuals with stroke, and (3) relate this task-related reorganization of brain function to the amount of paretic arm use after stroke. In the second chapter, we systematically reviewed all relevant literature examining brain activation during force production after stroke. The following chapters (chapters 3 and 4) applied functional magnetic resonance imaging (fMRI) to examine the neural correlates of force production and modulation after stroke. Chapter 2 supports differences in task-related brain activation dependent on features of stroke, such as severity and chronicity, as well as influence of rehabilitation. In addition, results suggest that activation of common motor areas of the brain during force production can be identified in relation to functional outcome after stroke. Results from the subsequent two chapters (3 and 4), demonstrate that brain function reorganizes in terms of absolute, and not relative force production after stroke. Specifically, stroke participants exhibit greater activation of motor areas than healthy controls when matched for absolute force production. Moreover, there is a relationship between paretic arm usage and brain activation, where stroke participants having less paretic arm use, as measured using wrist accelerometers, exhibit higher brain activation. Results of this thesis suggest that during absolute force production, brain activation may approach near maximal levels in stroke participants at lower forces than healthy controls. Furthermore, this effect may be amplified even further in subjects with less paretic arm usage, as increased activation in motor areas occurs in participants with less arm use after stroke. Ultimately, the results from this thesis will contribute to research relevant to brain reorganization in individuals with stroke and may lead to the development of new, beneficial therapeutic interventions that optimize brain reorganization and improve functional recovery after stroke. / Medicine, Faculty of / Graduate

The observations made in brain-lesioned patients and the result of functional brain imaging studies converge to the hypothesis that the posterior parietal cortex (PPC) is involved in calculation and number processing. However, if numerical disorders generally result from a left parietal lesion, the results of some brain imaging studies suggest that the right PPC could also play a role in number magnitude processing. In order to clarify this question, we used transcranial magnetic stimulation to induce a virtual lesion of the left or right PPC in healthy subjects while they performed number comparison. Our results show that the integrity of the left PPC is a necessary condition for the precise discrimination required during close number comparison; whereas the comparison of far numbers can be performed by either hemisphere as suggested by the fact that this task is affected only by the simultaneous virtual lesion of both hemispheres. In order to better identify which processes underlie the numerical competence of the PPC, we then studied the possible interactions between number processing and visuo-motor functions. Indeed, a meta-analysis performed on functional imaging data revealed that number processing depends on parietal regions, but also on certain premotor areas, which are very close to those involved in the control of finger movements. In a first series of experiments, we thus observed an excitability increase in motor circuits during the enumeration of dots presented on a computer screen. Given that the counting task was performed with both hands at rest, this increase was interpreted as reflecting the mental simulation of pointing movements or sequential finger rising as counting goes on. In a second series of experiments, we showed that information related to number magnitude could interfere with the aperture of the finger grip required to grasp an object. These results suggest that the conformation of the hand to object size shares, with the representation of numbers, common processes for magnitude estimate. In conclusion, our thesis supports the hypothesis that our numerical capacities rely, at least partially, on visuo-motor functions involving the PPC; this could explain why the numerical capacities of the left hemisphere, which is dominant for motor activities, are more precise. / Les observations réalisées chez les patients cérébrolésés ainsi que le résultat des études d'imagerie cérébrale fonctionnelle convergent vers l'hypothèse selon laquelle le cortex pariétal postérieur (CPP) est impliqué dans le traitement des nombres et le calcul. Cependant, si les troubles du calcul résultent le plus souvent d'une lésion pariétale gauche, les résultats de certaines études d'imagerie fonctionnelle suggèrent que le CPP droit pourrait également jouer un rôle dans le traitement de la magnitude des nombres. Afin de clarifier cette question, nous avons utilisé la stimulation magnétique transcrânienne pour induire une lésion virtuelle du CPP gauche ou droit chez des sujets sains réalisant une tâche de comparaison de nombres. Nos résultats montrent que l'intégrité du CPP gauche est une condition nécessaire à la discrimination précise requise lors de la comparaison de nombres proches; la comparaison de nombres éloignés peut, quant à elle, être réalisée par l'un ou l'autre hémisphère comme le suggère le fait que cette tâche n'est affectée que par lésion virtuelle simultanée des deux hémisphères. Afin de mieux appréhender les processus sur lesquels s'appuient les compétences numériques du CPP, nous avons ensuite étudié les interactions possibles entre le traitement des nombres et les fonctions visuo-motrices. En effet, une méta-analyse réalisée sur des données d'imagerie fonctionelle a révélé que le traitement des nombres dépend de régions pariétales, mais également de certaines aires prémotrices, proches de celles impliquées dans le contrôle des mouvements des doigts. Dans une première série d'expériences, nous avons ainsi observé une augmentation de l'excitabilité des circuits moteurs lors du comptage de points présentés sur l'écran d'un ordinateur. Etant donné que la tâche de comptage était réalisée avec les mains au repos, cette augmentation a été interprétée comme le reflet d'une simulation mentale de mouvements de pointage ou d'extension séquentielle des doigts pendant le comptage. Dans une deuxième série d'expériences, nous avons montré que l'information relative à la magnitude des nombres pouvait interférer avec l'ouverture de la pince bidigitale requise pour saisir un objet. Ces résultats suggèrent que la conformation de la main adaptée à la taille des objets partage, avec la représentation des nombres, des processus communs d'estimation de la magnitude. En conclusion, notre travail supporte l'hypothèse selon laquelle nos capacités numériques pourraient, en partie du moins, reposer sur des fonctions visuo-motrices impliquant le CPP ; ceci pourrait expliquer pourquoi les capacités numériques de l'hémisphère gauche, dominant pour les activités motrices, sont plus précises.

The observations made in brain-lesioned patients and the result of functional brain imaging studies converge to the hypothesis that the posterior parietal cortex (PPC) is involved in calculation and number processing. However, if numerical disorders generally result from a left parietal lesion, the results of some brain imaging studies suggest that the right PPC could also play a role in number magnitude processing. In order to clarify this question, we used transcranial magnetic stimulation to induce a virtual lesion of the left or right PPC in healthy subjects while they performed number comparison. Our results show that the integrity of the left PPC is a necessary condition for the precise discrimination required during close number comparison; whereas the comparison of far numbers can be performed by either hemisphere as suggested by the fact that this task is affected only by the simultaneous virtual lesion of both hemispheres. In order to better identify which processes underlie the numerical competence of the PPC, we then studied the possible interactions between number processing and visuo-motor functions. Indeed, a meta-analysis performed on functional imaging data revealed that number processing depends on parietal regions, but also on certain premotor areas, which are very close to those involved in the control of finger movements. In a first series of experiments, we thus observed an excitability increase in motor circuits during the enumeration of dots presented on a computer screen. Given that the counting task was performed with both hands at rest, this increase was interpreted as reflecting the mental simulation of pointing movements or sequential finger rising as counting goes on. In a second series of experiments, we showed that information related to number magnitude could interfere with the aperture of the finger grip required to grasp an object. These results suggest that the conformation of the hand to object size shares, with the representation of numbers, common processes for magnitude estimate. In conclusion, our thesis supports the hypothesis that our numerical capacities rely, at least partially, on visuo-motor functions involving the PPC; this could explain why the numerical capacities of the left hemisphere, which is dominant for motor activities, are more precise. / Les observations réalisées chez les patients cérébrolésés ainsi que le résultat des études d'imagerie cérébrale fonctionnelle convergent vers l'hypothèse selon laquelle le cortex pariétal postérieur (CPP) est impliqué dans le traitement des nombres et le calcul. Cependant, si les troubles du calcul résultent le plus souvent d'une lésion pariétale gauche, les résultats de certaines études d'imagerie fonctionnelle suggèrent que le CPP droit pourrait également jouer un rôle dans le traitement de la magnitude des nombres. Afin de clarifier cette question, nous avons utilisé la stimulation magnétique transcrânienne pour induire une lésion virtuelle du CPP gauche ou droit chez des sujets sains réalisant une tâche de comparaison de nombres. Nos résultats montrent que l'intégrité du CPP gauche est une condition nécessaire à la discrimination précise requise lors de la comparaison de nombres proches; la comparaison de nombres éloignés peut, quant à elle, être réalisée par l'un ou l'autre hémisphère comme le suggère le fait que cette tâche n'est affectée que par lésion virtuelle simultanée des deux hémisphères. Afin de mieux appréhender les processus sur lesquels s'appuient les compétences numériques du CPP, nous avons ensuite étudié les interactions possibles entre le traitement des nombres et les fonctions visuo-motrices. En effet, une méta-analyse réalisée sur des données d'imagerie fonctionelle a révélé que le traitement des nombres dépend de régions pariétales, mais également de certaines aires prémotrices, proches de celles impliquées dans le contrôle des mouvements des doigts. Dans une première série d'expériences, nous avons ainsi observé une augmentation de l'excitabilité des circuits moteurs lors du comptage de points présentés sur l'écran d'un ordinateur. Etant donné que la tâche de comptage était réalisée avec les mains au repos, cette augmentation a été interprétée comme le reflet d'une simulation mentale de mouvements de pointage ou d'extension séquentielle des doigts pendant le comptage. Dans une deuxième série d'expériences, nous avons montré que l'information relative à la magnitude des nombres pouvait interférer avec l'ouverture de la pince bidigitale requise pour saisir un objet. Ces résultats suggèrent que la conformation de la main adaptée à la taille des objets partage, avec la représentation des nombres, des processus communs d'estimation de la magnitude. En conclusion, notre travail supporte l'hypothèse selon laquelle nos capacités numériques pourraient, en partie du moins, reposer sur des fonctions visuo-motrices impliquant le CPP ; ceci pourrait expliquer pourquoi les capacités numériques de l'hémisphère gauche, dominant pour les activités motrices, sont plus précises.