The Contribution of Eye-Hand Coordination Impairment to Functional Deficits in Stroke

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PROJECT SUMMARY Current standard of care in post-stroke upper-limb motor training has measurably reduced impairment and increased both active range of motion and movement quality. However, such improvements rarely generalize to performance gains for activities of daily living and functional independence. One of the hallmarks of functional arm movement is the seamless integration of visual inputs and limb control, mediated by the ocular motor system. However, this important foundation of functional performance and recovery has not been incorporated into stroke rehabilitation. This gap exists because not enough is known about basic eye-hand coordination (EHC), associated neuroanatomy, and how EHC is affected by stroke. Our preliminary data provide strong evidence that specific eye-hand coordination deficits can result from MCA stroke. The eye-hand coordination system is currently not addressed in neurorehabilitation research or clinical rehabilitation because of a lack of understanding of the mechanisms that underlie this coordination and how such mechanisms may be affected by stroke. This proposal will examine the neuroanatomical foundations of eye-hand coordination and how these networks are affected by middle cerebral artery stroke. The results are expected to provide a foundation for improved understanding of eye-hand coordination in functional deficits and functional recovery, post-stroke. This advanced understanding should provide the basis for a line of translational research that will lead to new clinical assessments and interventions to address eye-hand coordination deficits in stroke survivors. This knowledge may, in turn, address the current gap between motor recovery and functional recovery in stroke survivors with eye-hand coordination dyscoordination (EHdC). Our primary hypotheses are that MCA stroke can produce deficits in EHC through damage to specific frontoparietal circuits, and that changes in these circuits can predict functional recovery following stroke. We will address these hypotheses through the following two Aims. In Aim 1, we will determine the contribution of EHdC to motor recovery and function in MCA stroke. Hypothesis: MCA stroke produces EHC deficits that interfere with functional upper-limb recovery and functional independence. Aim 2: To identify microstructural changes to frontoparietal networks related to motor recovery and EHdC in MCA stroke. Hypothesis: Microstructural integrity in MCA stroke will relate to dyscoordination (mistiming). The findings from this proposal will detail the functional neuroanatomy underlying eye-hand coordination, and the functional implications of lesions in this system to functional performance. This foundation of knowledge will provide for a translational line of research to determine contributions of eye-hand coordination to functional deficits and functional stroke recovery.