title: Cerebellar mediation of the complexity of bimanual compared to unimanual movements.
abstract: OBJECTIVE
  To study rapidly alternating movements under fMRI in order to identify the brain regions that mediate increased complexity in bimanual vs unimanual movements and to verify the localization of a clinical test of limb ataxia (diadochokinesis).
  
  
  METHODS
  Unimanual and bimanual movements, that is, palm(s) pronated then supinated, served as stimulation in a block design fMRI investigation at 1.5 T. Analyses compared bimanual movements and rest for each hand separately and the unimanual conditions combined. A pronation/supination task was chosen as it provides the same objective motor output during unimanual and bimanual formats. The increased coordination demand of the bimanual format (phase/antiphase movements) was expected to result in distinct activation in supplementary motor, primary motor, prefrontal, and cerebellar regions.
  
  
  RESULTS
  The bimanual task uniquely elicited responses in specific anterior medial and posterior (vermal) cerebellar regions.
  
  
  CONCLUSIONS
  The study corroborated clinical use of diadochokinesis tasks to test for aspects of cerebellar integrity. The data do not support the literature emphasizing basal ganglia mediation of this type of coordinated movement. Cerebellar medial and vermal regions (in connection with central nuclei) are proposed as the locus within the cerebellum for mediating complexity, that is, the effective integration of separate limb movements that proceed in an asynchronous but systematic fashion.
authors.affiliation: Department of Neurology, Jefferson Medical College, Thomas Jefferson University, Philadelphia 19107, USA. joseph.tracy@mail.tju.edu
authors.forename: J I
authors.initials: JI
authors.lastname: Tracy
authors.forename: S S
authors.initials: SS
authors.lastname: Faro
authors.forename: F B
authors.initials: FB
authors.lastname: Mohammed
authors.forename: A B
authors.initials: AB
authors.lastname: Pinus
authors.forename: S M
authors.initials: SM
authors.lastname: Madi
authors.forename: J W
authors.initials: JW
authors.lastname: Laskas
mesh_terms: D000328:Adult; D001931:Brain Mapping; D002531:Cerebellum / Q000502:physiology*; D005260:Female; D007839:Functional Laterality / Q000502:physiology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007699:Kinesthesis / Q000502:physiology; D008279:Magnetic Resonance Imaging; D008297:Male; D009048:Motor Skills / Q000502:physiology*; D011434:Proprioception / Q000502:physiology