{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T10:46:15Z","timestamp":1772621175086,"version":"3.50.1"},"reference-count":65,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T00:00:00Z","timestamp":1772582400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Studies using transcranial magnetic stimulation and electromyography suggest that disrupted functional corticospinal connectivity significantly contributes to difficulty in initiating and controlling voluntary movements such as walking. In individuals with Cerebral Palsy (CP), the corticospinal tract (CST) may therefore be identified as a potential target for improving gait control. Increasing corticospinal excitability may enhance voluntary control of lower-limb muscles and improve selective activation patterns during gait. However, it remains uncertain whether this pathway can be further activated given the damage caused by the brain lesion. Moreover, muscle synergies, a cooperative activation of groups of muscles, play an essential role in efficient and adaptive locomotion. Disrupted CST projections may reduce the specificity and strength of descending commands, which can lead to the fusion or splitting of muscle synergies. This impaired descending modulation could explain the reduced number of synergies and lower variance often reported in people with CP. Understanding and improving the modulation of these synergies could lead to better rehabilitation strategies for individuals with CP. The objective of this study was to assess whether a visuomotor walking task promotes an increase in corticospinal excitability and a modulation of muscle synergies compared to a simple walking task in individuals with CP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Sixteen individuals with CP were initially recruited, muscle synergy analyses were conducted in 14 participants and TMS-based corticospinal excitability assessments in 11 participants, due to contraindications to TMS or technical issues. In addition, 14 control subjects took part in this study. Each participant performed a simple walking task and a visuomotor walking task (i.e., stepping onto virtual targets) at comfortable speed, in counterbalanced order. Transcranial magnetic stimulations were delivered during walking at approximately 40% of the gait cycle (late stance phase), corresponding to minimal tibialis anterior activity. Muscle synergies were extracted from full gait cycles recorded throughout each condition. Motor evoked potentials (MEPs) in the tibialis anterior muscle were induced using transcranial magnetic stimulation. Muscle synergies were extracted from surface electromyography signals acquired from six key lower-limb muscles during both tasks. Values were expressed as (median [Q1\u2013Q3]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the visuomotor task, MEPs increased by 59.4% in the CP group (simple task MEP\u202f=\u202f1.89 [1.00\u20133.09] a.u vs. visuomotor task MEP\u202f=\u202f2.70 [1.59\u20134.80] a.u;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f\u2264\u202f0.01) and 113.8% in the control group (simple task MEP\u202f=\u202f1.95 [0.99\u20132.72] a.u vs. visuomotor task MEP\u202f=\u202f2.91 [1.97\u20133.66] a.u;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f\u2264\u202f0.01). An increase in the number of synergies was observed during visuomotor task in CP group (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.018).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These results suggest that performing a visuomotor walking task allows to enhance the corticospinal excitability in both individuals with CP and control subjects. Moreover, CP individuals showed that either the number or the structure of synergies are modulated by the visuomotor task, in comparison to control subjects. Longitudinal studies are recommended to assess the impact of the integration of complex tasks in gait rehabilitation interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1669546","type":"journal-article","created":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T05:42:16Z","timestamp":1772602936000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Modulation of corticospinal excitability and muscle synergies during visuomotor locomotor task in individuals with and without cerebral palsy: a TMS and EMG study"],"prefix":"10.3389","volume":"17","author":[{"given":"Yosra","family":"Cherni","sequence":"first","affiliation":[{"name":"Centre interdisciplinaire de recherche en r\u00e9adaptation et int\u00e9gration sociale (Cirris), CIUSSS de la Capitale-Nationale","place":["Qu\u00e9bec, QC, Canada"]},{"name":"\u00c9cole des sciences de la r\u00e9adaptation, Universit\u00e9 Laval","place":["Qu\u00e9bec, QC, Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Ghislieri","sequence":"additional","affiliation":[{"name":"BIOLAB, D\u00e9partement de l'\u00e9lectronique et des t\u00e9l\u00e9communications, \u00c9cole polytechnique de Turin","place":["Turin, Italy"]},{"name":"Polito Med Lab, \u00c9cole polytechnique de Turin","place":["Turin, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurent","family":"Bouyer","sequence":"additional","affiliation":[{"name":"Centre interdisciplinaire de recherche en r\u00e9adaptation et int\u00e9gration sociale (Cirris), CIUSSS de la Capitale-Nationale","place":["Qu\u00e9bec, QC, Canada"]},{"name":"\u00c9cole des sciences de la r\u00e9adaptation, Universit\u00e9 Laval","place":["Qu\u00e9bec, QC, Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine","family":"Mercier","sequence":"additional","affiliation":[{"name":"Centre 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Neurol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1016\/j.ridd.2015.09.010","article-title":"Ipsilesional motor-evoked potential absence in pediatric hemiparesis impacts tracking accuracy of the less affected hand","volume":"47","author":"Cassidy","year":"2015","journal-title":"Res Dev Disabil"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1395","DOI":"10.1093\/brain\/114.3.1395","article-title":"Altered corticospinal projections to lower limb motoneurons in subjects with cerebral palsy","volume":"114","author":"Brouwer","year":"1991","journal-title":"Brain J Neurol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1223","DOI":"10.1093\/brain\/116.5.1223","article-title":"Patterns of central motor reorganization in hemiplegic cerebral palsy","volume":"116","author":"Carr","year":"1993","journal-title":"Brain"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1016\/0304-3940(90)90735-r","article-title":"Do injuries to the developing human brain alter corticospinal projections?","volume":"108","author":"Brouwer","year":"1990","journal-title":"Neurosci Lett"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"928","DOI":"10.1016\/j.jelekin.2014.07.004","article-title":"Altered corticomuscular coherence elicited by paced isotonic contractions in individuals with cerebral palsy: a case-control study","volume":"24","author":"Riquelme","year":"2014","journal-title":"J Electromyogr Kinesiol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1016\/B978-0-444-53355-5.00012-9","article-title":"Involvement of the corticospinal tract in the control of human gait","volume":"192","author":"Barth\u00e9lemy","year":"2011","journal-title":"Prog Brain Res"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1093\/ptj\/74.5.399","article-title":"Stroke disability","volume":"74","author":"Duncan","year":"1994","journal-title":"Phys 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Neurosci"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"e0152784","DOI":"10.1371\/journal.pone.0152784","article-title":"Synergistic structure in the speed dependent modulation of muscle activity in human walking","volume":"11","author":"Buurke","year":"2016","journal-title":"PLoS One"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"4","DOI":"10.3389\/fnhum.2018.00004","article-title":"Speed-dependent modulation of muscle activity based on muscle synergies during treadmill walking","volume":"12","author":"Kibushi","year":"2018","journal-title":"Front Hum Neurosci"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1016\/j.gaitpost.2017.10.007","article-title":"Similarity of muscle synergies extracted from the lower limb including the deep muscles between level and uphill treadmill walking","volume":"59","author":"Saito","year":"2018","journal-title":"Gait 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Neurophysiol"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"238","DOI":"10.1016\/j.jneumeth.2011.11.020","article-title":"Stimulating deep cortical structures with the batwing coil: how to determine the intensity for transcranial magnetic stimulation using coil\u2013cortex distance","volume":"204","author":"Cai","year":"2012","journal-title":"J Neurosci Methods"},{"key":"ref43","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1016\/S1388-2457(02)00144-X","article-title":"Variation in the response to transcranial magnetic brain stimulation in the general population","volume":"113","author":"Wassermann","year":"2002","journal-title":"Clin Neurophysiol"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1186\/s13643-017-0440-8","article-title":"The number of stimuli required to reliably assess corticomotor excitability and primary motor cortical representations using transcranial magnetic stimulation (TMS): a systematic review and meta-analysis","volume":"6","author":"Cavaleri","year":"2017","journal-title":"Syst Rev"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1016\/s1050-6411(00)00027-4","article-title":"Development of recommendations for SEMG sensors and sensor placement procedures","volume":"10","author":"Hermens","year":"2000","journal-title":"J Electromyogr Kinesiol"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1123\/jab.13.2.135","article-title":"The use of surface electromyography in biomechanics","volume":"13","author":"De Luca","year":"1997","journal-title":"J Appl Biomech"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1109\/OJEMB.2023.3263123","article-title":"Optimal identification of muscle synergies from typical sit-to-stand clinical tests","volume":"4","author":"Ranaldi","year":"2023","journal-title":"IEEE Open J Eng Med Biol"},{"key":"ref48","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1038\/44565","article-title":"Learning the parts of objects by non-negative matrix factorization","volume":"401","author":"Lee","year":"1999","journal-title":"Nature"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"1009","DOI":"10.1007\/s00421-021-04604-9","article-title":"How to improve the muscle synergy analysis methodology?","volume":"121","author":"Turpin","year":"2021","journal-title":"Eur J Appl Physiol"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"8266","DOI":"10.1038\/s41598-020-65257-w","article-title":"Non-negative matrix factorisation is the most appropriate method for extraction of muscle synergies in walking and running","volume":"10","author":"Rabbi","year":"2020","journal-title":"Sci Rep"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1152\/jn.01096.2010","article-title":"Consistency of muscle synergies during pedaling across different mechanical constraints","volume":"106","author":"Hug","year":"2011","journal-title":"J Neurophysiol"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"844","DOI":"10.1152\/jn.00825.2009","article-title":"Merging of healthy motor modules predicts reduced locomotor performance and muscle coordination complexity post-stroke","volume":"103","author":"Clark","year":"2010","journal-title":"J Neurophysiol"},{"key":"ref53","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v050.i12","article-title":"nparLD: an R software package for the nonparametric analysis of longitudinal data in factorial experiments","volume":"50","author":"Noguchi","year":"2012","journal-title":"J Stat Softw"},{"key":"ref54","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1111\/1467-8721.ep10768783","article-title":"Statistical power analysis","volume":"1","author":"Cohen","year":"1992","journal-title":"Curr Dir Psychol 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Res"},{"key":"ref58","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1016\/j.bbr.2010.04.027","article-title":"Corticospinal excitability during observation and imagery of simple and complex hand tasks: implications for motor rehabilitation","volume":"213","author":"Roosink","year":"2010","journal-title":"Behav Brain Res"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1007\/s00221-011-2977-4","article-title":"Rapid changes in corticospinal excitability during force field adaptation of human walking","volume":"217","author":"Barth\u00e9lemy","year":"2012","journal-title":"Exp Brain Res"},{"key":"ref60","doi-asserted-by":"publisher","first-page":"872","DOI":"10.1111\/j.1460-9568.2007.05320.x","article-title":"Corticospinal control of the thumb-index grip depends on precision of force control: a transcranial magnetic stimulation and functional magnetic resonance imagery study in humans","volume":"25","author":"Bonnard","year":"2007","journal-title":"Eur J Neurosci"},{"key":"ref61","doi-asserted-by":"publisher","first-page":"1721","DOI":"10.1111\/psyp.12737","article-title":"Motor-evoked potentials reveal a motor-cortical readout of evidence accumulation for sensorimotor decisions","volume":"53","author":"Hadar","year":"2016","journal-title":"Psychophysiology"},{"key":"ref62","doi-asserted-by":"publisher","first-page":"747","DOI":"10.5535\/arm.2011.35.6.747","article-title":"Facilitation of corticospinal excitability according to motor imagery and mirror therapy in healthy subjects and stroke patients","volume":"35","author":"Kang","year":"2011","journal-title":"Ann Rehabil Med"},{"key":"ref63","doi-asserted-by":"publisher","first-page":"3238","DOI":"10.1007\/s10439-016-1660-0","article-title":"Neuro-mechanics of recumbent leg cycling in post-acute stroke patients","volume":"44","author":"Ambrosini","year":"2016","journal-title":"Ann Biomed 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