After chronic impairment of the right dominant hand, some individuals are able to compensate with increased performance with the intact left nondominant hand. This process may depend on the nondominant (right) hemisphere's ability to access dominant (left) hemisphere mechanisms. To predict or modulate patients' ability to compensate with the left hand, we must understand the neural mechanisms and connections that underpin this process.
Methods:
We studied 17 right-handed healthy adults who underwent resting-state functional connectivity (FC) magnetic resonance imaging scans before 10 days of training on a left-hand precision drawing task. We sought to identify right-hemisphere areas where FC from left-hemisphere seeds (primary motor cortex, intraparietal sulcus [IPS], inferior parietal lobule) would predict left-hand skill learning or magnitude.
Results:
Left-hand skill learning was predicted by convergent FC from left primary motor cortex and left IPS onto the same small region (0.31 cm3) in the right superior parietal lobule (SPL).
Discussion:
For patients who must compensate with the left hand, the right SPL may play a key role in integrating left-hemisphere mechanisms that typically control the right hand. Our study provides the first model of how interhemispheric functional connections in the human brain may support compensation after chronic injury to the right hand.
Impact statement
This article presents the first model of how the human brain applies left-hemisphere (dominant hand [DH]) specializations to support the right hemisphere for compensatory action with the nondominant hand (NDH). Compensation with the NDH is critical for the rehabilitation after many neurological disorders that lead to irreversible impairment of the DH (e.g., stroke, amputation, nerve injury), but no effective therapies exist to promote compensation because the neural mechanisms remain unknown. Therefore, this article will open up new directions in rehabilitation neuroscience by presenting a testable model of the connections that underpin much needed (and currently nonexistent) therapies.
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