Supraspinal locomotor control in quadrupeds and humans.

Locomotion in humans and other vertebrates is based on spinal pattern generators, which are regulated by supraspinal control. Most of our knowledge about the hierarchical network of supraspinal locomotion centres derives from animal experiments, mainly in the cat. Here we summarize evidence that the supraspinal network of quadrupeds is conserved in humans despite their transition to bipedalism. By use of mental imagery of locomotion in fMRI we found (1), locomotion modulates sensory systems and is itself modulated by sensory signals. During automated locomotion in healthy subjects cortical sensory inhibition occurs in vestibular and somatosensory areas; this inhibition is cancelled in the congenitally blind; (2), we delineated separate and distinct areas in the brainstem and cerebellum which are remarkably similar to the feline locomotor network. The activations found here include homologues to the pacemakers for gait initiation and speed regulation in the interfastigial cerebellum and bilateral midbrain tegmentum (cerebellar and mesencephalic locomotor regions), their descending target regions in the pontine reticular formation, and the rhythm generators in the cerebellar vermis and paravermal cerebellar cortex. This conservation of the basic organization of supraspinal locomotor control during vertebrate phylogeny opens new perspectives for both, the diagnosis and treatment of common gait disorders. It is conceivable that electrical stimulation of locomotor brain stem centres may initiate and improve gait in selected patients suffering from Parkinson's disease or progressive supranuclear palsy.