Functional and Structural Properties of Interhemispheric Interaction between Bilateral Precentral Hand Motor Regions in a Top Wheelchair Racing Paralympian

Long-term motor training can cause functional and structural changes in the human brain. Assessing how the training of specific movements affects specific parts of the neural circuitry is essential to understand better the underlying mechanisms of motor training-induced plasticity in the human brain. We report a single-case neuroimaging study that investigated functional and structural properties in a professional athlete of wheelchair racing. As wheelchair racing requires bilateral synchronization of upper limb movements, we hypothesized that functional and structural properties of interhemispheric interactions in the central motor system might differ between the professional athlete and controls. Functional and diffusion magnetic resonance imaging (fMRI and dMRI) data were obtained from a top Paralympian (P1) in wheelchair racing. With 23 years of wheelchair racing training starting at age eight, she holds an exceptional competitive record. Furthermore, fMRI and dMRI data were collected from three other paraplegic participants (P2-P4) with long-term wheelchair sports training other than wheelchair racing and 37 able-bodied control volunteers. Based on the fMRI data analyses, P1 showed activation in the bilateral precentral hand sections and greater functional connectivity between these sections during a right-hand unimanual task. In contrast, other paraplegic participants and controls showed activation in the contralateral hemisphere and deactivation in the ipsilateral hemisphere. Moreover, dMRI data analysis revealed that P1 exhibited significantly lower mean diffusivity along the transcallosal pathway connecting the bilateral precentral motor regions than control participants, which was not observed in the other paraplegic participants. These results suggest that long-term training with bilaterally synchronized upper-limb movements may promote bilateral recruitment of the precentral hand sections. Such recruitment may affect the structural circuitry involved in the interhemispheric interaction between the bilateral precentral regions. This study provides valuable evidence of the extreme adaptability of the human brain.