BRAINSTEM AND SPINAL CIRCUITS FOR THE CONTROL
OF SKILLED FORELIMB BEHAVIORS
Skilled forelimb behaviors rely on the activation of forelimb muscles in diverse sequences to pro-
duce an almost infinite number of movement patterns that we and other mammals can perform.
Proximal and distal limb muscles represent a constrained spatial continuum along the extremities.
The act of moving the arm transports the hand to particular locations (e.g., through the process of
reaching), and within these constraints, the hand can carry out a myriad of movements (e.g., grasp-
ing, scratching, object manipulation) (Figure 2). The generation of these complex behaviors as
well as the monitoring of their execution requires modular, adaptable, and highly organized neu-
ronal circuits. Such circuits are needed to carry out these behaviors with high temporal precision
and to allow for adjustments during ongoing movements. The reach-to-grasp task is a common
behavioral paradigm that is used to dissect circuits involved in skilled forelimb movement that
rodents execute using strategies and behavioral phases similar to humans (Lemon 2008, Sacrey
et al. 2009, Whishaw & Pellis 1990). Therefore, although understanding the neuronal circuits
controlling skilled forelimb behaviors is a challenging task, it opens the possibility to define and
study the function of core circuit elements both in the genetically accessible rodent model and in
higher-order species.
Much work in the past has focused on corticospinal connectivity and the role of these pathways
in complex forelimb movements, with particular emphasis on direct connections from the cortex
to spinal premotor and motor neurons (Dum & Strick 1991, Lemon 2008, Levine et al. 2012,
Ueno et al. 2018, Wang et al. 2017). The reason for a high interest in this area was the observation
that corticomotoneuronal synapses increase in abundance with advancing evolution from rodents
to monkeys to humans (Kuypers 1964, Lemon 2008). This process is paralleled by increasing lev-
els of sophistication in dexterous movements, culminating in the ability to control single digits
(Kuypers 1964, Lemon 2008). Early on, it was already clear that circuits in the brainstem are also
involved in controlling skilled forelimb movements, as evidenced by lesion studies and electro-
physiological recordings in cats and monkeys (Buford & Davidson 2004, Kuypers & Lawrence
1967, Schepens & Drew 2004, Soteropoulos et al. 2012). Moreover, work with cortical- or spinal
cord–injury models suggests that brainstem circuits in the reticular formation and red nucleus gain
functional importance under these compromised experimental conditions. Proposed mechanisms
contributing to hand function recovery after injury include axonal sprouting by cortical axons at
the brainstem level and/or by reticulospinal axons in the spinal cord, thus compensating for the
reduction or lack of cortical access to the spinal cord (Baker 2011, Baker et al. 2015, Fregosi et al.
2018, Mosberger et al. 2018). Here, we review progress on the identification, anatomical organi-
zation, and function of neuronal circuits connecting the brainstem and spinal cord bidirectionally,
with a role in shaping skilled forelimb behaviors in the uninjured nervous system.
A key requirement for the generation of skilled forelimb movements is the ability of spinal cir-
cuitry to integrate supraspinal motor instructions, process this information, and send commands
to cervical motor neurons innervating forelimb muscles. Classical studies noted a mediolateral di-
vision in the lower brainstem, with lateral regions more prominently accessing intermediate and
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Annu. Rev. Neurosci. 2019.42:485-504. Downloaded from www.annualreviews.org
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