Spatial properties and interhemispheric differences of the sensory hand cortical representation: a neuromagnetic study

Neuromagnetic integrated methods tracking human brain mechanisms of sensorimotor areas 'plastic' reorganisation

The potential for reorganization in the adult brain has been largely underestimated in the past and we are just beginning to understand the organisational principles involved in functional recovery. A bulk of experimental evidences have been accumulated in support of the hypothesis that neuronal aggregates adjacent to a lesion in the cortical brain areas can be progressively vicarious to the function of the damaged neurones. Such a reorganisation, if occurring in the affected hemisphere of a patient with a monohemispheric lesion, should significantly modify the interhemispheric symmetry of somatotopic organisation of the sensorimotor cortices, both in terms of absolute surfaces and number of "recruited" neurons, as well as of spatial coordinates. In fact, a roughly symmetrical organisation of sensorimotor - particularly for the hand contorl - in the right and left hemisphere has been observed in healthy humans by different methods of functional brain imaging, including fMRI, TMS, MEG, HD-EEG. Not uniform results about the functional brain activity related to sensory, motor and cognitive functions in normal and diseased subjects are often due to differences in the experimental paradigm designed as well as in the spatial and temporal resolution of the neuroimaging techniques used. The multi-modal integration of data obtained with several neuroimaging techniques allowed a coherent modelling of human brain higher functions. Functional magnetic resonance imaging (fMRI) provided fine spatial details (millimetres) of the brain responses, which were compared with the cortical maps of the motor output to different body districts obtained with transcranial magnetic stimulation (TMS). Magnetoencephalography (MEG) ability to study sensorimotor areas by analysing cortical magnetic fields, is also complementary to the motor cortex topographical mapping provided by TMS. MEG high temporal resolution allows to detect relatively restricted functional neuronal pools activated during cerebral processing of external stimuli. Moreover, these brain responses can be investigated with magnetoencephalography (MEG) and high density electroencephalography (EEG) techniques, with elevated time resolution (ms). With respect to the high resolution EEG technique, the MEG technique allowed a more precise localisation of the sites of neural activity buried into the cortical sulci, but was unable to detect the response of the crown of the cortical giri and of the frontal-mesial cortex (including the supplementary motor area), because of its poor sensitivity to radially oriented dipoles. The integration of functional and anatomical information provide cues on the relationship between brain activity and anatomic sites where this takes place, allowing the characterisation of the physiological activity of the cortical brain layers as well as to study the plastic reorganisation of the brain in different pathological conditions following stroke, limb amputation, spinal cord injury, hemisperectomy.

Morphology of somatosensory evoked fields: inter-hemispheric similarity as a parameter for physiological and pathological neural connectivity

The morphology of somatosensory evoked fields (SEF) following electrical separate stimulation of left and right median nerve in 22 healthy volunteers was explored. The analysis of morphological properties of individual SEFs has been performed, in order to quantify an inter-hemispheric correlation coefficient. Despite a high inter-subject variability of the SEF morphologies, a high intra-subject inter-hemispheric shape correlation occurs in the post-stimulus epoch of 100 ms from the stimulus onset. Accordingly, a normative value for the parameter describing the SEF inter-hemispheric correlation coefficient has been calculated. The present work establishes quantitative and normative descriptions of the shape similarity of SEFs from the two hands in the left and right hemispheres. This provides a database for a new parameter, which might be useful in detecting alterations in the primary sensory cortical activation due to possible unilateral alterations of sensory inflow because of either peripheral or central deficits. The described procedure has been successfully applied to a small number of patients affected by unilateral cerebrovascular lesion.

Magnetoencephalography in the study of human somatosensory cortical processing

Magnetoencephalography (MEG) is a totally non-invasive research method which provides information about cortical dynamics on a millisecond time-scale. Whole-scalp magnetic field patterns following stimulation of different peripheral nerves indicate activation of an extensive cortical network. At the SI cortex, the responses reflect mainly the activity of area 3b, with clearly somatotopical representations of different body parts. The SII cortex is activated bilaterally and it also receives, besides tactile input, nociceptive afference. Somatically evoked MEG signals may also be detected from the posterior parietal cortex, central mesial cortex and the frontal lobe. The serial versus parallel processing in the cortical somatosensory network is still under debate.

The sensory somatotopic map of the human hand demonstrated at 4 Tesla

Recent attempts at high-resolution sensory-stimulated fMRI performed at 1.5 T have had very limited success at demonstrating a somatotopic organization for individual digits. Our purpose was to determine if functional MRI at 4 T can demonstrate the sensory somatotopic map of the human hand. Sensory functional MRI was performed at 4 T in five normal volunteers using a low-frequency vibratory stimulus on the pad of each finger of the left hand. A simple motor control task was also performed. The data were normalized to a standard atlas, and individual and group statistical parametric maps (SPMs) were computed for each task. Volume of activation and distribution of cluster maxima were compared for each task. For three of the subjects, the SPMs demonstrated a somatotopic organization of the sensory cortex. The group SPMs demonstrated a clear somatotopic organization of the sensory cortex. The thumb to fifth finger were organized, in general, with a lateral to medial, inferior to superior, and anterior to posterior relationship. There was overlap in the individual SPMs between fingers. The sensory activation spanned a space of 12-18 mm (thumb to fifth finger) on the primary sensory cortex. The motor activation occurred consistently at the superior-most extent of the sensory activation within and across subjects. The sensory somatotopic map of the human hand can be identified at 4 T. High-resolution imaging at 4 T can be useful for detailed functional imaging studies.

A neuromagnetic normative data set for hemispheric sensory hand cortical representations and their interhemispheric differences

Somatotopy of human hand primary sensory cortex has been studied neuromagnetically [C. Baumgartner, A. Doppelbauer, L. Deecke, D.S. Barth, J. Zeitlhofer, G. Lindinger, W.W. Sutherling, Neuromagnetic investigation of somatotopy of human hand somatosensory cortex, Exp. Brain Res. 87 (1991) 641-648.] [1]. Investigation of sensory cortex devoted to the hand will be of major importance in relation to clinical recovery after sensorimotor deficits as well as an index of plasticity phenomena following alterations of peripheral nerves inputs. Here a normative data set has been constructed, on the basis of the neuromagnetic investigation of the primary sensory hand cortical representation in the two hemispheres of 20 healthy volunteers. This can be used to evaluate interhemispheric differences of the 'sensory' hand areas during experimental paradigms in the healthy as well as following patients with monohemispheric lesions. The localizations in each hemisphere of the cortical Equivalent Current Dipoles (ECDs) activated with the shortest latencies (N20m and P30m components) by separate stimulation of left and right median nerve, thumb and little finger were analysed. By considering the ECDs to thumb and little finger stimulation the boundaries of the hand cortical representation in primary sensory cortex, the 'hand extension' was measured as the distance between the two. For all the considered parameters (related to N20m and P30m ECDs: latency, strength, spatial position in the individual head, 'hand extension', interhemispheric differences) the appropriate variable distribution was considered and by including the 98% of the healthy population normative limits were calculated.

On the reorganization of sensory hand areas after mono-hemispheric lesion: a functional (MEG)/anatomical (MRI) integrative study

The topography of primary sensory cortical hand area following a monohemispheric lesion (sudden = stroke; progressive = neoplasm) was investigated in relationship with clinical recovery of sensorimotor deficits. Twenty seven patients with monohemispheric lesions were studied in a clinically stabilized condition. Functional informations from magnetoencephalography (MEG) were integrated with anatomical data from magnetic resonance imaging (MRI). MEG localizations of the neurons firing at early latencies in primary sensory cortex after separate stimulation of median nerve, thumb and little fingers of each hand were carried out. Characteristics of cerebral equivalent current dipoles (ECDs) activated by each contralateral stimulation, the 'hand extension' (i.e., the distance in millimetres between ECDs of first and fifth digits), as well as interhemispheric differences of the tested parameters were investigated. Finally, ECDs' locations were integrated with MRI. Lesions involving cortical (C) or subcortical (s.c.) areas receiving sensory input from the hand were often combined to increase interhemispheric asymmetry of the tested parameters (22% for C and 49% for s.c. lesions). This might be due to an activation of neuronal districts which in the affected hemisphere (AH) differ from those normally activated in the unaffected hemisphere (UH) and in the control population. Moreover, the 'hand extension' was enlarged on the AH--more frequently after a SC lesion--mainly due to a medial shift of the little finger ECD, combined to a tendency of both finger ECDs to shift frontally. After a C lesion, responses from the AH were often stronger than normal. Spatial reorganizations were also seen in the UH (7% of C and 14% of SC lesions). 'Hand extension' in the UH was selectively enlarged for the P30m only when combined with a similar enlargement in the AH. Significant interhemispheric asymmetries due to neuronal reorganization in the AH were associated with worse clinical outcomes compared to patients without asymmetries.