Multisensory integration in children: a preliminary ERP study

Multisensory integration and interactions across vision, hearing, and somatosensation in autism spectrum development and typical development

Most prior studies of multisensory integration (MSI) in autism have measured MSI in only a single combination of modalities - typically audiovisual integration. The present study used onset reaction times (RTs) and 125-channel electroencephalography (EEG) to examine different forms of bimodal and trimodal MSI based on combinations of auditory (noise burst), somatosensory (finger tap), and visual (flash) stimuli presented in a spatially-aligned manner using a custom desktop apparatus. A total of 36 autistic and 19 non-autistic adolescents between the ages of 11-14 participated. Significant RT multisensory facilitation relative to summed unisensory RT was observed in both groups, as were significant differences between summed unisensory and multisensory ERPs. Although the present study's statistical approach was not intended to test effect latencies, these interactions may have begun as early as ∼45 ms, constituting "early" (<100 ms) MSI. RT and ERP measurements of MSI appeared independent of one another. Groups did not significantly differ in multisensory RT facilitation, but we found exploratory evidence of group differences in the magnitude of audiovisual interactions in ERPs. Future research should make greater efforts to explore MSI in under-represented populations, especially autistic people with intellectual disabilities and nonspeaking/minimally-verbal autistic people.

Design and validation of a wireless Body Sensor Network for integrated EEG and HD-sEMG acquisitions

Sensorimotor integration is the process through which the human brain plans the motor program execution according to external sources. Within this context, corticomuscular and corticokinematic coherence analyses are common methods to investigate the mechanism underlying the central control of muscle activation. This requires the synchronous acquisition of several physiological signals, including EEG and sEMG. Nevertheless, physical constraints of the current, mostly wired, technologies limit their application in dynamic and naturalistic contexts. In fact, although many efforts were made in the development of biomedical instrumentation for EEG and HD-sEMG signal acquisition, the need for an integrated wireless system is emerging. We hereby describe the design and validation of a new fully wireless body sensor network for the integrated acquisition of EEG and HD-sEMG signals. This Body Sensor Network is composed of wireless bio-signal acquisition modules, named sensor units, and a set of synchronization modules used as a general-purpose system for time-locked recordings. The system was characterized in terms of accuracy of the synchronization and quality of the collected signals. An in-depth characterization of the entire system and an end-to-end comparison of the wireless EEG sensor unit with a wired benchmark EEG device were performed. The proposed device represents an advancement of the State-of-the-Art technology allowing the integrated acquisition of EEG and HD-sEMG signals for the study of sensorimotor integration.

An Exploratory Study Testing Autonomic Reactivity to Pain in Women with Sensory Over-Responsiveness

BACKGROUND

Difficulty modulating sensory input related to multi-sensory integration dysfunction, specifically the sensory over-responsive (SOR) type, is associated with psychological distress and hyperalgesia in children and adults. Scares reports suggest atypical autonomic nervous system (ANS) reactivity to innocuous sensory stimuli in children with SOR. Thus, the ANS may contribute to sensory stimuli responses and psychological distress. This exploratory study aimed to characterize the ANS reactivity to single and dual pain stimulation, and in relation to psychological distress in adults with SOR.

METHODS

Healthy women with SOR (n = 9) vs. without SOR (n = 9) underwent two runs of single pain stimulation and a third run comprised of dual pain stimulation. Pain was self-rated, while heart rate variability was measured and analyzed in the time and frequency domains. In addition, questionnaires assessing anxiety and somatization were utilized.

RESULTS

While controls demonstrated a vagal tone withdrawal (root mean square of successive differences in R-R-intervals; (RMSSD)) p = 0.029 from base-line to the third run, this was absent in the SOR group. However, no group differences were found in pain ratings. Furthermore, groups differed in the correlations between R-R mean and the level of both anxiety (p = 0.006) and somatization (p < 0.001); while in the SOR group, higher levels of anxiety and somatization correlated with shorter R-R intervals, the opposite was found in the control group.

CONCLUSIONS

This is the first study to demonstrate in women with SOR atypical vagal tone reactivity to challenging pain load. Vagal tone reactivity is related to both pain ratings and psychological distress.

Late attentional processes potentially compensate for early perceptual multisensory integration deficits in children with autism: evidence from evoked potentials

Sensory processing deficits and altered long-range connectivity putatively underlie Multisensory Integration (MSI) deficits in Autism Spectrum Disorder (ASD). The present study set out to investigate non-social MSI stimuli and their electrophysiological correlates in young neurotypical adolescents and adolescents with ASD. We report robust MSI effects at behavioural and electrophysiological levels. Both groups demonstrated normal behavioural MSI. However, at the neurophysiological level, the ASD group showed less MSI-related reduction of the visual P100 latency, greater MSI-related slowing of the auditory P200 and an overall temporally delayed and spatially constrained onset of MSI. Given the task design and patient sample, and the age of our participants, we argue that electro-cortical indices of MSI deficits in ASD: (a) can be detected in early-adolescent ASD, (b) occur at early stages of perceptual processing, (c) can possibly be compensated by later attentional processes, (d) thus leading to normal MSI at the behavioural level.

Neonatal Multisensory Processing in Preterm and Term Infants Predicts Sensory Reactivity and Internalizing Tendencies in Early Childhood

Multisensory processes include the capacity to combine information from the different senses, often improving stimulus representations and behavior. The extent to which multisensory processes are an innate capacity or instead require experience with environmental stimuli remains debated. We addressed this knowledge gap by studying multisensory processes in prematurely born and full-term infants. We recorded 128-channel event-related potentials (ERPs) from a cohort of 55 full-term and 61 preterm neonates (at an equivalent gestational age) in response to auditory, somatosensory, and combined auditory-somatosensory multisensory stimuli. Data were analyzed within an electrical neuroimaging framework, involving unsupervised topographic clustering of the ERP data. Multisensory processing in full-term infants was characterized by a simple linear summation of responses to auditory and somatosensory stimuli alone, which furthermore shared common ERP topographic features. We refer to the ERP topography observed in full-term infants as "typical infantile processing" (TIP). In stark contrast, preterm infants exhibited non-linear responses and topographies less-often characterized by TIP; there were distinct patterns of ERP topographies to multisensory and summed unisensory conditions. We further observed that the better TIP characterized an infant's ERPs, independently of prematurity, the more typical was the score on the Infant/Toddler Sensory Profile (ITSP) at 12 months of age and the less likely was the child to the show internalizing tendencies at 24 months of age. Collectively, these results highlight striking differences in the brain's responses to multisensory stimuli in children born prematurely; differences that relate to later sensory and internalizing functions.

Understanding event-related potentials (ERPs) in clinical and basic language and communication disorders research: a tutorial

BACKGROUND

Event-related potentials (ERPs), which are electrophysiological neural responses time-locked to a stimulus, have become an increasingly common tool in language and communication disorders research. They can provide complementary evidence to behavioural measures as well as unique perspectives on communication disorders. ERPs have the distinct advantage of providing precise information about the timing of neural processes and can be used in cases where it is difficult to obtain responses from participants, such as infants or individuals who are minimally verbal. However, clinicians and clinician-scientists rarely receive training in how to interpret ERP research.

AIMS

To provide information that allows readers to better understand, interpret and evaluate research using ERPs. We focus on research related to communication sciences and disorders and the information that is most relevant to interpreting research articles.

METHOD

We explain what ERPs are and how ERP data are collected, referencing key texts and primary research articles. Potential threats to validity, guidelines for interpreting data, and the pros and cons using of ERPs are discussed. Research in the area of paediatric language disorders is used as a model; common paradigms such as the semantic incongruity N400 and auditory mismatch negativity are used as tangible examples. With this foundation of understanding ERPs, the state of the field in terms of how ERPs are used and the ways they may inform the field are discussed.

MAIN CONTRIBUTION

To date, no review has focused on ERPs as they relate to clinical or communication research. The main contribution of this review is that it provides practical information geared toward understanding ERP research.

CONCLUSIONS

ERPs offer insights into neural processes supporting communication and can both complement behaviour and provide information that behavioural measures cannot. We encourage readers to evaluate articles using ERPs critically, effectively pushing the field forward through increased understanding and rigor. What this paper adds ERPs have become more prevalent in research relevant to communication sciences and disorders. In order for clinicians to review and evaluate this research, an understanding of ERPs is needed. This review adds to the field by providing an accessible description of what ERPs are, a description of what ERP components are, and the most relevant commonly used components, as well as how ERP data are recorded and processed. With this foundational understanding of how ERPs work, guidelines for the interpretation of ERP data are given. Though few ERP studies currently have direct implications for clinical practice, we discuss several ways through which ERPs can impact clinical practice in future, by providing information that cannot be obtained by behaviour alone about the aetiology of disorders, and as potential biomarkers of disorder or treatment response.

Sensory Modulation in Children Exposed to Continuous Traumatic Stress

Preliminary evidence supports a possible association between post-traumatic stress disorder (PTSD) and sensory modulation disorder (SMD). Nevertheless, the research focusing on this relationship in children is notably limited. This study examined children with and without PTS symptoms, by comparing their mothers' perceptions of their responses to sensory events in daily life. Mothers of 134 non-referred children aged 5-11, exposed to continuous traumatic stress due to political violence, completed the UCLA-RI and the Short Sensory Profile questionnaires. Significant differences emerged between children with different levels of PTS symptoms in various sensory modalities. Furthermore, half of the symptomatic children had suspected clinically significant deficits in sensory processing. In addition, PTSD symptoms were significantly associated with most of the sensory processing scores. Logistic regression indicated that the overall sensory processing score was a significant predictor of group classification. The results indicate that children with PTS symptoms may be at increased risk for sensory processing deficits. Evaluation of sensory processing should be incorporated into the routine evaluation of this population in order to determine whether this is an additional factor contributing to a child's difficulties in participating in daily activities. Subsequent intervention programs should then address the multiple needs of these children.

Unisensory and Multisensory Responses in Fetal Alcohol Spectrum Disorders (FASD): Effects of Spatial Congruence

While it is generally accepted that structural and functional brain deficits underlie the behavioral deficits associated with Fetal Alcohol Spectrum Disorders (FASD), the degree to which these problems are expressed in sensory pathology is unknown. Electrophysiological measures indicate that neural processing is delayed in visual and auditory domains. Furthermore, multiple reports of white matter deficits due to prenatal alcohol exposure indicate altered cortical connectivity in individuals with FASD. Multisensory integration requires close coordination between disparate cortical areas leading us to hypothesize that individuals with FASD will have impaired multisensory integration relative to healthy control (HC) participants. Participants' neurophysiological responses were recorded using magnetoencephalography (MEG) during passive unisensory or simultaneous, spatially congruent or incongruent multisensory auditory and somatosensory stimuli. Source timecourses from evoked responses were estimated using multi-dipole spatiotemporal modeling. Auditory M100 response latency was faster for the multisensory relative to the unisensory condition but no group differences were observed. M200 auditory latency to congruent stimuli was earlier and congruent amplitude was larger in participants with FASD relative to controls. Somatosensory M100 response latency was faster in right hemisphere for multisensory relative to unisensory stimulation in both groups. FASD participants' somatosensory M200 responses were delayed by 13 ms, but only for the unisensory presentation of the somatosensory stimulus. M200 results indicate that unisensory and multisensory processing is altered in FASD; it remains to be seen if the multisensory response represents a normalization of the unisensory deficits.

Active touch facilitates object size perception in children but not adults: A multisensory event related potential study

In order to increase perceptual precision the adult brain dynamically combines redundant information from different senses depending on their reliability. During object size estimation, for example, visual, auditory and haptic information can be integrated to increase the precision of the final size estimate. Young children, however, do not integrate sensory information optimally and instead rely on active touch. Whether this early haptic dominance is reflected in age-related differences in neural mechanisms and whether it is driven by changes in bottom-up perceptual or top-down attentional processes has not yet been investigated. Here, we recorded event-related-potentials from a group of adults and children aged 5-7 years during an object size perception task using auditory, visual and haptic information. Multisensory information was presented either congruently (conveying the same information) or incongruently (conflicting information). No behavioral responses were required from participants. When haptic size information was available via actively tapping the objects, response amplitudes in the mid-parietal area were significantly reduced by information congruency in children but not in adults between 190 ms-250 ms and 310 ms-370 ms. These findings indicate that during object size perception only children's brain activity is modulated by active touch supporting a neural maturational shift from sensory dominance in early childhood to optimal multisensory benefit in adulthood.

Sensory Modulation Disorder (SMD) and Pain: A New Perspective

Sensory modulation disorder (SMD) affects sensory processing across single or multiple sensory systems. The sensory over-responsivity (SOR) subtype of SMD is manifested clinically as a condition in which non-painful stimuli are perceived as abnormally irritating, unpleasant, or even painful. Moreover, SOR interferes with participation in daily routines and activities (Dunn, 2007; Bar-Shalita et al., 2008; Chien et al., 2016), co-occurs with daily pain hyper-sensitivity, and reduces quality of life due to bodily pain. Laboratory behavioral studies have confirmed abnormal pain perception, as demonstrated by hyperalgesia and an enhanced lingering painful sensation, in children and adults with SMD. Advanced quantitative sensory testing (QST) has revealed the mechanisms of altered pain processing in SOR whereby despite the existence of normal peripheral sensory processing, there is enhanced facilitation of pain-transmitting pathways along with preserved but delayed inhibitory pain modulation. These findings point to central nervous system (CNS) involvement as the underlying mechanism of pain hypersensitivity in SOR. Based on the mutual central processing of both non-painful and painful sensory stimuli, we suggest shared mechanisms such as cortical hyper-excitation, an excitatory-inhibitory neuronal imbalance, and sensory modulation alterations. This is supported by novel findings indicating that SOR is a risk factor and comorbidity of chronic non-neuropathic pain disorders. This is the first review to summarize current empirical knowledge investigating SMD and pain, a sensory modality not yet part of the official SMD realm. We propose a neurophysiological mechanism-based model for the interrelation between pain and SMD. Embracing the pain domain could significantly contribute to the understanding of this condition’s pathogenesis and how it manifests in daily life, as well as suggesting the basis for future potential mechanism-based therapies.

Neural Foundations of Ayres Sensory Integration®

Sensory integration, now trademarked as Ayres Sensory Integration^® or ASI, is based on principles of neuroscience and provides a framework for understanding the contributions of the sensory and motor foundations of human behavior. The theory and practice of ASI continues to evolve as greater understanding of the neurobiology of human behavior emerges. In this paper we examine core constructs of ASI identified in the seminal work of Dr. Jean Ayres, and present current neuroscience research that underlies the main patterns of sensory integration function and dysfunction. We consider how current research verifies and clarifies Ayres’ propositions by describing functions of the vestibular, proprioceptive, and tactile sensory systems, and exploring their relationships to ocular, postural, bilateral integration, praxis, and sensory modulation. We close by proposing neuroplasticity as the mechanisms underlying change as a result of ASI intervention.

Somatosensory Cross-Modal Reorganization in Children With Cochlear Implants

Deprived of sensory input, as in deafness, the brain tends to reorganize. Cross-modal reorganization occurs when cortices associated with deficient sensory modalities are recruited by other, intact senses for processing of the latter's sensory input. Studies have shown that this type of reorganization may affect outcomes when sensory stimulation is later introduced via intervention devices. One such device is the cochlear implant (CI). Hundreds of thousands of CIs have been fitted on people with hearing impairment worldwide, many of them children. Factors such as age of implantation have proven useful in predicting speech perception outcome with these devices in children. However, a portion of the variance in speech understanding ability remains unexplained. It is possible that the degree of cross-modal reorganization may explain additional variability in listening outcomes. Thus, the current study aimed to examine possible somatosensory cross-modal reorganization of the auditory cortices. To this end we used high density EEG to record cortical responses to vibrotactile stimuli in children with normal hearing (NH) and those with CIs. We first investigated cortical somatosensory evoked potentials (CSEP) in NH children, in order to establish normal patterns of CSEP waveform morphology and sources of cortical activity. We then compared CSEP waveforms and estimations of cortical sources between NH children and those with CIs to assess the degree of somatosensory cross-modal reorganization. Results showed that NH children showed expected patterns of CSEP and current density reconstructions, such that postcentral cortices were activated contralaterally to the side of stimulation. Participants with CIs also showed this pattern of activity. However, in addition, they showed activation of auditory cortical areas in response to somatosensory stimulation. Additionally, certain CSEP waveform components were significantly earlier in the CI group than the children with NH. These results are taken as evidence of cross-modal reorganization by the somatosensory modality in children with CIs. Speech perception in noise scores were negatively associated with CSEP waveform components latencies in the CI group, suggesting that the degree of cross-modal reorganization is related to speech perception outcomes. These findings may have implications for clinical rehabilitation in children with cochlear implants.

The audio-visual integration effect on music emotion: Behavioral and physiological evidence

Previous research has indicated that, compared to audio-only presentation, audio-visual congruent presentation can lead to a more intense emotional response. In the present study, we investigated the audio-visual integration effect on emotions elicited by positive or negative music and the role of visual information presentation durations. The participants were presented with audio-only condition, audio-visual congruent condition, and audio-visual incongruent condition and then required to judge the intensity of emotional experience elicited by the music. Their emotional responses to the music were measured using self-ratings and physiological aspects, including heart rate, skin temperature, EMG root mean square and prefrontal EEG. Relative to the audio-only presentation, the audio-visual congruent presentation led to a more intense emotional response. More importantly, the audio-visual integration occurred both in the positive music and in the negative music. Furthermore, the audio-visual integration effect was larger for positive music than for negative music; meanwhile the audio-visual integration effect was strongest with the visual information presented within 80s for negative music, which indicated that this integration effect was more likely to occur in the negative music. These results suggest that when the music was positive, the effect of audio-visual integration was greater. When the music was negative, the modulation effect of the presentation durations of visual information on the music-induced emotion was more significant.

Steady-State EEG and Psychophysical Measures of Multisensory Integration to Cross-Modally Synchronous and Asynchronous Acoustic and Vibrotactile Amplitude Modulation Rate

According to thetemporal principleof multisensory integration, cross-modal synchronisation of stimulus onset facilitates multisensory integration. This is typically observed as a greater response to multisensory stimulation relative to the sum of the constituent unisensory responses (i.e.,superadditivity). The aim of the present study was to examine whether the temporal principle extends to the cross-modal synchrony of amplitude-modulation (AM) rate. It is well established that psychophysical sensitivity to AM stimulation is strongly influenced by AM rate where the optimum rate differs according to sensory modality. This rate-dependent sensitivity is also apparent from EEG steady-state response (SSR) activity, which becomes entrained to the stimulation rate and is thought to reflect neural processing of the temporal characteristics of AM stimulation. In this study we investigated whether cross-modal congruence of AM rate reveals both psychophysical and EEG evidence of enhanced multisensory integration. To achieve this, EEG SSR and psychophysical sensitivity to simultaneous acoustic and/or vibrotactile AM stimuli were measured at cross-modally congruent and incongruent AM rates. While the results provided no evidence of superadditive multisensory SSR activity or psychophysical sensitivity, the complex pattern of results did reveal a consistent correspondence between SSR activity and psychophysical sensitivity to AM stimulation. This indicates that entrained EEG activity may provide a direct measure of cortical activity underlying multisensory integration. Consistent with the temporal principle of multisensory integration, increased vibrotactile SSR responses and psychophysical sensitivity were found for cross-modally congruent relative to incongruent AM rate. However, no corresponding increase in auditory SSR or psychophysical sensitivity was observed for cross-modally congruent AM rates. This complex pattern of results can be understood in terms of the likely influence of theprinciple of inverse effectivenesswhere the temporal principle of multisensory integration was only evident in the context of reduced perceptual sensitivity for the vibrotactile but not the auditory modality.

Touching lips and hearing fingers: effector-specific congruency between tactile and auditory stimulation modulates N1 amplitude and alpha desynchronization

Understanding the interactions between audition and sensorimotor processes is of theoretical importance, particularly in relation to speech processing. Although one current focus in this area is on interactions between auditory perception and the motor system, there has been less research on connections between the auditory and somatosensory modalities. The current study takes a novel approach to this omission by examining specific auditory-tactile interactions in the context of speech and non-speech sound production. Electroencephalography was used to examine brain responses when participants were presented with speech syllables (a bilabial sound /pa/ and a non-labial sound /ka/) or finger-snapping sounds that were simultaneously paired with tactile stimulation of either the lower lip or the right middle finger. Analyses focused on the sensory-evoked N1 in the event-related potential and the extent of alpha band desynchronization elicited by the stimuli. N1 amplitude over fronto-central sites was significantly enhanced when the bilabial /pa/ sound was paired with tactile lip stimulation and when the finger-snapping sound was paired with tactile stimulation of the finger. Post-stimulus alpha desynchronization at central sites was also enhanced when the /pa/ sound was accompanied by tactile stimulation of the lip. These novel findings indicate that neural aspects of somatosensory-auditory interactions are influenced by the congruency between the location of the bodily touch and the bodily origin of a perceived sound.

The State of the Science on Sensory Factors and Their Impact on Daily Life for Children: A Scoping Review

The objective of this study was to identify and synthesize research about how sensory factors affect daily life of children. We designed a conceptual model to guide a scoping review of research published from 2005 to October 2014 (10 years). We searched MEDLINE, CINAHL, and PsycINFO and included studies about sensory perception/processing; children, adolescents/young adults; and participation. We excluded studies about animals, adults, and review articles. Our process resulted in 261 articles meeting criteria. Research shows that children with conditions process sensory input differently than peers. Neuroscience evidence supports the relationship between sensory-related behaviors and brain activity. Studies suggest that sensory processing is linked to social participation, cognition, temperament, and participation. Intervention research illustrates the importance of contextually relevant practices. Future work can examine the developmental course of sensory processing aspects of behavior across the general population and focus on interventions that support children's sensory processing as they participate in their daily lives.

Assessment of Sensory Processing Characteristics in Children between 3 and 11 Years Old: A Systematic Review

The assessment of sensory perception, discrimination, integration, modulation, praxis, and other motor skills, such as posture, balance, and bilateral motor coordination, is necessary to identify the sensory and motor factors influencing the development of personal autonomy. The aim of this work is to study the assessment tools currently available for identifying different patterns of sensory processing. There are 15 tests available that have psychometric properties, primarily for the US population. Nine of them apply to children in preschool and up to grade 12. The assessment of sensory processing is a process that includes the use of standardized tests, administration of caregiver questionnaires, and clinical observations. The review of different studies using PRISMA criteria or Osteba Critical Appraisal Cards reveals that the most commonly used tools are the Sensory Integration and Praxis Test, the Sensory Processing Measure, and the Sensory Profile.

New Flexible Silicone-Based EEG Dry Sensor Material Compositions Exhibiting Improvements in Lifespan, Conductivity, and Reliability

This study investigates alternative material compositions for flexible silicone-based dry electroencephalography (EEG) electrodes to improve the performance lifespan while maintaining high-fidelity transmission of EEG signals. Electrode materials were fabricated with varying concentrations of silver-coated silica and silver flakes to evaluate their electrical, mechanical, and EEG transmission performance. Scanning electron microscope (SEM) analysis of the initial electrode development identified some weak points in the sensors' construction, including particle pull-out and ablation of the silver coating on the silica filler. The newly-developed sensor materials achieved significant improvement in EEG measurements while maintaining the advantages of previous silicone-based electrodes, including flexibility and non-toxicity. The experimental results indicated that the proposed electrodes maintained suitable performance even after exposure to temperature fluctuations, 85% relative humidity, and enhanced corrosion conditions demonstrating improvements in the environmental stability. Fabricated flat (forehead) and acicular (hairy sites) electrodes composed of the optimum identified formulation exhibited low impedance and reliable EEG measurement; some initial human experiments demonstrate the feasibility of using these silicone-based electrodes for typical lab data collection applications.

An Inflatable and Wearable Wireless System for Making 32-Channel Electroencephalogram Measurements

Potable electroencephalography (EEG) devices have become critical for important research. They have various applications, such as in brain-computer interfaces (BCI). Numerous recent investigations have focused on the development of dry sensors, but few concern the simultaneous attachment of high-density dry sensors to different regions of the scalp to receive qualified EEG signals from hairy sites. An inflatable and wearable wireless 32-channel EEG device was designed, prototyped, and experimentally validated for making EEG signal measurements; it incorporates spring-loaded dry sensors and a novel gasbag design to solve the problem of interference by hair. The cap is ventilated and incorporates a circuit board and battery with a high-tolerance wireless (Bluetooth) protocol and low power consumption characteristics. The proposed system provides a 500/250 Hz sampling rate, and 24 bit EEG data to meet the BCI system data requirement. Experimental results prove that the proposed EEG system is effective in measuring audio event-related potential, measuring visual event-related potential, and rapid serial visual presentation. Results of this work demonstrate that the proposed EEG cap system performs well in making EEG measurements and is feasible for practical applications.

Multisensory integration and child neurodevelopment

A considerable number of cognitive processes depend on the integration of multisensory information. The brain integrates this information, providing a complete representation of our surrounding world and giving us the ability to react optimally to the environment. Infancy is a period of great changes in brain structure and function that are reflected by the increase of processing capacities of the developing child. However, it is unclear if the optimal use of multisensory information is present early in childhood or develops only later, with experience. The first part of this review has focused on the typical development of multisensory integration (MSI). We have described the two hypotheses on the developmental process of MSI in neurotypical infants and children, and have introduced MSI and its neuroanatomic correlates. The second section has discussed the neurodevelopmental trajectory of MSI in cognitively-challenged infants and children. A few studies have brought to light various difficulties to integrate sensory information in children with a neurodevelopmental disorder. Consequently, we have exposed certain possible neurophysiological relationships between MSI deficits and neurodevelopmental disorders, especially dyslexia and attention deficit disorder with/without hyperactivity.

Design, Fabrication, and Experimental Validation of Novel Flexible Silicon-Based Dry Sensors for Electroencephalography Signal Measurements

Many commercially available electroencephalography (EEG) sensors, including conventional wet and dry sensors, can cause skin irritation and user discomfort owing to the foreign material. The EEG products, especially sensors, highly prioritize the comfort level during devices wear. To overcome these drawbacks for EEG sensors, this paper designs Societe Generale de Surveillance S \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{upgreek} \usepackage{mathrsfs} \setlength{\oddsidemargin}{-69pt} \begin{document} }{}$\cdot $ \end{document} A \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{upgreek} \usepackage{mathrsfs} \setlength{\oddsidemargin}{-69pt} \begin{document} }{}$\cdot $ \end{document} (SGS)-certified, silicon-based dry-contact EEG sensors (SBDSs) for EEG signal measurements. According to the SGS testing report, SBDSs extract does not irritate skin or induce noncytotoxic effects on L929 cells according to ISO10993-5. The SBDS is also lightweight, flexible, and nonirritating to the skin, as well as capable of easily fitting to scalps without any skin preparation or use of a conductive gel. For forehead and hairy sites, EEG signals can be measured reliably with the designed SBDSs. In particular, for EEG signal measurements at hairy sites, the acicular and flexible design of SBDS can push the hair aside to achieve satisfactory scalp contact, as well as maintain low skin-electrode interface impedance. Results of this paper demonstrate that the proposed sensors perform well in the EEG measurements and are feasible for practical applications.

Autism and sensory processing disorders: shared white matter disruption in sensory pathways but divergent connectivity in social-emotional pathways

Over 90% of children with Autism Spectrum Disorders (ASD) demonstrate atypical sensory behaviors. In fact, hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment is now included in the DSM-5 diagnostic criteria. However, there are children with sensory processing differences who do not meet an ASD diagnosis but do show atypical sensory behaviors to the same or greater degree as ASD children. We previously demonstrated that children with Sensory Processing Disorders (SPD) have impaired white matter microstructure, and that this white matter microstructural pathology correlates with atypical sensory behavior. In this study, we use diffusion tensor imaging (DTI) fiber tractography to evaluate the structural connectivity of specific white matter tracts in boys with ASD (n = 15) and boys with SPD (n = 16), relative to typically developing children (n = 23). We define white matter tracts using probabilistic streamline tractography and assess the strength of tract connectivity using mean fractional anisotropy. Both the SPD and ASD cohorts demonstrate decreased connectivity relative to controls in parieto-occipital tracts involved in sensory perception and multisensory integration. However, the ASD group alone shows impaired connectivity, relative to controls, in temporal tracts thought to subserve social-emotional processing. In addition to these group difference analyses, we take a dimensional approach to assessing the relationship between white matter connectivity and participant function. These correlational analyses reveal significant associations of white matter connectivity with auditory processing, working memory, social skills, and inattention across our three study groups. These findings help elucidate the roles of specific neural circuits in neurodevelopmental disorders, and begin to explore the dimensional relationship between critical cognitive functions and structural connectivity across affected and unaffected children.

Uni- and crossmodal refractory period effects of event-related potentials provide insights into the development of multisensory processing

To assess uni- and multisensory development in humans, uni- and crossmodal event-related potential (ERP) refractory period effects were investigated. Forty-one children from 4 to 12 years of age and 15 young adults performed a bimodal oddball task with frequent and rare visual and auditory stimuli presented with two different interstimulus intervals (ISIs). Amplitudes of the visual and auditory ERPs were modulated as a function of the age of the participants, the modality of the preceding stimulus (same vs. different) and the preceding ISI (1000 or 2000 ms). While unimodal refractory period effects were observed in all age groups, crossmodal refractory period effects differed among age groups. Early crossmodal interactions (<150 ms) existing in the youngest age group (4–6 years) disappeared, while later crossmodal interactions (>150 ms) emerged with a parietal topography in older children and adults. Our results are compatible with the intersensory differentiation and the multisensory perceptual narrowing approach of multisensory development. Moreover, our data suggest that uni- and multisensory development run in parallel with unimodal development leading.

Abnormal white matter microstructure in children with sensory processing disorders

Sensory processing disorders (SPD) affect 5–16% of school-aged children and can cause long-term deficits in intellectual and social development. Current theories of SPD implicate primary sensory cortical areas and higher-order multisensory integration (MSI) cortical regions. We investigate the role of white matter microstructural abnormalities in SPD using diffusion tensor imaging (DTI). DTI was acquired in 16 boys, 8–11 years old, with SPD and 24 age-, gender-, handedness- and IQ-matched neurotypical controls. Behavior was characterized using a parent report sensory behavior measure, the Sensory Profile. Fractional anisotropy (FA), mean diffusivity (MD) and radial diffusivity (RD) were calculated. Tract-based spatial statistics were used to detect significant group differences in white matter integrity and to determine if microstructural parameters were significantly correlated with behavioral measures. Significant decreases in FA and increases in MD and RD were found in the SPD cohort compared to controls, primarily involving posterior white matter including the posterior corpus callosum, posterior corona radiata and posterior thalamic radiations. Strong positive correlations were observed between FA of these posterior tracts and auditory, multisensory, and inattention scores (r = 0.51–0.78; p < 0.001) with strong negative correlations between RD and multisensory and inattention scores (r = − 0.61–0.71; p < 0.001). To our knowledge, this is the first study to demonstrate reduced white matter microstructural integrity in children with SPD. We find that the disrupted white matter microstructure predominantly involves posterior cerebral tracts and correlates strongly with atypical unimodal and multisensory integration behavior. These findings suggest abnormal white matter as a biological basis for SPD and may also distinguish SPD from overlapping clinical conditions such as autism and attention deficit hyperactivity disorder.

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Abnormal posterior white matter microstructure in sensory processing disorders (SPD)

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Posterior cerebral white matter microstructure correlates with sensory behavior.

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DTI may help distinguish SPD from autism spectrum disorder and ADHD.

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DTI may yield prognostic and predictive biomarkers of SPD for clinical use.

Dissociation of psychophysical and EEG steady-state response measures of cross-modal temporal correspondence for amplitude modulated acoustic and vibrotactile stimulation

Research examining multisensory integration suggests that the correspondence of stimulus characteristics across modalities (cross-modal correspondence) can have a dramatic influence on both neurophysiological and perceptual responses to multimodal stimulation. The current study extends prior research by examining the cross-modal correspondence of amplitude modulation rate for simultaneous acoustic and vibrotactile stimulation using EEG and perceptual measures of sensitivity to amplitude modulation. To achieve this, psychophysical thresholds and steady-state responses (SSRs) were measured for acoustic and vibrotactile amplitude modulated (AM) stimulation for 21 and 40 Hz AM rates as a function of the cross-modal correspondence. The study design included three primary conditions to determine whether the changes in the SSR and psychophysical thresholds were due to the cross-modal temporal correspondence of amplitude modulated stimuli: NONE (AM in one modality only), SAME (the same AM rate for each modality) and DIFF (different AM rates for each modality). The results of the psychophysical analysis showed that AM detection thresholds for the simultaneous AM conditions (i.e., SAME and DIFF) were significantly higher (i.e., lower sensitivity) than AM detection thresholds for the stimulation of a single modality (i.e., NONE). SSR results showed significant effects of SAME and DIFF conditions on SSR activity. The different pattern of results for perceptual and SSR measures of cross-modal correspondence of AM rate indicates a dissociation between entrained cortical activity (i.e., SSR) and perception.

Multisensory processing in children with autism: high-density electrical mapping of auditory-somatosensory integration

Successful integration of signals from the various sensory systems is crucial for normal sensory-perceptual functioning, allowing for the perception of coherent objects rather than a disconnected cluster of fragmented features. Several prominent theories of autism suggest that automatic integration is impaired in this population, but there have been few empirical tests of this thesis. A standard electrophysiological metric of multisensory integration (MSI) was used to test the integrity of auditory-somatosensory integration in children with autism (N=17, aged 6-16 years), compared to age- and IQ-matched typically developing (TD) children. High-density electrophysiology was recorded while participants were presented with either auditory or somatosensory stimuli alone (unisensory conditions), or as a combined auditory-somatosensory stimulus (multisensory condition), in randomized order. Participants watched a silent movie during testing, ignoring concurrent stimulation. Significant differences between neural responses to the multisensory auditory-somatosensory stimulus and the unisensory stimuli (the sum of the responses to the auditory and somatosensory stimuli when presented alone) served as the dependent measure. The data revealed group differences in the integration of auditory and somatosensory information that appeared at around 175 ms, and were characterized by the presence of MSI for the TD but not the autism spectrum disorder (ASD) children. Overall, MSI was less extensive in the ASD group. These findings are discussed within the framework of current knowledge of MSI in typical development as well as in relation to theories of ASD.

Auditory-somatosensory multisensory interactions in humans: dissociating detection and spatial discrimination

Simple reaction times (RTs) to auditory-somatosensory (AS) multisensory stimuli are facilitated over their unisensory counterparts both when stimuli are delivered to the same location and when separated. In two experiments we addressed the possibility that top-down and/or task-related influences can dynamically impact the spatial representations mediating these effects and the extent to which multisensory facilitation will be observed. Participants performed a simple detection task in response to auditory, somatosensory, or simultaneous AS stimuli that in turn were either spatially aligned or misaligned by lateralizing the stimuli. Additionally, we also informed the participants that they would be retrogradely queried (one-third of trials) regarding the side where a given stimulus in a given sensory modality was presented. In this way, we sought to have participants attending to all possible spatial locations and sensory modalities, while nonetheless having them perform a simple detection task. Experiment 1 provided no cues prior to stimulus delivery. Experiment 2 included spatially uninformative cues (50% of trials). In both experiments, multisensory conditions significantly facilitated detection RTs with no evidence for differences according to spatial alignment (though general benefits of cuing were observed in Experiment 2). Facilitated detection occurs even when attending to spatial information. Performance with probes, quantified using sensitivity (d'), was impaired following multisensory trials in general and significantly more so following misaligned multisensory trials. This indicates that spatial information is not available, despite being task-relevant. The collective results support a model wherein early AS interactions may result in a loss of spatial acuity for unisensory information.

An exploratory event-related potential study of multisensory integration in sensory over-responsive children

Children who are over-responsive to sensation have defensive and "fight or flight" reactions to ordinary levels of sensory stimulation in the environment. Based on clinical observations, sensory over-responsivity is hypothesized to reflect atypical neural integration of sensory input. To examine a possible underlying neural mechanism of the disorder, integration of simultaneous multisensory auditory and somatosensory stimulation was studied in twenty children with sensory over-responsivity (SOR) using event-related potentials (ERPs). Three types of sensory stimuli were presented and ERPs were recorded from thirty-two scalp electrodes while participants watched a silent cartoon: bilateral auditory clicks, right somatosensory median nerve electrical pulses, or both simultaneously. The paradigm was passive; no behavioral responses were required. To examine integration, responses to simultaneous multisensory auditory-somatosensory stimulation were compared to the sum of unisensory auditory plus unisensory somatosensory responses in four time-windows: (60-80 ms, 80-110 ms, 110-150 ms, and 180-220 ms). Specific midline and lateral electrode sites were examined over scalp regions where auditory-somatosensory integration was expected based on previous studies. Midline electrode sites (Fz, Cz, and Pz) showed significant integration during two time-windows: 60-80 ms and 180-220 ms. Significant integration was also found at contralateral electrode site (C3) for the time-window between 180 and 220 ms. At ipsilateral electrode sites (C4 and CP6), no significant integration was found during any of the time-windows (i.e. the multisensory ERP was not significantly different from the summed unisensory ERP). These results demonstrate that MSI can be reliably measured in children with SOR and provide evidence that multisensory auditory-somatosensory input is integrated during both early and later stages of sensory information processing, mainly over fronto-central scalp regions.

Perspectives on sensory processing disorder: a call for translational research

THIS ARTICLE EXPLORES THE CONVERGENCE OF TWO FIELDS, WHICH HAVE SIMILAR THEORETICAL ORIGINS: a clinical field originally known as sensory integration and a branch of neuroscience that conducts research in an area also called sensory integration. Clinically, the term was used to identify a pattern of dysfunction in children and adults, as well as a related theory, assessment, and treatment method for children who have atypical responses to ordinary sensory stimulation. Currently the term for the disorder is sensory processing disorder (SPD). In neuroscience, the term sensory integration refers to converging information in the brain from one or more sensory domains. A recent subspecialty in neuroscience labeled multisensory integration (MSI) refers to the neural process that occurs when sensory input from two or more different sensory modalities converge. Understanding the specific meanings of the term sensory integration intended by the clinical and neuroscience fields and the term MSI in neuroscience is critical. A translational research approach would improve exploration of crucial research questions in both the basic science and clinical science. Refinement of the conceptual model of the disorder and the related treatment approach would help prioritize which specific hypotheses should be studied in both the clinical and neuroscience fields. The issue is how we can facilitate a translational approach between researchers in the two fields. Multidisciplinary, collaborative studies would increase knowledge of brain function and could make a significant contribution to alleviating the impairments of individuals with SPD and their families.

Early, low-level auditory-somatosensory multisensory interactions impact reaction time speed

Several lines of research have documented early-latency non-linear response interactions between audition and touch in humans and non-human primates. That these effects have been obtained under anesthesia, passive stimulation, as well as speeded reaction time tasks would suggest that some multisensory effects are not directly influencing behavioral outcome. We investigated whether the initial non-linear neural response interactions have a direct bearing on the speed of reaction times. Electrical neuroimaging analyses were applied to event-related potentials in response to auditory, somatosensory, or simultaneous auditory-somatosensory multisensory stimulation that were in turn averaged according to trials leading to fast and slow reaction times (using a median split of individual subject data for each experimental condition). Responses to multisensory stimulus pairs were contrasted with each unisensory response as well as summed responses from the constituent unisensory conditions. Behavioral analyses indicated that neural response interactions were only implicated in the case of trials producing fast reaction times, as evidenced by facilitation in excess of probability summation. In agreement, supra-additive non-linear neural response interactions between multisensory and the sum of the constituent unisensory stimuli were evident over the 40-84 ms post-stimulus period only when reaction times were fast, whereas subsequent effects (86-128 ms) were observed independently of reaction time speed. Distributed source estimations further revealed that these earlier effects followed from supra-additive modulation of activity within posterior superior temporal cortices. These results indicate the behavioral relevance of early multisensory phenomena.