Face representation in the human secondary somatosensory cortex

Face-hand sensorimotor interactions revealed by afferent inhibition

Reorganization of the sensorimotor cortex following permanent (e.g., amputation) or temporary (e.g., local anaesthesia) deafferentation of the hand has revealed large-scale plastic changes between the hand and face representations that are accompanied by perceptual correlates. The physiological mechanisms underlying this reorganization remain poorly understood. The aim of this study was to investigate sensorimotor interactions between the face and hand using an afferent inhibition transcranial magnetic stimulation protocol in which the motor evoked potential elicited by the magnetic pulse is inhibited when it is preceded by an afferent stimulus. We hypothesized that if face and hand representations in the sensorimotor cortex are functionally coupled, then electrocutaneous stimulation of the face would inhibit hand muscle motor responses. In two separate experiments, we delivered an electrocutaneous stimulus to either the skin over the right upper lip (Experiment 1) or right cheek (Experiment 2) and recorded muscular activity from the right first dorsal interosseous. Both lip and cheek stimulation inhibited right first dorsal interosseous motor evoked potentials. To investigate the specificity of this effect, we conducted two additional experiments in which electrocutaneous stimulation was applied to either the right forearm (Experiment 3) or right upper arm (Experiment 4). Forearm and upper arm stimulation also significantly inhibited the right first dorsal interosseous motor evoked potentials, but this inhibition was less robust than the inhibition associated with face stimulation. These findings provide the first evidence for face-to-hand afferent inhibition.

Application of Various Methods to Evaluate the Postoperative Characteristics of Expanded Pedicled Deltopectoral Flap for Large Facial Scars

ABSTRACT

The expanded pedicled deltopectoral flap (EPDF) has been widely used to repair large facial scars. Although doctors and patients are usually satisfied with the outcomes, the actual functional recovery and cosmetic effects of EPDF are still unknown. It is, therefore, necessary to objectively investigate the effect of transferred EPDF by using a variety of methods. From January 2008 to December 2018, 52 patients who underwent EPDF surgery at Xijing Hospital were enrolled. Sense of touch, static 2-point discrimination, elasticity, and color were measured. Thermesthesia and algesthesia were also tested. Postoperative scars were evaluated using the patient and observer scar assessment scale. Satisfaction of patients, doctors, and laypersons was investigated. The algaesthesis, thalposis, and rhigosis scores were 4.7 ± 0.7, 3.7 ± 0.9, and 4.5 ± 0.8, respectively. The tactile score was 0.3 ± 0.2 mN, and 2-point discrimination was 10.1 ± 4.8 mm. L*, a*, hemoglobin, and melanin content of the flaps were significantly different when compared with normal skin (P < 0.05). The satisfaction of doctors, patients, and laypersons was 88.5%, 71.2%, and 67.3%, respectively. The higher satisfaction of patients was mainly associated with the smaller color difference between the flap and the surrounding skin, and lower patient and observer scar assessment scale score. These results confirm that excellent functional recovery and reliable cosmetic effects are observed when facial scars are repaired with EPDF. The methods used in this study can be applied to the evaluation of functional recovery and cosmetic outcomes of transferred flaps, which may provide a more comprehensive understanding of flap assessment.

The signing body: extensive sign language practice shapes the size of hands and face

The representation of the metrics of the hands is distorted, but is susceptible to malleability due to expert dexterity (magicians) and long-term tool use (baseball players). However, it remains unclear whether modulation leads to a stable representation of the hand that is adopted in every circumstance, or whether the modulation is closely linked to the spatial context where the expertise occurs. To this aim, a group of 10 experienced Sign Language (SL) interpreters were recruited to study the selective influence of expertise and space localisation in the metric representation of hands. Experiment 1 explored differences in hands’ size representation between the SL interpreters and 10 age-matched controls in near-reaching (Condition 1) and far-reaching space (Condition 2), using the localisation task. SL interpreters presented reduced hand size in near-reaching condition, with characteristic underestimation of finger lengths, and reduced overestimation of hands and wrists widths in comparison with controls. This difference was lost in far-reaching space, confirming the effect of expertise on hand representations is closely linked to the spatial context where an action is performed. As SL interpreters are also experts in the use of their face with communication purposes, the effects of expertise in the metrics of the face were also studied (Experiment 2). SL interpreters were more accurate than controls, with overall reduction of width overestimation. Overall, expertise modifies the representation of relevant body parts in a specific and context-dependent manner. Hence, different representations of the same body part can coexist simultaneously.

The influence of joint attention and partner trustworthiness on cross-modal sensory cueing

Joint attention refers to the coordinated attention between social partners to an object of shared interest, usually involving shared gaze toward the object. In the laboratory, however, joint attention is often investigated using computerized gaze cueing tasks that do not allow shared gaze. Instead, these computerized tasks require the participant to maintain fixation on the virtual partner's face, while the partner gazes to the left or right. Here we designed a modified gaze cueing task that better simulates a natural joint attention episode by allowing shared gaze, while still maintaining tight experimental control. In our computerized task the participant's gaze and the gaze of a virtual partner were manipulated independently, resulting in shared or unshared gaze. Following each gaze shift of the virtual partner a touch stimulus was delivered on one of the cheeks of the participant. We analyzed behavioral and neural (electro-encephalography) responses to the touch. Faster reaction-times and stronger lateralization of alpha power were observed when the touched cheek was in a jointly attended hemispace compared with a singly attended or unattended hemispace. Importantly, these effects were unique to joint attention and could not be explained as the additive effects of own gaze and gaze cue direction. Underlining its social nature, we found that the behavioral effect was absent when we repeated our experiment with nonsocial cues (arrows) instead of gaze cues. Furthermore, when we compared trustworthy with untrustworthy virtual partners (trustworthiness judgements based on facial appearance) we found the effect only for trustworthy and not for untrustworthy virtual partners. We conclude that joint attention based on shared gaze influences attentional orienting such that cross-modal sensory processing at the jointly attended location is facilitated, particularly when the partner is trustworthy. This indicates that social interactions and trustworthiness judgements affect cortical and behavioral responses to sensory information.

My true face: Unmasking one's own face representation

Face recognition has been the focus of multiple studies, but little is still known on how we represent the structure of one's own face. Most of the studies have focused on the topic of visual and haptic face recognition, but the metric representation of different features of one's own face is relatively unknown. We investigated the metric representation of the face in young adults by developing a proprioceptive pointing task to locate face landmarks in the first-person perspective. Our data revealed a large overestimation of width for all face features which resembles, in part, the size in somatosensory cortical representation. In contrast, face length was compartmentalised in two different regions: upper (underestimated) and bottom (overestimated); indicating size differences possibly due to functionality. We also identified shifts of the location judgments, with all face areas perceived closer to the body than they really were, due to a potential influence of the self-frame of reference. More importantly, the representation of the face appeared asymmetrical, with an overrepresentation of right side of the face, due to the influence of lateralization biases for strong right-handers. We suggest that these effects may be due to functionality influences and experience that affect the construction of face structural representation, going beyond the parallel of the somatosensory homunculus.

An fMRI investigation of the neural correlates underlying the autonomous sensory meridian response (ASMR)

Introduction : The "autonomous sensory meridian response" (ASMR) is a neologism used to describe an internal sensation of deep relaxation and pleasant head tingling which is often stimulated by gentle sounds, light touch, and personal attention. Methods : An fMRI-based methodology was employed to examine the brain activation of subjects prescreened for ASMR-receptivity (n=10) as they watched ASMR videos and identified specific moments of relaxation and tingling. Results : Subjects who experienced ASMR showed significant activation in regions associated with both reward (NAcc) and emotional arousal (dACC and Insula/IFG). Brain activation during ASMR showed similarities to patterns previously observed in musical frisson as well as affiliative behaviors. Conclusion : This is the first study to measure the activation of various brain regions during ASMR and these results may help to reveal the mechanistic underpinnings of this sensation.

Tactile representation of the head and shoulders assessed by fMRI in the nonhuman primate

In nonhuman primates, tactile representation at the cortical level has mostly been studied using single-cell recordings targeted to specific cortical areas. In this study, we explored the representation of tactile information delivered to the face or the shoulders at the whole brain level, using functional magnetic resonance imaging (fMRI) in the nonhuman primate. We used air puffs delivered to the center of the face, the periphery of the face, or the shoulders. These stimulations elicited activations in numerous cortical areas, encompassing the primary and secondary somatosensory areas, prefrontal and premotor areas, and parietal, temporal, and cingulate areas as well as low-level visual cortex. Importantly, a specific parieto-temporo-prefrontal network responded to the three stimulations but presented a marked preference for air puffs directed to the center of the face. This network corresponds to areas that are also involved in near-space representation, as well as in the multisensory integration of information at the interface between this near space and the skin of the face, and is probably involved in the construction of a peripersonal space representation around the head.

Depicting the inner and outer nose: the representation of the nose and the nasal mucosa on the human primary somatosensory cortex (SI)

The nose is important not only for breathing, filtering air, and perceiving olfactory stimuli. Although the face and hands have been mapped, the representation of the internal and external surface of the nose on the primary somatosensory cortex (SI) is still poorly understood. To fill this gap functional magnetic resonance imaging (fMRI) was used to localize the nose and the nasal mucosa in the Brodman areas (BAs) 3b, 1, and 2 of the human postcentral gyrus (PG). Tactile stimulation during fMRI was applied via a customized pneumatically driven device to six stimulation sites: the alar wing of the nose, the lateral nasal mucosa, and the hand (serving as a reference area) on the left and right side of the body. Individual representations could be discriminated for the left and right hand, for the left nasal mucosa and left alar wing of the nose in BA 3b and BA 1 by comparing mean activation maxima and Euclidean distances. Right-sided nasal conditions and conditions in BA 2 could further be separated by different Euclidean distances. Regarding the alar wing of the nose, the results concurred with the classic sensory homunculus proposed by Penfield and colleagues. The nasal mucosa was not only determined an individual and bilateral representation, its position on the somatosensory cortex is also situated closer to the caudal end of the PG compared to that of the alar wing of the nose and the hand. As SI is commonly activated during the perception of odors, these findings underscore the importance of the knowledge of the representation of the nasal mucosa on the primary somatosensory cortex, especially for interpretation of results of functional imaging studies about the sense of smell.

A time-varying source connectivity approach to reveal human somatosensory information processing

Exploration of neural sources and their effective connectivity based on transient changes in electrophysiological activities to external stimuli is important for understanding brain mechanisms of sensory information processing. However, such cortical mechanisms have not yet been well characterized in electrophysiological studies since (1) it is difficult to estimate the stimulus-activated neural sources and their activities and (2) it is difficult to identify transient effective connectivity between neural sources in the order of milliseconds. To address these issues, we developed a time-varying source connectivity approach to effectively capture fast-changing information flows between neural sources from high-density Electroencephalography (EEG) recordings. This time-varying source connectivity approach was applied to somatosensory evoked potentials (SEPs), which were elicited by electrical stimulation of right hand and recorded using 64 channels from 16 subjects, to reveal human somatosensory information processing. First, SEP sources and their activities were estimated, both at single-subject and group level, using equivalent current dipolar source modeling. Then, the functional integration among SEP sources was explored using a Kalman smoother based time-varying effective connectivity inference method. The results showed that SEPs were mainly generated from the contralateral primary somatosensory cortex (SI), bilateral secondary somatosensory cortex (SII), and cingulate cortex (CC). Importantly, we observed a serial processing of somatosensory information in human somatosensory cortices (from SI to SII) at earlier latencies (<150 ms) and a reciprocal processing between SII and CC at later latencies (>200 ms).

The face as a sensory organ

BACKGROUND

The human face is a highly specialized organ for receiving the sensory information from the environment and for its transmission to the cortex. The advent of facial transplantation has shown that excellent reconstruction of disfiguring defects can be achieved; thus, the expectations are now focused on functional recovery of the transplant. So far, restoration of facial sensation has not received the same attention as the recovery of motor function.

METHODS

A thorough review of the literature was performed to investigate the current knowledge on the sensory pathways of the human face and their functions to evaluate current methods of sensory assessment and the available data on normal sensation.

RESULTS

The presence of Meissner and Ruffini corpuscles, Merkel disks, hair-associated fibers, and intraepidermal free nerve endings was confirmed. Occurrence of extensive cross-communications between trigeminal and facial nerve was substantiated. Two-point discrimination and pressure thresholds represented the most objective measures of facial sensation. Age, sex, and smoker status of the patients were shown to influence normal sensibility values. The most suitable areas for sensory testing based on the tested modality and innervation were inferred. The anatomical course of the nerves and their variations had implications for the harvest of face allografts and repair of the sensory nerves.

CONCLUSIONS

This review has illustrated the complexity of sensory pathways of the face and their influence on somatic and visceral responses. In view of the discussed data, during facial transplantation, it is important to consider different mechanisms of restoration of facial sensation.

Somatosensory processing of the tongue in humans

We review research on somatosensory (tactile) processing of the tongue based on data obtained using non-invasive neurophysiological and neuroimaging methods. Technical difficulties in stimulating the tongue, due to the noise elicited by the stimulator, the fixation of the stimulator, and the vomiting reflex, have necessitated the development of specialized devices. In this article, we show the brain activity relating to somatosensory processing of the tongue evoked by such devices. More recently, the postero-lateral part of the tongue has been stimulated, and the brain response compared with that on stimulation of the antero-lateral part of the tongue. It is likely that a difference existed in somatosensory processing of the tongue, particularly around primary somatosensory cortex, Brodmann area 40, and the anterior cingulate cortex.

fMRI reflects functional connectivity of human somatosensory cortex

Unilateral sensory stimulation reliably elicits contralateral somatotopic activation of primary (SI) and secondary (SII) somatosensory cortex. There is an ongoing debate about the occurrence and nature of concomitant ipsilateral SI and SII activation. Here we used functional magnetic resonance imaging (fMRI) in healthy human subjects with unilateral tactile stimulation of fingers and lips, to compare somatosensory activation patterns from distal and proximal body parts. We hypothesized that fMRI in humans should reflect the functional connectivity of somatosensory cortex as predicted by animal studies. We show that both unilateral finger and lip stimulations activate contra- and ipsilateral SI and SII cortices with high detection frequency. Correlations of BOLD-signals to the applied hemodynamic reference function were significantly higher in contralateral as compared to ipsilateral SI and SII cortices for both finger and lip stimulation, reflecting strong contribution of contralateral thalamocortical input. Furthermore, BOLD-signal correlations were higher in SI than in SII activations on the contralateral but not on the ipsilateral side. While these asymmetries within and across hemispheres were consistent for finger and lip stimulations, indicating analogous underlying organizing principles, they were less prominent for lip stimulation. Somatotopic organization was detected in SI but not in SII representations of fingers and lips. These results qualitatively and quantitatively support the prevalent concepts of anatomical and functional connectivity in the somatosensory system and therefore may allow interpretation of sensory evoked fMRI signals in terms of normal human brain function. Thus, the assessment of human somatosensory function with fMRI may permit in the future investigations of pathological conditions.

Dodecapus: An MR-compatible system for somatosensory stimulation

Somatotopic mapping of human body surface using fMRI is challenging. First, it is difficult to deliver tactile stimuli in the scanner. Second, multiple stimulators are often required to cover enough area of the complex-shaped body surface, such as the face. In this study, a computer-controlled pneumatic system was constructed to automatically deliver air puffs to 12 locations on the body surface through an MR-compatible manifold (Dodecapus) mounted on a head coil inside the scanner bore. The timing of each air-puff channel is completely programmable and this allows systematic and precise stimulation on multiple locations on the body surface during functional scans. Three two-condition block-design "Localizer" paradigms were employed to localize the cortical representations of the face, lips, and fingers, respectively. Three "Phase-encoded" paradigms were employed to map the detailed somatotopic organizations of the face, lips, and fingers following each "Localizer" paradigm. Multiple somatotopic representations of the face, lips, and fingers were localized and mapped in primary motor cortex (MI), ventral premotor cortex (PMv), polysensory zone (PZ), primary (SI) and secondary (SII) somatosensory cortex, parietal ventral area (PV) and 7b, as well as anterior and ventral intraparietal areas (AIP and VIP). The Dodecapus system is portable, easy to setup, generates no radio frequency interference, and can also be used for EEG and MEG experiments. This system could be useful for non-invasive somatotopic mapping in both basic and clinical studies.

The Helix: A multi-modal tactile stimulator for human functional neuroimaging

In order to expand the repertoire of somatosensory functions that can be effectively studied through functional MRI, we have developed a tactile stimulator which can deliver rich and varied combinations of stimulation that simulate natural tactile exploration. The system is computer controlled and compatible with an MRI environment. Complex aspects of somesthesis can thus be studied independent of confounds introduced by motor activity or problems with precision, accuracy or reproducibility of stimulus delivery.

Somatosensory evoked magnetic fields to air-puff stimulation on the soft palate

Impairment of sensory input to the soft palate has been reported in patients with obstructive sleep apnea syndrome. To investigate the reaction in the central nervous system related to soft palate perception, we measured the somatosensory evoked magnetic fields following air-puff stimulation in seven healthy volunteers by using a helmet-shaped 122-channel neuromagnetometer. The air-puffs were produced using compressed nitrogen and directed to the middle of the soft palate with an intraoral device. To evaluate the laterality of responses we used another appliance in which the air-puffs were directed to the middle and right side of the soft palate. In all the subjects, responses were identified symmetrically in the bilateral parietotemporal regions with a mean latency of about 130 ms from the soft palate stimulation. Prior to this peak, no distinct early responses were observed. There was no significant difference in the responses between the middle and right side stimulation. Corresponding equivalent current dipoles were estimated around the Sylvian fissures. These results suggested that the responses were derived from the second somatosensory areas. In conclusion, we could record long-latency responses to air-puff stimulation of the soft palate in the bilateral second somatosensory areas.