TMS in cognitive neuroscience: Virtual lesion and beyond

Disability and persistent motor deficits are linked to structural crossed cerebellar diaschisis in chronic stroke

Brain imaging has significantly contributed to our understanding of the cerebellum being involved in recovery after non-cerebellar stroke. Due to its connections with supratentorial brain networks, acute stroke can alter the function and structure of the contralesional cerebellum, known as crossed cerebellar diaschisis (CCD). Data on the spatially precise distribution of structural CCD and their implications for persistent deficits after stroke are notably limited. In this cross-sectional study, structural MRI and clinical data were analyzed from 32 chronic stroke patients, at least 6 months after the event. We quantified lobule-specific contralesional atrophy, as a surrogate of structural CCD, in patients and healthy controls. Volumetric data were integrated with clinical scores of disability and motor deficits. Diaschisis-outcome models were adjusted for the covariables age, lesion volume, and damage to the corticospinal tract. We found that structural CCD was evident for the whole cerebellum, and particularly for lobules V and VI. Lobule VI diaschisis was significantly correlated with clinical scores, that is, volume reductions in contralesional lobule VI were associated with higher levels of disability and motor deficits. Lobule V and the whole cerebellum did not show similar diaschisis-outcome relationships across the spectrum of the clinical scores. These results provide novel insights into stroke-related cerebellar plasticity and might thereby promote lobule VI as a key area prone to structural CCD and potentially involved in recovery and residual motor functioning.

Rapid estimation of cortical neuron activation thresholds by transcranial magnetic stimulation using convolutional neural networks

BACKGROUND

Transcranial magnetic stimulation (TMS) can modulate neural activity by evoking action potentials in cortical neurons. TMS neural activation can be predicted by coupling subject-specific head models of the TMS-induced electric field (E-field) to populations of biophysically realistic neuron models; however, the significant computational cost associated with these models limits their utility and eventual translation to clinically relevant applications.

OBJECTIVE

To develop computationally efficient estimators of the activation thresholds of multi-compartmental cortical neuron models in response to TMS-induced E-field distributions.

METHODS

Multi-scale models combining anatomically accurate finite element method (FEM) simulations of the TMS E-field with layer-specific representations of cortical neurons were used to generate a large dataset of activation thresholds. 3D convolutional neural networks (CNNs) were trained on these data to predict thresholds of model neurons given their local E-field distribution. The CNN estimator was compared to an approach using the uniform E-field approximation to estimate thresholds in the non-uniform TMS-induced E-field.

RESULTS

The 3D CNNs estimated thresholds with mean absolute percent error (MAPE) on the test dataset below 2.5% and strong correlation between the CNN predicted and actual thresholds for all cell types (R2 > 0.96). The CNNs estimated thresholds with a 2-4 orders of magnitude reduction in the computational cost of the multi-compartmental neuron models. The CNNs were also trained to predict the median threshold of populations of neurons, speeding up computation further.

CONCLUSION

3D CNNs can estimate rapidly and accurately the TMS activation thresholds of biophysically realistic neuron models using sparse samples of the local E-field, enabling simulating responses of large neuron populations or parameter space exploration on a personal computer.

Behavioral Differences Across Theta Burst Stimulation Protocols. A Study on the Sense of Agency in Healthy Humans

Background

Theta burst stimulation (TBS) is a non-invasive brain stimulation method. Various stimulation protocols have been proposed, for instance, stimulation at 50 Hz with pattern at 5 Hz, or at 30 Hz with pattern at 6 Hz. To identify better stimulation parameters for behavioral applications, we investigated the effects of 50-Hz continuous TBS (cTBS) on the sense of agency (SoA), and compared them with a previously published study with 30-Hz cTBS.

Methods

Based on power analysis from a previous sample using two applications of 30-Hz cTBS, we recruited 20 healthy subjects in a single-blind, Vertex-controlled, randomized, crossover trial. Participants were stimulated with one application of 50-Hz cTBS over the right posterior parietal cortex (rPPC), a key area for agency processing, and the vertex, in a random order. A behavioral task targeting the SoA was done before and after stimulation. After controlling for baseline differences across samples, we studied the effect of stimulation in the two protocols separately.

Results

Compared to the previously published 30-Hz protocol, 50-Hz cTBS over the rPPC did not reveal significant changes in the SoA, similar to sham Vertex stimulation.

Conclusion

One application of 50-Hz cTBS was not sufficient to elicit behavioral effects, compared to two applications of 30-Hz cTBS, as previously described. This may be due to a mechanism of synaptic plasticity, consolidated through consecutive stimulation cycles. Our results are relevant for future studies aiming at modulating activity of the rPPC in cognitive domains other than agency, and in patients affected by abnormal agency, who could benefit from treatment options based on TBS.

An Overview of Noninvasive Brain Stimulation: Basic Principles and Clinical Applications

The brain has the innate ability to undergo neuronal plasticity, which refers to changes in its structure and functions in response to continued changes in the environment. Although these concepts are well established in animal slice preparation models, their application to a large number of human subjects could only be achieved using noninvasive brain stimulation (NIBS) techniques. In this review, we discuss the mechanisms of plasticity induction using NIBS techniques including transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), transcranial alternating current stimulation (tACS), random noise stimulation (RNS), transcranial ultrasound stimulation (TUS), vagus nerve stimulation (VNS), and galvanic vestibular stimulation (GVS). We briefly introduce these techniques, explain the stimulation parameters and potential clinical implications. Although their mechanisms are different, all these NIBS techniques can be used to induce plasticity at the systems level, to examine the neurophysiology of brain circuits and have potential therapeutic use in psychiatric and neurological disorders. TMS is the most established technique for the treatment of brain disorders, and repetitive TMS is an approved treatment for medication-resistant depression. Although the data on the clinical utility of the other modes of stimulation are more limited, the electrical stimulation techniques (tDCS, tACS, RNS, VNS, GVS) have the advantage of lower cost, portability, applicability at home, and can readily be combined with training or rehabilitation. Further research is needed to expand the clinical utility of NIBS and test the combination of different modes of NIBS to optimize neuromodulation induced clinical benefits.

The Neurological Asymmetry of Self-Face Recognition

While the desire to uncover the neural correlates of consciousness has taken numerous directions, self-face recognition has been a constant in attempts to isolate aspects of self-awareness. The neuroimaging revolution of the 1990s brought about systematic attempts to isolate the underlying neural basis of self-face recognition. These studies, including some of the first fMRI (functional magnetic resonance imaging) examinations, revealed a right-hemisphere bias for self-face recognition in a diverse set of regions including the insula, the dorsal frontal lobe, the temporal parietal junction, and the medial temporal cortex. In this systematic review, we provide confirmation of these data (which are correlational) which were provided by TMS (transcranial magnetic stimulation) and patients in which direct inhibition or ablation of right-hemisphere regions leads to a disruption or absence of self-face recognition. These data are consistent with a number of theories including a right-hemisphere dominance for self-awareness and/or a right-hemisphere specialization for identifying significant social relationships, including to oneself.

Causal Inferences in Repetitive Transcranial Magnetic Stimulation Research: Challenges and Perspectives

Transcranial magnetic stimulation (TMS) is used to make inferences about relationships between brain areas and their functions because, in contrast to neuroimaging tools, it modulates neuronal activity. The central aim of this article is to critically evaluate to what extent it is possible to draw causal inferences from repetitive TMS (rTMS) data. To that end, we describe the logical limitations of inferences based on rTMS experiments. The presented analysis suggests that rTMS alone does not provide the sort of premises that are sufficient to warrant strong inferences about the direct causal properties of targeted brain structures. Overcoming these limitations demands a close look at the designs of rTMS studies, especially the methodological and theoretical conditions which are necessary for the functional decomposition of the relations between brain areas and cognitive functions. The main points of this article are that TMS-based inferences are limited in that stimulation-related causal effects are not equivalent to structure-related causal effects due to TMS side effects, the electric field distribution, and the sensitivity of neuroimaging and behavioral methods in detecting structure-related effects and disentangling them from confounds. Moreover, the postulated causal effects can be based on indirect (network) effects. A few suggestions on how to manage some of these limitations are presented. We discuss the benefits of combining rTMS with neuroimaging in experimental reasoning and we address the restrictions and requirements of rTMS control conditions. The use of neuroimaging and control conditions allows stronger inferences to be gained, but the strength of the inferences that can be drawn depends on the individual experiment's designs. Moreover, in some cases, TMS might not be an appropriate method of answering causality-related questions or the hypotheses have to account for the limitations of this technique. We hope this summary and formalization of the reasoning behind rTMS research can be of use not only for scientists and clinicians who intend to interpret rTMS results causally but also for philosophers interested in causal inferences based on brain stimulation research.

The role of the right posterior parietal cortex in prism adaptation and its aftereffects

Adaptation to optical prisms (Prismatic Adaptation, PA) displacing the visual scene laterally, on one side of visual space, is both a procedure for investigating visuo-motor plasticity and a powerful tool for the rehabilitation of Unilateral Spatial Neglect (USN). Two processes are involved in PA: i) recalibration (the reduction of the error of manual pointings toward the direction of the prism-induced displacement of the visual scene); ii) the successive realignment after prisms' removal, indexed by the Aftereffects (AEs, in egocentric straight-ahead pointing tasks, the deviation in a direction opposite to the visual displacement previously induced by prisms). This study investigated the role of the posterior parietal cortex (PPC) of the right hemisphere in PA and AEs, by means of low frequency repetitive Transcranial Magnetic Stimulation (rTMS). Proprioceptive and Visuo-proprioceptive egocentric straight-ahead pointing tasks were used to assess the presence and magnitude of AEs. The primary right visual cortex (V1) was also stimulated, to assess the selectivity of the PPC effects on the two processes of PA (recalibration and realignment) in comparison with a cortical region involved in visual processing. Results showed a slower adaptation to prisms when rTMS was delivered before PA, regardless of target site (right PPC or V1). AEs were reduced only by PPC rTMS applied before or after PA, as compared to a sham stimulation. These findings suggest a functional and neural dissociation between realignment and recalibration. Indeed, PA interference was induced by rTMS to both the PPC and V1, indicating that recalibration is supported by a parieto-occipital network. Conversely, AEs were disrupted only by rTMS delivered to the PPC, thus unveiling a relevant role of this region in the development and maintenance of the realignment.

Transcranial magnetic stimulation over the right temporoparietal junction influences the sense of agency in healthy humans

Background

The sense of agency is an important aspect of motor control. Impaired sense of agency has been linked to several medical conditions, including schizophrenia and functional neurological disorders. A complex brain network subserves the sense of agency, and the right temporoparietal junction is one of its main nodes. In this paper, we tested whether transcranial magnetic stimulation over the right temporoparietal junction elicited behavioural changes in the sense of agency.

Methods

In experiment 1, 15 healthy participants performed a behavioural task during functional MRI, with the goal of localizing the area relevant for the sense of agency in the right temporoparietal junction. In the task, the movement of a cursor (controlled by the participants) was artificially manipulated, and the sense of agency was either diminished (turbulence) or enhanced (magic). In experiment 2, we applied transcranial magnetic stimulation in 20 healthy participants in a sham-controlled, crossover trial with excitatory, inhibitory or sham (vertex) stimulation. We measured the summary agency score, an indicator of the sense of agency (lower values correspond to diminished sense of agency).

Results

Experiment 1 revealed a peak of activation during agency manipulation in the right temporoparietal junction (Montreal Neurological Institute coordinates x, y, z: 68, -26, 34). Experiment 2 showed that inhibition of the right temporoparietal junction significantly reduced the summary agency score in both turbulence (from -14.4 ± 11.4% to -22.5 ± 8.9%), and magic (from -0.7 ± 5.8% to -4.4 ± 4.4%).

Limitations

We found no excitatory effects, possibly because of a ceiling effect (because healthy participants have a normal sense of agency) or noneffectiveness of the excitatory protocol.

Conclusion

Our experiments showed that the network subserving the sense of agency was amenable to neuromodulation in healthy participants. This sets the ground for further research in patients with impaired sense of agency. Clinical trial identification: DRKS00012992 (German clinical trials registry).

The "virtual lesion" approach to transcranial magnetic stimulation: studying the brain-behavioral relationships in experimental pain

Transcranial magnetic stimulation (TMS) can be used to create a temporary “virtual lesion” (VL) of a target cortical area, disrupting its function and associated behavior. Transcranial magnetic stimulation can therefore test the functional role of specific brain areas. This scoping review aims at investigating the current literature of the “online” TMS-evoked VL approach to studying brain–behavioral relationships during experimental pain in healthy subjects. Ovid-Medline, Embase, and Web of Science electronic databases were searched. Included studies tested different TMS-based VLs of various pain brain areas during continuous experimental pain or when time-locked to a noxious stimulus. Outcome measures assessed different pain measurements. Initial screening resulted in a total of 403 studies, of which 17 studies were included in the review. The VLs were directed to the prefrontal, primary and secondary somatosensory, primary motor, and parietal cortices through single/double/triple/sequence of five-TMS pulses or through repeated TMS during mechanical, electrical contact, radiant heat, or capsaicin-evoked noxious stimulation. Despite a wide variability among the VL protocols, outcome measures, and study designs, a behavioral VL effect (decrease or increase in pain responses) was achieved in the majority of the studies. However, such findings on the relationships between the modified brain activity and the manifested pain characteristics were often mixed. To conclude, TMS–elicited VLs during experimental pain empower our understanding of brain–behavior relationships at specific time points during pain processing. The mixed findings of these relationships call for an obligatory standard of all pain-related TMS protocols for clearly determining the magnitude and direction of TMS-induced behavioral effects.

MR imaging central thalamic deep brain stimulation restored autistic-like social deficits in the rat

BACKGROUND

Social deficit is a core symptom in autism spectrum disorder (ASD). Although deep brain stimulation (DBS) has been proposed as a potential treatment for ASD, an ideal target nucleus is yet to be identified. DBS at the central thalamic nucleus (CTN) is known to alter corticostriatal and limbic circuits, and subsequently increase the exploratory motor behaviors, cognitive performance, and skill learning in neuropsychiatric and neurodegenerative disorders.

OBJECTIVE

We first investigated the ability of CTN-DBS to selectively engage distinct brain circuits and compared the spatial distribution of evoked network activity and modulation. Second, we investigated whether CTN-DBS intervention improves social interaction in a valproic acid-exposed ASD rat offspring model.

METHODS

Brain regions activated through CTN-DBS by using a magnetic resonance (MR)-compatible neural probe, which is capable of inducing site-selective microstimulations during functional MRI (fMRI), were investigated. We then performed functional connectivity MRI, the three-chamber social interaction test, and Western blotting analyses to evaluate the therapeutic efficacy of CTN-DBS in an ASD rat offspring model.

RESULTS

The DBS-evoked fMRI results indicated that the activated brain regions were mainly located in cortical areas, limbic-related areas, and the dorsal striatum. We observed restoration of brain functional connectivity (FC) in corticostriatal and corticolimbic circuits after CTN-DBS, accompanied with increased social interaction and decreased social avoidance in the three-chamber social interaction test. The dopamine D2 receptor decreased significantly after CTN-DBS treatment, suggesting changes in synaptic plasticity and alterations in the brain circuits.

CONCLUSIONS

Applying CTN-DBS to ASD rat offspring increased FC and altered the synaptic plasticity in the corticolimbic and the corticostriatal circuits. This suggests that CTN-DBS could be an effective treatment for improving the social behaviors of individuals with ASD.

Effects of continuous theta-burst stimulation of the primary motor and secondary somatosensory areas on the central processing and the perception of trigeminal nociceptive input in healthy volunteers

Supplemental Digital Content is Available in the Text.

Inactivating paired continuous theta-burst stimulation of the primary motor cortex but not on the secondary somatosensory area flattened the relationship between brain activation and stimulus strength while not impacting on the subjective perceptions.

Noninvasive modulation of the activity of pain-related brain regions by means of transcranial magnetic stimulation promises an innovative approach at analgesic treatments. However, heterogeneous successes in pain modulation by setting reversible “virtual lesions” at different brain areas point at unresolved problems including the optimum stimulation site. The secondary somatosensory cortex (S2) has been previously identified to be involved in the perception of pain-intensity differences. Therefore, impeding its activity should impede the coding of the sensory component of pain intensity, resulting in a flattening of the relationship between pain intensity and physical stimulus strength. This was assessed using inactivating spaced continuous theta-burst stimulation (cTBS) in 18 healthy volunteers. In addition, cTBS was applied on the primary motor cortex (M1) shown previously to yield moderate and variable analgesic effects, whereas sham stimulation at both sites served as placebo condition. Continuous theta-burst stimulation flattened the relationship between brain activation and stimulus strength, mainly at S2, the insular cortex, and the postcentral gyrus (16 subjects analyzed). However, these effects were observed after inactivation of M1 while this effect was not observed after inactivation of S2. Nevertheless, both the M1 and the S2-spaced cTBS treatment were not reflected in the ratings of the nociceptive stimuli of different strengths (17 subjects analyzed), contrasting with the clear coding of stimulus strength by these data. Hence, while modulating the central processing of nociceptive input, cTBS failed to produce subjectively relevant changes in pain perception, indicating that the method in the present implementation is still unsuitable for clinical application.

How is electrical stimulation of the brain experienced, and how can we tell? Selected considerations on sensorimotor function and speech

Electrical stimulation of the nervous system is a powerful tool for localizing and examining the function of numerous brain regions. Delivered to certain regions of the cerebral cortex, electrical stimulation can evoke a variety of first-order effects, including observable movements or an urge to move, or somatosensory, visual, or auditory percepts. In still other regions the subject may be oblivious to the stimulation. Often overlooked, however, is whether the subject is aware of the stimulation, and if so, how the stimulation is experienced by the subject. In this review of how electrical stimulation has been used to study selected aspects of sensorimotor and language function, we raise questions that future studies might address concerning the subjects' second-order experiences of intention and agency regarding evoked movements, of the naturalness of evoked sensory percepts, and of other qualia that might be evoked in the absence of an overt first-order experience.

Can a single pulse transcranial magnetic stimulation targeted to the motor cortex interrupt pain processing?

The modulatory role of the primary motor cortex (M1), reflected by an inhibitory effect of M1-stimulation on clinical pain, motivated us to deepen our understanding of M1’s role in pain modulation. We used Transcranial Magnetic Stimulation (TMS)-induced virtual lesion (VL) to interrupt with M1 activity during noxious heat pain. We hypothesized that TMS-VL will effect experimental pain ratings. Three VL protocols were applied consisting of single-pulse TMS to transiently interfere with right M1 activity: (1) VL_M1- TMS applied to 11 subjects, 20 msec before the individual’s first pain-related M1 peak activation, as determined by source analysis (sLORETA), (2) VL_-50 (N = 16; TMS applied 50 ms prior to noxious stimulus onset), and (3) VL₊₁₅₀ (N = 16; TMS applied 150 ms after noxious stimulus onset). Each protocol included 3 conditions ('pain-alone', ' TMS-VL', and ‘SHAM-VL’), each consisted of 30 noxious heat stimuli. Pain ratings were compared, in each protocol, for TMS-VL vs. SHAM-VL and vs. pain-alone conditions. Repeated measures analysis of variance, corrected for multiple comparisons revealed no significant differences in the pain ratings between the different conditions within each protocol. Therefore, our results from this exploratory study suggest that a single pulse TMS-induced VL that is targeted to M1 failed to interrupt experimental pain processing in the specific three stimulation timing examined here.

Morphology controls how hippocampal CA1 pyramidal neuron responds to uniform electric fields: a biophysical modeling study

Responses of different neurons to electric field (EF) are highly variable, which depends on intrinsic properties of cell type. Here we use multi-compartmental biophysical models to investigate how morphologic features affect EF-induced responses in hippocampal CA1 pyramidal neurons. We find that the basic morphologies of neuronal elements, including diameter, length, bend, branch, and axon terminals, are all correlated with somatic depolarization through altering the current sources or sinks created by applied field. Varying them alters the EF threshold for triggering action potentials (APs), and then determines cell sensitivity to suprathreshold field. Introducing excitatory postsynaptic potential increases cell excitability and reduces morphology-dependent EF firing threshold. It is also shown that applying identical subthreshold EF results in distinct polarizations on cell membrane with different realistic morphologies. These findings shed light on the crucial role of morphologies in determining field-induced neural response from the point of view of biophysical models. The predictions are conducive to better understanding the variability in modulatory effects of EF stimulation at the cellular level, which could also aid the interpretations of how applied fields activate central nervous system neurons and affect relevant circuits.

The role of the supplementary motor area for speech and language processing

Apart from its function in speech motor control, the supplementary motor area (SMA) has largely been neglected in models of speech and language processing in the brain. The aim of this review paper is to summarize more recent work, suggesting that the SMA has various superordinate control functions during speech communication and language reception, which is particularly relevant in case of increased task demands. The SMA is subdivided into a posterior region serving predominantly motor-related functions (SMA proper) whereas the anterior part (pre-SMA) is involved in higher-order cognitive control mechanisms. In analogy to motor triggering functions of the SMA proper, the pre-SMA seems to manage procedural aspects of cognitive processing. These latter functions, among others, comprise attentional switching, ambiguity resolution, context integration, and coordination between procedural and declarative memory structures. Regarding language processing, this refers, for example, to the use of inner speech mechanisms during language encoding, but also to lexical disambiguation, syntax and prosody integration, and context-tracking.

Transcranial magnetic stimulation (TMS) inhibits cortical dendrites

One of the leading approaches to non-invasively treat a variety of brain disorders is transcranial magnetic stimulation (TMS). However, despite its clinical prevalence, very little is known about the action of TMS at the cellular level let alone what effect it might have at the subcellular level (e.g. dendrites). Here, we examine the effect of single-pulse TMS on dendritic activity in layer 5 pyramidal neurons of the somatosensory cortex using an optical fiber imaging approach. We find that TMS causes GABAB-mediated inhibition of sensory-evoked dendritic Ca(2+) activity. We conclude that TMS directly activates fibers within the upper cortical layers that leads to the activation of dendrite-targeting inhibitory neurons which in turn suppress dendritic Ca(2+) activity. This result implies a specificity of TMS at the dendritic level that could in principle be exploited for investigating these structures non-invasively.

Thematic role assignment in the posterior parietal cortex: A TMS study

Verbs denote relations between entities acting a role in an event. Thematic roles are essential to the correct use of verbs and involve both semantic and syntactic aspects. We used repetitive Transcranial Magnetic Stimulation (rTMS) to study the involvement of three different left parietal sites in the understanding of thematic roles. In a sentence-to-picture matching task, twelve participants were asked to judge whether or not a given picture matched with a written sentence. Pictures represented simple reversible actions, and sentences were in the active or passive diathesis. Whereas both active and passive sentences require the correct encoding of thematic roles, passives also imply thematic reanalysis, as the canonical order of thematic roles is systematically reversed. The experiment was divided in three sessions. In each session a different parietal site (anterior, middle, posterior) was stimulated at 5 Hz in an event-related fashion, time-locked to the presentation of visual stimuli. Results showed increased accuracy for passive sentences following posterior parietal stimulation. The effect appeared to be (a) TMS-related, as no effect was observed in a control, no-TMS experiment with eighteen new participants; (b) independent from semantic processes involved in word-picture association, as no TMS-related effects were observed in a picture-word matching task. We interpret the results as showing that the posterior parietal site is specifically involved in the assignment of thematic roles, in particular when the correct interpretation of a sentence requires reanalysis of temporarily encoded thematic roles, as in passive reversible sentences.

[Transcranial magnetic stimulation (TMS), inhibition processes and attention deficit/hyperactivity disorder (ADHD) - an overview]

Motor system excitability can be tested by transcranial magnetic stimulation CFMS). In this article, an overview of recent methodological developments and research findings related to attention deficit/hyperactivity disorder (ADHD) is provided. Different TMS parameters that reflect the function of interneurons in the motor cortex may represent neurophysiological markers of inhibition in ADHD, particularly the so-called intracortical inhibition. In children with a high level of hyperactivity and impulsivity, intracortical inhibition was comparably low at rest as shortly before the execution of a movement. TMS-evoked potentials can also be measured in the EEG so that investigating processes of excitability is not restricted to motor areas in future studies. The effects of methylphenidate on motor system excitability may be interpreted in the sense of a 'fine-tuning' with these mainly dopaminergic effects also depending on genetic parameters (DAT1 transporter). A differentiated view on the organization of motor control can be achieved by a combined analysis of TMS parameters and event-related potentials. Applying this bimodal approach, strong evidence for a deviant implementation of motor control in children with ADHD and probably compensatory mechanisms (with involvement of the prefrontal cortex) was obtained. These findings, which contribute to a better understanding of hyperactivity/impulsivity, inhibitory processes and motor control in ADHD as well as the mechanisms of medication, underline the relevance of TMS as a neurophysiological method in ADHD research.

Attention fine-tunes auditory-motor processing of speech sounds

The earliest stages of cortical processing of speech sounds take place in the auditory cortex. Transcranial magnetic stimulation (TMS) studies have provided evidence that the human articulatory motor cortex contributes also to speech processing. For example, stimulation of the motor lip representation influences specifically discrimination of lip-articulated speech sounds. However, the timing of the neural mechanisms underlying these articulator-specific motor contributions to speech processing is unknown. Furthermore, it is unclear whether they depend on attention. Here, we used magnetoencephalography and TMS to investigate the effect of attention on specificity and timing of interactions between the auditory and motor cortex during processing of speech sounds. We found that TMS-induced disruption of the motor lip representation modulated specifically the early auditory-cortex responses to lip-articulated speech sounds when they were attended. These articulator-specific modulations were left-lateralized and remarkably early, occurring 60-100 ms after sound onset. When speech sounds were ignored, the effect of this motor disruption on auditory-cortex responses was nonspecific and bilateral, and it started later, 170 ms after sound onset. The findings indicate that articulatory motor cortex can contribute to auditory processing of speech sounds even in the absence of behavioral tasks and when the sounds are not in the focus of attention. Importantly, the findings also show that attention can selectively facilitate the interaction of the auditory cortex with specific articulator representations during speech processing.

Effects of extremely low-frequency magnetic fields on the response of a conductance-based neuron model

To provide insights into the modulation of neuronal activity by extremely low-frequency (ELF) magnetic field (MF), we present a conductance-based neuron model and introduce ELF sinusoidal MF as an additive voltage input. By analyzing spike times and spiking frequency, it is observed that neuron with distinct spiking patterns exhibits different response properties in the presence of MF exposure. For tonic spiking neuron, the perturbations of MF exposure on spike times is maximized at the harmonics of neuronal intrinsic spiking frequency, while it is maximized at the harmonics of bursting frequency for burst spiking neuron. As MF intensity increases, the perturbations also increase. Compared with tonic spiking, bursting dynamics are less sensitive to the perturbations of ELF MF exposure. Further, ELF MF exposure is more prone to perturb neuronal spike times relative to spiking frequency. Our finding suggests that the resonance may be one of the neural mechanisms underlying the modulatory effects of the low-intensity ELF MFs on neuronal activities. The results highlight the impacts of ELF MFs exposure on neuronal activity from the single cell level, and demonstrate various factors including ELF MF properties and neuronal spiking characteristics could determine the outcome of exposure. These insights into the mechanism of MF exposure may be relevant for the design of multi-intensity magnetic stimulus protocols, and may even contribute to the interpretation of MF effects on the central nervous systems.

Utility of TMS to understand the neurobiology of speech

According to a traditional view, speech perception and production are processed largely separately in sensory and motor brain areas. Recent psycholinguistic and neuroimaging studies provide novel evidence that the sensory and motor systems dynamically interact in speech processing, by demonstrating that speech perception and imitation share regional brain activations. However, the exact nature and mechanisms of these sensorimotor interactions are not completely understood yet. Transcranial magnetic stimulation (TMS) has often been used in the cognitive neurosciences, including speech research, as a complementary technique to behavioral and neuroimaging studies. Here we provide an up-to-date review focusing on TMS studies that explored speech perception and imitation. Single-pulse TMS of the primary motor cortex (M1) demonstrated a speech specific and somatotopically specific increase of excitability of the M1 lip area during speech perception (listening to speech or lip reading). A paired-coil TMS approach showed increases in effective connectivity from brain regions that are involved in speech processing to the M1 lip area when listening to speech. TMS in virtual lesion mode applied to speech processing areas modulated performance of phonological recognition and imitation of perceived speech. In summary, TMS is an innovative tool to investigate processing of speech perception and imitation. TMS studies have provided strong evidence that the sensory system is critically involved in mapping sensory input onto motor output and that the motor system plays an important role in speech perception.

How your hand drives my eyes

When viewing object-related hand actions people make proactive eye movements of the same kind as those made when performing such actions. Why is this so? It has been suggested that proactive gaze when viewing a given hand action depends on the recruitment of motor areas such as the ventral premotor (PMv) cortex that would be involved in the execution of that action. However, direct evidence for a distinctive role of the PMv cortex in driving gaze behavior is still lacking. We recorded eye moments while viewing hand actions before and immediately after delivering repetitive transcranial magnetic stimulation (rTMS) over the left PMv and the posterior part of the left superior temporal sulcus, which is known to be involved in high-order visual action processing. Our results showed that rTMS-induced effects were selective with respect to the viewed actions following the virtual lesion of the left PMv only. This, for the first time, provides direct evidence that the PMv cortex might selectively contribute to driving the viewer's gaze to the action's target. When people view another's action, their eyes may be driven by motor processes similar to those they would need to perform the action themselves.

Using TMS to study the role of the articulatory motor system in speech perception

Background: The ability to communicate using speech is a remarkable skill, which requires precise coordination of articulatory movements and decoding of complex acoustic signals. According to the traditional view, speech production and perception rely on motor and auditory brain areas, respectively. However, there is growing evidence that auditory-motor circuits support both speech production and perception.Aims: In this article we provide a review of how transcranial magnetic stimulation (TMS) has been used to investigate the excitability of the motor system during listening to speech and the contribution of the motor system to performance in various speech perception tasks. We also discuss how TMS can be used in combination with brain-imaging techniques to study interactions between motor and auditory systems during speech perception.Main contribution: TMS has proven to be a powerful tool to investigate the role of the articulatory motor system in speech perception.Conclusions: TMS studies have provided support for the view that the motor structures that control the movements of the articulators contribute not only to speech production but also to speech perception.

Effective connectivity hierarchically links temporoparietal and frontal areas of the auditory dorsal stream with the motor cortex lip area during speech perception

A left-hemispheric cortico-cortical network involving areas of the temporoparietal junction (Tpj) and the posterior inferior frontal gyrus (pIFG) is thought to support sensorimotor integration of speech perception into articulatory motor activation, but how this network links with the lip area of the primary motor cortex (M1) during speech perception is unclear. Using paired-coil focal transcranial magnetic stimulation (TMS) in healthy subjects, we demonstrate that Tpj→M1 and pIFG→M1 effective connectivity increased when listening to speech compared to white noise. A virtual lesion induced by continuous theta-burst TMS (cTBS) of the pIFG abolished the task-dependent increase in pIFG→M1 but not Tpj→M1 effective connectivity during speech perception, whereas cTBS of Tpj abolished the task-dependent increase of both effective connectivities. We conclude that speech perception enhances effective connectivity between areas of the auditory dorsal stream and M1. Tpj is situated at a hierarchically high level, integrating speech perception into motor activation through the pIFG.

Facilitation of speech repetition accuracy by theta burst stimulation of the left posterior inferior frontal gyrus

The posterior part of the inferior frontal gyrus (pIFG) in the left hemisphere is thought to form part of the putative human mirror neuron system and is assigned a key role in mapping sensory perception onto motor action. Accordingly, the pIFG is involved in motor imitation of the observed actions of others but it is not known to what extent speech repetition of auditory-presented sentences is also a function of the pIFG. Here we applied fMRI-guided facilitating intermittent theta burst transcranial magnetic stimulation (iTBS), or depressant continuous TBS (cTBS), or intermediate TBS (imTBS) over the left pIFG of healthy subjects and compared speech repetition accuracy of foreign Japanese sentences before and after TBS. We found that repetition accuracy improved after iTBS and, to a lesser extent, after imTBS, but remained unchanged after cTBS. In a control experiment, iTBS was applied over the left middle occipital gyrus (MOG), a region not involved in sensorimotor processing of auditory-presented speech. Repetition accuracy remained unchanged after iTBS of MOG. We argue that the stimulation type and stimulation site specific facilitating effect of iTBS over left pIFG on speech repetition accuracy indicates a causal role of the human left-hemispheric pIFG in the translation of phonological perception to motor articulatory output for repetition of speech. This effect may prove useful in rehabilitation strategies that combine repetitive speech training with iTBS of the left pIFG in speech disorders, such as aphasia after cerebral stroke.

Auditory-motor processing of speech sounds

The motor regions that control movements of the articulators activate during listening to speech and contribute to performance in demanding speech recognition and discrimination tasks. Whether the articulatory motor cortex modulates auditory processing of speech sounds is unknown. Here, we aimed to determine whether the articulatory motor cortex affects the auditory mechanisms underlying discrimination of speech sounds in the absence of demanding speech tasks. Using electroencephalography, we recorded responses to changes in sound sequences, while participants watched a silent video. We also disrupted the lip or the hand representation in left motor cortex using transcranial magnetic stimulation. Disruption of the lip representation suppressed responses to changes in speech sounds, but not piano tones. In contrast, disruption of the hand representation had no effect on responses to changes in speech sounds. These findings show that disruptions within, but not outside, the articulatory motor cortex impair automatic auditory discrimination of speech sounds. The findings provide evidence for the importance of auditory-motor processes in efficient neural analysis of speech sounds.

Fronto-parietal Areas Necessary for a Multisensory Representation of Peripersonal Space in Humans: An rTMS Study

A network of brain regions including the ventral premotor cortex (vPMc) and the posterior parietal cortex (PPc) is consistently recruited during processing of multisensory stimuli within peripersonal space (PPS). However, to date, information on the causal role of these fronto-parietal areas in multisensory PPS representation is lacking. Using low-frequency repetitive TMS (rTMS; 1 Hz), we induced transient virtual lesions to the left vPMc, PPc, and visual cortex (V1, control site) and tested whether rTMS affected audio–tactile interaction in the PPS around the hand. Subjects performed a timed response task to a tactile stimulus on their right (contralateral to rTMS) hand while concurrent task-irrelevant sounds were presented either close to the hand or 1 m far from the hand. When no rTMS was delivered, a sound close to the hand reduced RT-to-tactile targets as compared with when a far sound was presented. This space-dependent, auditory modulation of tactile perception was specific to a hand-centered reference frame. Such a specific form of multisensory interaction near the hand can be taken as a behavioral hallmark of PPS representation. Crucially, virtual lesions to vPMc and PPc, but not to V1, eliminated the speeding effect due to near sounds, showing a disruption of audio–tactile interactions around the hand. These findings indicate that multisensory interaction around the hand depends on the functions of vPMc and PPc, thus pointing to the necessity of this human fronto-parietal network in multisensory representation of PPS.

The neuropsychology of face perception: beyond simple dissociations and functional selectivity

Face processing relies on a distributed, patchy network of cortical regions in the temporal and frontal lobes that respond disproportionately to face stimuli, other cortical regions that are not even primarily visual (such as somatosensory cortex), and subcortical structures such as the amygdala. Higher-level face perception abilities, such as judging identity, emotion and trustworthiness, appear to rely on an intact face-processing network that includes the occipital face area (OFA), whereas lower-level face categorization abilities, such as discriminating faces from objects, can be achieved without OFA, perhaps via the direct connections to the fusiform face area (FFA) from several extrastriate cortical areas. Some lesion, transcranial magnetic stimulation (TMS) and functional magnetic resonance imaging (fMRI) findings argue against a strict feed-forward hierarchical model of face perception, in which the OFA is the principal and common source of input for other visual and non-visual cortical regions involved in face perception, including the FFA, face-selective superior temporal sulcus and somatosensory cortex. Instead, these findings point to a more interactive model in which higher-level face perception abilities depend on the interplay between several functionally and anatomically distinct neural regions. Furthermore, the nature of these interactions may depend on the particular demands of the task. We review the lesion and TMS literature on this topic and highlight the dynamic and distributed nature of face processing.

Uncovering Multisensory Processing through Non-Invasive Brain Stimulation

Most of current knowledge about the mechanisms of multisensory integration of environmental stimuli by the human brain derives from neuroimaging experiments. However, neuroimaging studies do not always provide conclusive evidence about the causal role of a given area for multisensory interactions, since these techniques can mainly derive correlations between brain activations and behavior. Conversely, techniques of non-invasive brain stimulation (NIBS) represent a unique and powerful approach to inform models of causal relations between specific brain regions and individual cognitive and perceptual functions. Although NIBS has been widely used in cognitive neuroscience, its use in the study of multisensory processing in the human brain appears a quite novel field of research. In this paper, we review and discuss recent studies that have used two techniques of NIBS, namely transcranial magnetic stimulation and transcranial direct current stimulation, for investigating the causal involvement of unisensory and heteromodal cortical areas in multisensory processing, the effects of multisensory cues on cortical excitability in unisensory areas, and the putative functional connections among different cortical areas subserving multisensory interactions. The emerging view is that NIBS is an essential tool available to neuroscientists seeking for causal relationships between a given area or network and multisensory processes. With its already large and fast increasing usage, future work using NIBS in isolation, as well as in conjunction with different neuroimaging techniques, could substantially improve our understanding of multisensory processing in the human brain.

The use of transcranial magnetic stimulation in cognitive neuroscience: a new synthesis of methodological issues

Transcranial magnetic stimulation (TMS) has become a mainstay of cognitive neuroscience, thus facing new challenges due to its widespread application on behaviorally silent areas. In this review we will summarize the main technical and methodological considerations that are necessary when using TMS in cognitive neuroscience, based on a corpus of studies and technical improvements that has become available in most recent years. Although TMS has been applied only relatively recently on a large scale to the study of higher functions, a range of protocols that elucidate how this technique can be used to investigate a variety of issues is already available, such as single pulse, paired pulse, dual-site, repetitive and theta burst TMS. Finally, we will touch on recent promising approaches that provide powerful new insights about causal interactions among brain regions (i.e., TMS with other neuroimaging techniques) and will enable researchers to enhance the functional resolution of TMS (i.e., state-dependent TMS). We will end by briefly summarizing and discussing the implications of the newest safety guidelines.

Using EEG to explore how rTMS produces its effects on behavior

A commonly held view is that, when delivered during the performance of a task, repetitive TMS (rTMS) influences behavior by producing transient "virtual lesions" in targeted tissue. However, findings of rTMS-related improvements in performance are difficult to reconcile with this assumption. With regard to the mechanism whereby rTMS influences concurrent task performance, a combined rTMS/EEG study conducted in our lab has revealed a complex set of relations between rTMS, EEG activity, and behavioral performance, with the effects of rTMS on power in the alpha band and on alpha:gamma phase synchrony each predicting its effect on behavior. These findings suggest that rTMS influences performance by biasing endogenous task-related oscillatory dynamics, rather than creating a "virtual lesion". To further differentiate these two alternatives, in the present study we compared the effects of 10 Hz rTMS on neural activity with the results of an experiment in which rTMS was replaced with 10 Hz luminance flicker. We reasoned that 10 Hz flicker would produce widespread entrainment of neural activity to the flicker frequency, and comparison of these EEG results with those from the rTMS study would shed light on whether the latter also reflected entrainment to an exogenous stimulus. Results revealed pronounced evidence for "entrainment noise" produced by 10 Hz flicker-increased oscillatory power and inter-trial coherence (ITC) at the driving frequency, and increased alpha:gamma phase synchronization-that were nonetheless largely uncorrelated with behavior. This contrasts markedly with 10-Hz rTMS, for which the only evidence for stimulation-induced noise, elevated ITC at 30 Hz, differed qualitatively from the flicker results. Simultaneous recording of the EEG thus offers an important means of directly testing assumptions about how rTMS exerts its effects on behavior.