Rapid experience-dependent plasticity following somatosensory damage

Physiological oculo-auricular-facial-mandibular synkinesis elicited in humans by gaze deviations

Integrated motor behaviors involving ocular motion-associated movements of the head, neck, pinna, and parts of the face are commonly seen in animals orienting to a visual target. A number of coordinated movements have also been observed in humans making rapid gaze shifts to horizontal extremes, which may be vestiges of these. Since such integrated mechanisms point to a non-pathological co-activation of several anatomically separate cranial circuits in humans, it is important to see how the different pairs of integrative motor behaviors with a common trigger (i.e., ocular motion) manifest in relation to one another. Here, we systematically examined the pattern of eye movement-induced recruitment of multiple cranial muscles in humans. Simultaneous video-oculography and bilateral surface electromyograms of transverse auricular, temporalis, frontalis, and masseter muscles were recorded in 15 healthy subjects (8 females; 29.3±5.2 years) while they made head-fixed, horizontal saccadic, pursuit and optokinetic eye movements. Potential chin laterotrusion linked to contractions of masticator muscles was captured with a yaw-fixed accelerometer. Our findings objectively show an orchestrated aural-facial-masticatory muscle response to a range of horizontal eye movements (prevalence of 21-93%). These responses were most prominent during eccentric saccades. We further reveal distinctions between the various observed activation patterns in terms of their profile (transient or sustained), laterality (with respect to direction of gaze) and timing (with respect to saccade onset). Possible underlying neural substrates, their atavistic behavioral significance, and potential clinical applications for monitoring sensory attention and designing attention-directed hearing aids in the future are discussed.

Examining central biases in somatosensory localization: Evidence from brain-damaged individuals

How does the brain localize touch under conditions of uncertainty caused by brain damage? By testing single cases, previous work found mislocalization of touch toward the center of the hand. We investigated whether such central bias changes as a function of uncertainty in somatosensory system. Fifty-one brain-damaged individuals were presented with a tactile detection task to establish their tactile threshold, and a tactile localization task in which they localized suprathreshold stimuli presented at different locations on the hand. We predicted that with increased somatosensory uncertainty, indexed by higher detection thresholds, participants would more likely to localize the stimuli toward the center of the hand. Consistent with this prediction, participants' localization errors were biased towards the center of the hand and, importantly, this bias increased as detection threshold increased. These findings provide evidence that instead of showing random errors, uncertainty leads to systematic localization errors toward the center of the hand. We discuss these findings under different frameworks as potential mechanisms to explain biases in tactile localization subsequent to brain damage.

Brain (re)organisation following amputation: Implications for phantom limb pain

Following arm amputation the region that represented the missing hand in primary somatosensory cortex (S1) becomes deprived of its primary input, resulting in changed boundaries of the S1 body map. This remapping process has been termed 'reorganisation' and has been attributed to multiple mechanisms, including increased expression of previously masked inputs. In a maladaptive plasticity model, such reorganisation has been associated with phantom limb pain (PLP). Brain activity associated with phantom hand movements is also correlated with PLP, suggesting that preserved limb functional representation may serve as a complementary process. Here we review some of the most recent evidence for the potential drivers and consequences of brain (re)organisation following amputation, based on human neuroimaging. We emphasise other perceptual and behavioural factors consequential to arm amputation, such as non-painful phantom sensations, perceived limb ownership, intact hand compensatory behaviour or prosthesis use, which have also been related to both cortical changes and PLP. We also discuss new findings based on interventions designed to alter the brain representation of the phantom limb, including augmented/virtual reality applications and brain computer interfaces. These studies point to a close interaction of sensory changes and alterations in brain regions involved in body representation, pain processing and motor control. Finally, we review recent evidence based on methodological advances such as high field neuroimaging and multivariate techniques that provide new opportunities to interrogate somatosensory representations in the missing hand cortical territory. Collectively, this research highlights the need to consider potential contributions of additional brain mechanisms, beyond S1 remapping, and the dynamic interplay of contextual factors with brain changes for understanding and alleviating PLP.

Re-learning and remembering in the lesioned brain

It is well known that re-learning language skills after a brain lesion can be very difficult. However, while learning and memory challenges have been extensively researched in amnesic individuals, very little research attention has been directed at understanding the characteristics of learning and memory that are relevant to recovery and rehabilitation of acquired language impairments. Even in the absence of damage to the medial temporal lobe regions classically associated with learning and memory, these individuals often suffer damage to frontal and other subcortical areas associated with learning and memory that may contribute to the learning challenges they face. Therefore, an understanding of the learning and memory profiles of post-stroke language impairments is important for the development and optimization of rehabilitation approaches. In two studies, we examine the degree to which certain basic characteristics of learning and memory, identified in neurotypical individuals, are intact in individuals with post-stroke language impairment. We specifically consider fundamental principles regarding the optimal spacing of learning trials that have been shown to reliably operate in neurotypical adults, across a wide range of language domains. We report on two studies that examine whether or not these principles also apply in language re-learning and retention for individuals with acquired deficits in written language production. Study 1 compared distributed vs. clustered training schedules, while Study 2 examined-for the first time in the context of re-learning-the relationship between the spacing of training trials and the retention period. This investigation revealed that, despite significant cognitive deficits and brain lesions, remarkably similar principles govern re-learning and retention in the lesioned brain as have been found to apply in neurologically healthy individuals. These results allow us to begin to integrate our understanding of recovery with the broader literature on learning and memory and have implications for the optimal organization of rehabilitation. Specifically, the findings raise questions regarding the traditional compression of rehabilitation within relatively short time windows.

Automated and Quantitative Assessment of Tactile Mislocalization After Stroke

Topesthesia, the recognition of tactile stimulation location on the skin, can be severely affected by neurological injuries, such as stroke. Despite topesthesia being crucial for manipulating objects and interacting with the environment during activities of daily living, deficits cannot be quantitatively captured with current clinical assessments and are, as a consequence, not well-understood. The present work describes a novel automated assessment tool for tactile mislocalization in neurological patients with somatosensory deficits. We present two cases of ischemic stroke patients, describe their tactile localization deficits with the automated assessment, and compare the results to a standard manual clinical assessment. Using the automated assessment tool, it was possible to identify, locate, precisely quantify, and depict the patients' deficits in topesthesia. In comparison, the clinical assessment was not sensitive enough and some deficits would remain undetected due to ceiling effects. In addition, an MRI structural analysis of the lesion supported the existence of somatosensory deficits. This novel and quantitative assessment may not only help to raise awareness of the implications of deficits in topesthesia, but would also allow monitoring recovery throughout the rehabilitation process, informing treatment design, and objectively evaluating treatment efficacy.

Biases in tactile localization by pointing: compression for weak stimuli and centering for distributions of stimuli

Weak electrocutaneous stimuli applied to the forearm are erroneously localized toward its middle (Steenbergen P, Buitenweg JR, Trojan J, Veltink PH. Exp Brain Res 232: 597-607, 2014). We asked whether mechanical touch stimuli exhibit a similar bias and whether the bias is toward the middle of the forearm or toward the middle of the recent stimulus distribution. In experiments 1 and 2, participants ( n = 12 and n = 10) localized by pointing von Frey filaments applied to four locations on the dorsal forearm. Individually adjusted weak and strong stimuli ( experiment 1) or two levels of strong stimuli ( experiment 2) were presented in single sessions in random order. Weaker stimuli were localized with greater variability than the strong, with compression toward the middle of the forearm. Responses to the two levels of strong stimuli did not differ. In experiment 3, participants ( n = 16) were presented two spatially offset stimulus distributions (8 cm center-to-center), each offset from the forearm middle, on 2 different days. Out of four target locations comprising each distribution, two were shared. Responses to weak stimuli were compressed compared with responses to strong stimuli. Importantly, biases for the common targets had opposite directions, each being toward the middle of the distribution within which targets were presented. Responses to strong stimuli also exhibited a distribution-dependent bias, a 2-cm overall shift across the forearm midpoint. We conclude that touch localization is subject to intensity-dependent biases determined by the recent history of stimulation and possibly also by the available or perceived response space. NEW & NOTEWORTHY Recent findings show that weak electrical stimuli applied to the forearm are mislocalized toward the forearm middle, relative to strong stimuli. We found that weak mechanical stimuli are similarly mislocalized. The bias changed if, as a group, stimuli were not centered on the forearm middle: weak stimuli gravitated toward the center of prior stimulation. Localization of strong stimuli was also biased, consistent with the tendency to center responses within the available response space.

The Impact of Feedback on the Different Time Courses of Multisensory Temporal Recalibration

The capacity to rapidly adjust perceptual representations confers a fundamental advantage when confronted with a constantly changing world. Unexplored is how feedback regarding sensory judgments (top-down factors) interacts with sensory statistics (bottom-up factors) to drive long- and short-term recalibration of multisensory perceptual representations. Here, we examined the time course of both cumulative and rapid temporal perceptual recalibration for individuals completing an audiovisual simultaneity judgment task in which they were provided with varying degrees of feedback. We find that in the presence of feedback (as opposed to simple sensory exposure) temporal recalibration is more robust. Additionally, differential time courses are seen for cumulative and rapid recalibration dependent upon the nature of the feedback provided. Whereas cumulative recalibration effects relied more heavily on feedback that informs (i.e., negative feedback) rather than confirms (i.e., positive feedback) the judgment, rapid recalibration shows the opposite tendency. Furthermore, differential effects on rapid and cumulative recalibration were seen when the reliability of feedback was altered. Collectively, our findings illustrate that feedback signals promote and sustain audiovisual recalibration over the course of cumulative learning and enhance rapid trial-to-trial learning. Furthermore, given the differential effects seen for cumulative and rapid recalibration, these processes may function via distinct mechanisms.

What can errors tell us about body representations?

In this review, we examine how tactile misperceptions provide evidence regarding body representations. First, we propose that tactile detection and localization are serial processes, in contrast to parallel processing hypotheses based on patients with numbsense. Second, we discuss how information in primary somatosensory maps projects to body size and shape representations to localize touch on the skin surface, and how responses after use-dependent plasticity reflect changes in this mapping. Third, we review situations in which our body representations are inconsistent with our actual body shape, specifically discussing phantom limb phenomena and anesthetization. We discuss problems with the traditional remapping hypothesis in amputees, factors that modulate perceived body size and shape, and how changes in perceived body form influence tactile localization. Finally, we review studies in which brain-damaged individuals perceive touch on the opposite side of the body, and demonstrate how interhemispheric mechanisms can give rise to these anomalous percepts.

Somatotopic mismatch of hand representation following stroke: is recovery possible?

Well-organized somatotopic representation of the hand is required to interpret input from cutaneous mechanoreceptors. Previous reports have identified patients with various distortions of somatotopic representation after stroke. Importantly, those patients were investigated years after the stroke, indicating that afferent signal regained access to the cortical circuits; however, further plastic changes, which would re-establish somatotopic order and ability to correctly localize tactile stimuli, did not follow. Thus, it was not known whether somatotopic organization could be restored in such patients and whether there is a potential for new rehabilitation strategies. This is the first case report demonstrating normalization of somatotopic representation.