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Tang DL, Niziolek CA, Parrell B. Modulation of somatosensation by transcranial magnetic stimulation over somatosensory cortex: a systematic review. Exp Brain Res 2023; 241:951-977. [PMID: 36949150 PMCID: PMC10851347 DOI: 10.1007/s00221-023-06579-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 02/17/2023] [Indexed: 03/24/2023]
Abstract
Over the last three decades, transcranial magnetic stimulation (TMS) has gained popularity as a tool to modulate human somatosensation. However, the effects of different stimulation types on the multiple distinct subdomains of somatosensation (e.g., tactile perception, proprioception and pain) have not been systematically compared. This is especially notable in the case of newer theta-burst stimulation protocols now in widespread use. Here, we aimed to systematically and critically review the existing TMS literature and provide a complete picture of current knowledge regarding the role of TMS in modulating human somatosensation across stimulation protocols and somatosensory domains. Following the PRISMA guidelines, fifty-four studies were included in the current review and were compared based on their methodologies and results. Overall, findings from these studies provide evidence that different types of somatosensation can be both disrupted and enhanced by targeted stimulation of specific somatosensory areas. Some mixed results, however, were reported in the literature. We discussed possible reasons for these mixed results, methodological limitations of existing investigations, and potential avenues for future research.
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Affiliation(s)
- Ding-Lan Tang
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI, USA
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Caroline A Niziolek
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI, USA.
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA.
| | - Benjamin Parrell
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI, USA.
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA.
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Xu J, Lopez AJ, Hoque MM, Borich MR, Kesar TM. Temporal Profile of Descending Cortical Modulation of Spinal Excitability: Group and Individual-Specific Effects. Front Integr Neurosci 2022; 15:777741. [PMID: 35197831 PMCID: PMC8859157 DOI: 10.3389/fnint.2021.777741] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 12/21/2021] [Indexed: 11/16/2022] Open
Abstract
Sensorimotor control is modulated through complex interactions between descending corticomotor pathways and ascending sensory inputs. Pairing sub-threshold transcranial magnetic stimulation (TMS) with peripheral nerve stimulation (PNS) modulates the Hoffmann’s reflex (H-reflex), providing a neurophysiologic probe into the influence of descending cortical drive on spinal segmental circuits. However, individual variability in the timing and magnitude of H-reflex modulation is poorly understood. Here, we varied the inter-stimulus interval (ISI) between TMS and PNS to systematically manipulate the relative timing of convergence of descending TMS-induced volleys with respect to ascending PNS-induced afferent volleys in the spinal cord to: (1) characterize effective connectivity between the primary motor cortex (M1) and spinal circuits, mediated by both direct, fastest-conducting, and indirect, slower-conducting descending pathways; and (2) compare the effect of individual-specific vs. standard ISIs. Unconditioned and TMS-conditioned H-reflexes (24 different ISIs ranging from −6 to 12 ms) were recorded from the soleus muscle in 10 able-bodied individuals. The magnitude of H-reflex modulation at individualized ISIs (earliest facilitation delay or EFD and individual-specific peak facilitation) was compared with standard ISIs. Our results revealed a significant effect of ISI on H-reflex modulation. ISIs eliciting earliest-onset facilitation (EFD 0 ms) ranged from −3 to −5 ms across individuals. No difference in the magnitude of facilitation was observed at EFD 0 ms vs. a standardized short-interval ISI of −1.5 ms. Peak facilitation occurred at longer ISIs, ranging from +3 to +11 ms. The magnitude of H-reflex facilitation derived using an individual-specific peak facilitation was significantly larger than facilitation observed at a standardized longer-interval ISI of +10 ms. Our results suggest that unique insights can be provided with individual-specific measures of top-down effective connectivity mediated by direct and/or fastest-conducting pathways (indicated by the magnitude of facilitation observed at EFD 0 ms) and other descending pathways that encompass relatively slower and/or indirect connections from M1 to spinal circuits (indicated by peak facilitation and facilitation at longer ISIs). By comprehensively characterizing the temporal profile and inter-individual variability of descending modulation of spinal reflexes, our findings provide methodological guidelines and normative reference values to inform future studies on neurophysiological correlates of the complex array of descending neural connections between M1 and spinal circuits.
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Affiliation(s)
- Jiang Xu
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University, Atlanta, GA, United States
| | - Alejandro J. Lopez
- Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University, Atlanta, GA, United States
- Neuroscience Graduate Program, Graduate Division of Biological and Biomedical Sciences, Emory University, Atlanta, GA, United States
| | - Maruf M. Hoque
- Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University, Atlanta, GA, United States
| | - Michael R. Borich
- Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University, Atlanta, GA, United States
| | - Trisha M. Kesar
- Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University, Atlanta, GA, United States
- *Correspondence: Trisha M. Kesar
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Iwata Y, Jono Y, Mizusawa H, Kinoshita A, Hiraoka K. Interhemispheric Inhibition Induced by Transcranial Magnetic Stimulation Over Primary Sensory Cortex. Front Hum Neurosci 2016; 10:438. [PMID: 27630554 PMCID: PMC5006631 DOI: 10.3389/fnhum.2016.00438] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 08/16/2016] [Indexed: 11/21/2022] Open
Abstract
The present study investigated whether the long-interval interhemispheric inhibition (LIHI) is induced by the transcranial magnetic stimulation over the primary sensory area (S1-TMS) without activation of the conditioning side of the primary motor area (M1) contributing to the contralateral motor evoked potential (MEP), whether the S1-TMS-induced LIHI is dependent on the status of the S1 modulated by the tactile input, and whether the pathways mediating the LIHI are different from those mediating the M1-TMS-induced LIHI. In order to give the TMS over the S1 without eliciting the MEP, the intensity of the S1-TMS was adjusted to be the sub-motor-threshold level and the trials with the MEP response elicited by the S1-TMS were discarded online. The LIHI was induced by the S1-TMS given 40 ms before the test TMS in the participants with the attenuation of the tactile perception of the digit stimulation (TPDS) induced by the S1-TMS, indicating that the LIHI is induced by the S1-TMS without activation of the conditioning side of the M1 contributing to the contralateral MEP in the participants in which the pathways mediating the TPDS is sensitive to the S1-TMS. The S1-TMS-induced LIHI was positively correlated with the attenuation of the TPDS induced by the S1-TMS, indicating that the S1-TMS-induced LIHI is dependent on the effect of the S1-TMS on the pathways mediating the TPDS at the S1. In another experiment, the effect of the digit stimulation given before the conditioning TMS on the S1- or M1-TMS-induced LIHI was examined. The digit stimulation produces tactile input to the S1 causing change in the status of the S1. The S1-TMS-induced LIHI was enhanced when the S1-TMS was given in the period in which the tactile afferent volley produced by the digit stimulation just arrived at the S1, while the LIHI induced by above-motor-threshold TMS over the contralateral M1 was not enhanced by the tactile input. Thus, the S1-TMS-induced LIHI is dependent on the status of the S1 modulated by the tactile input, and the pathways mediating the sub-motor-threshold S1-TMS-induced LIHI are not the same as the pathways mediating the above-motor-threshold M1-TMS-induced LIHI.
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Affiliation(s)
- Yasuyuki Iwata
- Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University Habikino, Japan
| | - Yasutomo Jono
- Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University Habikino, Japan
| | - Hiroki Mizusawa
- Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University Habikino, Japan
| | - Atsushi Kinoshita
- Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University Habikino, Japan
| | - Koichi Hiraoka
- College of Health and Human Sciences, Osaka Prefecture University Habikino, Japan
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Tamè L, Holmes NP. Involvement of human primary somatosensory cortex in vibrotactile detection depends on task demand. Neuroimage 2016; 138:184-196. [PMID: 27233148 DOI: 10.1016/j.neuroimage.2016.05.056] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 05/09/2016] [Accepted: 05/22/2016] [Indexed: 10/21/2022] Open
Abstract
UNLABELLED Detecting and discriminating sensory stimuli are fundamental functions of the nervous system. Electrophysiological and lesion studies suggest that macaque primary somatosensory cortex (SI) is critically involved in discriminating between stimuli, but is not required simply for detecting stimuli. By contrast, transcranial magnetic stimulation (TMS) studies in humans have shown near-complete disruption of somatosensory detection when a single pulse of TMS is delivered over SI. To address this discrepancy, we measured the sensitivity and decision criteria of participants detecting vibrotactile stimuli with individually-tailored fMRI-guided TMS over SI, over a control site not activated by vibrotactile stimuli (inferior parietal lobule, IPL), or away from the head (a no TMS condition). In a one-interval detection task, TMS increased participants' likelihood of reporting 'no' target present regardless of site, but TMS over SI also decreased detection sensitivity, and prevented improvement in tactile sensitivity over time. We then measured tactile thresholds in a series of two-interval forced-choice (2IFC) detection and discrimination tasks with lower dependence on response criteria and short-term memory load. We found that thresholds for detecting stimuli were comparable with TMS over SI and IPL, but TMS over SI specifically and significantly impaired frequency discrimination. We conclude that, in accordance with macaque studies, human SI is required for discriminating between tactile stimuli and for maintaining stimulus representations over time, or under high task demand, but may not be required for simple tactile detection. SIGNIFICANT STATEMENT Studies on monkeys have suggested that the primary somatosensory cortex is responsible for discriminating between different vibrations on the fingertips, but not just for detecting these vibrations. However, similar studies in humans suggest that the somatosensory cortex is required both for detecting and discriminating between tactile stimuli. We used magnetic brain stimulation to interfere with human somatosensory cortex while healthy volunteers detected and discriminated between vibrations applied to their fingertips. We found that the somatosensory cortex is required for keeping vibrotactile stimuli in memory for short periods of time and for comparing two vibrotactile stimuli, but is not required merely for detecting vibrotactile stimulation. This suggests that human primary somatosensory cortex is not always needed for vibrotactile detection.
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Affiliation(s)
- Luigi Tamè
- Centre for Integrative Neuroscience & Neurodynamics, School of Psychology & Clinical Language Sciences, University of Reading, Reading, UK; Center for Mind/Brain Sciences, University of Trento, Rovereto, Italy; Department of Psychological Sciences, Birkbeck, University of London, London, UK.
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Understanding the role of the primary somatosensory cortex: Opportunities for rehabilitation. Neuropsychologia 2015; 79:246-55. [PMID: 26164474 DOI: 10.1016/j.neuropsychologia.2015.07.007] [Citation(s) in RCA: 164] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 06/19/2015] [Accepted: 07/07/2015] [Indexed: 12/14/2022]
Abstract
Emerging evidence indicates impairments in somatosensory function may be a major contributor to motor dysfunction associated with neurologic injury or disorders. However, the neuroanatomical substrates underlying the connection between aberrant sensory input and ineffective motor output are still under investigation. The primary somatosensory cortex (S1) plays a critical role in processing afferent somatosensory input and contributes to the integration of sensory and motor signals necessary for skilled movement. Neuroimaging and neurostimulation approaches provide unique opportunities to non-invasively study S1 structure and function including connectivity with other cortical regions. These research techniques have begun to illuminate casual contributions of abnormal S1 activity and connectivity to motor dysfunction and poorer recovery of motor function in neurologic patient populations. This review synthesizes recent evidence illustrating the role of S1 in motor control, motor learning and functional recovery with an emphasis on how information from these investigations may be exploited to inform stroke rehabilitation to reduce motor dysfunction and improve therapeutic outcomes.
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Staines WR, Bolton DAE. Transcranial magnetic stimulation techniques to study the somatosensory system: research applications. HANDBOOK OF CLINICAL NEUROLOGY 2014; 116:671-9. [PMID: 24112932 DOI: 10.1016/b978-0-444-53497-2.00053-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
The introduction of brain stimulation research techniques such as transcranial magnetic stimulation (TMS) has greatly advanced the understanding of the somatosensory system in humans. Over the last several years, several studies have focused on applying TMS in a variety of contexts to alter transiently the excitability of the somatosensory cortex or regions that project to it and exert some control over its activity in specific behavioral contexts. Specific foci that are discussed in this chapter are methods of repetitive TMS, including theta-burst protocols, delivered to the primary somatosensory cortex that have been shown to affect behavioral indices of somatic sensation such as tactile perception. Similar stimulation techniques can also be applied to distant areas that interact with and modulate activity in somatosensory cortex (i.e., attentional or motor networks). For example, suppression of the dorsolateral prefrontal cortex modifies the attention-modulation of somatosensory information in modality-specific cortices. Overall this chapter is focused on understanding the interaction of activity in systems that function with the somatosensory system in behavioral contexts. These include systems such as those that control attention, whether sustained or selective between sensory modalities, or those that control movement based on targets present in other sensory systems.
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Affiliation(s)
- W Richard Staines
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada.
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Lee KG, Jacobs MF, Asmussen MJ, Zapallow CM, Tommerdahl M, Nelson AJ. Continuous theta-burst stimulation modulates tactile synchronization. BMC Neurosci 2013; 14:89. [PMID: 23968301 PMCID: PMC3844444 DOI: 10.1186/1471-2202-14-89] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Accepted: 08/21/2013] [Indexed: 11/22/2022] Open
Abstract
Background Temporal order judgement (TOJ) is the ability to detect the order of occurrence of two sequentially delivered stimuli. Previous research has shown that TOJ in the presence of synchronized periodic conditioning stimuli impairs TOJ performance, and this phenomenon is suggested to be mediated by GABAergic interneurons that cause perceptual binding across the two skin sites. Application of continuous theta-burst repetitive TMS (cTBS) over primary somatosensory cortex (SI) alters temporal and spatial tactile perception. The purpose of this study was to examine TOJ perception in the presence and absence of synchronized periodic conditioning stimuli before and after cTBS applied over left-hemisphere SI. A TOJ task was administered on the right index and middle finger (D2 and D3) in two separate sessions in the presence and absence of conditioning stimuli (a background low amplitude sinusoidal vibration). Results CTBS reduced the impact of the conditioning stimuli on TOJ performance for up to 18 minutes following stimulation while sham cTBS did not affect TOJ performance. In contrast, the TOJ task performed in the absence of synchronized conditioning stimulation was unaltered following cTBS. Conclusion We conclude that cTBS suppresses inhibitory networks in SI that mediate perceptual binding during TOJ synchronization. CTBS offers one method to suppress cortical excitability in the cortex and potentially benefit clinical populations with altered inhibitory cortical circuits. Additionally, TOJ measures with conditioning stimuli may provide an avenue to assess sensory processing in neurologically impaired patient populations.
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Affiliation(s)
- Kevin Gh Lee
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario N2L 3G1, Canada.
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Legon W, Dionne JK, Staines WR. Continuous theta burst stimulation of the supplementary motor area: effect upon perception and somatosensory and motor evoked potentials. Brain Stimul 2013; 6:877-83. [PMID: 23706289 DOI: 10.1016/j.brs.2013.04.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Revised: 04/22/2013] [Accepted: 04/23/2013] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The supplementary motor area (SMA) has been implicated in many aspects of movement preparation and execution. In addition to motor roles, the SMA is responsive to somesthetic stimuli though it is unclear exactly what role the SMA plays in a somatosensory network. OBJECTIVE/HYPOTHESIS It is the purpose of this study to assess how continuous theta burst stimulation (cTBS) of the SMA affects both somatosensory (SEPs) and motor evoked potentials (MEPs) and if cTBS leads to alterations in tactile perception thresholds of the index fingertip. METHODS In experiment 1, cTBS was delivered over scalp sites FCZ (SMA stimulation) (n = 10) and CZ (control stimulation) (n = 10) in separate groups for 40 s (600 pulses) at 90% of participants' resting motor threshold. For both groups, median nerve SEPs were elicited from the right wrist at rest via electrical stimulation (0.5 ms pulse) before and at 10 min intervals post-cTBS out to 30 min (t = pre, 10, 20, and 30 min). Subjects' perceptual thresholds were assessed at similar time intervals as the SEP data using a biothesiometer (120 Hz vibration). In experiment 2 (n = 10) the effect of cTBS to SMA upon single and paired-pulse MEP amplitudes from the right first dorsal interosseous (FDI) was assessed. RESULTS cTBS to scalp site FCZ (SMA stimulation) reduced the frontal N30 SEP and increased tactile perceptual thresholds 30 min post-stimulation. However, parietal SEPs and MEP amplitudes from both single and paired-pulse stimulation were unaffected at all time points post-stimulation. cTBS to stimulation site CZ (control) did not result in any physiological or behavioral changes. CONCLUSION(S) These data demonstrate cTBS to the SMA reduces the amplitude of the N30 coincident with an increase in vibration sensation threshold but does not affect primary somatosensory or motor cortex excitability. The SMA may play a significant role in a somatosensory tactile attention network.
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Affiliation(s)
- Wynn Legon
- Department of Kinesiology, University of Waterloo, 200 University Ave. West, Waterloo, Ontario N2L 3G1, Canada
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Song S, Sandrini M, Cohen LG. Modifying somatosensory processing with non-invasive brain stimulation. Restor Neurol Neurosci 2012; 29:427-37. [PMID: 22124034 DOI: 10.3233/rnn-2011-0614] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Purposeful manipulation of cortical plasticity and excitability within somatosensory regions may have therapeutic potential. Non-invasive brain stimulation (NBS) techniques such as transcranial magnetic stimulation (TMS) or transcranial direct current stimulation (tDCS) have shown promise towards this end with certain NBS protocols augmenting somatosensory processing and others down-regulating it. Here, we review NBS protocols which, when applied to primary somatosensory cortex, facilitate cortical excitability and tactile acuity (i.e., high-frequency repetitive TMS (rTMS), intermittent theta burst stimulation (TBS), paired associative stimulation (PAS) N20-5 to 0, anodal tDCS), and protocols that inhibit the same (i.e., low-frequency rTMS, continuous TBS, PAS N20-20, cathodal tDCS). Other studies have targeted multisensory regions of the brain to modulate somatosensory processing. These studies in full present a wide array of strategies in which NBS can be utilized to influence somatosensory processing in a behaviorally and clinically relevant capacity.
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Affiliation(s)
- Sunbin Song
- Human Cortical Physiology and Stroke Neurorehabilitation Section, NINDS, NIH, MD20892, USA
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Cardoso-Cruz H, Sameshima K, Lima D, Galhardo V. Dynamics of Circadian Thalamocortical Flow of Information during a Peripheral Neuropathic Pain Condition. Front Integr Neurosci 2011; 5:43. [PMID: 22007162 PMCID: PMC3188809 DOI: 10.3389/fnint.2011.00043] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Accepted: 08/04/2011] [Indexed: 11/16/2022] Open
Abstract
It is known that the thalamocortical loop plays a crucial role in the encoding of sensory–discriminative features of painful stimuli. However, only a few studies have addressed the changes in thalamocortical dynamics that may occur after the onset of chronic pain. Our goal was to evaluate how the induction of chronic neuropathic pain affected the flow of information within the thalamocortical loop throughout the brain states of the sleep–wake cycle. To address this issue we recorded local field potentials (LFPs) – both before and after the establishment of neuropathic pain in awake freely moving adult rats chronically implanted with arrays of multielectrodes in the lateral thalamus and primary somatosensory cortex. Our results show that the neuropathic injury induced changes in the number of wake and slow-wave-sleep (SWS) state episodes, and especially in the total number of transitions between brain states. Moreover, partial directed coherence – analysis revealed that the amount of information flow between cortex and thalamus in neuropathic animals decreased significantly, indicating that the overall thalamic activity had less weight over the cortical activity. However, thalamocortical LFPs displayed higher phase-locking during awake and SWS episodes after the nerve lesion, suggesting faster transmission of relevant information along the thalamocortical loop. The observed changes are in agreement with the hypothesis of thalamic dysfunction after the onset of chronic pain, and may result from diminished inhibitory effect of the primary somatosensory cortex over the lateral thalamus.
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Affiliation(s)
- Helder Cardoso-Cruz
- Departamento de Biologia Experimental, Faculdade de Medicina, Universidade do Porto Porto, Portugal
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Meehan SK, Linsdell MA, Handy TC, Boyd LA. Interhemispheric enhancement of somatosensory cortical excitability through contralateral repetitive transcranial magnetic stimulation. Clin Neurophysiol 2011; 122:1637-44. [DOI: 10.1016/j.clinph.2011.01.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2010] [Revised: 01/04/2011] [Accepted: 01/07/2011] [Indexed: 11/15/2022]
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Spatiotemporal properties modulate intermodal influences on early somatosenory processing during sensory-guided movement. Clin Neurophysiol 2009; 120:1371-80. [DOI: 10.1016/j.clinph.2009.05.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2009] [Revised: 04/20/2009] [Accepted: 05/05/2009] [Indexed: 11/19/2022]
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