Spatial properties and interhemispheric differences of the sensory hand cortical representation: a neuromagnetic study

The Differences Between Motor Attempt and Motor Imagery in Brain-Computer Interface Accuracy and Event-Related Desynchronization of Patients With Hemiplegia

Background: Motor attempt and motor imagery (MI) are two common motor tasks used in brain-computer interface (BCI). They are widely researched for motor rehabilitation in patients with hemiplegia. The differences between the motor attempt (MA) and MI tasks of patients with hemiplegia can be used to promote BCI application. This study aimed to explore the accuracy of BCI and event-related desynchronization (ERD) between the two tasks.

Materials and Methods: We recruited 13 patients with stroke and 3 patients with traumatic brain injury, to perform MA and MI tasks in a self-control design. The BCI accuracies from the bilateral, ipsilesional, and contralesional hemispheres were analyzed and compared between different tasks. The cortical activation patterns were evaluated with ERD and laterality index (LI).

Results: The study showed that the BCI accuracies of MA were significantly (p < 0.05) higher than MI in the bilateral, ipsilesional, and contralesional hemispheres in the alpha-beta (8–30 Hz) frequency bands. There was no significant difference in ERD and LI between the MA and MI tasks in the 8–30 Hz frequency bands. However, in the MA task, there was a negative correlation between the ERD values in the channel CP1 and ipsilesional hemispheric BCI accuracies (r = −0.552, p = 0.041, n = 14) and a negative correlation between the ERD values in channel CP2 and bilateral hemispheric BCI accuracies (r = −0.543, p = 0.045, n = 14). While in the MI task, there were negative correlations between the ERD values in channel C4 and bilateral hemispheric BCI accuracies (r = −0.582, p = 0.029, n = 14) as well as the contralesional hemispheric BCI accuracies (r = −0.657, p = 0.011, n = 14). As for motor dysfunction, there was a significant positive correlation between the ipsilesional BCI accuracies and FMA scores of the hand part in 8–13 Hz (r = 0.565, p = 0.035, n = 14) in the MA task and a significant positive correlation between the ipsilesional BCI accuracies and FMA scores of the hand part in 13–30 Hz (r = 0.558, p = 0.038, n = 14) in the MI task.

Conclusion: The MA task may achieve better BCI accuracy but have similar cortical activations with the MI task. Cortical activation (ERD) may influence the BCI accuracy, which should be carefully considered in the BCI motor rehabilitation of patients with hemiplegia.

Age-related differences in proprioceptive asymmetries

Age-related differences in proprioceptive asymmetries have received little attention. This study aimed to determine differences in asymmetry of the right/left upper limb proprioceptive systems between younger and older adults. Asymmetries were compared in two "eyes closed" experiments involving the same elbow joints. Position sense was tested in two matching conditions: ipsilateral remembered and contralateral concurrent. Movement sense was tested while reproducing with the opposite forearm the illusory movement elicited by distal tendon vibration applied to the reference forearm. Older adults exhibited a larger error when matching with the non-dominant than dominant forearm in the ipsilateral remembered condition and a disparate asymmetry in the contralateral condition when compared to younger adults. In addition, in older adults, the velocity of reproduced illusory movements was slower, and asymmetry in movement perception was not significant. The difference in proprioceptive asymmetry between younger and older adults might be attributed to a significant reduction of the sensory system gain affecting, more particularly, the left non-dominant arm sensory system via several physiological and neurophysiological mechanisms.

Thalamo-cortical network dysfunction in temporal lobe epilepsy

OBJECTIVES

Imaging and neurophysiological data shows that the cortical disfunction caused by focal epilepsy is not limited to the epileptic focus, thus raising the modern vision of focal epilepsy as a network disorder. The involvement of deep thalamo-cortical projections in temporal lobe epilepsy is a clear example. We aimed at demonstrating the interictal functional impairment of thalamo-cortical network in drug-naïve TLE patients through the study of high frequency oscillations of somatosensory evoked potentials (HF-SEP).

METHODS

Twelve healthy controls (HC; 8 females, 52.2 ± 17.3 years-old) and 12 drug-naïve TLE patients (8 females, 55.5 ± 21.5 years-old) underwent bilateral median HF-SEP, recorded by scalp electrodes. Cp3'-Fz and Cp4'-Fz traces were filtered (400-800 Hz) to evidence HF-SEP.

RESULTS

HF-SEP duration in the affected hemisphere was significantly longer when compared to that of both the unaffected hemisphere and HC hemispheres. No significant inter-hemispheric differences were found in areas, powers and latencies of HF-SEP wavelets.

CONCLUSION

Our results demonstrate that TLE induces early interictal functional impairments of the thalamo-cortical network.

SIGNIFICANCE

Our data strongly corroborates the vision of focal epilepsy as a network disorder and offers a new neurophysiological tool to test pharmacological, surgical and neuromodulatory therapies.

Effects of side-dominance on knee joint proprioceptive target-matching asymmetries

AIMS

Right- and left-side-dominant individuals reveal target-matching asymmetries between joints of the dominant and non-dominant upper limbs. However, it is unclear if such asymmetries are also present in lower limb's joints. We hypothesized that right-side-dominant participants perform knee joint target-matching tasks more accurately with their non-dominant leg compared to left-side-dominant participants.

METHODS

Participants performed position sense tasks using each leg by moving each limb separately and passively on an isokinetic dynamometer.

RESULTS

Side-dominance affected (p < 0.05) knee joint absolute position errors only in the non-dominant leg but not in the dominant leg: right-side-dominant participants produced less absolute position errors (2.82° ± 0.72°) with the non-dominant leg compared to left-side-dominant young participants (3.54° ± 0.33°).

CONCLUSIONS

In conclusion, right-side-dominant participants tend to perform a target-matching task more accurately with the non-dominant leg compared to left-side-dominant participants. Our results extend the literature by showing that right-hemisphere specialization under proprioceptive target-matching tasks may be not evident at the lower limb joints.

Active prosthesis dependent functional cortical reorganization following stroke

The present study investigated the neural correlates associated with gait improvements triggered by an active prosthesis in patients with drop-foot following stroke during the chronic stage. Eleven patients took part in the study. MEG recordings in conjunction with somatosensory stimulation of the left and right hand as well as gait analyses were performed shortly before or after prosthesis implantation surgery and 3–4 months later. Plastic changes of the sensorimotor cortex of the ipsi- and contralesional hemisphere were revealed. Gait analysis indicated that all patients improved their gait with the active prosthesis. Patients with larger plastic changes within the lesioned hemisphere maintained their improved gait performance even when the prosthesis was turned off. Patients with larger contralesional changes also improved their gait with the active prosthesis. However, their gait measures decreased when the prosthesis was turned off. The current data provide the neural basis of gait improvement triggered by an active prosthesis and has important implications with respect to the choice of the type of active prosthesis (implantable vs removable) and to the selection procedure of the patients (length of testing period).

Cortical plasticity in patients with median nerve lesions studied with MEG

We have previously shown age- and time-dependent effects on brain activity in the primary somatosensory cortex (SI), in a functional magnetic resonance imaging (fMRI) study of patients with median nerve injury. Whereas fMRI measures the hemodynamic changes in response to increased neural activity, magnetoencephalography (MEG) offers a more concise way of examining the evoked response, with superior temporal resolution. We therefore wanted to combine these imaging techniques to gain additional knowledge of the plasticity processes in response to median nerve injury. Nine patients with median nerve trauma at the wrist were examined with MEG. The N1 and P1 responses at stimulation of the injured median nerve at the wrist were lower in amplitude compared to the healthy side (p < .04). Ulnar nerve stimulation of the injured hand resulted in larger N1 amplitude (p < .04). The amplitude and latency of the response did not correlate with the sensory discrimination ability. There was no correlation between N1 amplitude and size of cortical activation in fMRI. There was no significant difference in N1 latency between the injured and healthy median nerve. N1 latency correlated positively with age in both the median and ulnar nerve, and in both the injured and the healthy hand (p < .02 or p < .001). It is concluded that conduction failure in the injured segment of the median nerve decreases the amplitude of the MEG response. Disinhibition of neighboring cortical areas may explain the increased MEG response amplitude to ulnar nerve stimulation. This can be interpreted as a sign of brain plasticity.

Spatiotemporal dynamics of bimanual integration in human somatosensory cortex and their relevance to bimanual object manipulation

Little is known about the spatiotemporal dynamics of cortical responses that integrate slightly asynchronous somatosensory inputs from both hands. This study aimed to clarify the timing and magnitude of interhemispheric interactions during early integration of bimanual somatosensory information in different somatosensory regions and their relevance for bimanual object manipulation and exploration. Using multi-fiber probabilistic diffusion tractography and MEG source analysis of conditioning-test (C-T) median nerve somatosensory evoked fields in healthy human subjects, we sought to extract measures of structural and effective callosal connectivity between different somatosensory cortical regions and correlated them with bimanual tactile task performance. Neuromagnetic responses were found in major somatosensory regions, i.e., primary somatosensory cortex SI, secondary somatosensory cortex SII, posterior parietal cortex, and premotor cortex. Contralateral to the test stimulus, SII activity was maximally suppressed by 51% at C-T intervals of 40 and 60 ms. This interhemispheric inhibition of the contralateral SII source activity correlated directly and topographically specifically with the fractional anisotropy of callosal fibers interconnecting SII. Thus, the putative pathway that mediated inhibitory interhemispheric interactions in SII was a transcallosal route from ipsilateral to contralateral SII. Moreover, interhemispheric inhibition of SII source activity correlated directly with bimanual tactile task performance. These findings were exclusive to SII. Our data suggest that early interhemispheric somatosensory integration primarily occurs in SII, is mediated by callosal fibers that interconnect homologous SII areas, and has behavioral importance for bimanual object manipulation and exploration.

Upper limb kinesthetic asymmetries: gender and handedness effects

Proprioceptive and motor information contribute to movement representation; however, the equivalence of homologous contralateral sensorimotor processes as a function of gender and handedness has received little attention. The present work investigated asymmetry in contralateral reproductions of movements elicited by tendon vibration in right and left handed young adults of both genders. With eyes closed, illusions of elbow flexion movement elicited by a 100 Hz vibration applied to the distal tendon of the right or left triceps muscle were matched concurrently with the opposite limb. Overall, movement velocity was larger for females than males, asymmetric and handedness dependent in males. Conversely, consistent symmetry was found between left and right-handed females. These findings lead us to suggest that hand preference and gender contribute to differences in movement representation that may result from the combination of cortical structural differences and information processing specific to each hemisphere and gender.

Glutamate-mediated primary somatosensory cortex excitability correlated with circulating copper and ceruloplasmin

Objective. To verify whether markers of metal homeostasis are related to a magnetoencephalographic index representative of glutamate-mediated excitability of the primary somatosensory cortex. The index is identified as the source strength of the earliest component (M20) of the somatosensory magnetic fields (SEFs) evoked by right median nerve stimulation at wrist. Method. Thirty healthy right-handed subjects (51 ± 22 years) were enrolled in the study. A source reconstruction algorithm was applied to assess the amount of synchronously activated neurons subtending the M20 and the following SEF component (M30), which is generated by two independent contributions of gabaergic and glutamatergic transmission. Serum copper, ceruloplasmin, iron, transferrin, transferrin saturation, and zinc levels were measured. Results. Total copper and ceruloplasmin negatively correlated with the M20 source strength. Conclusion. This pilot study suggests that higher level of body copper reserve, as marked by ceruloplasmin variations, parallels lower cortical glutamatergic responsiveness.

Thalamocortical sensorimotor circuit in multiple sclerosis: an integrated structural and electrophysiological assessment

Demyelination and axonal damage are pathologic hallmarks of multiple sclerosis (MS), leading to loss of neuronal synchronization, functional disconnection amongst brain relays, and clinical sequelae. To investigate these properties, the primary component of the sensorimotor network was analyzed in mildly disabled Relapsing-Remitting MS patients without sensory symptoms at the time of the investigation. By magnetoencephalography (MEG), the recruitment pattern within the primary sensory (S1) and motor (M1) areas was estimated through the morphology of the early components of somatosensory evoked magnetic fields (SEFs), after evaluating the S1 responsiveness to sensory inputs from the contralateral arm. In each hemisphere, network recruitment properties were correlated with ispilateral thalamus volume, estimated by morphometric techniques upon high-resolution 3D structural magnetic resonance images (MRI). S1 activation was preserved, whereas SEF morphology was strikingly distorted in MS patients, marking a disruption of primary somatosensory network patterning. An unbalance of S1-M1 dynamic recruitment was documented and correlated with the thalamic volume reduction in the left hemisphere. These findings support the model of MS as a disconnection syndrome, with major susceptibility to damage experienced by nodes belonging to more frequently recruited and highly specialized networks.

Primary sensory and motor cortex activities during voluntary and passive ankle mobilization by the SHADE orthosis

This study investigates cortical involvement during ankle passive mobilization in healthy subjects, and is part of a pilot study on stroke patient rehabilitation. Magnetoencephalographic signals from the primary sensorimotor areas devoted to the lower limb were collected together with simultaneous electromyographic activities from tibialis anterior (TA). This was done bilaterally, on seven healthy subjects (aged 29 ± 7), during rest, left and right passive ankle dorsiflexion (imparted through the SHADE orthosis, O-PM, or neuromuscular electrical stimulation, NMES-PM), and during active isometric contraction (IC-AM). The effects of focussing attention on ankle passive movements were considered. Primary sensory (FS(S1)) and motor (FS(M1)) area activities were discriminated by the Functional Source Separation algorithm. Only contralateral FS(S1) was recruited by common peroneal nerve stimulation and only contralateral FS(M1) displayed coherence with TA muscular activity. FS(M1) showed higher power of gamma rhythms (33-90 Hz) than FS(S1). Both sources displayed higher beta (14-32 Hz) and gamma powers in the left than in the right hemisphere. Both sources displayed a bilateral reduction of beta power during IC-AM with respect to rest. Only FS(S1) beta band power reduced during O-PM. No beta band modulation was observed of either source during NMES-PM. Mutual FS(S1)-FS(M1) coherence in gamma2 band (61-90 Hz) showed a slight trend towards an increase when focussing attention during O-PM. Somatosensory and motor counterparts of lower limb cortical representations were discriminated in both hemispheres. SHADE was effective in generating repeatable dorsiflexion and inducing primary sensory involvement similarly to voluntary movement.

Observing touch activates human primary somatosensory cortex

We used magnetoencephalography to show that the human primary somatosensory (SI) cortex is activated by mere observation of touch. Somatosensory evoked fields were measured from adult human subjects in two conditions. First, the experimenter touched the subject's right hand with her index finger (Experienced touch). In the second condition, the experimenter touched her own hand in a similar manner (Observed touch). Minimum current estimates were computed across three consecutive 300-ms time windows (0-300, 300-600 and 600-900 ms) with respect to touch onset. During 'Experienced touch', as expected, the contralateral (left) SI cortex was strongly activated in the 0-300 ms time window. In the same time window, statistically significant activity also occurred in the ipsilateral SI, although it was only 2.5% of the strength of the contralateral activation; the ipsilateral activation continued in the 300-600 ms time window. During 'Observed touch', the left SI cortex was activated during the 300-600 ms interval; the activation strength was 7.5% of that during the significantly activated period (0-300 ms) of 'Experienced touch'. The results suggest that when people observe somebody else being touched, activation of their own somatosensory circuitry may contribute to understanding of the other person's somatosensory experience.

BA3b and BA1 activate in a serial fashion after median nerve stimulation: direct evidence from combining source analysis of evoked fields and cytoarchitectonic probabilistic maps

This study combines source analysis imaging data for early somatosensory processing and the probabilistic cytoarchitectonic maps (PCMs). Human somatosensory evoked fields (SEFs) were recorded by stimulating left and right median nerves. Filtering the recorded responses in different frequency ranges identified the most responsive frequency band. The short-latency averaged SEFs were analyzed using a single equivalent current dipole (ECD) model and magnetic field tomography (MFT). The identified foci of activity were superimposed with PCMs. Two major components of opposite polarity were prominent around 21 and 31 ms. A weak component around 25 ms was also identified. For the most responsive frequency band (50-150 Hz) ECD and MFT revealed one focal source at the contralateral Brodmann area 3b (BA3b) at the peak of N20. The component ~25 ms was localised in Brodmann area 1 (BA1) in 50-150 Hz. By using ECD, focal generators around 28-30 ms located initially in BA3b and 2 ms later to BA1. MFT also revealed two focal sources - one in BA3b and one in BA1 for these latencies. Our results provide direct evidence that the earliest cortical response after median nerve stimulation is generated within the contralateral BA3b. BA1 activation few milliseconds later indicates a serial mode of somatosensory processing within cytoarchitectonic SI subdivisions. Analysis of non-invasive magnetoencephalography (MEG) data and the use of PCMs allow unambiguous and quantitative (probabilistic) interpretation of cytoarchitectonic identity of activated areas following median nerve stimulation, even with the simple ECD model, but only when the model fits the data extremely well.

Hand sensory-motor cortical network assessed by functional source separation

The functional source separation procedure (FSS) was applied to identify the activities of the primary sensorimotor areas (SM1) devoted to hand control. FSS adds a functional constraint to the cost function of the basic independent component analysis, and obtains source activity all along different processing states. Magnetoencephalographic signals from the left SM1 were recorded in 14 healthy subjects during a simple sensorimotor paradigm--galvanic right median nerve stimuli intermingled with submaximal isometric thumb opposition. Two functional sources related to the sensory flow in the primary cortex were extracted requiring maximal responsiveness to the nerve stimulation at around 20 and 30 ms (S1a, S1b). Maximal cortico-muscular coherence was required for the extraction of the motor source (M1). Sources were multiplied by the Euclidean norm of their corresponding weight vectors, allowing amplitude comparisons among sources in a fixed position. In all subjects, S1a, S1b, M1 were successfully obtained, positioned consistently with the SM1 organization, and behaved as physiologically expected during the movement and processing of the sensory stimuli. The M1 source reacted to the nerve stimulation with higher intensity at latencies around 30 ms than around 20 ms. The FSS method was demonstrated to be able to obtain the dynamics of different primary cortical network activities, two devoted mainly to sensory inflow, and the other to the motor control of the contralateral hand. It was possible to observe each source both during pure sensory processing and during motor tasks. In all conditions, a direct comparison of source intensities can be achieved.

Defining brain–machine interface applications by matching interface performance with device requirements

Interaction with machines is mediated by human-machine interfaces (HMIs). Brain-machine interfaces (BMIs) are a particular class of HMIs and have so far been studied as a communication means for people who have little or no voluntary control of muscle activity. In this context, low-performing interfaces can be considered as prosthetic applications. On the other hand, for able-bodied users, a BMI would only be practical if conceived as an augmenting interface. In this paper, a method is introduced for pointing out effective combinations of interfaces and devices for creating real-world applications. First, devices for domotics, rehabilitation and assistive robotics, and their requirements, in terms of throughput and latency, are described. Second, HMIs are classified and their performance described, still in terms of throughput and latency. Then device requirements are matched with performance of available interfaces. Simple rehabilitation and domotics devices can be easily controlled by means of BMI technology. Prosthetic hands and wheelchairs are suitable applications but do not attain optimal interactivity. Regarding humanoid robotics, the head and the trunk can be controlled by means of BMIs, while other parts require too much throughput. Robotic arms, which have been controlled by means of cortical invasive interfaces in animal studies, could be the next frontier for non-invasive BMIs. Combining smart controllers with BMIs could improve interactivity and boost BMI applications.

Interhemispheric asymmetry of primary hand representation and recovery after stroke: A MEG study

In patients affected by monohemispheric stroke in the middle cerebral artery territory, who do not regain a normal neurological function, a positive contribution to the clinical recovery seems to be made by the involvement of primary hand representation areas in the affected hemisphere (AH), excessively asymmetric to its homologous in the unaffected hemisphere (UH). We investigated primary sensory hand areas in 41 chronic patients who had improved their clinical status without reaching complete recovery. The location and strength of the first cerebral sources activated by a contralateral galvanic median nerve stimulation (M20 and M30) were evaluated in both hemispheres, together with their interhemispheric differences. The source displacement in the AH with respect to the UH was positively correlated with clinical recovery (Spearman's rho=0.584, p=0.003). The excessive interhemispheric asymmetry - as defined on the basis of reference ranges in the healthy population - could be interpreted as the involvement of neuronal pools in the AH outside the hand 'omega zone' of the Rolandic sulcus, revealing the presence of plasticity phenomena. The present data provide support to a positive role of cerebral plasticity phenomena, partially contributing to post-stroke recovery in patients unable to achieve normal neurological function.

Functional source separation and hand cortical representation for a brain-computer interface feature extraction

A brain-computer interface (BCI) can be defined as any system that can track the person's intent which is embedded in his/her brain activity and, from it alone, translate the intention into commands of a computer. Among the brain signal monitoring systems best suited for this challenging task, electroencephalography (EEG) and magnetoencephalography (MEG) are the most realistic, since both are non-invasive, EEG is portable and MEG could provide more specific information that could be later exploited also through EEG signals. The first two BCI steps require set up of the appropriate experimental protocol while recording the brain signal and then to extract interesting features from the recorded cerebral activity. To provide information useful in these BCI stages, our aim is to provide an overview of a new procedure we recently developed, named functional source separation (FSS). As it comes from the blind source separation algorithms, it exploits the most valuable information provided by the electrophysiological techniques, i.e. the waveform signal properties, remaining blind to the biophysical nature of the signal sources. FSS returns the single trial source activity, estimates the time course of a neuronal pool along different experimental states on the basis of a specific functional requirement in a specific time period, and uses the simulated annealing as the optimization procedure allowing the exploit of functional constraints non-differentiable. Moreover, a minor section is included, devoted to information acquired by MEG in stroke patients, to guide BCI applications aiming at sustaining motor behaviour in these patients. Relevant BCI features - spatial and time-frequency properties - are in fact altered by a stroke in the regions devoted to hand control. Moreover, a method to investigate the relationship between sensory and motor hand cortical network activities is described, providing information useful to develop BCI feedback control systems. This review provides a description of the FSS technique, a promising tool for the BCI community for online electrophysiological feature extraction, and offers interesting information to develop BCI applications to sustain hand control in stroke patients.

Conditioning transcutaneous electrical nerve stimulation induces delayed gating effects on cortical response: A magnetoencephalographic study

The present study was undertaken to investigate after-effects of 7 Hz non-painful prolonged stimulation of the median nerve on somatosensory-evoked fields (SEFs). The working hypothesis that conditioning peripheral stimulations might produce delayed interfering ("gating") effects on the response of somatosensory cortex to test stimuli was evaluated. In the control condition, electrical thumb stimulation induced SEFs in ten subjects. In the experimental protocol, a conditioning median nerve stimulation at wrist preceded 6 electrical thumb stimulations. Equivalent current dipoles fitting SEFs modeled responses of contralateral primary area (SI) and bilateral secondary somatosensory areas (SII) following control and experimental conditions. Compared to the control condition, conditioning stimulation induced no amplitude modulation of SI response at the initial stimulus-related peak (20 ms). In contrast, later response from SI (35 ms) and response from SII were significantly weakened in amplitude. Gradual but fast recovery towards control amplitude levels was observed for the response from SI-P35, while a slightly slower cycle was featured from SII. These findings point to a delayed "gating" effect on the synchronization of somatosensory cortex after peripheral conditioning stimulations. This effect was found to be more lasting in SII area, as a possible reflection of its integrative role in sensory processing.

fMRI-vs-MEG evaluation of post-stroke interhemispheric asymmetries in primary sensorimotor hand areas

Growing evidence emphasizes a positive role of brain ipsilesional (IL) reorganization in stroke patients with partial recovery. Ten patients affected by a monohemispheric stroke in the middle cerebral artery territory underwent functional magnetic resonance (fMRI) and magnetoencephalography (MEG) evaluation of the primary sensory (S1) activation via the same paradigm (median nerve galvanic stimulation). Four patients did not present S1 fMRI activation [Rossini, P.M., Altamura, C., Ferretti, A., Vernieri, F., Zappasodi, F., Caulo, M., Pizzella, V., Del Gratta, C., Romani, G.L., Tecchio, F., 2004. Does cerebrovascular disease affect the coupling between neuronal activity and local haemodynamics? Brain 127, 99-110], although inclusion criteria required bilateral identifiable MEG responses. Mean Euclidean distance between fMRI and MEG S1 activation Talairach coordinates was 10.1+/-2.9 mm, with a 3D intra-class correlation (ICC) coefficient of 0.986. Interhemispheric asymmetries, evaluated by an MEG procedure independent of Talairach transformation, were outside or at the boundaries of reference ranges in 6 patients. In 3 of them, the IL activation presented medial or lateral shift with respect to the omega-shaped post-rolandic area while in the other 3, IL areas were outside the peri-rolandic region. In conclusion, despite dissociated intensity, the MEG and fMRI activations displayed good spatial consistency in stroke patients, thus confirming excessive interhemispheric asymmetries as a suitable indicator of unusual recruitments in the ipsilesional hemisphere, within or outside the peri-rolandic region.

Outcome prediction in acute monohemispheric stroke via magnetoencephalography

BACKGROUND

Following an ischemic stroke a highly variable clinical outcome is commonly evident despite similar onset symptoms as well as lesion characteristics. The aim of this study was to identify indexes providing early prediction of functional recovery, in addition to clinical severity and lesion dimension at onset of stroke.

METHODS

In 32 patients, magnetoencephalographic (MEG) parameters collected in the acute phase (<10 days from symptoms onset, T0) from affected (AH) and unaffected (UH) hemispheres at rest and evoked by sensory stimuli were evaluated in association with the clinical outcome in a stabilized phase (T1, median 7.8 months) classified with three levels: worsening, partial and full recovery.

RESULTS

Multiple multinomial logistic regression indicated AH gamma and UH delta band powers able to prognosticate clinical outcome at T1. After inclusion in this analysis, lesion volume had the strongest predictive ability, and UH delta band power remained as a predictive factor with a measurable cut-off, maximizing both sensitivity and specificity of the prediction: a patient with UH delta below cut-off would recover to some extent; a patient with UH delta above cut-off would have a probability of about 70% to worsen.

CONCLUSIONS

MEG UH delta and AH gamma band powers were found to provide useful information about long-term outcome prognosis. Only the increase of delta band activity in the unaffected hemisphere contains information about the outcome in addition to the lesion volume.

Functional source separation from magnetoencephalographic signals

We propose a novel cerebral source extraction method (functional source separation, FSS) starting from extra-cephalic magnetoencephalographic (MEG) signals in humans. It is obtained by adding a functional constraint to the cost function of a basic independent component analysis (ICA) model, defined according to the specific experiment under study, and removing the orthogonality constraint, (i.e., in a single-unit approach, skipping decorrelation of each new component from the subspace generated by the components already found). Source activity was obtained all along processing of a simple separate sensory stimulation of thumb, little finger, and median nerve. Being the sources obtained one by one in each stage applying different criteria, the a posteriori "interesting sources selection" step is avoided. The obtained solutions were in agreement with the homuncular organization in all subjects, neurophysiologically reacting properly and with negligible residual activity. On this basis, the separated sources were interpreted as satisfactorily describing highly superimposed and interconnected neural networks devoted to cortical finger representation. The proposed procedure significantly improves the quality of the extraction with respect to a standard BSS algorithm. Moreover, it is very flexible in including different functional constraints, providing a promising tool to identify neuronal networks in very general cerebral processing.

Cortical Characterization and Inter-Dipole Distance Between Unilateral Median Versus Ulnar Nerve Stimulation of Both Hands in MEG

Contralateral somatosensory evoked fields (SEF) by whole head MEG after unilateral median and ulnar nerve stimulation of both hands were studied in 10 healthy right-handed subjects. Major parameters describing cortical activity were examined to discriminate median and ulnar nerve evoked responses. Somatic sensitivity showed high similarity in the 4 study conditions for both hand and nerve. The brain SEFs consisted of 7-8 major peak stages with consistent responses in all subjects at M20, M30, M70 and M90. Comparable inter-hemispheric waveform profile but high inter-subject variability was found. Median nerve induced significantly shorter latencies in the early activities than those of the ulnar nerve. The 3D cortical maps in the post stimulus 450 ms timeframe showed for both nerves two polarity reversals, an early and a late one which is a new finding. Dipole characteristics showed differential sites for the M20 and M30 in the respective nerve. Higher dipole moments evoked by the median nerve were noticed when compared to the ulnar. Furthermore, the results of the dipole distances between both nerves for M20 were calculated to be at 11.17 mm +/- 4.93 (LH) and 16.73 mm +/- 5.66 (RH), respectively after right hand versus left hand stimulation. This study showed substantial differences in the cortical responses between median and ulnar nerve. Especially the dipole distance between median and ulnar nerve on the cortex was computed accurately for the first time in MEG. Little is known however of the cortical responses in chronic pain patients and the parameter(s) that may change in an individual patient or a group. These results provide precise basis for further evaluating cortical changes in functional disorders and disease sequelae related to median and ulnar nerves.

Long-term effects of stroke on neuronal rest activity in rolandic cortical areas

To understand the relationship between neuronal function and clinical state in the framework of stroke, the long-term poststroke rolandic spontaneous neuronal activity was studied by means of magnetoencephalography. Fifty-six patients who had suffered a unilateral stroke within the middle cerebral artery were enrolled. Median time since stroke was 2.8 years. In association with lesion features and clinical picture, total and relative band powers and the spectral entropy were analyzed in the affected (AH) and unaffected (UH) hemispheres in comparison with an age-matched control group. An increase of absolute and relative slow band powers and a reduction of relative fast band powers were found in patients' AH with respect to both UH and control values. Absolute delta band was higher than in controls also in UH. New findings were the increase of rolandic rest activity power also in the alpha band and the decrease of spectral entropy in AH with respect to both UH and control values. Moreover, our results in chronic stroke patients indicate frequency-selective alterations related to specific dysfunctions: global clinical status was mostly impaired in patients with larger lesions and increased total and slow band activity powers, whereas hand functionality was mostly disrupted in patients with subcortical involvement and reduction of high-frequency rhythms and spectral entropy. Total power increase and spectral richness decrease are in agreement with a higher synchrony of local neuronal activity, a reduction of the intracortical inhibitory network's efficiency, and an increase of neuronal excitability.

Hand cortical representation at rest and during activation: Gender and age effects in the two hemispheres

OBJECTIVE

To characterize the age- and gender- dependence of sensory hand cortical representation in the two hemispheres in healthy population.

METHODS

In 57 adults, the cerebral activity from rolandic areas as detected by magnetoencephalography was considered both in a resting state (spectral power properties) and in response to the electrical stimulation of the contralateral median nerve (M20 and M30 cortical sources).

RESULTS

We found a dependence of rest and evoked activity on age (alpha rhythm slowing, high frequency power increase, M20 latency increase, M20 strength increase, no change in M30) and on gender (higher alpha frequency, higher beta power, higher spectral entropy, lower M20 amplitude in women). These changes were quite symmetrical in the two hemispheres, making the interhemispheric differences non-dependent on age and gender. Moreover, lower total power and faster alpha rhythm appeared in the dominant hemisphere.

CONCLUSIONS

Age and gender have a significant effect on spontaneous and evoked activity at the primary sensorimotor cortex.

SIGNIFICANCE

The results consolidate the reference base in healthy population, to study pathological conditions. Inter-hemispheric asymmetries are confirmed as a sensitive indicator for the early identification of possible neuronal rearrangements due to unilateral brain injuries.

Brain plasticity in recovery from stroke: an MEG assessment

The aim of this paper was to deepen understanding about the role played by brain plasticity in obtaining clinical recovery. Eighteen patients, who had recovered partially or totally from dysfunctions due to a monohemispheric infarction within the middle cerebral artery territory, underwent magnetoencephalographic (MEG) recordings of rolandic areas cerebral activity both in rest state (spectral power properties) and in response to the electrical stimulation of the contralateral median nerve (M20 and M30 cortical sources). MEG evaluation was performed in acute (T0: mean 5 days from ischemic attach) and post-acute phase (T1: median 6 months). At T1, all the inter-hemispheric asymmetries were reduced for both spontaneous and evoked activity parameters with respect to T0. In post-acute phase, lower cortical excitability, higher delta and theta power and lower spectral entropy were associated to a worse clinical state. An unusual recruitment-as revealed by an excessive inter-hemispheric asymmetry of M20 cortical source position-correlated with higher level of clinical amelioration in the patients who showed a partial recovery. In addition to confirmative evidence that "normalization" of neural activity in both the affected and unaffected hemispheres subtends best clinical recovery, present data provide support to the positive role of cerebral plasticity phenomena--i.e. unusual neural recruitments--to regain lost functions in those patients unable to achieve total recovery.

Cortical short-term fatigue effects assessed via rhythmic brain-muscle coherence

This study is aimed at assessing the short-term effects of muscular fatigue on the sensorimotor areas organization in the left and right hemispheres. Magnetoencephalographic (MEG) and electromyographic (EMG) activities were simultaneously recorded during the execution of a non-fatiguing motor task, performed before and after a task known to induce muscle fatigue (Fatigue). Coherence between cerebral and muscular rhythms as well as cerebral and muscular rhythms spectral densities were estimated during this non-fatiguing task and at rest. The MEG-EMG coherence in the beta band (13-32 Hz) was higher after than before Fatigue. The background activity reduction during contraction with respect to rest (i.e. the cerebral reactivity) was less evident after than before Fatigue in the gamma (33-45 Hz) and beta bands. When differentiating subjects on the base of Fatigue endurance times, while a huge inter-subject variability was found, an evident intra-subject similarity was observed for left and right arms, suggesting that resistance to fatigue is more an individual ability than a motor skill differentiated for the dominant and non-dominant side. In conclusion, signs of a more selective neural recruitment, more coupled with muscular activity, appeared as short-term effects of muscular fatigue in primary sensorimotor cortical areas. Evidence suggested that the reduction of cortical recruitment and the increased cortico-muscular coupling are distinct mechanisms.

Sensory-motor interaction in primary hand cortical areas: A magnetoencephalography assessment

Movement control requires continuous and reciprocal exchange of information between activities of motor areas involved in the task program execution and those elaborating proprioceptive sensory information. Our aim was to investigate the sensorimotor interactions in the region dedicated to hand control in healthy humans, focusing onto primary sensory and motor cortices, by selecting the time window at very early latencies. Through magnetoencephalographic recordings, we obtained a simultaneous assessment of sensory cortex activity modulation due to movement and of motor cortex activity modulation due to sensory stimulation, by eliciting a galvanic stimulation to the nerve (the median nerve) innervating a muscle (the opponens pollicis), at rest or during voluntary contraction. The primary sensory and motor cortices activities were investigated respectively through excitability in response to sensory stimulation and the cortico-muscular coherence. The task was performed bilaterally. A clear reduction of the cortico-muscular coherence was found in the short time window following stimuli (between around 150-450 ms). In the same time period, the motor control of isometric contraction was preserved. This could suggest that cortical component of voluntary movement control was transiently mediated by neuronal firing rate tuning more than by cortico-muscular synchronization. In addition to the known primary sensory cortex inhibition due to movement, a more evident reduction was found for the component known to include a contribution from primary motor areas. Gating effects were lower in the dominant left hemisphere, suggesting that sensorimotor areas dominant for hand control benefit of narrowing down gating effects.

Whole-head MEG analysis of cortical spatial organization from unilateral stimulation of median nerve in both hands: No complete hemispheric homology

We examined the contralateral hemispheric cortical activity in MEG (151 ch) after unilateral median nerve stimulation of the right and left hand in twenty healthy right-handed subjects. The goal was to establish parameters to describe cortical activity of the hemispheric responses and to study the potential ability to assess differences in volunteers and patients. We focused on the within-subject similarity and differences between evoked fields in both hands. Cortical activity was characterized by the overlay display of waveforms (CWP), number of peak stages, loci of focal maxima and minima in each stage, 3D topographic maps and exemplified equivalent current dipole characteristics. The paired-wise test was used to analyze the hemispheric differences. The waveform morphology was unique across the subjects, similar CWPs were noted in both hemispheres of the individual. The contralateral hemispheric responses showed a well defined temporal-spatial activation of six to seven stages in the 500 ms window. Consistently (in over 80% of subjects), the six stages across the subjects were 20M, 30M, 50M, 70M, 90M, and 150M. A 240M was present in the left hemisphere (LH) in 15/20 subjects and in the right hemisphere (RH) in 10/20. Statistics of the latencies and amplitudes of these seven stages were calculated. Our results indicated that the latency was highly consistent and exhibited no statistical mean difference for all stages. Furthermore, no mean amplitude differences between both hemispheres at each stage were found. The patterns of magnetic fields in both hemispheres were consistent in 70% of the subjects. A laterality index (L.I.) was used for defining the magnetic field amplitude differences between two hemispheres for each individual. Overall, the absolute amplitude of the brain responses was larger in the left than in the right hemisphere in the majority of subjects (16/20), yet a significant portion (4/20) exhibited right dominance of the N20m activity. Each individual exhibited a unique CWP, there was reliable consistency of peak latencies and mean amplitudes in median nerve MEG. Nevertheless, this study indicates the limitations of using the intact hemisphere responses to compare with those from the affected (brain) side and suggests caution in assuming full homology in the cortical organization of both hemispheres. This study provides some results to address clinical issues like which parameter describes individual differences best. Whether a genuine difference is found or whether any difference may simply represent the variability encountered in a normal population.

Rhythmic brain activity at rest from rolandic areas in acute mono-hemispheric stroke: a magnetoencephalographic study

In order to deepen our knowledge of the brain's ability to react to a cerebral insult, it is fundamental to obtain a "snapshot" of the acute phase, both for understanding the neural condition immediately after the insult and as a starting point for follow-up and clinical outcome prognosis. The characteristics of the brain's spontaneous neuronal activity in perirolandic cortical areas were investigated in 32 patients who had a stroke in the middle cerebral artery (MCA) territory of one hemisphere in the previous 10 days. Magnetic fields from both left and right rolandic areas were recorded at rest with open eyes. Total and band power properties, the individual alpha frequency (IAF) and the spectral entropy were analyzed and compared with a sex-age matched control group. In agreement with electroencephalographic literature, low frequency absolute powers were higher and high frequency were lower in the affected (AH) than in the unaffected hemisphere (UH), and also their values in both hemispheres differed from control values. An IAF reduction was found in AH with respect to UH. As new findings, the total power was higher in AH than in UH, after excluding 4 right-damaged patients with cortico-subcortical lesions, who showed a completely disorganized spectral pattern. Spectral entropy was lower in AH than in UH. Clinical severity correlated with the AH decrease of gamma band power, IAF and spectral entropy. Larger lesions were associated to worse clinical pictures and MEG alterations. A lesion affecting the MCA territory of one hemisphere induces a perilesional increase of the low-frequency rhythms' spectral power within the AH rolandic areas; the same effect was present also in the UH, indicating interhemispheric diaschisis. In the AH, results showed an increase of the total power and a reduction of the spectral entropy, suggesting a higher synchrony of local neuronal activity, a reduction of the intra-cortical inhibitory networks efficiency and an increase of neuronal excitability. Direct correlation linked gamma band activity preservation and less severe clinical status. Dependence of the clinical picture, and associated spectral alterations, on the lesion volume and not on the lesion level, suggests a diffuse neuronal impairment, rather than a selective structures damage, contributing to neurological status in the acute phase of stroke.

Neural connectivity in hand sensorimotor brain areas: an evaluation by evoked field morphology

The connectivity pattern of the neural network devoted to sensory processing depends on the timing of relay recruitment from receptors to cortical areas. The aim of the present work was to uncover and quantify the way the cortical relay recruitment is reflected in the shape of the brain-evoked responses. We recorded the magnetic somatosensory evoked fields (SEF) generated in 36 volunteers by separate bilateral electrical stimulation of median nerve, thumb, and little fingers. After defining an index that quantifies the shape similarity of two SEF traces, we studied the morphologic characteristics of the recorded SEFs within the 20-ms time window that followed the impulse arrival at the primary sensory cortex. Based on our similarity criterion, the shape of the SEFs obtained stimulating the median nerve was observed to be more similar to the one obtained from the thumb (same median nerve innervation) than to the one obtained from the little finger (ulnar nerve innervation). In addition, SEF shapes associated with different brain regions were more similar within an individual than between subjects. Because the SEF morphologic characteristics turned out to be quite diverse among subjects, we defined similarity levels that allowed us to identify three main classes of SEF shapes in normalcy. We show evidence that the morphology of the evoked response describes the anatomo-functional connectivity pattern in the primary sensory areas. Our findings suggest the possible existence of a thalamo-cortico-thalamic responsiveness loop related to the different classes.

Brain sensorimotor hand area functionality in acute stroke: insights from magnetoencephalography

An understanding of the functional readjustments that the brain undergoes during the early days after a stroke would give us a major insight into how and how much neurons are capable to react to an insult. Thirty-two patients affected by an acute monohemispheric ischemic stroke were enrolled in the study. Magnetoencephalography was used to record the somatosensory-evoked fields (SEF) generated in response to median nerve stimulation. Latency, strength, and position of the related early cortical components (M20 and M30) were studied both separately within each hemisphere, and in terms of interhemispheric differences. Interhemispheric cross-correlations among SEF waveshapes in the two hemispheres were also investigated. Overall, except for some source displacement possibly induced by the perilesional edema, results did not demonstrate any unusual neural recruitment. The severity of the clinical picture was found related to the sources' strengths (both as absolute values and as interhemispheric differences), to excessive interhemispheric differences in SEF waveshapes and in the M30 latencies. Signs of an enhanced excitability were present in the affected hemisphere (AH) following a cortical lesion, usually in combination with preserved hand functionality. An enhanced excitability of the unaffected hemisphere (UH) was paired with larger lesions with cortical involvement; signs compatible with an abnormal transcallosal transmission and intracortical function of inhibitory GABAergic interneurons in the AH were found subtending UH enhancement. Spared responsiveness from Brodmann's area (BA) 2 and posterior parietal areas despite an altered response from BA 3b was found in six patients, combined to high hand functionality. Present results in acute phase increase the knowledge of the mechanisms governing brain adaptation/reaction capabilities, for future efforts to establish therapeutic and rehabilitative procedures.

District-related frequency specificity in hand cortical representation: dynamics of regional activation and intra-regional synchronization

The aim of this work was to study the degree of neuronal synchronization occurring within the portion of the somatosensory cortex devoted to hand control during an external sensory stimulation. In this way, we focused on the properties of the sensory cortical representation, rather than the more investigated motor one. To this aim, we collected magnetoencephalograhic data from healthy subjects during separate stimulation of their thumbs and little fingers and analyzed these data by means of a time-dependent 'synchronization index'. The properties of this index within the beta [16-32 Hz] and gamma [36-44 Hz] frequency bands suggest that the hand representation in the human primary cortex follows a frequency coding, in addition to the somatotopic one, for discriminating different districts. Our results showed that the gamma synchronization is higher following stimulation of the thumb than of the little finger and we suggest that the strength of gamma band synchronization works as a code for functional prevalence. In particular, our comparative analysis of the dynamic synchronization index and the signal amplitude suggests that a prevalent district (thumb) recruits a smaller number of higher-synchronic gamma band tuned neurons than a non-prevalent district (little finger).

Optimization of an independent component analysis approach for artifact identification and removal in magnetoencephalographic signals

OBJECTIVE

To propose a noise reduction procedure for magnetoencephalography (MEG) signals introducing an automatic detection system of artifactual components (ICs) separated by an independent component analysis (ICA) algorithm, and a control cycle on reconstructed cleaned data to recovery part of non-artifactual signals possibly lost by the blind mechanism.

METHODS

The procedure consisted of three main steps: (1) ICA for blind source separation (BSS); (2) automatic detection method of artifactual components, based on statistical and spectral ICs characteristics; (3) control cycle on 'discrepancy,' i.e. on the difference between original data and those reconstructed using only ICs automatically retained. Simulated data were generated as representative mixtures of some common brain frequencies, a source of internal Gaussian noise, power line interference, and two real artifacts (electrocardiogram=ECG, electrooculogram=EOG), with the adjunction of a matrix of Gaussian external noise. Three real data samples were chosen as representative of spontaneous noisy MEG data.

RESULTS

In simulated data the proposed set of markers selected three components corresponding to ECG, EOG and the Gaussian internal noise; in real-data examples, the automatic detection system showed a satisfactory performance in detecting artifactual ICs. 'Discrepancy' control cycle was redundant in simulated data, as expected, but it was a significant amelioration in two of the three real-data cases.

CONCLUSIONS

The proposed automatic detection approach represents a suitable strengthening and simplification of pre-processing data analyses. The proposed 'discrepancy' evaluation, after automatic pruning, seems to be a suitable way to render negligible the risk of loose non-artifactual activity when applying BSS methods to real data.

SIGNIFICANCE

The present noise reduction procedure, including ICA separation phase, automatic artifactual ICs selection and 'discrepancy' control cycle, showed good performances both on simulated and real MEG data. Moreover, application to real signals suggests the procedure to be able to separate different cerebral activity sources, even if characterized by very similar frequency contents.

Integrated technology for evaluation of brain function and neural plasticity

The study of neural plasticity has expanded rapidly in the past decades and has shown the remarkable ability of the developing, adult, and aging brain to be shaped by environmental inputs in health and after a lesion. Robust experimental evidence supports the hypothesis that neuronal aggregates adjacent to a lesion in the sensorimotor brain areas can take over progressively the function previously played by the damaged neurons. It definitely is accepted that such a reorganization modifies sensibly the interhemispheric differences in somatotopic organization of the sensorimotor cortices. This reorganization largely subtends clinical recovery of motor performances and sensorimotor integration after a stroke. Brain functional imaging studies show that recovery from hemiplegic strokes is associated with a marked reorganization of the activation patterns of specific brain structures. To regain hand motor control, the recovery process tends over time to bring the bilateral motor network activation toward a more normal intensity/extent, while overrecruiting simultaneously new areas, perhaps to sustain this process. Considerable intersubject variability exists in activation/hyperactivation pattern changes over time. Some patients display late-appearing dorsolateral prefrontal cortex activation, suggesting the development of "executive" strategies to compensate for the lost function. The AH in stroke often undergoes a significant "remodeling" of sensory and motor hand somatotopy outside the "normal" areas, or enlargement of the hand representation. The UH also undergoes reorganization, although to a lesser degree. Although absolute values of the investigated parameters fluctuate across subjects, secondary to individual anatomic variability, variation is minimal with regards to interhemispheric differences, due to the fact that individual morphometric characters are mirrored in the two hemispheres. Excessive interhemispheric asymmetry of the sensorimotor hand areas seems to be the parameter with highest sensitivity in describing brain reorganization after a monohemispheric lesion, and mapping motor and somatosensory cortical areas through focal TMS, fMRI, PET, EEG, and MEG is useful in studying hand representation and interhemispheric asymmetries in normal and pathologic conditions. TMS and MEG allow the detection of sensorimotor areas reshaping, as a result of either neuronal reorganization or recovery of the previously damaged neural network. These techniques have the advantage of high temporal resolution but also have limitations. TMS provides only bidimensional scalp maps, whereas MEG, even if giving three-dimensional mapping of generator sources, does so by means of inverse procedures that rely on the choice of a mathematical model of the head and the sources. These techniques do not test movement execution and sensorimotor integration as used in everyday life. fMRI and PET may provide the ideal means to integrate the findings obtained with the other two techniques. This multitechnology combined approach is at present the best way to test the presence and amount of plasticity phenomena underlying partial or total recovery of several functions, sensorimotor above all. Dynamic patterns of recovery are emerging progressively from the relevant literature. Enhanced recruitment of the affected cortex, be it spared perilesional tissue, as in the case of cortical stroke, or intact but deafferented cortex, as in subcortical strokes, seems to be the rule, a mechanism especially important in early postinsult stages. The transfer over time of preferential activation toward contralesional cortices, as observed in some cases, seems, however, to reflect a less efficient type of plastic reorganization, with some aspects of maladaptive plasticity. Reinforcing the use of the affected side can cause activation to increase again in the affected side with a corresponding enhancement of clinical function. Activation of the UH MI may represent recruitment of direct (uncrossed) corticospinal tracts and relate more to mirror movements, but it more likely reflects activity redistribution within preexisting bilateral, large-scale motor networks. Finally, activation of areas not normally engaged in the dysfunctional tasks, such as the dorsolateral prefrontal cortex or the superior parietal cortex in motor paralysis, might reflect the implication of compensatory cognitive strategies. An integrated approach with technologies able to investigate functional brain imaging is of considerable value in providing information on the excitability, extension, localization, and functional hierarchy of cortical brain areas. Deepening knowledge of the mechanisms regulating the long-term recovery (even if partial), observed for most neurologic sequelae after neural damage, might prompt newer and more efficacious therapeutic and rehabilitative strategies for neurologic diseases.

Gamma synchronization in human primary somatosensory cortex as revealed by somatosensory evoked neuromagnetic fields

Cortical sensory neurons synchronize their activity at multiple frequency bands after an external stimulation. In the somatosensory cortical areas, previous reports describe more discrete and somatotopically specific neural synchronization at the gamma band. Therefore, an efficient gamma synchronization of the neurons in primary somatosensory cortex (S1) may be expected to characterize the stimulus processing from the thumb, i.e. the hand's most skillful area. To test this hypothesis, neuromagnetic fields were evoked over human S1 by the electrical stimulation of the contralateral thumb or little finger. Neuronal synchronization was indexed by the spectral coherence of the evoked neuromagnetic fields overlying S1. The frequencies of interest were the beta (16-32 Hz) and gamma (36-46 Hz) bands. The global amount of the coherence was defined as the total event-related coherence (ERCoh) among all magnetic sensors overlying the S1. Results showed prevalent increment of beta ERCoh (20-32 Hz) after the little finger stimulation and of gamma ERCoh (36-44 Hz) after the thumb stimulation. These results suggest that the neural synchronization in S1, as revealed by the ERCoh, may vary in frequency as a function of the finger stimulated. In this framework, the neural synchronization at gamma band may characterize the cortical representation of thumb, functionally prevalent with respect to little finger in humans.

Post-stroke plastic reorganisation in the adult brain

Recovery of function after a stroke is attributable to several factors, including events in the first few days (eg, reabsorption of perilesional oedema, tissue reperfusion). However, consistent reorganisation and recovery after a stroke takes weeks or months. In the early stages, recovery from stroke can vary greatly among patients with identical clinical symptoms. Neuroimaging techniques that enable us to assess baseline and task-related functions, and neurophysiological techniques that measure brain function in "real time", can be used to study the recovery of brain lesions after a stroke. In this review, we discuss important neuroimaging and neurophysiological studies of post-stroke brain reorganisation.

Abnormal cortical sensory activation in dystonia: an fMRI study

Despite the obvious motor manifestations of focal dystonia, it is recognised that the sensory system plays an important role in this condition. This functional magnetic resonance imaging study examines the sensory representations of individual digits both within the subregions of the primary sensory cortex (SI) and in other nonprimary sensory areas. Patients with focal dystonia and controls were scanned during vibrotactile stimulation of both the index (digit 2) and little (digit 5) fingers of their dominant hand (which was the affected hand in all the dystonic subjects). The activation maps obtained were analysed for location, size, and magnitude of activation and three-dimensional (3-D) orientation of digit representations. Data from both groups were compared. There were significant differences in the average 3-D separation between the two digit representations in area 1 of SI between subject groups (9.6 +/- 1.2 mm for controls and 4.1 +/- 0.2 mm for dystonic subjects). There were also strong trends for reversed ordering of the representation of the two digits in both the secondary sensory cortex and posterior parietal area between the two groups. In addition, in dystonic subjects, there was significant under activation in the secondary somatosensory cortex (SII/area 40) for both digits and in the posterior parietal area for digit 5. These results indicate the presence of widespread activation abnormalities in the cortical sensory system in dystonia.

Carpal tunnel syndrome modifies sensory hand cortical somatotopy: a MEG study

The adult somatosensory system has shown reorganizational abilities at cortical and subcortical levels after peripheral nerve lesions. In the present study the effects of carpal tunnel syndrome (CTS) are investigated as reflected on the somatotopy of the primary cortical hand representation. Position and intensity of cortical sources activated by the separate electrical stimulation of median nerve and Digits 1, 3, and 5 of both affected and non-affected hands are evaluated by magnetoencephalographic (MEG) technique. Correlation of MEG results with patient-, physician- and neurophysiological-oriented evaluations of CTS was carried out. Patients showed changes in cortical hand somatotopy in strict relationship to self-referred assessment of symptoms and hand disability in daily activities, including: 1) a more extended representation of the affected hand when paresthesias prevailed; and 2) a more restricted representation due to lateral shift of the little finger was observed when pain symptoms dominated the clinical picture. Contralateral to the side of CTS, the cortical sources activated by Digit 5-stimulation appeared significantly enhanced with respect to contralateral ones from non-affected hand. When comparing the amplitude of peripheral sensory nerve action potentials of median and ulnar nerves to that of cortical responses (i.e., ECD strengths of M20 and M30 components after stimulation of Digits 3 and 5), a significant selective amplification of M30 with respect to M20 and sensory nerve action potential (SNAP) appeared during Digit 3 stimulation compared to that observed for Digit 5. This has been interpreted as a central magnification mechanism in brain responsiveness, possibly revealing a safety factor enabling sensory perception despite the small peripheral signal due to nerve trunk dysfunction. Hum.

Somatotopic organization of the ventral and dorsal finger surface representations in human primary sensory cortex evaluated by magnetoencephalography

Cortical reorganization of the subtly differentiated hand map after peripheral nerve injury might be better understood if there was a topographic conception of the homuncular representation of the dorsal finger surfaces in humans, in addition to the well-established sequential rostrocaudal array of the ventral finger aspects in cortical area 3b. In the present magnetoencephalographic study, tactile pneumatic stimulation was delivered to the fingertip and to the ventral and dorsal proximal phalanx of each digit of the dominant hand in 20 right-handed volunteers. Source localization of equivalent current dipoles underlying the recorded somatosensory evoked magnetic field was performed using a Cartesian coordinate system established by the anatomical landmarks nasion and preauricular points. Of the first major peak of each somatosensory evoked field, the region with the maximum field power (root-mean-square across channels) was selected for source reconstruction. Analysis of variance for repeated measures yielded significant results with respect to the arrangement of digits along the vertical coordinate axis, demonstrating a sequential array from the most inferiorly located D1 to the most superiorly located D5 for all different stimulus positions. This is the first study providing evidence for a sequential topographical arrangement of not only the ventral but also the dorsal surface representations of the individual digits in the human somatosensory cortex. The study contributes to a better understanding of the somatosensory hand representation in human primary cortex and provides useful information with regard to cortical plasticity studies in patients with peripheral nerve injuries at the upper extremity.

Interhemispheric differences of sensory hand areas after monohemispheric stroke: MEG/MRI integrative study

Seventeen clinically stabilized monohemispheric stroke patients were studied in order to investigate the chronic topographical modifications induced on primary sensory cortical hand areas by a monohemispheric stroke within the middle cerebral artery territory. Magnetoencephalographic (MEG) localization of the cortical areas activated following electrical separate stimulation of the median nerve, thumb, and little fingers was integrated with magnetic resonance imaging. Spatial localization of Equivalent Current Dipoles (ECDs) of the short-latency cortical responses generated in primary sensory cortices, "hand area" (distance between 1st and 5th digits ECDs), interhemispheric differences of such parameters, as well as of somatosensory-evoked fields waveshapes were investigated and compared with a control population. Lesions involving the cortico-subcortical areas receiving sensory input from the hand induced excessive asymmetry of MEG spatial parameters and response morphology between the unaffected (UH) and the affected hemisphere (AH). "Hand area" was significantly larger on AH in 20% of cases after a subcortical, and in 13% after a cortical, lesion. Responses from AH were excessively delayed in 20% ECDs. Interhemispheric ECDs strength differences were larger than normal in 25% of cases after both types of lesions; the strength in the AH being enlarged after all cortical, and only 24% of subcortical strokes. In a significant percentage of monohemispheric strokes, excessive interhemispheric differences were found between AH and UH, suggesting that brain areas outside the normal boundaries and usually not reached by a dense sensory input from the opposite hand and fingers may act as somatosensory "hand" centers. Correlation analysis between clinical outcome and cortical reorganization in the AH suggests that this mechanism is linked with hand sensorimotor recovery.

Conscious and preconscious adaptation to rhythmic auditory stimuli: a magnetoencephalographic study of human brain responses

This study was triggered by the experimental evidence that subjects required to tap in synchrony with a heard rhythm spontaneously time their tapping to variations in rhythm frequency even when these variations are so small that they are not consciously detectable. We performed a series of magnetoencephalographic (MEG) measurements, aimed at investigating whether the response of the auditory cortex discriminates randomly administered series of brief tones differing from each other only by their interstimulus intervals (ISI). Moreover, by combining psychophysical measurements, conscious and preconscious adjustments of tapping to rhythm variations were compared with brain cortical responses. The ISIs were varied by 2% or 20% from a "central" value of 500 ms. Subjects always consciously detected the 20% ISI changes and easily adjusted their tapping accordingly, whereas they never consciously detected the 2% ISI changes, even though they always correctly adjusted their tapping to them. Analysis of the auditory evoked fields (AEFs) showed that the intensity of the M100 component decreased with decreasing ISI both for 20% and 2% variations in a statistically significant manner, despite the fact that the 2% variation was not consciously perceived. The M100 behavior indicated that connections between auditory and motor cortexes may exist that are able to use the information on rhythm variations in the stimuli even when these are not consciously identified by the subject. The ability of the auditory cortex to discriminate different time characteristics of the incoming rhythmic stimuli is discussed in this paper in relation to the theories regarding the physiology of time perception and discrimination.