Sustained attention modulates the immediate effect of de-afferentation on the cortical representation of the digits: source localization of somatosensory evoked potentials in humans

GABA Modulates Frequency-Dependent Plasticity in Humans

Frequency-dependent reorganization of the primary somatosensory cortex, together with perceptual changes, arises following repetitive sensory stimulation. Here, we investigate the role of GABA in this process. We co-stimulated two finger tips and measured GABA and Glx using magnetic resonance (MR) spectroscopy at the beginning and end of the stimulation. Participants performed a perceptual learning task before and after stimulation. There were 2 sessions with stimulation frequency either at or above the resonance frequency of the primary somatosensory cortex (23 and 39 Hz, respectively). Perceptual learning occurred following above resonance stimulation only, while GABA reduced during this condition. Lower levels of early GABA were associated with greater perceptual learning. One possible mechanism underlying this finding is that cortical disinhibition “unmasks” lateral connections within the cortex to permit adaptation to the sensory environment. These results provide evidence in humans for a frequency-dependent inhibitory mechanism underlying learning and suggest a mechanism-based approach for optimizing neurostimulation frequency.

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In the context of repetitive sensory stimulation, GABA release is frequency dependent

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Stimulating above the resonance frequency of the somatosensory cortex reduces GABA

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Perceptual learning is associated with a reduction in GABA

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Early GABA reduction opens a window for plasticity and learning

Repetitive Passive Movement Modulates Corticospinal Excitability: Effect of Movement and Rest Cycles and Subject Attention

Repetitive passive movement (PM) affects corticospinal excitability; however, it is unknown whether a duty cycle which repeats movement and rest, or subjects’ conscious attention to movements, affects corticospinal excitability. We aimed to clarify the effect of the presence or absence of a duty cycle and subjects’ attention on corticospinal excitability. Three experiments were conducted. In Experiment 1, PM of the right index finger was performed for 10 min. Three conditions were used: (1) continuous PM (cPM) at a rate of 40°/s; (2) intermittent PM (iPM) with a duty cycle at 40°/s; and (3) iPM at 100°/s. In conditions 1 and 3, motor evoked potential (MEP) amplitude was significantly reduced. In Experiment 2, PM was performed for 30 min: condition 1 comprised cPM at a rate of 40°/s and Condition 2 comprised iPM at 40°/s. MEP amplitude significantly decreased in both conditions. In Experiment 3, PM was performed for 10 min: condition 1 comprised paying attention to the moving finger during iPM and Condition 2 was similar to Condition 1 but while counting images on a monitor without looking at the movement finger, and Condition 3 comprised counting images on a monitor without performing PM. MEP amplitude significantly increased only under Condition 1. Thus, afferent input from movements above a certain threshold may affect corticospinal excitability reduction. Furthermore, corticospinal excitability increases when paying attention to passive finger movement.

The effect of local vs remote experimental pain on motor learning and sensorimotor integration using a complex typing task

Recent work demonstrated that capsaicin-induced acute pain improved motor learning performance; however, baseline accuracy was very high, making it impossible to discern the impact of acute pain on motor learning and retention. In addition, the effects of the spatial location of capsaicin application were not explored. Two experiments were conducted to determine the interactive effects of acute pain vs control (experiment 1) and local vs remote acute pain (experiment 2) on motor learning and sensorimotor processing. For both experiments, somatosensory evoked potential (SEP) amplitudes and motor learning acquisition and retention (accuracy and response time) data were collected at baseline, after application, and after motor learning. Experiment 1: N11 (P < 0.05), N13 (P < 0.05), and N30 (P < 0.05) SEP peak amplitudes increased after motor learning in both groups, whereas the N20 SEP peak increased in the control group (P < 0.05). At baseline, the intervention group outperformed the control group in accuracy (P < 0.001). Response time improved after motor learning (P < 0.001) and at retention (P < 0.001). Experiment 2: The P25 SEP peak decreased in the local group after application of capsaicin cream (P < 0.01), whereas the N30 SEP peaks increased after motor learning in both groups (P < 0.05). Accuracy improved in the local group at retention (P < 0.005), and response time improved after motor learning (P < 0.005) and at retention (P < 0.001). This study suggests that acute pain may increase focal attention to the body part used in motor learning, contributing to our understanding of how the location of pain impacts somatosensory processing and the associated motor learning.

Cortical reorganization after macroreplantation at the upper extremity: a magnetoencephalographic study

With the development of microsurgical techniques, replantation has become a feasible alternative to stump treatment after the amputation of an extremity. It is known that amputation often induces phantom limb pain and cortical reorganization within the corresponding somatosensory areas. However, whether replantation reduces the risk of comparable persisting pain phenomena as well as reorganization of the primary somatosensory cortex is still widely unknown. Therefore, the present study aimed to investigate the potential development of persistent pain and cortical reorganization of the hand and lip areas within the sensory cortex by means of magnetoencephalographic dipole analyses after replantation of a traumatically amputated upper limb proximal to the radiocarpal joint. Cortical reorganization was investigated in 13 patients with limb replantation using air puff stimulation of the phalanges of both thumbs and both corners of the lower lip. Displacement of the centre of gravity of lip and thumb representations and increased cortical activity were found in the limb and face areas of the primary somatosensory cortex contralateral to the replanted arm when compared to the ipsilateral hemisphere. Thus, cortical reorganization in the primary somatosensory cortex also occurs after replantation of the upper extremity. Patients' reports of pain in the replanted body part were negatively correlated with the amount of cortical reorganization, i.e. the more pain the patients reported, the less reorganization of the subjects' hand representation within the primary somatosensory cortex was observed. Longitudinal studies in patients after macroreplantation are necessary to assess whether the observed reorganization in the primary somatosensory cortex is a result of changes within the representation of the replanted arm and/or neighbouring representations and to assess the relationship between the development of persistent pain and reorganization.

The effect of electrical stimulation on corticospinal excitability is dependent on application duration: a same subject pre-post test design

BACKGROUND

In humans, corticospinal excitability is known to increase following motor electrical stimulation (ES) designed to mimic a voluntary contraction. However, whether the effect is equivalent with different application durations and whether similar effects are apparent for short and long applications is unknown. The aim of this study was to investigate whether the duration of peripheral motor ES influenced its effect on corticospinal excitability.

METHODS

The excitability of the corticomotor pathway to abductor pollicis brevis (APB) was measured in fourteen health subjects using transcranial magnetic stimulation before, immediately after and 10 minutes after three different durations (20-, 40-, 60-min) of motor ES (30Hz, ramped). This intervention was designed to mimic a voluntary contraction in APB. To control for effects of motor ES on the peripheral elements (muscle fibre, membrane, neuromuscular junction), maximum compound muscle actions potentials (M-waves) were also recorded at each time point. Results were analysed using a repeated measures analysis of variance.

RESULTS

Peripheral excitability was reduced following all three motor ES interventions. Conversely, corticospinal excitability was increased immediately following 20- and 40-min applications of motor ES and this increase was maintained at least 20-min following the intervention. A 60-min application of motor ES did not alter corticospinal excitability.

CONCLUSIONS

A 20-min application of motor ES that is designed to mimic voluntary muscle contraction is as effective as that applied for 40-min when the aim of the intervention is to increase corticospinal excitability. Longer motor ES durations of 60-min do not influence corticospinal excitability, possibly as a result of homeostatic plasticity mechanisms.

Interactions within the hand representation in primary somatosensory cortex of primates

Previous studies indicate that primary somatosensory cortical area 3b in macaques contains a somatotopic map of the hand, encompassing representations of each digit. However, numerous observations including recent findings in anesthetized New World monkeys indicate that that the digit representations within the map are not discrete. We assessed the generality and spatial extent of these effects in awake macaques. We show that, within a given digit representation, (1) there is response to stimulation of all other digits tested, extending across most or all of the digit map, and (2) response to stimulation of the locally preferred digit is modulated by concurrent stimulation of each of the other digits. Control experiments rule out effects of attention and mechanical spread of stimulation. We thus confirm that, even at the first level of somatosensory cortical processing, inputs from potentially all of the digits frame the context within which the input to a single digit is represented.

Short-term modulation of the ipsilateral primary sensory cortex by nociceptive interference revealed by SEPs

We studied the modulation of the topographic arrangement of the human ipsilateral primary somatosensory cortex following interference of nociceptive stimuli by means of dipole source analysis. Multichannel somatosensory evoked potentials were obtained by electrical stimulation of digits 1 and 5 of the left hand before, during and after the application of pain to digits 2-4 of the right hand. The primary cortical response of the SEP (N20) was obtained for dipole localization of the representation of the primary sensory cortex receiving input from digits 1 to 5. The 3D-distance between these sides was calculated for further analysis. To account for possible attentional effects recordings were performed while simultaneously to this intervention subjects were asked to turn their attention to the right or left hand in a pseudorandom order. The application of pain induced an expansion of the 3D-distance between digits 1 and 5. Focusing attention to the stimulated limb or the site of the intervention did not yield to an additional effect. Our results provide further evidence for the presence of a quickly adapting interaction between primary somatosensory areas of both hemispheres following an interference of nociceptive stimulation in SEPs. This modifying process is probably mediated by interhemispheric and intercortical connections leading to hyperexcitability of the primary sensory cortex contralateral to that receiving nociceptive input. Spatial attention does not seem to have an impact on this kind of short-term intercortical plasticity.

Improvement of spatial tactile acuity by transcranial direct current stimulation

OBJECTIVE

Non-invasive brain stimulation such as transcranial direct current stimulation (tDCS) has been successfully used to induce polarity-specific excitability changes in the brain. However, it is still unknown if anodal tDCS (tDCS(anodal)) applied to the primary somatosensory cortex (S1) can lead to behavioral changes in performance of tactile discriminative tasks.

METHODS

Using an accurate tactile discrimination task (grating orientation task: GOT) we tested the hypothesis that application of 1mA of tDCS(anodal) (current density at the electrodes of 0.04mA/cm2) over the left S1 can lead to an improved tactile spatial acuity in the contralateral index-finger (IF).

RESULTS

Performance in the GOT task with the contralateral IF but not with the ipsilateral IF was enhanced for about 40min after a 20min application of tDCS(anodal) in the absence of changes with sham stimulation.

CONCLUSIONS

These results provide the first evidence that tDCS(anodal) over S1 improves performance in a complex somatosensory task beyond the period of stimulation.

SIGNIFICANCE

The ability to induce performance improvement in the somatosensory domain with tDCS applied over S1 could be used to promote functional recovery in patients with diminished tactile perception.

Studying the human somatosensory hand area: A new way to compare fMRI and MEG

Valid localization is a prerequisite to study plasticity of the somatosensory cortex in humans. We compared the localizations of left and right thumb and little finger in the primary somatosensory cortex obtained with fMRI and MEG. Representations were investigated in 11 healthy right-handed subjects using echoplanar fMRI and 122-channel MEG together with electric finger stimulation. Activation observed with fMRI was based on an increase in the BOLD signal. Most of the activation clusters (71.1%) were located on the lateral surface of the postcentral gyrus. Representations of thumb and little finger were 17mm apart on average and consistently showed a somatotopic arrangement with the thumb representation inferior, lateral, and anterior to the representation of the little finger. Activation observed with MEG was modelled by equivalent current dipoles. Dipole localization was compatible with an assumed origin of activation within the posterior wall of the central sulcus. The Euclidian distance between corresponding dipoles was 11.5mm on average with deviations from the expected spatial arrangement of 35, 30, and 20% in the x-, y- und z-direction, respectively. Our study demonstrates how relative localization of somatosensory activations can serve as an indicator for localization validity when comparing different methods or studying somatosensory plasticity.

Short-term cortical reorganization by deafferentation of the contralateral sensory cortex

The topographic arrangement of the human primary somatosensory cortex following deafferentation of the contralateral cortex has been investigated by means of dipole source analysis. Somatosensory-evoked potentials were obtained by electrical stimulation of digit 1 and digit 5 of the left hand before and after anesthesia of digits 2-4 of the right hand during different terms of attention. Anesthesia induced an expansion of the three-dimensional distance between digits 1 and 5. This suggests intercortical plasticity modulated between bilateral primary somatosensory cortical areas, which is unaffected by spatial attention. These changes occur rapidly and are probably mediated by disinhibition of intercortical connections, leading to hyperexcitability of the primary sensory cortex that is contralateral to the region undergoing deafferentation.

Tactile hyperacuity thresholds correlate with finger maps in primary somatosensory cortex (S1)

Behavioral tactile discrimination thresholds were compared with functional magnetic resonance imaging measurements of cortical finger representations within primary somatosensory cortex (S1) for 10 human subjects to determine whether cortical magnification in S1 could account for the variation in tactile hyperacuity thresholds of the fingers. Across 10 subjects, the increase in tactile thresholds from the index finger to the little finger correlated with the decrease in cortical representation across fingers in S1. Additionally, representations of the fingers within S1, in Brodmann areas 3b and 1, were also correlated with the thresholds. These results suggest that tactile hyperacuity is largely determined by the cortical representation of the fingers in S1.

A functional architecture of optic flow in the inferior parietal lobule of the behaving monkey

The representation of navigational optic flow across the inferior parietal lobule was assessed using optical imaging of intrinsic signals in behaving monkeys. The exposed cortex, corresponding to the dorsal-most portion of areas 7a and dorsal prelunate (DP), was imaged in two hemispheres of two rhesus monkeys. The monkeys actively attended to changes in motion stimuli while fixating. Radial expansion and contraction, and rotation clockwise and counter-clockwise optic flow stimuli were presented concentric to the fixation point at two angles of gaze to assess the interrelationship between the eye position and optic flow signal. The cortical response depended upon the type of flow and was modulated by eye position. The optic flow selectivity was embedded in a patchy architecture within the gain field architecture. All four optic flow stimuli tested were represented in areas 7a and DP. The location of the patches varied across days. However the spatial periodicity of the patches remained constant across days at ∼950 and 1100 µm for the two animals examined. These optical recordings agree with previous electrophysiological studies of area 7a, and provide new evidence for flow selectivity in DP and a fine scale description of its cortical topography. That the functional architectures for optic flow can change over time was unexpected. These and earlier results also from inferior parietal lobule support the inclusion of both static and dynamic functional architectures that define association cortical areas and ultimately support complex cognitive function.

Cortical Dynamics As A Therapeutic Mechanism for Touch Healing

Touch Healing (TH) therapies, defined here as treatments whose primary route of administration is tactile contact and/or active guiding of somatic attention, are ubiquitous across cultures. Despite increasing integration of TH into mainstream medicine through therapies such as Reiki, Therapeutic Touch,(TM) and somatically focused meditation practices such as Mindfulness-Based Stress Reduction, relatively little is known about potential underlying mechanisms. Here, we present a neuroscientific explanation for the prevalence and effectiveness of TH therapies for relieving chronic pain. We begin with a cross-cultural review of several different types of TH treatments and identify common characteristics, including: light tactile contact and/or a somatosensory attention directed toward the body, a behaviorally relevant context, a relaxed context and repeated treatment sessions. These cardinal features are also key elements of established mechanisms of neural plasticity in somatosensory cortical maps, suggesting that sensory reorganization is a mechanism for the healing observed. Consideration of the potential health benefits of meditation practice specifically suggests that these practices provide training in the regulation of neural and perceptual dynamics that provide ongoing resistance to the development of maladaptive somatic representations. This model provides several direct predictions for investigating ways that TH may induce cortical plasticity and dynamics in pain remediation.

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.

Effects of motor activity on the organization of primary somatosensory cortex

Recent studies have shown that adaptation of representational maps within the primary somatosensory cortex can be induced by task-related motor activity. Here, we explore the relationship between the complexity of the motor task and the extent of task-specific adaptation within the primary somatosensory cortex. We hypothesized that the extent of adaptation increases with the complexity of the motor task. Using neuromagnetic source imaging based on electrical stimulation of the thumb and ring finger, we demonstrate that cortical finger representations are more distant during performance of the pinch finger grip than in a rest condition. Our data suggest that somatosensory cortical maps undergo rapid modulation depending on the task-specific involvement of somatosensory feedback in movements.

Investigations of dipole localization accuracy in MEG using the bootstrap

We describe the use of the nonparametric bootstrap to investigate the accuracy of current dipole localization from magnetoencephalography (MEG) studies of event-related neural activity. The bootstrap is well suited to the analysis of event-related MEG data since the experiments are repeated tens or even hundreds of times and averaged to achieve acceptable signal-to-noise ratios (SNRs). The set of repetitions or epochs can be viewed as a set of independent realizations of the brain's response to the experiment. Bootstrap resamples can be generated by sampling with replacement from these epochs and averaging. In this study, we applied the bootstrap resampling technique to MEG data from somatotopic experimental and simulated data. Four fingers of the right and left hand of a healthy subject were electrically stimulated, and about 400 trials per stimulation were recorded and averaged in order to measure the somatotopic mapping of the fingers in the S1 area of the brain. Based on single-trial recordings for each finger we performed 5000 bootstrap resamples. We reconstructed dipoles from these resampled averages using the Recursively Applied and Projected (RAP)-MUSIC source localization algorithm. We also performed a simulation for two dipolar sources with overlapping time courses embedded in realistic background brain activity generated using the prestimulus segments of the somatotopic data. To find correspondences between multiple sources in each bootstrap, sample dipoles with similar time series and forward fields were assumed to represent the same source. These dipoles were then clustered by a Gaussian Mixture Model (GMM) clustering algorithm using their combined normalized time series and topographies as feature vectors. The mean and standard deviation of the dipole position and the dipole time series in each cluster were computed to provide estimates of the accuracy of the reconstructed source locations and time series.

Reduction of somatosensory evoked fields in the primary somatosensory cortex in a one-back task

In the present study, responses of the somatosensory cortex to sensory input of ten human volunteers were investigated during a one-back task with different conditions of attention. During an condition of attention subjects were requested to detect a predefined sequence of tactile stimuli applied to two different fingers of the dominant hand while a series of visual stimuli was presented simultaneously with an asynchronous stimulus-onset to the tactile stimuli. During an condition of distraction subjects received the identical series of visual and tactile stimuli like in the condition of attention but were now requested to detect a predefined stimulus sequence within the visual stimulus domain. In both conditions, somatosensory evoked magnetic fields (SEFs) to the tactile stimuli were recorded by means of a 31-channel magnetoencephalograph (MEG) from subjects' contralateral primary somatosensory cortex. The mean global field power, the dipole strength, the maximum current density, and the first component of the singular value decomposition (SVD) of magnetic fields were used to compare early components of the SEF in the conditions of attention versus distraction. Surprisingly, results revealed significant decreases of measures of all four parameters during the condition of attention as compared to the condition of distraction indicating that early responses of the primary somatosensory cortex became significantly reduced in the condition of attention. We hypothesize that changes in the centre-periphery-relationship of receptive fields in the primary somatosensory cortex may account for this unexpected result.

Perceptual context-dependent remodeling of the forepaw map in the SI cortex of rats trained on tactile discrimination

We combined behavioral assessment of texture discrimination and electrophysiological mapping of concomitant reorganization in the forepaw representation within the SI cortex. Rats were housed in enriched (EE) or impoverished (IE) environments which have been shown to remodel the forepaw map and possibly alter discriminative abilities. In addition, animals were trained to discriminate homogeneous floorboards of invariant roughness from heterogeneous floorboards of gradually decreasing roughness contrasts during locomotion. As reported recently, differences in perceptual abilities were not related to housing conditions, but to a predilection for a floorboard type [Bourgeon S, Xerri C, Coq JO. Abilities in tactile discrimination of textures in adult rats exposed to enriched or impoverished environments. Behav Brain Res 2004;153:217-231]. Consistently, the present study shows that cortical map remodeling resulting from short-duration daily experience can prevail over changes induced by housing conditions. The relative area of glabrous skin representation was related to the discrimination performance and learning abilities in the rats (H) with a predilection for heterogeneous floorboards, i.e. in the animals performing discrimination in the most challenging perceptual context. By contrast, this cortical area was influenced by the duration of sensory experience in rats (h) with a predilection for homogeneous floorboards. Both EE condition and training to discrimination selectively decreased the sizes of the SI neurons' receptive fields (RFs) located on glabrous skin. Smaller RFs and larger cortical areas serving glabrous skin were correlated with better perceptual performances and learning abilities in the H rats only. The present study shows that representational reorganization related to tactile discrimination performances depends upon the perceptual context.

Hand posture modulates cortical finger representation in SII

Somatosensory magnetic fields evoked by electrical stimuli of the thumb or the index finger were recorded using a whole head magnetoencephalography (MEG) system in 10 subjects performing different finger postures, open hand posture and close hand posture for picking up a small object. The mean Euclidean distances between the ECD (equivalent current dipole) locations for the thumb and index finger in the secondary somatosensory cortex (SII) across the subjects were 8.5 +/- 2.1 mm in the close hand posture and 11.2 +/- 2.6 mm in the open hand posture. The distance was significantly shorter in the close hand posture (paired t test, P = 0.002, n = 8). However, the distances of the P38m and P60m components in the primary somatosensory cortex (SI) were not significantly different between the two hand postures (P38m: 13.4 +/- 5.6 mm in the open and 13.5 +/- 3.9 mm in the close; P60m: 12.4 +/- 2.6 mm in the open and 16.2 +/- 5.3 mm in the close). This shortening of the spatial distance between the cortical finger representations suggests a similarity in humans of the rapid changes in the dynamics of cortical circuits reported in animal studies. In addition, the overlap of the cortical finger representations, which might be suggested by the shortening of the distance between the ECDs in SII, is likely to play a role in information integration between sensory inputs from the thumb and index finger.

Attention induces reciprocal activity in the human somatosensory cortex enhancing relevant- and suppressing irrelevant inputs from fingers

OBJECTIVE

We studied whether attention regulates information processing in the human primary somatosensory cortex (SI) by selective enhancement of relevant- and suppression of irrelevant information.

METHODS

Under successive and simultaneous electric stimuli to both the right index and middle fingers, tactile stimuli were randomly (20%) presented on one of the two fingers in separate two runs exchanging the finger. Subjects were requested to discriminate the tactile stimuli in an attention task to induce attention to one finger and to ignore the stimuli in a control task to avoid such an attention focus. Somatosensory evoked magnetic fields were measured only for the two-finger electric stimulation and an early component (M50) was analyzed.

RESULTS

In spite of the two-finger simultaneous stimulation, attention to either the index or middle finger lowered or heightened the M50-sourse location, respectively. The attention task did not increase the M50 amplitude.

CONCLUSIONS

Attention to a finger enhanced selectively the representation of the finger in the SI cortex. However, this SI activity did not increase the M50 amplitude, suggesting that the attention suppressed another finger region receiving the unattended inputs.

SIGNIFICANCE

Attention regulates the SI activity by selectively enhancing the task-relevant information and by filtering out other noise inputs.

Rapid functional plasticity in the primary somatomotor cortex and perceptual changes after nerve block

The mature human primary somatosensory cortex displays a striking plastic capacity to reorganize itself in response to changes in sensory input. Following the elimination of afferent return, produced by either amputation, deafferentation by dorsal rhizotomy, or nerve block, there is a well-known but little-understood 'invasion' of the deafferented region of the brain by the cortical representation zones of still-intact portions of the brain adjacent to it. We report here that within an hour of abolishing sensation from the radial and medial three-quarters of the hand by pharmacological blockade of the radial and median nerves, magnetic source imaging showed that the cortical representation of the little finger and the skin beneath the lower lip, whose intact cortical representation zones are adjacent to the deafferented region, had moved closer together, presumably because of their expansion across the deafferented area. A paired-pulse transcranial magnetic stimulation procedure revealed a motor cortex disinhibition for two muscles supplied by the unaffected ulnar nerve. In addition, two notable perceptual changes were observed: increased two-point discrimination ability near the lip and mislocalization of touch of the intact ulnar portion of the fourth finger to the neighbouring third finger whose nerve supply was blocked. We suggest that disinhibition within the somatosensory system as a functional correlate for the known enlargement of cortical representation zones might account for not only the 'invasion' phenomenon, but also for the observed behavioural correlates of the nerve block.

Modulation of Associative Human Motor Cortical Plasticity by Attention

The role of attention in generating motor memories remains controversial principally because it is difficult to separate the effects of attention from changes in kinematics of motor performance. We attempted to disentangle attention from performance effects by varying attention while plasticity was induced in human primary motor cortex by external stimulation in the absence of voluntary movement. A paired associative stimulation (PAS) protocol was employed consisting of repetitive application of single afferent electric stimuli, delivered to the right median nerve, paired with single-pulse transcranial magnetic stimulation (TMS) over the optimal site for activation of the right abductor pollicis brevis muscle (APB) to generate near-synchronous events in the left primary motor cortex. In experiment 1, the spatial location of attention was varied. PAS failed to induce plasticity when the subject's attention was directed to their left hand, away from the right target hand the cortical representation of which was being stimulated by PAS. In experiment 2, the grade of attention to the target hand was manipulated. PAS-induced plasticity was maximal when the subject viewed their target hand, and its magnitude was slightly reduced when the subject could only feel their hand. Conversely, plasticity was completely blocked when the subject's attention was diverted from the target hand by a competing cognitive task. A similar modulation by attention was observed for PAS-induced changes in the duration of the silent period evoked by TMS in voluntarily contracted muscle. Associative plasticity in the human motor cortex depends decisively on attention.

Activation in SI and SII: the influence of vibrotactile amplitude during passive and task-relevant stimulation

Using functional magnetic resonance imaging (fMRI), responses in human somatosensory cortex were quantified in response to changes in the amplitude of peripheral stimulation during (1) passive vibration and (2) an attention-demanding tactile tracking task whereby changes in vibration amplitude were used to guide motor behaviour. Functional MRI was conducted using a scanner operating at 1.5 T, and vibration was delivered to the volar surface of the right index finger with a custom-built magnetomechanical device. Results showed that primary somatosensory cortex (SI) reliably reflects changes in vibration amplitude applied to the finger during passive vibration and also in the presence of a task that modulates the activity in SI. Secondary somatosensory cortex did not reveal any clear relationship with vibration amplitude but was more often activated during the attention demanding tracking task compared with passive vibration. The present study supports an increasing stimulus-response relationship between vibrotactile stimuli and activity in SI that persists during attentive, active states.

Absence of gaze direction effects on EEG measures of sensorimotor function

OBJECTIVE

Gaze direction is known to modulate the activation patterns of sensorimotor areas as seen at the single cell level and in functional magnetic resonance imaging (fMRI). To determine whether such gaze direction effects can be observed in scalp-recorded electroencephalogram (EEG) measures of sensorimotor function we investigated somatosensory evoked potentials (SEPs) and steady state movement related cortical potentials (MRPs).

METHODS

In two separate experiments, SEPs were elicited by electrical stimulation of the median nerve (experiment 1) and steady state MRPs were induced by 2 Hz tapping paced by an auditory cue (experiment 2), while subjects directed their gaze 15 degrees to the left or to the right.

RESULTS

Gaze direction failed to produce any appreciable differences in the waveforms of the SEPs or MRPs. In particular, there was no effect on peak amplitude, peak latency and peak scalp topography measures of SEP and MRP components, or on spatial or temporal parameters of dipole models of the underlying cortical generators. Additional frequency domain analyses did not reveal reliable gaze-related changes in induced power at electrode sites overlying somatosensory and motor areas, or in coherence between pairs of parietal, central and frontal electrodes, across a broad range of frequencies.

CONCLUSIONS

EEG measures of sensorimotor function, obtained in a non-visual motor task, are insensitive to modulatory effects of gaze direction in sensorimotor areas that are observable with fMRI.

Hand posture modulates neuronal interaction in the primary somatosensory cortex of humans

OBJECTIVE

To investigate the effects of hand posture on the modulation of neuronal interactions in the cortical finger regions of the human somatosensory cortex.

METHODS

Neuronal magnetic fields, evoked by electrical stimuli to the thumb and/or to the index finger of the right hand, were recorded in different hand postures ('OPEN': opened hand and 'CLOSE': both fingers in opposite position to pick up something) by using a whole head type magnetoencephalography. The equivalent current dipole (ECD) for components in the primary (SI) and secondary somatosensory cortices (SII) was calculated. The interaction ratio (IR) was calculated as a ratio of the vector sum of ECD moments evoked by respective stimulation of each finger to the ECD moment evoked by simultaneous stimulation of both fingers.

RESULTS

The mean IR of N20m was significantly larger in CLOSE than in OPEN (p=0.033, ANOVA). On the contrary, the IR of P40m was larger in OPEN than in CLOSE (p=0.042). The IR of SII components was not significantly different between the different hand postures (p=0.35).

CONCLUSIONS

Neuronal interaction between the thumb and index finger in the human SI is modulated by hand posture. Provided that forming hand posture is related to receiving sensory input, the interaction modulation may play a role in the facilitation of somatosensory processing.

SIGNIFICANCE

Our results suggest experimental evidence for the immediate modulation of neuronal activity in the somatosensory area.

Immediate cortical reorganization after local anesthetic block of the thumb: source localization of somatosensory evoked potentials in human subjects

Psychophysical observations after anesthesia of the thumb raise the question whether the functional border between the thumb and the index is functionally distinct. We present a source localization study using equivalent current dipole modeling of somatosensory evoked potentials (SEPs) following mechanical air-puff stimulation of the first, second and third digits before and during anesthesia of the thumb. Source reconstruction was based on 96-channel SEP recordings. During anesthesia of the thumb the distance between the cortical representation of the thumb and the second and third digits immediately decreased. This indicates a shift of the cortical representation of the second and third digits towards the deafferented area of the anesthetized thumb. Thus, the present results did not confirm the hypothesis of a functional border of the cortical representation between thumb and index finger in this particular task.

Functional organization of primary somatosensory cortex depends on the focus of attention

We used magnetic source imaging in human subjects to reveal within-subject variations of the homuncular hand representation within the primary somatosensory cortex modulated by attention. In one condition subjects were trained to detect sequential leftward or rightward stimulus motion across the fingers of the left hand ("hand" condition) and in a different condition to detect stimulus motion at a specific finger on this hand ("finger" condition). Afferent input was controlled by applying exactly the same stimulus pattern to the digits in the two tasks. Segregation of the somatotopic hand representation (an increase in the distance between the representations of digits 2 and 5) was observed, commencing with the onset of practice, in the finger relative to the hand condition. Subsequent training in the hand and finger conditions with feedback for correctness did not modify segregation, indicating that segregation was a task effect and not a training effect. These findings indicate that the hand representation within the primary somatosensory cortex is not statically fixed but is dynamically modulated by top-down mechanisms to support task requirements. A greater capacity for modulation of the functional cortical organization was positively correlated with superior learning and task performance.

Human brain plasticity: an emerging view of the multiple substrates and mechanisms that cause cortical changes and related sensory dysfunctions after injuries of sensory inputs from the body

Injuries of peripheral inputs from the body cause sensory dysfunctions that are thought to be attributable to functional changes in cerebral cortical maps of the body. Prevalent theories propose that these cortical changes are explained by mechanisms that preeminently operate within cortex. This paper reviews findings from humans and other primates that point to a very different explanation, i.e. that injury triggers an immediately initiated, and subsequently continuing, progression of mechanisms that alter substrates at multiple subcortical as well as cortical locations. As part of this progression, peripheral injuries cause surprisingly rapid neurochemical/molecular, functional, and structural changes in peripheral, spinal, and brainstem substrates. Moreover, recent comparisons of extents of subcortical and cortical map changes indicate that initial subcortical changes can be more extensive than cortical changes, and that over time cortical and subcortical extents of change reach new balances. Mechanisms for these changes are ubiquitous in subcortical and cortical substrates and include neurochemical/molecular changes that cause functional alterations of normal excitation and inhibition, atrophy and degeneration of normal substrates, and sprouting of new connections. The result is that injuries that begin in the body become rapidly further embodied in reorganizational make-overs of the entire core of the somatosensory brain, from peripheral sensory neurons to cortex. We suggest that sensory dysfunctions after nerve, root, dorsal column (spinal), and amputation injuries can be viewed as diseases of reorganization in this core.

Dynamic changes in area 1 somatosensory cortex during transient sensory deprivation: a preliminary study

To investigate the neural plasticity in the somatosensory cortex, changes in somatosensory evoked potentials (SSEPs) during finger ischemia were evaluated and compared with those affected by touch or movement interference. Somatosensory evoked potentials were recorded in the vicinity of the central sulcus in four patients with intractable epilepsy. During electrical stimulation to a selected finger, ischemic anesthesia was induced in another finger. Effects of tactile or movement interference were examined during electrical stimulation to the selected finger by applying tactile stimulation to or inducing voluntary movement of the other finger. Dynamic SSEPs were recorded during varying levels of sensory deprivation and different types of interference, and the dynamic nature of the SSEP changes within an individual was studied in detail. Somatosensory evoked potential changes appeared during finger ischemia and tended to persist during the postischemic stage, which is indicative of sensory plasticity and the maintenance of new conditioning. Amplitudes of the early and late cortical components increased when complete finger anesthesia was induced-a sign of the unmasking phenomenon. Amplitudes of early cortical SSEPs decreased when ischemic anesthesia was incomplete, similar to the findings when tactile or movement interference was applied. Surrounding inhibition, therefore, may become dominant before the unmasking phenomenon appears in early cortical SSEPs.

Shifts in cortical representations predict human discrimination improvement

We report experiments combining assessment of spatial tactile discrimination behavior and measurements of somatosensory-evoked potentials in human subjects before and after short-term plastic changes to demonstrate a causal link between the degree of altered performance and reorganization. Plastic changes were induced by a Hebbian coactivation protocol of simultaneous pairing of tactile stimuli. As a result of coactivation, spatial discrimination thresholds were lowered; however, the amount of discrimination improvement was variable across subjects. Analysis of somatosensory-evoked potentials revealed a significant, but also variable shift in the localization of the N20-dipole of the index finger that was coactivated. The Euclidean distance between the dipole pre- and post-coactivation was significantly larger on the coactivated side (mean 9.13 +/- 3.4 mm) than on the control side (mean 4.90 +/- 2.7 mm, P = 0.008). Changes of polar angles indicated a lateral and inferior shift on the postcentral gyrus of the left hemisphere representing the coactivated index finger. To explore how far the variability of improvement was reflected in the degree of reorganization, we correlated the perceptual changes with the N20-dipole shifts. We found that the changes in discrimination abilities could be predicted from the changes in dipole localization. Little gain in spatial discrimination was associated with small changes in dipole shifts. In contrast, subjects who showed a large cortical reorganization also had lowest thresholds. All changes were highly selective as no transfer to the index finger of the opposite, non-coactivated hand was found. Our results indicate that human spatial discrimination performance is subject to improvement on a short time scale by a Hebbian stimulation protocol without invoking training, attention, or reinforcement. Plastic processes related to the improvement were localized in primary somatosensory cortex and were scaled with the degree of the individual perceptual improvement.

The temporal profile of interactions between sensory information from both hands in the secondary somatosensory cortex

OBJECTIVE

To elucidate the temporal profile of interactions between sensory information from both hands in the somatosensory cortex.

METHODS

Somatosensory evoked fields (SEFs), generated by stimulation applied to the right index finger after a preceding stimulation to the left index finger, were recorded using a whole head-type magnetoencephalography (MEG). The paired electrical stimuli were applied with a stimulation onset asynchrony (SOA) of 50, 100, 200, 300, or 400 ms.

RESULTS

The mean SEF intensities in the primary somatosensory area (SI) of five subjects, which were evoked approximately 40 ms after the latter of the paired stimuli, were not significantly smaller than that evoked in the control condition when only the right finger was stimulated. In contrast, SEFs in the secondary somatosensory area (SII), generated approximately 100 ms after the stimuli, were suppressed when the paired stimuli were applied at an SOA of 100 ms (P<0.05, t test). In addition, SEFs at approximately 150 ms after the stimuli were significantly suppressed at SOAs of 50, 100 (P<0.05), 200, and 300 ms (P<0.1).

CONCLUSION

Within a time window of approximately 300 ms, sensory information from the left finger significantly affected the SEFs generated by sensory inputs from the right finger. This time window may be required for the integration of sensory input.

Attending to and remembering tactile stimuli: a review of brain imaging data and single-neuron responses

Clinical and neuroimaging observations of the cortical network implicated in tactile attention have identified foci in parietal somatosensory, posterior parietal, and superior frontal locations. Tasks involving intentional hand-arm movements activate similar or nearby parietal and frontal foci. Visual spatial attention tasks and deliberate visuomotor behavior also activate overlapping posterior parietal and frontal foci. Studies in the visual and somatosensory systems thus support a proposal that attention to the spatial location of an object engages cortical regions responsible for the same coordinate referents used for guiding purposeful motor behavior. Tactile attention also biases processing in the somatosensory cortex through amplification of responses to relevant features of selected stimuli. Psychophysical studies demonstrate retention gradients for tactile stimuli like those reported for visual and auditory stimuli, and suggest analogous neural mechanisms for working memory across modalities. Neuroimaging studies in humans using memory tasks, and anatomic studies in monkeys support the idea that tactile information relayed from the somatosensory cortex is directed ventrally through the insula to the frontal cortex for short-term retention and to structures of the medial temporal lobe for long-term encoding. At the level of single neurons, tactile (such as visual and auditory) short-term memory appears as a persistent response during delay intervals between sampled stimuli.

Neuromagnetic integrated methods tracking human brain mechanisms of sensorimotor areas 'plastic' reorganisation

The potential for reorganization in the adult brain has been largely underestimated in the past and we are just beginning to understand the organisational principles involved in functional recovery. A bulk of experimental evidences have been accumulated in support of the hypothesis that neuronal aggregates adjacent to a lesion in the cortical brain areas can be progressively vicarious to the function of the damaged neurones. Such a reorganisation, if occurring in the affected hemisphere of a patient with a monohemispheric lesion, should significantly modify the interhemispheric symmetry of somatotopic organisation of the sensorimotor cortices, both in terms of absolute surfaces and number of "recruited" neurons, as well as of spatial coordinates. In fact, a roughly symmetrical organisation of sensorimotor - particularly for the hand contorl - in the right and left hemisphere has been observed in healthy humans by different methods of functional brain imaging, including fMRI, TMS, MEG, HD-EEG. Not uniform results about the functional brain activity related to sensory, motor and cognitive functions in normal and diseased subjects are often due to differences in the experimental paradigm designed as well as in the spatial and temporal resolution of the neuroimaging techniques used. The multi-modal integration of data obtained with several neuroimaging techniques allowed a coherent modelling of human brain higher functions. Functional magnetic resonance imaging (fMRI) provided fine spatial details (millimetres) of the brain responses, which were compared with the cortical maps of the motor output to different body districts obtained with transcranial magnetic stimulation (TMS). Magnetoencephalography (MEG) ability to study sensorimotor areas by analysing cortical magnetic fields, is also complementary to the motor cortex topographical mapping provided by TMS. MEG high temporal resolution allows to detect relatively restricted functional neuronal pools activated during cerebral processing of external stimuli. Moreover, these brain responses can be investigated with magnetoencephalography (MEG) and high density electroencephalography (EEG) techniques, with elevated time resolution (ms). With respect to the high resolution EEG technique, the MEG technique allowed a more precise localisation of the sites of neural activity buried into the cortical sulci, but was unable to detect the response of the crown of the cortical giri and of the frontal-mesial cortex (including the supplementary motor area), because of its poor sensitivity to radially oriented dipoles. The integration of functional and anatomical information provide cues on the relationship between brain activity and anatomic sites where this takes place, allowing the characterisation of the physiological activity of the cortical brain layers as well as to study the plastic reorganisation of the brain in different pathological conditions following stroke, limb amputation, spinal cord injury, hemisperectomy.

Tactile coactivation-induced changes in spatial discrimination performance

We studied coactivation-based cortical plasticity at a psychophysical level in humans. For induction of plasticity, we used a protocol of simultaneous pairing of tactile stimulation to follow as closely as possible the idea of Hebbian learning. We reported previously that a few hours of tactile coactivation resulted in selective and reversible reorganization of receptive fields and cortical maps of the hindpaw representation of the somatosensory cortex of adult rats (Godde et al., 1996). In the present study, simultaneous spatial two-point discrimination was tested on the tip of the right index finger in human subjects as a marker of plastic changes. After 2 hr of coactivation we found a significant improvement in discrimination performance that was reversible within 8 hr. Reduction of the duration of the coactivation protocol revealed that 30 min was not sufficient to drive plastic changes. Repeated application of coactivation over 3 consecutive days resulted in a delayed recovery indicating stabilization of the improvement over time. Perceptual changes were highly selective because no transfer of improved performance to fingers that were not stimulated was found. The results demonstrate the potential role of sensory input statistics (i.e., their probability of occurrence and spatiotemporal relationships) in the induction of cortical plasticity without involving cognitive factors such as attention or reinforcement.

Setting goals for cognitive rehabilitation

Evidence for experience-dependent plasticity of the brain, including cell regeneration, means that rehabilitation can aim at reinstituting impaired cognitive function, as well as at training compensatory strategies for the lost function. New theoretical frameworks make predictions regarding the circumstances under which these two approaches should each be attempted. There has been progress over the past 6 years in designing effective rehabilitation strategies, with more of these having a strong theoretical basis in cognitive neuroscience. Basic cognitive science has generated counter-intuitive, but effective cognitive rehabilitation methods, showing that the goal of rehabilitation need not always be the most obvious one dictated by real life performance. Limb Activation Training for unilateral neglect is an example of a theoretically derived cognitive rehabilitation procedure that has now been clinically evaluated in clinical trials.