Changes in somatosensory evoked responses by repetition of the median nerve stimulation

Effect of acceleration of auditory inputs on the primary somatosensory cortex in humans

Cross-modal interaction occurs during the early stages of processing in the sensory cortex; however, its effect on neuronal activity speed remains unclear. We used magnetoencephalography to investigate whether auditory stimulation influences the initial cortical activity in the primary somatosensory cortex. A 25-ms pure tone was randomly presented to the left or right side of healthy volunteers at 1000 ms when electrical pulses were applied to the left or right median nerve at 20 Hz for 1500 ms because we did not observe any cross-modal effect elicited by a single pulse. The latency of N20 m originating from Brodmann's area 3b was measured for each pulse. The auditory stimulation significantly shortened the N20 m latency at 1050 and 1100 ms. This reduction in N20 m latency was identical for the ipsilateral and contralateral sounds for both latency points. Therefore, somatosensory-auditory interaction, such as input to the area 3b from the thalamus, occurred during the early stages of synaptic transmission. Auditory information that converged on the somatosensory system was considered to have arisen from the early stages of the feedforward pathway. Acceleration of information processing through the cross-modal interaction seemed to be partly due to faster processing in the sensory cortex.

Inhibitory effect of intensity and interstimulus interval of conditioning stimuli on somatosensory evoked magnetic fields

Magnetoencephalography (MEG) recordings were performed to investigate the inhibitory effects of conditioning stimuli with various types of interstimulus intervals (ISIs) or intensities on somatosensory evoked magnetic fields (SEFs) using a 306-ch whole-head MEG system. Twenty-three healthy volunteers participated in this study. Electrical stimuli were applied to the right median nerve at the wrist. Six pulse trains with ISIs of 500 ms were presented in Experiment 1. A paired-pulse paradigm with three kinds of conditioning stimulus (CON) intensities, 500 ms before the test stimulus (TS), was applied in Experiment 2. Finally, three CONs 500 or 1000 ms before TS were presented in Experiment 3. Three main SEF deflections (N20m, P35m, and P60m) were observed, and the source activities of P35m and P60m significantly decreased after the 2nd pulse of a six pulse trains. These source activities also significantly decreased with increasing intensity of CON. In addition, these attenuations of source activities were affected by CON-CON or CON-TS intervals. These results indicated that the source activities were modulated by the intensity and ISIs of CONs. Furthermore, P35m after the stimulation were very sensitive to CONs; however, the attenuation of P60m after the stimulation lasted for a longer period than that of P35m. Our findings suggest that the conditioning stimulation had inhibitory effects on subsequent evoked cortical responses for more than 500 ms. Our results also provide important clues about the nature of short-latency somatosensory responses in human studies.

Theta-burst transcranial magnetic stimulation alters cortical inhibition

Human cortical excitability can be modified by repetitive transcranial magnetic stimulation (rTMS), but the cellular mechanisms are largely unknown. Here, we show that the pattern of delivery of theta-burst stimulation (TBS) (continuous versus intermittent) differently modifies electric activity and protein expression in the rat neocortex. Intermittent TBS (iTBS), but not continuous TBS (cTBS), enhanced spontaneous neuronal firing and EEG gamma band power. Sensory evoked cortical inhibition increased only after iTBS, although both TBS protocols increased the first sensory response arising from the resting cortical state. Changes in the cortical expression of the calcium-binding proteins parvalbumin (PV) and calbindin D-28k (CB) indicate that changes in spontaneous and evoked cortical activity following rTMS are in part related to altered activity of inhibitory systems. By reducing PV expression in the fast-spiking interneurons, iTBS primarily affected the inhibitory control of pyramidal cell output activity, while cTBS, by reducing CB expression, more likely affected the dendritic integration of synaptic inputs controlled by other classes of inhibitory interneurons. Calretinin, the third major calcium-binding protein expressed by another class of interneurons was not affected at all. We conclude that different patterns of TBS modulate the activity of inhibitory cell classes differently, probably depending on the synaptic connectivity and the preferred discharge pattern of these inhibitory neurons.

Visual paired-pulse stimulation reveals enhanced visual cortex excitability in migraineurs

Migraine is a common ictal disorder with an interindividual heterogeneous characteristic, whose underlying mechanisms remain elusive. On the one hand migraine is associated with abnormal cortical hyperexcitability. On the other hand, studies reported lower amplitudes of visual-evoked potentials (VEPs) and concluded that low preactivation levels imply decreased excitability. Here we measured visual cortex excitability and paired-pulse suppression in subjects suffering from migraine without aura and in a group of aged- and gender-matched healthy subjects to address the relation between activation levels and excitability. To that aim, we analysed amplitudes of VEPs and paired-pulse suppression evoked by a paired-pulse stimulation paradigm using stimulus onset asynchronies (SOAs) between 80 and 133 ms. We found that in migraineurs in the interictal state the amplitudes of the first VEP were reduced as compared with healthy subjects by approximately 20%. In the case of paired-pulse suppression comparable to healthy controls, the second response amplitude should be reduced as well, which was not the case. Instead, the ratio between the first and second VEP was higher than in healthy controls and did not depend on SOA in the range tested, which demonstrates reduced paired-pulse suppression and therefore implicates increased cortical excitability. Our data show that in migraineurs VEPs were reduced presumably due to reduced activation levels. However, paired-pulse suppression using short SOAs in the range of 100 ms or less was even higher than in normal subjects. Thus, our data show that signatures of both hyper- and hypoexcitability can be found depending on stimulation condition.

Automatic auditory off-response in humans: an MEG study

We recorded cortical activities in response to the onset and offset of a pure tone of long duration (LONG) and a train of brief pulses of a pure tone with an interstimulus interval of 50 ms (ISI-50 ms) or 100 ms (ISI-100 ms) by use of magnetoencephalograms in 11 healthy volunteers to clarify temporal and spatial profiles of the auditory on- and off-cortical response. Results showed that a region around the superior temporal gyrus (STG) of both hemispheres responded to both the onset and offset of the stimulus. The location of the source responsible for the main activity (N1m) was not significantly different between the on- and off-responses for any of the three tones. The peak latency of on-N1m was similar under the three conditions, while the peak latency of off-N1m was precisely determined by the ISI, which suggested that off-N1m is based on short-term memory of the stimulus frequency. In addition, there was a positive correlation of the N1m amplitude of N1m between the on- and off-responses among the subjects. The present results suggested that auditory on-N1m and off-N1m have similar physiological significance involved in responding to abrupt changes.

Paired-pulse behavior of visually evoked potentials recorded in human visual cortex using patterned paired-pulse stimulation

Paired-pulse stimulation techniques are used as common tools to investigate cortical excitability and cortical plastic changes. Similar to investigations in the somatosensory and motor system here we applied a new paired-pulse paradigm to study the paired-pulse behavior of visually evoked potentials (VEPs) in 25 healthy subjects. VEPs were recorded and the responses to the first and the second P100 peak were analyzed at different SOAs [stimulus onset asynchrony (SOA) = interstimulus interval (ISI) + pulse duration (13 ms)]. Two measures describe the paired pulse interaction: the "amplitude ratio", the ratio of the second to the first amplitude, and the "latency shift", the difference of the inter-peak interval between the P100 peaks and the respective SOA. To separate alterations in the amplitude of the second VEP response due to changes in paired-pulse inhibition from those originating from superposition of the two waveforms, particularly at short SOAs, we created a waveform template from recordings made at SOAs of 1 s, where interaction can be assumed to be negligible. Superposed traces of VEP recordings were then created by adding two templates at delays corresponding to the SOAs used. The original recordings were then digitally subtracted from the traces obtained by superposition. Analysis of the subtracted traces revealed evidence that at short SOAs the second VEP response is substantially suppressed, a finding comparable to the paired-pulse inhibition described for motor and somatosensory cortex following paired-pulse stimulation. However, paired-pulse inhibition seen in V1 varied considerably from subject to subject, both in respect to amplitude, and to time of maximal inhibition. We found paired-pulse inhibition ranging from 12 to 76% (mean 34%) at SOAs between 80 (shortest discriminable SOA) and 320 ms (mean 128 ms). At intermediate SOAs between 80 and 720 ms (mean 215 ms) the amplitude ratios were between 94 and 145% (mean 116%) indicative of slight paired-pulse facilitation. Comparable to recovery studies by means of paired-pulse median nerve stimulation in somatosensory cortex, at shorter SOAs we found a delayed second VEP response. Combined together, our findings suggest that VEPs are characterized by significant paired-pulse inhibition at short SOAs, a phenomenon reminiscent of findings reported in other modalities. Possible mechanisms and pharmacological properties of the described paired-pulse behavior in visual cortex remain to be explored.

Cortical brain responses during passive nonpainful median nerve stimulation at low frequencies (0.5-4 Hz): an fMRI study

Previous findings have shown that the human somatosensory cortical systems that are activated by passive nonpainful electrical stimulation include the contralateral primary somatosensory area (SI), bilateral secondary somatosensory area (SII), and bilateral insula. The present study tested the hypothesis that these areas have different sensitivities to stimulation frequency in the condition of passive stimulation. Functional MRI (fMRI) was recorded in 24 normal volunteers during nonpainful electrical median nerve stimulations at 0.5, 1, 2, and 4 Hz repetition rates in separate recording blocks in pseudorandom order. Results of the blood oxygen level-dependent (BOLD) effect showed that the contralateral SI, the bilateral SII, and the bilateral insula were active during these stimulations. As a major finding, only the contralateral SI increased its activation with the increase of the stimulus frequency at the mentioned range. The fact that nonpainful median-nerve electrical stimuli at 4 Hz induces a larger BOLD response is of interest both for basic research and clinical applications in subjects unable to perform cognitive tasks in the fMRI scanner.

Sustained increase of somatosensory cortex excitability by tactile coactivation studied by paired median nerve stimulation in humans correlates with perceptual gain

Cortical excitability can be reliably assessed by means of paired-pulse stimulation techniques. Recent studies demonstrated particularly for motor and visual cortex that cortical excitability is systematically altered following the induction of learning processes or during the development of pathological symptoms. A recent tactile coactivation protocol developed by Godde and coworkers showed that improvement of tactile performance in humans can be achieved also without training through passive stimulation on a time scale of a few hours. Tactile coactivation evokes plastic changes in somatosensory cortical areas as measured by blood oxygenation level-dependent (BOLD) activation in fMRI or SEP-dipole localization, which correlated with the individual gain in performance. To demonstrate changes in excitability of somatosensory cortex after tactile coactivation, we combined assessment of tactile performance with recordings of paired-pulse SEPs after electrical median nerve stimulation of both the right coactivated and left control hand at ISIs of 30 and 100 ms before, 3 h after and 24 h after tactile coactivation. Amplitudes and latencies of the first and second cortical N20/P25 response components were calculated. For the coactivated hand, we found significantly lowered discrimination thresholds and significantly reduced paired-pulse ratios (second N20/P25 response/first N20/P25 response) at an ISI of 30 ms after tactile coactivation indicating enhanced cortical excitability. No changes in paired-pulse behaviour were observed for ISIs of 100 ms. Both psychophysical and cortical effects recovered to baseline 24 h after tactile coactivation. The individual increase of excitability correlated with the individual gain in discrimination performance. For the left control hand we found no effects of tactile coactivation on paired-pulse behaviour and discrimination threshold. Our results indicate that changes in cortical excitability are modified by tactile coactivation and were scaled with the degree of improvement of the individual perceptual learning. Conceivably, changes of cortical excitability seem to constitute an additional important marker and mechanism underlying plastic reorganization.

Enhanced reactivity and delayed recovery of sensorimotor cortex in the novelty seeking personality

BACKGROUND

The novelty seeking (NS) personality trait is hypothesized to be associated with high cortical reactivity, poor inhibitory control and/or varied dopaminergic neurotransmission in the basal ganglia. After somatosensory stimulation, electrical oscillations in alpha and beta bands generated in the sensorimotor cortex show a short duration decrease (event-related desynchronization) and a subsequent increase (event-related synchronization) that is thought to reflect cortical activation and the inhibitory/recovery process, respectively. These oscillatory changes are also believed to be affected by the status of the basal ganglia and by dopaminergic functions. In the present study, we investigated the association between the NS personality trait and somatosensory oscillatory changes after median nerve stimulation assessed by magnetoencephalography.

METHODS

From 48 healthy subjects, we selected 14 high scorers and 14 age- and sex-matched low scorers on the NS dimension of the Temperament and Character Inventory. Magnetic fields were recorded while subjects received electrical stimulation of either the right or left median nerve with equal probability and with a randomized interstimulus interval. Frequency analysis was performed on the alpha and beta bands.

RESULTS

Compared with the low NS group, the high NS group showed larger magnitude of beta event-related desynchronization and larger latencies of the alpha and beta event-related synchronization.

CONCLUSION

These results suggest that individuals with high degrees of the NS trait have greater reactivity and delayed recovery of the sensorimotor cortex in response to simple somatosensory stimulation. This may be significant for the understanding of their exploratory and impulsive behavior.