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Bress KS, Cascio CJ. Sensorimotor regulation of facial expression - An untouched frontier. Neurosci Biobehav Rev 2024; 162:105684. [PMID: 38710425 DOI: 10.1016/j.neubiorev.2024.105684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 04/16/2024] [Accepted: 04/18/2024] [Indexed: 05/08/2024]
Abstract
Facial expression is a critical form of nonverbal social communication which promotes emotional exchange and affiliation among humans. Facial expressions are generated via precise contraction of the facial muscles, guided by sensory feedback. While the neural pathways underlying facial motor control are well characterized in humans and primates, it remains unknown how tactile and proprioceptive information reaches these pathways to guide facial muscle contraction. Thus, despite the importance of facial expressions for social functioning, little is known about how they are generated as a unique sensorimotor behavior. In this review, we highlight current knowledge about sensory feedback from the face and how it is distinct from other body regions. We describe connectivity between the facial sensory and motor brain systems, and call attention to the other brain systems which influence facial expression behavior, including vision, gustation, emotion, and interoception. Finally, we petition for more research on the sensory basis of facial expressions, asserting that incomplete understanding of sensorimotor mechanisms is a barrier to addressing atypical facial expressivity in clinical populations.
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Affiliation(s)
- Kimberly S Bress
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA; Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA.
| | - Carissa J Cascio
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA; Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA; Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
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2
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Dharmadasa T, Pavey N, Tu S, Menon P, Huynh W, Mahoney CJ, Timmins HC, Higashihara M, van den Bos M, Shibuya K, Kuwabara S, Grosskreutz J, Kiernan MC, Vucic S. Novel approaches to assessing upper motor neuron dysfunction in motor neuron disease/amyotrophic lateral sclerosis: IFCN handbook chapter. Clin Neurophysiol 2024; 163:68-89. [PMID: 38705104 DOI: 10.1016/j.clinph.2024.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 02/08/2024] [Accepted: 04/14/2024] [Indexed: 05/07/2024]
Abstract
Identifying upper motor neuron (UMN) dysfunction is fundamental to the diagnosis and understanding of disease pathogenesis in motor neuron disease (MND). The clinical assessment of UMN dysfunction may be difficult, particularly in the setting of severe muscle weakness. From a physiological perspective, transcranial magnetic stimulation (TMS) techniques provide objective biomarkers of UMN dysfunction in MND and may also be useful to interrogate cortical and network function. Single, paired- and triple pulse TMS techniques have yielded novel diagnostic and prognostic biomarkers in MND, and have provided important pathogenic insights, particularly pertaining to site of disease onset. Cortical hyperexcitability, as heralded by reduced short interval intracortical inhibition (SICI) and increased short interval intracortical facilitation, has been associated with the onset of lower motor neuron degeneration, along with patterns of disease spread, development of specific clinical features such as the split hand phenomenon, and may provide an indication about the rate of disease progression. Additionally, reduction of SICI has emerged as a potential diagnostic aid in MND. The triple stimulation technique (TST) was shown to enhance the diagnostic utility of conventional TMS measures in detecting UMN dysfunction in MND. Separately, sophisticated brain imaging techniques have uncovered novel biomarkers of neurodegeneration that have bene associated with progression. The present review will discuss the utility of TMS and brain neuroimaging derived biomarkers of UMN dysfunction in MND, focusing on recently developed TMS techniques and advanced neuroimaging modalities that interrogate structural and functional integrity of the corticomotoneuronal system, with an emphasis on pathogenic, diagnostic, and prognostic utility.
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Affiliation(s)
- Thanuja Dharmadasa
- Department of Neurology, The Royal Melbourne Hospital City Campus, Parkville, Victoria, Australia
| | - Nathan Pavey
- Brain and Nerve Research Center, The University of Sydney, Sydney, Australia
| | - Sicong Tu
- Brain and Mind Centre, The University of Sydney, and Department of Neurology, Royal Prince Alfred Hospital, Australia
| | - Parvathi Menon
- Brain and Nerve Research Center, The University of Sydney, Sydney, Australia
| | - William Huynh
- Brain and Mind Centre, The University of Sydney, and Department of Neurology, Royal Prince Alfred Hospital, Australia
| | - Colin J Mahoney
- Brain and Mind Centre, The University of Sydney, and Department of Neurology, Royal Prince Alfred Hospital, Australia
| | - Hannah C Timmins
- Brain and Mind Centre, The University of Sydney, and Department of Neurology, Royal Prince Alfred Hospital, Australia
| | - Mana Higashihara
- Department of Neurology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Mehdi van den Bos
- Brain and Nerve Research Center, The University of Sydney, Sydney, Australia
| | - Kazumoto Shibuya
- Neurology, Chiba University, Graduate School of Medicine, Chiba, Japan
| | - Satoshi Kuwabara
- Neurology, Chiba University, Graduate School of Medicine, Chiba, Japan
| | - Julian Grosskreutz
- Precision Neurology, Excellence Cluster Precision Medicine in Inflammation, University of Lübeck, University Hospital Schleswig-Holstein Campus, Lübeck, Germany
| | - Matthew C Kiernan
- Brain and Mind Centre, The University of Sydney, and Department of Neurology, Royal Prince Alfred Hospital, Australia
| | - Steve Vucic
- Brain and Nerve Research Center, The University of Sydney, Sydney, Australia.
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Bianchini E, Rinaldi D, Alborghetti M, Simonelli M, D’Audino F, Onelli C, Pegolo E, Pontieri FE. The Story behind the Mask: A Narrative Review on Hypomimia in Parkinson's Disease. Brain Sci 2024; 14:109. [PMID: 38275529 PMCID: PMC10814039 DOI: 10.3390/brainsci14010109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/18/2024] [Accepted: 01/19/2024] [Indexed: 01/27/2024] Open
Abstract
Facial movements are crucial for social and emotional interaction and well-being. Reduced facial expressions (i.e., hypomimia) is a common feature in patients with Parkinson's disease (PD) and previous studies linked this manifestation to both motor symptoms of the disease and altered emotion recognition and processing. Nevertheless, research on facial motor impairment in PD has been rather scarce and only a limited number of clinical evaluation tools are available, often suffering from poor validation processes and high inter- and intra-rater variability. In recent years, the availability of technology-enhanced quantification methods of facial movements, such as automated video analysis and machine learning application, led to increasing interest in studying hypomimia in PD. In this narrative review, we summarize the current knowledge on pathophysiological hypotheses at the basis of hypomimia in PD, with particular focus on the association between reduced facial expressions and emotional processing and analyze the current evaluation tools and management strategies for this symptom, as well as future research perspectives.
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Affiliation(s)
- Edoardo Bianchini
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy; (E.B.); (D.R.); (M.A.); (M.S.)
- AGEIS, Université Grenoble Alpes, 38000 Grenoble, France
- Sant’Andrea University Hospital, 00189 Rome, Italy;
| | - Domiziana Rinaldi
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy; (E.B.); (D.R.); (M.A.); (M.S.)
- Sant’Andrea University Hospital, 00189 Rome, Italy;
| | - Marika Alborghetti
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy; (E.B.); (D.R.); (M.A.); (M.S.)
- Sant’Andrea University Hospital, 00189 Rome, Italy;
| | - Marta Simonelli
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy; (E.B.); (D.R.); (M.A.); (M.S.)
- Ospedale dei Castelli, ASL Rome 6, 00040 Ariccia, Italy
| | | | - Camilla Onelli
- Department of Molecular Medicine, University of Padova, 35121 Padova, Italy;
| | - Elena Pegolo
- Department of Information Engineering, University of Padova, 35131 Padova, Italy;
| | - Francesco E. Pontieri
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy; (E.B.); (D.R.); (M.A.); (M.S.)
- Sant’Andrea University Hospital, 00189 Rome, Italy;
- Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
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4
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Vucic S, Stanley Chen KH, Kiernan MC, Hallett M, Benninger DH, Di Lazzaro V, Rossini PM, Benussi A, Berardelli A, Currà A, Krieg SM, Lefaucheur JP, Long Lo Y, Macdonell RA, Massimini M, Rosanova M, Picht T, Stinear CM, Paulus W, Ugawa Y, Ziemann U, Chen R. Clinical diagnostic utility of transcranial magnetic stimulation in neurological disorders. Updated report of an IFCN committee. Clin Neurophysiol 2023; 150:131-175. [PMID: 37068329 PMCID: PMC10192339 DOI: 10.1016/j.clinph.2023.03.010] [Citation(s) in RCA: 44] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/28/2023] [Accepted: 03/09/2023] [Indexed: 03/31/2023]
Abstract
The review provides a comprehensive update (previous report: Chen R, Cros D, Curra A, Di Lazzaro V, Lefaucheur JP, Magistris MR, et al. The clinical diagnostic utility of transcranial magnetic stimulation: report of an IFCN committee. Clin Neurophysiol 2008;119(3):504-32) on clinical diagnostic utility of transcranial magnetic stimulation (TMS) in neurological diseases. Most TMS measures rely on stimulation of motor cortex and recording of motor evoked potentials. Paired-pulse TMS techniques, incorporating conventional amplitude-based and threshold tracking, have established clinical utility in neurodegenerative, movement, episodic (epilepsy, migraines), chronic pain and functional diseases. Cortical hyperexcitability has emerged as a diagnostic aid in amyotrophic lateral sclerosis. Single-pulse TMS measures are of utility in stroke, and myelopathy even in the absence of radiological changes. Short-latency afferent inhibition, related to central cholinergic transmission, is reduced in Alzheimer's disease. The triple stimulation technique (TST) may enhance diagnostic utility of conventional TMS measures to detect upper motor neuron involvement. The recording of motor evoked potentials can be used to perform functional mapping of the motor cortex or in preoperative assessment of eloquent brain regions before surgical resection of brain tumors. TMS exhibits utility in assessing lumbosacral/cervical nerve root function, especially in demyelinating neuropathies, and may be of utility in localizing the site of facial nerve palsies. TMS measures also have high sensitivity in detecting subclinical corticospinal lesions in multiple sclerosis. Abnormalities in central motor conduction time or TST correlate with motor impairment and disability in MS. Cerebellar stimulation may detect lesions in the cerebellum or cerebello-dentato-thalamo-motor cortical pathways. Combining TMS with electroencephalography, provides a novel method to measure parameters altered in neurological disorders, including cortical excitability, effective connectivity, and response complexity.
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Affiliation(s)
- Steve Vucic
- Brain, Nerve Research Center, The University of Sydney, Sydney, Australia.
| | - Kai-Hsiang Stanley Chen
- Department of Neurology, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan
| | - Matthew C Kiernan
- Brain and Mind Centre, The University of Sydney; and Department of Neurology, Royal Prince Alfred Hospital, Australia
| | - Mark Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health, Bethesda, Maryland, United States
| | - David H Benninger
- Department of Neurology, University Hospital of Lausanne (CHUV), Switzerland
| | - Vincenzo Di Lazzaro
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, University Campus Bio-Medico of Rome, Rome, Italy
| | - Paolo M Rossini
- Department of Neurosci & Neurorehab IRCCS San Raffaele-Rome, Italy
| | - Alberto Benussi
- Centre for Neurodegenerative Disorders, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Alfredo Berardelli
- IRCCS Neuromed, Pozzilli; Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Antonio Currà
- Department of Medico-Surgical Sciences and Biotechnologies, Alfredo Fiorini Hospital, Sapienza University of Rome, Terracina, LT, Italy
| | - Sandro M Krieg
- Department of Neurosurgery, Technical University Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany
| | - Jean-Pascal Lefaucheur
- Univ Paris Est Creteil, EA4391, ENT, Créteil, France; Clinical Neurophysiology Unit, Henri Mondor Hospital, AP-HP, Créteil, France
| | - Yew Long Lo
- Department of Neurology, National Neuroscience Institute, Singapore General Hospital, Singapore, and Duke-NUS Medical School, Singapore
| | | | - Marcello Massimini
- Dipartimento di Scienze Biomediche e Cliniche, Università degli Studi di Milano, Milan, Italy; Istituto Di Ricovero e Cura a Carattere Scientifico, Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Mario Rosanova
- Department of Biomedical and Clinical Sciences University of Milan, Milan, Italy
| | - Thomas Picht
- Department of Neurosurgery, Charité-Universitätsmedizin Berlin, Cluster of Excellence: "Matters of Activity. Image Space Material," Humboldt University, Berlin Simulation and Training Center (BeST), Charité-Universitätsmedizin Berlin, Germany
| | - Cathy M Stinear
- Department of Medicine Waipapa Taumata Rau, University of Auckland, Auckland, Aotearoa, New Zealand
| | - Walter Paulus
- Department of Neurology, Ludwig-Maximilians-Universität München, München, Germany
| | - Yoshikazu Ugawa
- Department of Human Neurophysiology, School of Medicine, Fukushima Medical University, Japan
| | - Ulf Ziemann
- Department of Neurology and Stroke, Eberhard Karls University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany; Hertie Institute for Clinical Brain Research, Eberhard Karls University of Tübingen, Otfried-Müller-Straße 27, 72076 Tübingen, Germany
| | - Robert Chen
- Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital-UHN, Division of Neurology-University of Toronto, Toronto Canada
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Konstantinović I, Bošković B, Šoda J, Dolić K, Đogaš Z, Lapčić M, Ledenko V, Vrgoč T, Rogić Vidaković M. The Cortical Silent Period in the Cricothyroid Muscle as a Neurophysiologic Feature for Dystonia Observation: E-Field-Navigated Transcranial Magnetic (TMS) Study. Biomedicines 2023; 11:biomedicines11051373. [PMID: 37239043 DOI: 10.3390/biomedicines11051373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/02/2023] [Accepted: 05/04/2023] [Indexed: 05/28/2023] Open
Abstract
The cortical silent period (cSP) is a period of electrical silence following a motor-evoked potential (MEP) in the electromyographic signal recorded from a muscle. The MEP can be elicited by transcranial magnetic stimulation (TMS) over the primary motor cortex site corresponding with the muscle. The cSP reflects the intracortical inhibitory process mediated by GABAA and GABAB receptors. The study aimed to investigate the cSP in the cricothyroid (CT) muscle after applying e-field-navigated TMS over the laryngeal motor cortex (LMC) in healthy subjects. Then, a cSP as a neurophysiologic feature for laryngeal dystonia was observed. We applied a single-pulse e-field-navigated TMS to the LMC over both hemispheres with hook-wire electrodes positioned in the CT muscle in nineteen healthy participants, which triggered the elicitation of contralateral and ipsilateral corticobulbar MEPs. The subjects were engaged in a vocalization task, and then we assessed the following metrics: LMC intensity, peak-to-peak MEP amplitude in the CT muscle, and cSP duration. The results showed that the cSP duration from the contralateral CT muscle was distributed from 40 ms to 60.83 ms, and from the ipsilateral CT muscle, from 40 ms to 65.58 ms. Also, no significant difference was found between the contralateral and ipsilateral cSP duration (t(30) = 0.85, p = 0.40), MEP amplitude in the CT muscle (t(30) = 0.91, p = 0.36), and LMC intensity (t(30) = 1.20, p = 0.23). To conclude, the applied research protocol showed the feasibility of recording LMC corticobulbar MEPs and observing the cSP during vocalization in healthy participants. Furthermore, an understanding of neurophysiologic cSP features can be used to study the pathophysiology of neurological disorders that affect laryngeal muscles, such as laryngeal dystonia.
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Affiliation(s)
| | - Braco Bošković
- Otorhinolaryngology Department, University Hospital of Split, 21000 Split, Croatia
| | - Joško Šoda
- Signal Processing, Analysis, and Advanced Diagnostics Research and Education Laboratory (SPAADREL), Faculty of Maritime Studies, University of Split, 21000 Split, Croatia
| | - Krešimir Dolić
- Diagnostic and Interventional Radiology Department, University Hospital of Split, 21000 Split, Croatia
- Medical Radiology, School of Medicine, University of Split, 21000 Split, Croatia
| | - Zoran Đogaš
- Split Sleep Medical Centre, University Hospital of Split, 21000 Split, Croatia
- Laboratory for Human and Experimental Neurophysiology, Department of Neuroscience, University of Split School of Medicine, 21000 Split, Croatia
| | - Mirko Lapčić
- Neurosurgery Division, University Hospital of Split, 21000 Split, Croatia
| | - Vlatko Ledenko
- Neurosurgery Division, University Hospital of Split, 21000 Split, Croatia
| | - Toni Vrgoč
- Laboratory for Human and Experimental Neurophysiology, Department of Neuroscience, University of Split School of Medicine, 21000 Split, Croatia
| | - Maja Rogić Vidaković
- Laboratory for Human and Experimental Neurophysiology, Department of Neuroscience, University of Split School of Medicine, 21000 Split, Croatia
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Ginatempo F, Loi N, Manca A, Rothwell JC, Deriu F. Is it possible to compare inhibitory and excitatory intracortical circuits in face and hand primary motor cortex? J Physiol 2022; 600:3567-3583. [PMID: 35801987 PMCID: PMC9544430 DOI: 10.1113/jp283137] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 06/13/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract Face muscles are important in a variety of different functions, such as feeding, speech and communication of non‐verbal affective states, which require quite different patterns of activity from those of a typical hand muscle. We ask whether there are differences in their neurophysiological control that might reflect this. Fifteen healthy individuals were studied. Standard single‐ and paired‐pulse transcranial magnetic stimulation (TMS) methods were used to compare intracortical inhibitory (short interval intracortical inhibition (SICI); cortical silent period (CSP)) and excitatory circuitries (short interval intracortical facilitation (SICF)) in two typical muscles, the depressor anguli oris (DAO), a face muscle, and the first dorsal interosseous (FDI), a hand muscle. TMS threshold was higher in DAO than in FDI. Over a range of intensities, resting SICF was not different between DAO and FDI, while during muscle activation SICF was stronger in FDI than in DAO (P = 0.012). At rest, SICI was stronger in FDI than in DAO (P = 0.038) but during muscle contraction, SICI was weaker in FDI than in DAO (P = 0.034). We argue that although many of the difference in response to the TMS protocols could result from the difference in thresholds, some, such as the reduction of resting SICI in DAO, may reflect fundamental differences in the physiology of the two muscle groups.
![]() Key points Transcranial magnetic stimulation (TMS) single‐ and paired‐pulse protocols were used to investigate and compare the activity of facilitatory and inhibitory intracortical circuits in a face (depressor anguli oris; DAO) and hand (first dorsal interosseous; FDI) muscles. Several TMS intensities and interstimulus intervals were tested with the target muscles at rest and when voluntarily activated. At rest, intracortical inhibitory activity was stronger in FDI than in DAO. In contrast, during muscle contraction inhibitory activity was stronger in DAO than in FDI. As many previous reports have found, the motor evoked potential threshold was higher in DAO than in FDI. Although many of the differences in response to the TMS protocols could result from the difference in thresholds, some, such as the reduction of resting short interval intracortical inhibition in DAO, may reflect fundamental differences in the physiology of the two muscle groups.
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Affiliation(s)
- Francesca Ginatempo
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43/b, Sassari, 07100, Italy
| | - Nicola Loi
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43/b, Sassari, 07100, Italy
| | - Andrea Manca
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43/b, Sassari, 07100, Italy
| | - John C Rothwell
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK
| | - Franca Deriu
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43/b, Sassari, 07100, Italy.,Unit of Endocrinology, Nutritional and Metabolic Disorders, AOU Sassari, Sassari, Italy
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Dong Z, Wang G, Lu S, Li J, Yan W, Wang SJ. Spontaneous Facial Expressions and Micro-expressions Coding: From Brain to Face. Front Psychol 2022; 12:784834. [PMID: 35058850 PMCID: PMC8763852 DOI: 10.3389/fpsyg.2021.784834] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 11/17/2021] [Indexed: 11/30/2022] Open
Abstract
Facial expressions are a vital way for humans to show their perceived emotions. It is convenient for detecting and recognizing expressions or micro-expressions by annotating a lot of data in deep learning. However, the study of video-based expressions or micro-expressions requires that coders have professional knowledge and be familiar with action unit (AU) coding, leading to considerable difficulties. This paper aims to alleviate this situation. We deconstruct facial muscle movements from the motor cortex and systematically sort out the relationship among facial muscles, AU, and emotion to make more people understand coding from the basic principles: We derived the relationship between AU and emotion based on a data-driven analysis of 5,000 images from the RAF-AU database, along with the experience of professional coders.We discussed the complex facial motor cortical network system that generates facial movement properties, detailing the facial nucleus and the motor system associated with facial expressions.The supporting physiological theory for AU labeling of emotions is obtained by adding facial muscle movements patterns.We present the detailed process of emotion labeling and the detection and recognition of AU. Based on the above research, the video's coding of spontaneous expressions and micro-expressions is concluded and prospected.
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Affiliation(s)
- Zizhao Dong
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Gang Wang
- School of Computer Science, Jiangsu University of Science and Technology, Zhenjiang, China
| | - Shaoyuan Lu
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of the Chinese Academy of Sciences, Beijing, China
| | - Jingting Li
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Wenjing Yan
- Department of Applied Psychology, College of Teacher Education, Wenzhou University, Zhejiang, China
| | - Su-Jing Wang
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of the Chinese Academy of Sciences, Beijing, China
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8
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Stipancic KL, Kuo YL, Miller A, Ventresca HM, Sternad D, Kimberley TJ, Green JR. The effects of continuous oromotor activity on speech motor learning: speech biomechanics and neurophysiologic correlates. Exp Brain Res 2021; 239:3487-3505. [PMID: 34524491 PMCID: PMC8599312 DOI: 10.1007/s00221-021-06206-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 08/25/2021] [Indexed: 11/26/2022]
Abstract
Sustained limb motor activity has been used as a therapeutic tool for improving rehabilitation outcomes and is thought to be mediated by neuroplastic changes associated with activity-induced cortical excitability. Although prior research has reported enhancing effects of continuous chewing and swallowing activity on learning, the potential beneficial effects of sustained oromotor activity on speech improvements is not well-documented. This exploratory study was designed to examine the effects of continuous oromotor activity on subsequent speech learning. Twenty neurologically healthy young adults engaged in periods of continuous chewing and speech after which they completed a novel speech motor learning task. The motor learning task was designed to elicit improvements in accuracy and efficiency of speech performance across repetitions of eight-syllable nonwords. In addition, transcranial magnetic stimulation was used to measure the cortical silent period (cSP) of the lip motor cortex before and after the periods of continuous oromotor behaviors. All repetitions of the nonword task were recorded acoustically and kinematically using a three-dimensional motion capture system. Productions were analyzed for accuracy and duration, as well as lip movement distance and speed. A control condition estimated baseline improvement rates in speech performance. Results revealed improved speech performance following 10 min of chewing. In contrast, speech performance following 10 min of continuous speech was degraded. There was no change in the cSP as a result of either oromotor activity. The clinical implications of these findings are discussed in the context of speech rehabilitation and neuromodulation.
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Affiliation(s)
- Kaila L Stipancic
- Department of Communicative Disorders and Sciences, University at Buffalo, Buffalo, NY, USA
| | - Yi-Ling Kuo
- Department of Physical Therapy, Upstate Medical University, Syracuse, NY, USA
| | - Amanda Miller
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, MA, USA
| | - Hayden M Ventresca
- Department of Rehabilitation Sciences, MGH Institute of Health Professions, Building 79/96, 2nd Floor 13th Street, Boston, MA, 02129, USA
| | - Dagmar Sternad
- Department of Biology, Northeastern University, Boston, MA, USA
| | - Teresa J Kimberley
- Department of Rehabilitation Sciences, MGH Institute of Health Professions, Building 79/96, 2nd Floor 13th Street, Boston, MA, 02129, USA
| | - Jordan R Green
- Department of Rehabilitation Sciences, MGH Institute of Health Professions, Building 79/96, 2nd Floor 13th Street, Boston, MA, 02129, USA.
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Loi N, Ginatempo F, Manca A, Melis F, Deriu F. Faces emotional expressions: from perceptive to motor areas in aged and young subjects. J Neurophysiol 2021; 126:1642-1652. [PMID: 34614362 DOI: 10.1152/jn.00328.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The role of age in perception and production of facial expressions is still unclear. Therefore, this work compared, in aged and young subjects, the effects of passive viewing of faces expressing different emotions on perceptive brain regions, such as occipital and temporal cortical areas and on the primary motor cortex (M1) innervating lower face muscles. Seventeen young (24.41 ± 0.71 yr) and seventeen aged (63.82 ± 0.99 yr) subjects underwent recording of event-related potentials (ERP), of motor potentials evoked by transcranial magnetic stimulation of face M1 in the depressor anguli oris muscle and reaction time assessment. In both groups, the P100 and N170 waves, as well as short-latency intracortical inhibition (SICI) and intracortical facilitation (ICF) were probed in face M1 after 300 ms from the presentation of images reporting faces expressing happy, sad, and neutral emotions. ERP data evidenced a major involvement of the right hemisphere in perceptual processing of faces, regardless of age. Compared with young subjects, the aged group showed a delayed N170 wave and a smaller P100 wave following the view of sad but not happy or neutral expressions, along with less accuracy and longer reaction times for recognition of the emotion expressed by faces. Aged subjects presented less SICI than young subjects, but facial expressions of happiness increased the excitability of face M1 with no differences between groups. In conclusion, data suggest that encoding of sad face expressions is impaired in the aged compared with the young group, whereas perception of happiness and its excitatory effects on face M1 remains preserved.NEW & NOTEWORTHY This study shows that aged subjects have less visual attention and impaired perception for sad, but not for happy, face expressions. Conversely, the view of happy, but not sad, faces increases excitability in face M1 bilaterally, regardless of age. The impaired attention for sad expressions, the preserved perception of faces expressing happiness, along with the enhancing effects of the latter on face M1 excitability, likely makes the aged subjects more motivated in approaching positive emotions.
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Affiliation(s)
- Nicola Loi
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | | | - Andrea Manca
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Francesco Melis
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Franca Deriu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy.,Unit of Endocrinology, Nutritional and Metabolic Disorders, AOU Sassari, Sassari, Italy
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10
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Leon-Ariza JS, Mosquera MA, Joy-Arriaga J, Fonseca A, Leon-Ariza DS, Gualdron-Leon MA, Bayona-Prieto J, Patel K, Leon-Sarmiento FE. The vagus nerve somatosensory evoked potential in the intact brain: state-of-evidence and some representative vignettes. Somatosens Mot Res 2020; 38:41-47. [PMID: 33200653 DOI: 10.1080/08990220.2020.1840346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Scalp-recorded evoked potentials elicited by applying afferent electrical stimulation at the tragus region of the human external ear have shown inconsistent results. We aim to disentangle discrepant findings and interpretations, and put forward novel physiological explanations on the origin of the vagus nerve somatosensory evoked potentials (VSEP). METHODS We systematically search and critically appraise in PubMed, Web of Science, and Scielo databases the scientific reports publishing VSEP findings elicited by afferent electrical stimulation at the tragus region from individuals without brain disorders. Eligible studies published from January 2000 to April 2020 were extracted. The following information was identified from each article: number of participants; age; gender; stimulating/recording and grounding electrodes as well as stimulus side, intensity, duration, frequency, and polarity. Information about physiological parameters and neurobiological variables was also extracted. Representative vignettes with novel scalp responses induced by stimulating the tragus were also included to add support to our conclusions. RESULTS 140 healthy participants were identified from six selected reports. Mean age ranged from 24.3 to 61.5 years. Stimulating and recording aspects were miscellaneous among studies. Scalp responses marked as the VSEP were recorded in 76% of participants, and showed high variability, low validity and poor reproducibility. Age correlated with response latencies. There were not gender differences in scalp response parameters. Cardiovascular function was unaltered by tragus stimulation. Vignettes showed that the VSEP was scalp muscle responses. CONCLUSION VSEP did not fulfil evoked potential guidelines. VSEP corresponded to volume conduction propagating from muscles surrounding scalp recording sites.
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Affiliation(s)
| | - Mario A Mosquera
- Miami Neuroscience Institute, Baptist Hospital South Florida, Miami, FL, USA
| | - Jose Joy-Arriaga
- Miami Neuroscience Institute, Baptist Hospital South Florida, Miami, FL, USA
| | - Angelo Fonseca
- Miami Neuroscience Institute, Baptist Hospital South Florida, Miami, FL, USA
| | | | | | | | - Kunal Patel
- Miami Neuroscience Institute, Baptist Hospital South Florida, Miami, FL, USA
| | - Fidias E Leon-Sarmiento
- Mediciencias Research Group, Miami, FL, USA.,Miami Neuroscience Institute, Baptist Hospital South Florida, Miami, FL, USA.,Universidad Nacional, Bogota, Colombia.,Department of Electrical and Computer Engineering, Florida International University, Miami, FL
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11
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Zhang X, Li R, Li H, Lu Z, Hu Y, Alhassan AB. Novel approach for electromyography-controlled prostheses based on facial action. Med Biol Eng Comput 2020; 58:2685-2698. [PMID: 32862364 PMCID: PMC7557511 DOI: 10.1007/s11517-020-02236-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 07/23/2020] [Indexed: 01/25/2023]
Abstract
Individuals with severe tetraplegia frequently require to control their complex assistive devices using body movement with the remaining activity above the neck. Electromyography (EMG) signals from the contractions of facial muscles enable people to produce multiple command signals by conveying information about attempted movements. In this study, a novel EMG-controlled system based on facial actions was developed. The mechanism of different facial actions was processed using an EMG control model. Four asymmetric and symmetry actions were defined to control a two-degree-of-freedom (2-DOF) prosthesis. Both indoor and outdoor experiments were conducted to validate the feasibility of EMG-controlled prostheses based on facial action. The experimental results indicated that the new paradigm presented in this paper yields high performance and efficient control for prosthesis applications. Graphical abstract Individuals with severe tetraplegia frequently require to control their complex assistive devices using body movement with the remaining activity above the neck. Electromyography (EMG) signals from the contractions of facial muscles enable people to produce multiple command signals by conveying information about attempted movements. In this study, a novel EMG-controlled system based on facial actions was developed. The mechanism of different facial actions was processed using an EMG control model. Four asymmetric and symmetry actions were defined to control a two-degree-of-freedom (2-DOF) prosthesis. Both indoor and outdoor experiments were conducted to validate the feasibility of EMG-controlled prostheses based on facial action. The experimental results indicated that the new paradigm presented in this paper yields high performance and efficient control for prosthesis applications.
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Affiliation(s)
- Xiaodong Zhang
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Key Laboratory of Intelligent Robot, Xi'an Jiaotong University, Xi'an, China
| | - Rui Li
- School of Mechanical and Precision Instrument Engineering, Xi'an University of Technology, Xi'an, China.
| | - Hanzhe Li
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Key Laboratory of Intelligent Robot, Xi'an Jiaotong University, Xi'an, China
| | - Zhufeng Lu
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Key Laboratory of Intelligent Robot, Xi'an Jiaotong University, Xi'an, China
| | - Yong Hu
- Department of Orthopaedics & Traumatology, The University of Hong Kong, Hong Kong, China
| | - Ahmad Bala Alhassan
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Key Laboratory of Intelligent Robot, Xi'an Jiaotong University, Xi'an, China
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12
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Ponglikitmongkol K, Boongird A, Termsarasab P. Bilateral asymmetric auricular myoclonus as a manifestation of focal motor seizure: Phenomenology, potential lateralizing value, and insights into auricular motor control. J Neurol Sci 2020; 413:116762. [PMID: 32169742 DOI: 10.1016/j.jns.2020.116762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 02/05/2020] [Accepted: 02/28/2020] [Indexed: 11/16/2022]
Affiliation(s)
- Krongkamol Ponglikitmongkol
- Division of Neurology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Apisit Boongird
- Division of Neurology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
| | - Pichet Termsarasab
- Division of Neurology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
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13
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Ginatempo F, Manzo N, Ibanez-Pereda J, Rocchi L, Rothwell JC, Deriu F. Happy faces selectively increase the excitability of cortical neurons innervating frowning muscles of the mouth. Exp Brain Res 2020; 238:1043-1049. [PMID: 32200403 DOI: 10.1007/s00221-020-05777-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 03/10/2020] [Indexed: 10/24/2022]
Abstract
Although facial muscles are heavily involved in emotional expressions, there is still a lack of evidence about the role of face primary motor cortex (face M1) in the processing of facial recognition and expression. This work investigated the effects of the passive viewing of different facial expressions on face M1 and compared data with those obtained from the hand M1. Thirty healthy subjects were randomly assigned to two groups undergoing transcranial magnetic stimulation (TMS) of face or hand M1. In both groups, short-latency intracortical inhibition (SICI) and intracortical facilitation (ICF) were probed in the depressor anguli oris (DAO) and first dorsal interosseous (FDI) muscles 300 ms after presentation of a picture of a face that expressed happy, sad or neutral emotions. Statistical analysis of SICI showed a non-significant effect of muscle (F1,28 = 1.903, p = 0.179), but a significant effect of emotion (F2,56 = 6.860, p = 0.004) and a significant interaction between muscle and emotion (F2,56 = 5.072, p = 0.015). Post hoc analysis showed that there was a significant reduction of SICI in the DAO muscle after presentation of a face with a happy expression compared with a neutral face (p < 0.001). In the FDI, a significant difference was observed between neutral and sad expressions (p = 0.010) No clear differences in ICF were detected. The different responses of face and hand muscles to emotional stimuli may be due to their functional roles in emotional expression versus protection of the body.
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Affiliation(s)
- Francesca Ginatempo
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43/b, 07100, Sassari, Italy
| | | | - Jaime Ibanez-Pereda
- Department of Clinical and Movement Neurosciences, UCL Institute of Neurology, London, UK.,Department of Bioengineering, Faculty of Engineering, Imperial College, London, UK
| | - Lorenzo Rocchi
- Department of Clinical and Movement Neurosciences, UCL Institute of Neurology, London, UK
| | - John C Rothwell
- Department of Clinical and Movement Neurosciences, UCL Institute of Neurology, London, UK
| | - Franca Deriu
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43/b, 07100, Sassari, Italy.
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14
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Lack of evidence for interhemispheric inhibition in the lower face primary motor cortex. Clin Neurophysiol 2019; 130:1917-1925. [DOI: 10.1016/j.clinph.2019.07.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 07/01/2019] [Accepted: 07/17/2019] [Indexed: 11/18/2022]
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15
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Goetz SM, Alavi SMM, Deng ZD, Peterchev AV. Statistical Model of Motor-Evoked Potentials. IEEE Trans Neural Syst Rehabil Eng 2019; 27:1539-1545. [PMID: 31283508 DOI: 10.1109/tnsre.2019.2926543] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Motor-evoked potentials (MEPs) are widely used for biomarkers and dose individualization in transcranial stimulation. The large variability of MEPs requires sophisticated methods of analysis to extract information fast and correctly. Development and testing of such methods relies on the availability for realistic models of MEP generation, which are presently lacking. This paper presents a statistical model that can simulate long sequences of individualized MEP amplitude data with properties matching experimental observations. The MEP model includes three sources of trial-to-trial variability: excitability fluctuations, variability in the neural and muscular pathways, and physiological and measurement noise. It also generates virtual human subject data from statistics of population variability. All parameters are extracted as statistical distributions from experimental data from the literature. The model exhibits previously described features, such as stimulus-intensity-dependent MEP amplitude distributions, including bimodal ones. The model can generate long sequences of test data for individual subjects with specified parameters or for subjects from a virtual population. The presented MEP model is the most detailed to date and can be used for the development and implementation of dosing and biomarker estimation algorithms for transcranial stimulation.
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16
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Superconditioning TMS for examining upper motor neuron function in MND. Exp Brain Res 2019; 237:2087-2103. [PMID: 31175383 DOI: 10.1007/s00221-019-05573-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 05/30/2019] [Indexed: 01/09/2023]
Abstract
We used transcranial magnetic stimulation (TMS) of motor cortex, including a novel four-pulse superconditioning (TMSsc) paradigm, in repeated examinations of motor-evoked potentials (MEPs) in eight subjects with motor neuron disease (MND), including seven with amyotrophic lateral sclerosis (ALS). The goals were: (1) to look for evidence of cortical hyperexcitability, including a reduction in short-interval intracortical inhibition (SICI); and (2) to examine the utility of using TMSsc for quantifying upper motor neuron function during MND progression. Testing of abductor pollicis brevis (APB) and tibialis anterior (TA) muscles bilaterally was carried out every 3 months in MND subjects for up to 2 years; results were compared to those from a cohort of 15 control subjects. Measures of SICI were not significantly different between control and MND subjects for either APB or TA muscles. Other measures of cortical excitability, including TMS threshold and MEP amplitude, were consistent with lowered cortical excitability in MND subjects. Certain combinations of superconditioning TMS were capable of causing stronger inhibition or facilitation of MEPs compared to dual-pulse TMS, for both APB and TA target muscles. Moreover, there were multiple cases in which target muscles unresponsive to strong single-pulse TMS, whether at rest or when tested with an active contraction, showed an MEP in response to TMSsc optimized for facilitation. Our findings suggest that a multi-faceted neurophysiologic protocol for examining upper motor neuron function in MND subjects might benefit from inclusion of TMSsc testing.
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17
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Kang J, Derva D, Kwon DY, Wallraven C. Voluntary and spontaneous facial mimicry toward other's emotional expression in patients with Parkinson's disease. PLoS One 2019; 14:e0214957. [PMID: 30973893 PMCID: PMC6459535 DOI: 10.1371/journal.pone.0214957] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 03/23/2019] [Indexed: 01/31/2023] Open
Abstract
A "masked face", that is, decreased facial expression is considered as one of the cardinal symptoms among individuals with Parkinson's disease (PD). Both spontaneous and voluntary mimicry toward others' emotional expressions is essential for both social communication and emotional sharing with others. Despite many studies showing impairments in facial movements in PD in general, it is still unclear whether voluntary, spontaneous, or both types of mimicry are affected and how the impairments affect the patients' quality of life. We investigated to verify whether impairments in facial movements happen for spontaneous as well as for voluntary expressions by quantitatively comparing muscle activations using surface electromyography. Dynamic facial expressions of Neutral, Anger, Joy, and Sad were presented during recordings in corrugator and zygomatic areas. In the spontaneous condition, participants were instructed to simply watch clips, whereas in the voluntary condition they were instructed to actively mimic the stimuli. We found that PD patients showed decreased mimicry in both spontaneous and voluntary conditions compared to a matched control group, although movement patterns in each emotion were similar in the two groups. Moreover, whereas the decrease in mimicry correlated with the decrease not in a health-related quality of life index (PDQ), it did so in a more subjective measurement of general quality of life index (SWB). The correlation between facial mimicry and subjective well-being index suggests that the 'masked face' symptom deteriorates patients' quality of life in a complex way affecting social and psychological aspects, which in turn may be linked to the increased depression risk among individuals with PD.
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Affiliation(s)
- June Kang
- Korea University, Department of Brain and Cognitive Engineering, Seoul, South Korea
- Empathy Research Institute, Seoul, South Korea
| | - Dilara Derva
- Korea University, Department of Brain and Cognitive Engineering, Seoul, South Korea
| | - Do-Young Kwon
- Korea University Ansan hospital, Department of Neurology, Ansan City, South Korea
| | - Christian Wallraven
- Korea University, Department of Brain and Cognitive Engineering, Seoul, South Korea
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18
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Weiss Lucas C, Kallioniemi E, Neuschmelting V, Nettekoven C, Pieczewski J, Jonas K, Goldbrunner R, Karhu J, Grefkes C, Julkunen P. Cortical Inhibition of Face and Jaw Muscle Activity and Discomfort Induced by Repetitive and Paired-Pulse TMS During an Overt Object Naming Task. Brain Topogr 2019; 32:418-434. [DOI: 10.1007/s10548-019-00698-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 01/16/2019] [Indexed: 01/27/2023]
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19
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Li R, Zhang X, Lu Z, Liu C, Li H, Sheng W, Odekhe R. An Approach for Brain-Controlled Prostheses Based on a Facial Expression Paradigm. Front Neurosci 2018; 12:943. [PMID: 30618572 PMCID: PMC6305548 DOI: 10.3389/fnins.2018.00943] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 11/29/2018] [Indexed: 12/26/2022] Open
Abstract
One of the most exciting areas of rehabilitation research is brain-controlled prostheses, which translate electroencephalography (EEG) signals into control commands that operate prostheses. However, the existing brain-control methods have an obstacle between the selection of brain computer interface (BCI) and its performance. In this paper, a novel BCI system based on a facial expression paradigm is proposed to control prostheses that uses the characteristics of theta and alpha rhythms of the prefrontal and motor cortices. A portable brain-controlled prosthesis system was constructed to validate the feasibility of the facial-expression-based BCI (FE-BCI) system. Four types of facial expressions were used in this study. An effective filtering algorithm based on noise-assisted multivariate empirical mode decomposition (NA-MEMD) and sample entropy (SampEn) was used to remove electromyography (EMG) artifacts. A wavelet transform (WT) was applied to calculate the feature set, and a back propagation neural network (BPNN) was employed as a classifier. To prove the effectiveness of the FE-BCI system for prosthesis control, 18 subjects were involved in both offline and online experiments. The grand average accuracy over 18 subjects was 81.31 ± 5.82% during the online experiment. The experimental results indicated that the proposed FE-BCI system achieved good performance and can be efficiently applied for prosthesis control.
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Affiliation(s)
- Rui Li
- Shaanxi Key Laboratory of Intelligent Robot, Xi'an Jiaotong University, Xi'an, China
| | - Xiaodong Zhang
- Shaanxi Key Laboratory of Intelligent Robot, Xi'an Jiaotong University, Xi'an, China
| | - Zhufeng Lu
- Shaanxi Key Laboratory of Intelligent Robot, Xi'an Jiaotong University, Xi'an, China
| | - Chang Liu
- Shaanxi Key Laboratory of Intelligent Robot, Xi'an Jiaotong University, Xi'an, China
| | - Hanzhe Li
- Shaanxi Key Laboratory of Intelligent Robot, Xi'an Jiaotong University, Xi'an, China
| | - Weihua Sheng
- School of Electrical and Computer Engineering, Oklahoma State University, Stillwater, OK, United States
- Shenzhen Academy of Robotics, Shenzhen, China
| | - Randolph Odekhe
- Shaanxi Key Laboratory of Intelligent Robot, Xi'an Jiaotong University, Xi'an, China
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20
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Abstract
A patient with intractable epilepsy, previous right frontal resection, and active vagus nerve stimulation (VNS) developed new onset quasi-continuous twitching around the left eye. Electroencephalography showed no correlate to the orbicularis oculi twitches apart from myographic potentials at the left supraorbital and anterior frontal electrodes. Magnetoencephalography was performed using spatiotemporal signal space separation to suppress magnetic artifacts associated with the VNS apparatus. Magnetoencephalographic source imaging performed on the data back-averaged from the left supraorbital myographic potentials revealed an intrasulcal cortical generator situated in the posterior wall of the right precentral gyrus representing the eye area of the motor homunculus.
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21
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Meincke J, Hewitt M, Reischl M, Rupp R, Schmidt-Samoa C, Liebetanz D. Cortical representation of auricular muscles in humans: A robot-controlled TMS mapping and fMRI study. PLoS One 2018; 13:e0201277. [PMID: 30052653 PMCID: PMC6065161 DOI: 10.1371/journal.pone.0201277] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 07/12/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Most humans have the ability to activate the auricular muscles. Although (intentional) control suggests an involvement of higher cortical centers underlying posterior auricular muscle (PAM) activation, the cortical representation of the auricular muscles is still unknown. METHODS With the purpose of identifying a possible cortical representation area we performed automated robotic and image-guided transcranial magnetic stimulation (TMS) mapping (n = 8) and functional magnetic resonance imaging (fMRI) (n = 13). For topographical comparison, a similar experimental protocol was applied for the first dorsal interosseus muscle (FDI) of the hand. RESULTS The calculated centers of gravity (COGs) of both muscles were located on the precentral gyrus with the PAM COGs located more laterally compared to the FDI. The distance between the mean PAM and mean FDI COG was 26.3 mm. The TMS mapping results were confirmed by fMRI, which showed a dominance of cortical activation within the precentral gyrus during the corresponding motor tasks. The correspondence of TMS and fMRI results was high. CONCLUSION The involvement of the primary motor cortex in PAM activation might point to an evolved function of the auricular muscles in humans and/or the ability of intentional (and selective) muscle activation.
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Affiliation(s)
- Jonna Meincke
- Clinic of Clinical Neurophysiology, Georg August University of Göttingen,
University Medical Center, Göttingen, Germany
| | - Manuel Hewitt
- Clinic of Clinical Neurophysiology, Georg August University of Göttingen,
University Medical Center, Göttingen, Germany
| | - Markus Reischl
- Institute for Applied Computer Science, Karlsruhe Institute of
Technology, Eggenstein-Leopoldshafen, Germany
| | - Rüdiger Rupp
- Spinal Cord Injury Center, Heidelberg University Hospital, Heidelberg,
Germany
| | - Carsten Schmidt-Samoa
- Department of Cognitive Neurology, Georg August University of Göttingen,
University Medical Center, Göttingen, Germany
| | - David Liebetanz
- Clinic of Clinical Neurophysiology, Georg August University of Göttingen,
University Medical Center, Göttingen, Germany
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22
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Abstract
The kinesthetic senses are the senses of position and movement of the body, senses we are aware of only on introspection. A method used to study kinesthesia is muscle vibration, which engages afferents of muscle spindles to trigger illusions of movement and changed position. When vibrating elbow flexors, it generates sensations of forearm extension, when vibrating extensors, sensations of forearm flexion. Vibrating the elbow joint produces no illusion. Vibrating flexors and extensors together at the same frequency also produces no illusion, because what is perceived is the signal difference between antagonist muscles of each arm and between arms. The size of the illusion depends on how the muscle has been conditioned beforehand, due to a property of muscle called thixotropy. When measuring the illusion, blindfolded subjects may carry out a matching or pointing task. In pointing, signals from muscle spindles are less important than in matching. Afferent signals from kinesthetic receptors project to areas of somatosensory cortex to generate sensations of detection and location. This is referred to the body model, which provides information about size and shape of body parts. Kinesthesia, together with vision and touch, is associated with the sense of body ownership. All three can combine or each, on its own, can generate ownership. Related is the sense of agency, the sense of being responsible for one's own actions. In recent times, much progress has been made using neuroimaging techniques to identify the various areas of the brain likely to be responsible for generating these sensations. © 2017 American Physiological Society. Compr Physiol 8:1157-1183, 2018.
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Affiliation(s)
- Uwe Proske
- Department of Physiology, Monash University, Clayton, Victoria, Australia
| | - Simon C Gandevia
- Neuroscience Research Australia and University of New South Wales, New South Wales, Australia
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23
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Schimmel M, Ono T, Lam OLT, Müller F. Oro-facial impairment in stroke patients. J Oral Rehabil 2017; 44:313-326. [PMID: 28128465 DOI: 10.1111/joor.12486] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2017] [Indexed: 01/10/2023]
Abstract
Stroke is considered one of the leading causes of death and acquired disability with a peak prevalence over the age of 80 years. Stroke may cause debilitating neurological deficiencies that frequently result in sensory deficits, motor impairment, muscular atrophy, cognitive deficits and psychosocial impairment. Oro-facial impairment may occur due to the frequent involvement of the cranial nerves' cortical representation areas, central nervous system pathways or motoneuron pools. The aim of this narrative, non-systematic review was to discuss the implications of stroke on oro-facial functions and oral health-related quality of life (OHRQoL). Stroke patients demonstrate an impaired masticatory performance, possibly due to reduced tongue forces and disturbed oral sensitivity. Furthermore, facial asymmetry is common, but mostly discrete and lip restraining forces are reduced. Bite force is not different between the ipsi- and contra-lesional side. In contrast, the contra-lesional handgrip strength and tongue-palate contact during swallowing are significantly impaired. OHRQoL is significantly reduced mainly because of the functional impairment. It can be concluded that impaired chewing efficiency, dysphagia, facial asymmetry, reduced lip force and OHRQoL are quantifiable symptoms of oro-facial impairment following a stroke. In the absence of functional rehabilitation, these symptoms seem not to improve. Furthermore, stroke affects the upper limb and the masseter muscle differently, both, at a functional and a morphological level. The rehabilitation of stroke survivors should, therefore, also seek to improve the strength and co-ordination of the oro-facial musculature. This would in turn help improve OHRQoL and the masticatory function, subsequently preventing weight loss and malnutrition.
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Affiliation(s)
- M Schimmel
- Division of Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Division of Gerodontology and Removable Prosthodontics, University of Geneva, Geneva, Switzerland
| | - T Ono
- Division of Comprehensive Prosthodontics, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - O L T Lam
- Department of Oral Rehabilitation, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - F Müller
- Division of Gerodontology and Removable Prosthodontics, University of Geneva, Geneva, Switzerland
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24
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Chen M, Summers RLS, Goding GS, Samargia S, Ludlow CL, Prudente CN, Kimberley TJ. Evaluation of the Cortical Silent Period of the Laryngeal Motor Cortex in Healthy Individuals. Front Neurosci 2017; 11:88. [PMID: 28326007 PMCID: PMC5339278 DOI: 10.3389/fnins.2017.00088] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 02/10/2017] [Indexed: 11/13/2022] Open
Abstract
Objective: This work aimed to evaluate the cortical silent period (cSP) of the laryngeal motor cortex (LMC) using the bilateral thyroarytenoid (TA) muscles with transcranial magnetic stimulation (TMS). Methods: In 11 healthy participants, fine-wire electromyography (EMG) was used to record bilateral TA muscle responses to single pulse TMS delivered to the LMC in both hemispheres. Peripheral responses to stimulation over the mastoid, where the vagus nerve exits the skull, were collected to verify the central origin of the cortical stimulation responses by comparing the latencies. Results: The cSP duration ranged from 41.7 to 66.4 ms. The peripherally evoked motor-evoked potential (MEP) peak occurred 5–9 ms earlier than the cortical responses (for both sides of TAs: p < 0.0001) with no silent period. The right TA MEP latencies were earlier than the left TA responses for both peripheral and cortical measures (p ≤ 0.0001). Conclusion: These findings demonstrate the feasibility of measuring cSP of LMC based on intrinsic laryngeal muscles responses during vocalization in healthy volunteers. Significance: The technique could be used to study the pathophysiology of neurological disorders that affect TA muscles, such as spasmodic dysphonia. Further, the methodology has application to other muscles of the head and neck not accessible using surface electrodes.
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Affiliation(s)
- Mo Chen
- Divisions of Physical Therapy and Rehabilitation Science, Department of Rehabilitation Medicine, School of Medicine, University of Minnesota Minneapolis, MN, USA
| | - Rebekah L S Summers
- Divisions of Physical Therapy and Rehabilitation Science, Department of Rehabilitation Medicine, School of Medicine, University of Minnesota Minneapolis, MN, USA
| | - George S Goding
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota Minneapolis, MN, USA
| | - Sharyl Samargia
- Department of Communication Sciences and Disorders, University of Wisconsin River Falls Campus River Falls, WI, USA
| | - Christy L Ludlow
- Department of Communication Sciences and Disorders, James Madison University Harrisonburg, VA, USA
| | - Cecília N Prudente
- Divisions of Physical Therapy and Rehabilitation Science, Department of Rehabilitation Medicine, School of Medicine, University of Minnesota Minneapolis, MN, USA
| | - Teresa J Kimberley
- Divisions of Physical Therapy and Rehabilitation Science, Department of Rehabilitation Medicine, School of Medicine, University of Minnesota Minneapolis, MN, USA
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Huang H, Liu WC, Song YH. Effects of repetitive transcranial magnetic stimulation on masseter motor-neuron pool excitability. Arch Oral Biol 2017; 73:289-294. [DOI: 10.1016/j.archoralbio.2016.10.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2015] [Revised: 08/14/2016] [Accepted: 10/14/2016] [Indexed: 02/08/2023]
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Säisänen L, Julkunen P, Kemppainen S, Danner N, Immonen A, Mervaala E, Määttä S, Muraja-Murro A, Könönen M. Locating and Outlining the Cortical Motor Representation Areas of Facial Muscles With Navigated Transcranial Magnetic Stimulation. Neurosurgery 2016; 77:394-405; discussion 405. [PMID: 26035404 DOI: 10.1227/neu.0000000000000798] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Navigated transcranial magnetic stimulation (nTMS) has become established as an accurate noninvasive technique for mapping the functional motor cortex for the representation areas of upper and lower limb muscles but not yet for facial musculature. OBJECTIVE To characterize the applicability and clinical impact of using nTMS to map cortical motor areas of facial muscles in healthy volunteers and neurosurgical tumor patients. METHODS Eight healthy volunteers and 12 patients with tumor were studied. The motor threshold (MT) was determined for the abductor pollicis brevis and mentalis muscles. The lateral part of the motor cortex was mapped with suprathreshold stimulation intensity, and motor evoked potentials were recorded from several facial muscles. The patient protocol was modified according to the clinical indication. RESULTS In all healthy subjects, motor evoked potentials were elicited in the mentalis (mean latency, 13.4 milliseconds) and orbicularis oris (mean latency, 12.6 milliseconds) muscles. At 110% of MT of the mentalis, the motor evoked potentials of facial muscles were elicited mainly in the precentral gyrus but also from one gyrus anterior and posterior to it. The cortical areas applicable for mapping were limited by an artifact attributable to direct peripheral nerve stimulation. The mapping protocol was successful in 10 of 12 tumor patients at locating the representation area of the lower facial muscles. The MT of the facial muscles was significantly higher than that of the abductor pollicis brevis. CONCLUSION nTMS is an applicable and clinically beneficial noninvasive method to preoperatively map the cortical representation areas of the facial muscles in the lower part of the face. Instead of using the MT of the abductor pollicis brevis, the stimulus intensity during mapping should be proportioned to the MT of a facial muscle.
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Affiliation(s)
- Laura Säisänen
- *Institute of Clinical Medicine, Faculty of Health Sciences and §Department of Applied Physics, University of Eastern Finland, Kuopio, Finland; ‡Departments of Clinical Neurophysiology, #Neurosurgery, and **Clinical Radiology, Kuopio University Hospital, Kuopio, Finland; ¶Department of Clinical Neurophysiology, NordLab Kajaani and ‖Kainuu Social and Health Care Joint Authority, Kainuu Central Hospital, Kajaani, Finland
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Castro-Meneses LJ, Johnson BW, Sowman PF. The effects of impulsivity and proactive inhibition on reactive inhibition and the go process: insights from vocal and manual stop signal tasks. Front Hum Neurosci 2015; 9:529. [PMID: 26500518 PMCID: PMC4594014 DOI: 10.3389/fnhum.2015.00529] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 09/11/2015] [Indexed: 11/20/2022] Open
Abstract
This study measured proactive and reactive response inhibition and their relationships with self-reported impulsivity. We examined the domains of both vocal and manual responding using a stop signal task (SST) with two stop probabilities: high and low probability stop (1/3 and 1/6 stops respectively). Our aim was to evaluate the effect stop probability would have on reactive and proactive inhibition. We tested 44 subjects and found that for the high compared to low probability stop signal condition, more proactive inhibition was evident and this was correlated with a reduction in the stop signal reaction time (SSRT). We found that reactive inhibition had a positive relationship with dysfunctional but not functional impulsivity in both vocal and manual domains of responding. These findings support the hypothesis that proactive inhibition may pre-activate the network for reactive inhibition.
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Affiliation(s)
- Leidy J. Castro-Meneses
- Department of Cognitive Science, Australian Research Council Centre of Excellence in Cognition and its Disorders, Macquarie UniversityNorth Ryde, NSW, Australia
- Department of Cognitive Science, Perception in Action Research Centre, Macquarie UniversityNorth Ryde, NSW, Australia
| | - Blake W. Johnson
- Department of Cognitive Science, Australian Research Council Centre of Excellence in Cognition and its Disorders, Macquarie UniversityNorth Ryde, NSW, Australia
| | - Paul F. Sowman
- Department of Cognitive Science, Australian Research Council Centre of Excellence in Cognition and its Disorders, Macquarie UniversityNorth Ryde, NSW, Australia
- Department of Cognitive Science, Perception in Action Research Centre, Macquarie UniversityNorth Ryde, NSW, Australia
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Vocal response inhibition is enhanced by anodal tDCS over the right prefrontal cortex. Exp Brain Res 2015; 234:185-95. [PMID: 26419662 DOI: 10.1007/s00221-015-4452-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 09/18/2015] [Indexed: 10/23/2022]
Abstract
Stopping outright (reactive inhibition) and slowing down (proactive inhibition) are types of response inhibition which have mainly been investigated in the manual effector system. This study compared reactive inhibition across manual and vocal effector systems, examined the effects of excitatory anodal transcranial direct current stimulation (anodal tDCS) over the right prefrontal cortex (right-PFC) and looked at the relationship between reactive and proactive inhibition. We hypothesised (1) that vocal reactive inhibition would be less effective than manual reactive inhibition as evidenced by longer stop signal reaction times; (2) that anodal tDCS would enhance both vocal and manual reactive inhibitions and (3) that proactive and reactive inhibitions would be positively related. We tested 14 participants over two sessions (one session with anodal tDCS and one session with sham stimulation) and applied stimulation protocol in the middle of the session, i.e. only during the second of three phases. We used a stop signal task across two stop conditions: relevant and irrelevant stop conditions in which stopping was required or ignored, respectively. We found that reactive inhibition was faster during and immediately after anodal tDCS relative to sham. We also found that greater level of proactive inhibition enhanced reactive inhibition (indexed by shorter stop signal reaction times). These results support the hypothesis that the right-PFC is part of a core network for reactive inhibition and supports previous contention that proactive inhibition is possibly modulated via preactivating the reactive inhibition network.
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Finisguerra A, Maffongelli L, Bassolino M, Jacono M, Pozzo T, D'Ausilio A. Generalization of motor resonance during the observation of hand, mouth, and eye movements. J Neurophysiol 2015; 114:2295-304. [PMID: 26289463 DOI: 10.1152/jn.00433.2015] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 08/18/2015] [Indexed: 11/22/2022] Open
Abstract
Transcranial magnetic stimulation (TMS) of the motor cortex shows that hand action observation (AO) modulates corticospinal excitability (CSE). CSE modulation alternatively maps low-level kinematic characteristics or higher-level features, like object-directed action goals. However, action execution is achieved through the control of muscle synergies, consisting of coordinated patterns of muscular activity during natural movements, rather than single muscles or object-directed goals. This synergistic organization of action execution also underlies the ability to produce the same functional output (i.e., grasping an object) using different effectors. We hypothesize that motor system activation during AO may rely on similar principles. To investigate this issue, we recorded both hand CSE and TMS-evoked finger movements which provide a much more complete description of coordinated patterns of muscular activity. Subjects passively watched hand, mouth and eyelid opening or closing, which are performing non-object-directed (intransitive) actions. Hand and mouth share the same potential to grasp objects, whereas eyelid does not allow object-directed (transitive) actions. Hand CSE modulation generalized to all effectors, while TMS evoked finger movements only to mouth AO. Such dissociation suggests that the two techniques may have different sensitivities to fine motor modulations induced by AO. Differently from evoked movements, which are sensitive to the possibility to achieve object-directed action, CSE is generically modulated by "opening" vs. "closing" movements, independently of which effector was observed. We propose that motor activities during AO might exploit the same synergistic mechanisms shown for the neural control of movement and organized around a limited set of motor primitives.
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Affiliation(s)
- Alessandra Finisguerra
- Robotics, Brain and Cognitive Sciences Department, Italian Institute of Technology, Genova, Italy; Dipartimento di Scienze Umane, Università Degli Studi di Udine, Udine, Italy
| | - Laura Maffongelli
- Robotics, Brain and Cognitive Sciences Department, Italian Institute of Technology, Genova, Italy
| | - Michela Bassolino
- Robotics, Brain and Cognitive Sciences Department, Italian Institute of Technology, Genova, Italy; Center for Neuroprosthetics, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland; and
| | - Marco Jacono
- Robotics, Brain and Cognitive Sciences Department, Italian Institute of Technology, Genova, Italy
| | - Thierry Pozzo
- Robotics, Brain and Cognitive Sciences Department, Italian Institute of Technology, Genova, Italy; IUF, INSERM U1093 Cognition, Action et Plasticité Sensorimotrice, Université de Bourgogne, Dijon, France
| | - Alessandro D'Ausilio
- Robotics, Brain and Cognitive Sciences Department, Italian Institute of Technology, Genova, Italy;
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Mercante B, Pilurzi G, Ginatempo F, Manca A, Follesa P, Tolu E, Deriu F. Trigeminal nerve stimulation modulates brainstem more than cortical excitability in healthy humans. Exp Brain Res 2015; 233:3301-11. [DOI: 10.1007/s00221-015-4398-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2015] [Accepted: 07/27/2015] [Indexed: 12/30/2022]
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Agarwal M, Ulmer JL, Klein AP, Mark LP. Cortical and Subcortical Substrates of Cranial Nerve Function. Semin Ultrasound CT MR 2015; 36:275-90. [PMID: 26233861 DOI: 10.1053/j.sult.2015.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The pivotal role of cranial nerves in a wholesome life experience cannot be overemphasized. Research has opened new avenues to understand cranial nerve function. Classical concept of strict bilateral cortical control of cranial nerves has given way to concepts of hemispheric dominance and hemispheric lateralization. An astute Neuroradiologist should keep abreast of these concepts and help patients and referring physicians by applying this knowledge in reading images. This chapter provides an overview of cranial nerve function and latest concepts pertaining to their cortical and subcortical control.
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Affiliation(s)
- Mohit Agarwal
- Department of Radiology, Medical College of Wisconsin, Milwaukee, WI.
| | - John L Ulmer
- Department of Radiology, Medical College of Wisconsin, Milwaukee, WI
| | - Andrew P Klein
- Department of Radiology, Medical College of Wisconsin, Milwaukee, WI
| | - Leighton P Mark
- Department of Radiology, Medical College of Wisconsin, Milwaukee, WI
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D'Ausilio A, Maffongelli L, Bartoli E, Campanella M, Ferrari E, Berry J, Fadiga L. Listening to speech recruits specific tongue motor synergies as revealed by transcranial magnetic stimulation and tissue-Doppler ultrasound imaging. Philos Trans R Soc Lond B Biol Sci 2014; 369:20130418. [PMID: 24778384 DOI: 10.1098/rstb.2013.0418] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The activation of listener's motor system during speech processing was first demonstrated by the enhancement of electromyographic tongue potentials as evoked by single-pulse transcranial magnetic stimulation (TMS) over tongue motor cortex. This technique is, however, technically challenging and enables only a rather coarse measurement of this motor mirroring. Here, we applied TMS to listeners' tongue motor area in association with ultrasound tissue Doppler imaging to describe fine-grained tongue kinematic synergies evoked by passive listening to speech. Subjects listened to syllables requiring different patterns of dorso-ventral and antero-posterior movements (/ki/, /ko/, /ti/, /to/). Results show that passive listening to speech sounds evokes a pattern of motor synergies mirroring those occurring during speech production. Moreover, mirror motor synergies were more evident in those subjects showing good performances in discriminating speech in noise demonstrating a role of the speech-related mirror system in feed-forward processing the speaker's ongoing motor plan.
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Affiliation(s)
- A D'Ausilio
- Robotics Brain and Cognitive Sciences Department, RBCS, Italian Institute of Technology, IIT, , via Morego, 30, Genova 16163, Italy
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Cattaneo L, Pavesi G. The facial motor system. Neurosci Biobehav Rev 2013; 38:135-59. [PMID: 24239732 DOI: 10.1016/j.neubiorev.2013.11.002] [Citation(s) in RCA: 116] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Revised: 10/18/2013] [Accepted: 11/02/2013] [Indexed: 12/23/2022]
Abstract
Facial movements support a variety of functions in human behavior. They participate in automatic somatic and visceral motor programs, they are essential in producing communicative displays of affective states and they are also subject to voluntary control. The multiplicity of functions of facial muscles, compared to limb muscles, is reflected in the heterogeneity of their anatomical and histological characteristics that goes well beyond the conventional classification in single facial muscles. Such parcellation in different functional muscular units is maintained throughout the central representation of facial movements from the brainstem up to the neocortex. Facial movements peculiarly lack a conventional proprioceptive feedback system, which is only in part vicariated by cutaneous or auditory afferents. Facial motor activity is the main marker of endogenous affective states and of the affective valence of external stimuli. At the cortical level, a complex network of specialized motor areas supports voluntary facial movements and, differently from upper limb movements, in such network there does not seem to be a prime actor in the primary motor cortex.
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Affiliation(s)
- Luigi Cattaneo
- Center for Mind/Brain Sciences, University of Trento, Via delle Regole 101, Mattarello, Trento 38123, Italy.
| | - Giovanni Pavesi
- Department of Neuroscience, University of Parma, Via Gramsci 14, Parma 43100, Italy
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Pilurzi G, Hasan A, Saifee TA, Tolu E, Rothwell JC, Deriu F. Intracortical circuits, sensorimotor integration and plasticity in human motor cortical projections to muscles of the lower face. J Physiol 2013; 591:1889-906. [PMID: 23297305 DOI: 10.1113/jphysiol.2012.245746] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Previous studies of the cortical control of human facial muscles documented the distribution of corticobulbar projections and the presence of intracortical inhibitory and facilitatory mechanisms. Yet surprisingly, given the importance and precision in control of facial expression, there have been no studies of the afferent modulation of corticobulbar excitability or of the plasticity of synaptic connections in the facial primary motor cortex (face M1). In 25 healthy volunteers, we used standard single- and paired-pulse transcranial magnetic stimulation (TMS) methods to probe motor-evoked potentials (MEPs), short-intracortical inhibition, intracortical facilitation, short-afferent and long-afferent inhibition and paired associative stimulation in relaxed and active depressor anguli oris muscles. Single-pulse TMS evoked bilateral MEPs at rest and during activity that were larger in contralateral muscles, confirming that corticobulbar projection to lower facial muscles is bilateral and asymmetric, with contralateral predominance. Both short-intracortical inhibition and intracortical facilitation were present bilaterally in resting and active conditions. Electrical stimulation of the facial nerve paired with a TMS pulse 5-200 ms later showed no short-afferent inhibition, but long-afferent inhibition was present. Paired associative stimulation tested with an electrical stimulation-TMS interval of 20 ms significantly facilitated MEPs for up to 30 min. The long-term potentiation, evoked for the first time in face M1, demonstrates that excitability of the facial motor cortex is prone to plastic changes after paired associative stimulation. Evaluation of intracortical circuits in both relaxed and active lower facial muscles as well as of plasticity in the facial motor cortex may provide further physiological insight into pathologies affecting the facial motor system.
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Affiliation(s)
- G Pilurzi
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
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35
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Honda R, Saito Y, Nakagawa E, Sugai K, Sukigara S, Sasaki M, Kaneko Y, Gunji A, Suzuki K. Focal cortical myoclonus in rolandic cortical dysplasia presenting as hemifacial twitching. Brain Dev 2012; 34:886-90. [PMID: 22449743 DOI: 10.1016/j.braindev.2012.02.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Revised: 02/23/2012] [Accepted: 02/28/2012] [Indexed: 11/17/2022]
Abstract
A 2-year-old girl presented with brief episodes of left hemifacial twitching. On ictal electroencephalography, repetitive focal spike discharges appeared at the right fronto-centro-temporal regions; these discharges preceded the onset of each twitch by 12 ms. Magnetic resonance imaging showed a linear abnormal signal intensity in the subcortical white matter at the right postcentral gyrus, where a cluster of dipole sources was detected by magnetoencephalography. These findings suggested that the patient had focal cortical myoclonus due to rolandic focal cortical dysplasia.
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Affiliation(s)
- Ryoko Honda
- Department of Child Neurology, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
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36
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Orbicularis oculi muscle activation during swallowing in humans. Exp Brain Res 2012; 224:79-91. [DOI: 10.1007/s00221-012-3290-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Accepted: 09/25/2012] [Indexed: 12/14/2022]
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Cortes M, Black-Schaffer RM, Edwards DJ. Transcranial magnetic stimulation as an investigative tool for motor dysfunction and recovery in stroke: an overview for neurorehabilitation clinicians. Neuromodulation 2012; 15:316-25. [PMID: 22624621 DOI: 10.1111/j.1525-1403.2012.00459.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
RATIONALE An improved understanding of motor dysfunction and recovery after stroke has important clinical implications that may lead to the design of more effective rehabilitation strategies for patients with hemiparesis. SCOPE Transcranial magnetic stimulation (TMS) is a safe and painless tool that has been used in conjunction with other existing diagnostic tools to investigate motor pathophysiology in stroke patients. Since TMS emerged more than two decades ago, its application in clinical and basic neuroscience has expanded worldwide. TMS can quantify the corticomotor excitability properties of clinically affected and unaffected muscles and can probe local cortical networks as well as remote but functionally related areas. This provides novel insight into the physiology of neural circuits underlying motor dysfunction and brain reorganization during the motor recovery process. This important tool needs to be used with caution by clinical investigators, its limitations need to be understood, and the results should to be interpreted along with clinical evaluation in this patient population. SUMMARY In this review, we provide an overview of the rationale, implementation, and limitations of TMS to study stroke motor physiology. This knowledge may be useful to guide future rehabilitation treatments by assessing and promoting functional plasticity.
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Affiliation(s)
- Mar Cortes
- Department of Neurology & Neuroscience, Winifred Masterson Burke Medical Research Institute, White Plains, NY, USA
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38
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Ross ED, Pulusu VK. Posed versus spontaneous facial expressions are modulated by opposite cerebral hemispheres. Cortex 2012; 49:1280-91. [PMID: 22699022 DOI: 10.1016/j.cortex.2012.05.002] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2012] [Revised: 04/17/2012] [Accepted: 05/07/2012] [Indexed: 01/04/2023]
Abstract
Clinical research has indicated that the left face is more expressive than the right face, suggesting that modulation of facial expressions is lateralized to the right hemisphere. The findings, however, are controversial because the results explain, on average, approximately 4% of the data variance. Using high-speed videography, we sought to determine if movement-onset asymmetry was a more powerful research paradigm than terminal movement asymmetry. The results were very robust, explaining up to 70% of the data variance. Posed expressions began overwhelmingly on the right face whereas spontaneous expressions began overwhelmingly on the left face. This dichotomy was most robust for upper facial expressions. In addition, movement-onset asymmetries did not predict terminal movement asymmetries, which were not significantly lateralized. The results support recent neuroanatomic observations that upper versus lower facial movements have different forebrain motor representations and recent behavioral constructs that posed versus spontaneous facial expressions are modulated preferentially by opposite cerebral hemispheres and that spontaneous facial expressions are graded rather than non-graded movements.
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Affiliation(s)
- Elliott D Ross
- Department of Neurology, University of Oklahoma Health Sciences Center and The VA Medical Center, Oklahoma City, OK 73104, USA.
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Groppa S, Oliviero A, Eisen A, Quartarone A, Cohen LG, Mall V, Kaelin-Lang A, Mima T, Rossi S, Thickbroom GW, Rossini PM, Ziemann U, Valls-Solé J, Siebner HR. A practical guide to diagnostic transcranial magnetic stimulation: report of an IFCN committee. Clin Neurophysiol 2012; 123:858-82. [PMID: 22349304 DOI: 10.1016/j.clinph.2012.01.010] [Citation(s) in RCA: 787] [Impact Index Per Article: 65.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2011] [Revised: 01/16/2012] [Accepted: 01/22/2012] [Indexed: 11/29/2022]
Abstract
Transcranial magnetic stimulation (TMS) is an established neurophysiological tool to examine the integrity of the fast-conducting corticomotor pathways in a wide range of diseases associated with motor dysfunction. This includes but is not limited to patients with multiple sclerosis, amyotrophic lateral sclerosis, stroke, movement disorders, disorders affecting the spinal cord, facial and other cranial nerves. These guidelines cover practical aspects of TMS in a clinical setting. We first discuss the technical and physiological aspects of TMS that are relevant for the diagnostic use of TMS. We then lay out the general principles that apply to a standardized clinical examination of the fast-conducting corticomotor pathways with single-pulse TMS. This is followed by a detailed description of how to examine corticomotor conduction to the hand, leg, trunk and facial muscles in patients. Additional sections cover safety issues, the triple stimulation technique, and neuropediatric aspects of TMS.
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Affiliation(s)
- S Groppa
- Department of Neurology, Christian Albrechts University, Kiel, Germany
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Bologna M, Fasano A, Modugno N, Fabbrini G, Berardelli A. Effects of subthalamic nucleus deep brain stimulation and L-DOPA on blinking in Parkinson's disease. Exp Neurol 2012; 235:265-72. [PMID: 22366535 DOI: 10.1016/j.expneurol.2012.02.004] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Revised: 01/31/2012] [Accepted: 02/06/2012] [Indexed: 11/28/2022]
Abstract
In this study we asked whether subthalamic nucleus deep brain stimulation (STN-DBS) alone, or in combination with l-dopa, modifies voluntary, spontaneous and reflex blinking in patients with Parkinson's disease (PD). Sixteen PD patients who underwent STN-DBS were studied in four experimental conditions: without STN-DBS and without l-dopa, STN-DBS alone, l-dopa alone and STN-DBS plus l-dopa. The results were compared with those obtained in 15 healthy controls. Voluntary blinking was assessed by asking participants to blink as fast as possible; spontaneous blinking was recorded during two 60s rest periods; reflex blinking was evoked by electrical stimulation of the supraorbital nerve. Blinking were recorded and analysed with the SMART motion system. STN-DBS increased the peak velocity and amplitude for both the closing and opening voluntary blink phases, but prolonged the inter-phase pause duration. l-dopa had no effects on voluntary blinking but reversed the increased inter-phase pause duration seen during STN-DBS. Spontaneous blink rate increased after either STN-DBS or l-dopa. Reflex blinking kinematics were not modified by STN-DBS or l-dopa. The STN-DBS effects on voluntary blinking kinematics and spontaneous blinking rate may occur as results of changes of cortico-basal ganglia activity. The prolonged pause duration of voluntary blinking indicates that STN-DBS has detrimental effects on the cranial region. These results also shed light on the pathophysiology of eyelids opening apraxia following STN-DBS.
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A novel human–machine interface based on recognition of multi-channel facial bioelectric signals. AUSTRALASIAN PHYSICAL & ENGINEERING SCIENCES IN MEDICINE 2011; 34:497-513. [DOI: 10.1007/s13246-011-0113-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2010] [Accepted: 11/06/2011] [Indexed: 11/27/2022]
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Tongue corticospinal modulation during attended verbal stimuli: Priming and coarticulation effects. Neuropsychologia 2011; 49:3670-6. [DOI: 10.1016/j.neuropsychologia.2011.09.022] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2010] [Revised: 09/14/2011] [Accepted: 09/15/2011] [Indexed: 11/18/2022]
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D'Ausilio A, Bufalari I, Salmas P, Busan P, Fadiga L. Vocal pitch discrimination in the motor system. BRAIN AND LANGUAGE 2011; 118:9-14. [PMID: 21458056 DOI: 10.1016/j.bandl.2011.02.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2010] [Revised: 01/22/2011] [Accepted: 02/27/2011] [Indexed: 05/30/2023]
Abstract
Speech production can be broadly separated into two distinct components: Phonation and Articulation. These two aspects require the efficient control of several phono-articulatory effectors. Speech is indeed generated by the vibration of the vocal-folds in the larynx (F0) followed by ''filtering" by articulators, to select certain resonant frequencies out of that wave (F1, F2, F3, etc.). Recently it has been demonstrated that the motor representation of articulators (lips and tongue) participates in the discrimination of articulatory sounds (lips- and tongue-related speech sounds). Here we investigate whether the results obtained on articulatory sounds discrimination could be extended to phonation by applying a dual-pulse TMS protocol while subjects had to discriminate F0-shifted vocal utterances [a]. Stimulation over the larynx motor representation, compared to the control site (tongue/lips motor cortex), induced a reduction in RT for stimuli including a subtle pitch shift. We demonstrate that vocal pitch discrimination, in analogy with the articulatory component, requires the contribution of the motor system and that this effect is somatotopically organized.
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Murakami T, Restle J, Ziemann U. Observation-execution matching and action inhibition in human primary motor cortex during viewing of speech-related lip movements or listening to speech. Neuropsychologia 2011; 49:2045-54. [PMID: 21458473 DOI: 10.1016/j.neuropsychologia.2011.03.034] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2010] [Revised: 03/15/2011] [Accepted: 03/24/2011] [Indexed: 10/18/2022]
Abstract
One influential theory posits that language has evolved from gestural communication through observation-execution matching processes in the mirror neuron system (MNS). This theory predicts that observation of speech-related lip movements or even listening to speech would result in effector and task specific increase of the excitability of the corresponding motor representations in the primary motor cortex (M1), since actual movement execution is known be effector and task specific. In addition, effector and task specific inhibitory control mechanisms should be important to prevent overt motor activation during observation of speech-related lip movements or listening to speech. We tested these predictions by applying focal transcranial magnetic stimulation to the left M1 of 12 healthy right-handed volunteers and measuring motor evoked potentials (MEPs) and short-interval intracortical inhibition (SICI) in a lip muscle, the right orbicularis oris (OO), vs. a hand muscle, the right first dorsal interosseus (FDI). We found that MEP and SICI increased only in the OO but not in the FDI during viewing of speech-related lip movements or listening to speech. These changes were highly task specific because they were absent when lip movements non-related to speech were viewed. Finally, the increase in MEP amplitude in the OO correlated inversely with accuracy of speech perception, i.e. the MEP increase was directly related to task difficulty. The MEP findings support the notion that observation-execution matching is an operating process in the putative human MNS that might have been fundamental for evolution of language. Furthermore, the SICI findings provide evidence that inhibitory mechanisms are recruited to prevent unwanted overt motor activation during action observation.
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Affiliation(s)
- Takenobu Murakami
- Department of Neurology, Goethe-University, Frankfurt am Main, Germany
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SCHIMMEL M, LEEMANN B, CHRISTOU P, KILIARIDIS S, HERRMANN FR, MÜLLER F. Quantitative assessment of facial muscle impairment in patients with hemispheric stroke. J Oral Rehabil 2011; 38:800-9. [DOI: 10.1111/j.1365-2842.2011.02219.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Bitter T, Sorger B, Hesselmann V, Krug B, Lackner K, Guntinas-Lichius O. Cortical representation sites of mimic movements after facial nerve reconstruction: A functional magnetic resonance imaging study. Laryngoscope 2011; 121:699-706. [DOI: 10.1002/lary.21399] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2010] [Revised: 09/28/2010] [Accepted: 10/05/2010] [Indexed: 11/10/2022]
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Cattaneo L, Saccani E, De Giampaulis P, Crisi G, Pavesi G. Central facial palsy revisited: A clinical-radiological study. Ann Neurol 2010; 68:404-8. [DOI: 10.1002/ana.22069] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Kranz G, Shamim EA, Lin PT, Kranz GS, Voller B, Hallett M. Blepharospasm and the modulation of cortical excitability in primary and secondary motor areas. Neurology 2009; 73:2031-6. [PMID: 19996078 PMCID: PMC2790233 DOI: 10.1212/wnl.0b013e3181c5b42d] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Traditionally, benign essential blepharospasm (BEB) is considered a disorder caused by basal ganglia dysfunction. Electrophysiologic and brain imaging studies suggest pathologic changes in excitability in the primary motor cortex (MC), anterior cingulate (AC), and secondary motor areas, such as premotor (PMC) and supplementary motor cortices (SMA). METHODS In this pilot study of 7 patients with BEB, we experimentally reduced cortical excitability of 4 areas: MC (first dorsal interosseus area), PMC, SMA, and AC, each with 3 noninvasive techniques: low-frequency repetitive transcranial magnetic stimulation (lfrTMS), continuous theta burst stimulation (cTBS), and cathodal transcranial direct current stimulation (tDCS). Primary outcome was the clinical effects on blepharospasm (blink rate observation by an investigator blinded to the intervention and subjective rating by the patient); secondary outcome was the blink reflex recovery curve (BRR). RESULTS lfrTMS resulted in a significant improvement over all 4 brain areas for physician rating, patient rating, and BRR, whereas cTBS and tDCS showed only trends for improvement in physician rating, but no improvements for patient rating and BRR. lfrTMS had a significantly higher effect over AC than MC for physician rating, but no differences were seen for other pairwise comparisons of stimulated brain areas. CONCLUSIONS Electrophysiologic and clinical improvements by functional inhibition of the medial frontal areas using low-frequency repetitive transcranial magnetic stimulation suggests that hypersensitivity of the anterior cingulate is directly or indirectly involved in the pathophysiology of benign essential blepharospasm. Inhibition of these areas using low-frequency repetitive transcranial magnetic stimulation could provide a therapeutic tool and is worthy of a larger study.
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Affiliation(s)
- G Kranz
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.
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Ni Z, Gunraj C, Nelson AJ, Yeh IJ, Castillo G, Hoque T, Chen R. Two Phases of Interhemispheric Inhibition between Motor Related Cortical Areas and the Primary Motor Cortex in Human. Cereb Cortex 2008; 19:1654-65. [DOI: 10.1093/cercor/bhn201] [Citation(s) in RCA: 161] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ortu E, Deriu F, Suppa A, Giaconi E, Tolu E, Rothwell JC. Intracortical modulation of cortical-bulbar responses for the masseter muscle. J Physiol 2008; 586:3385-404. [PMID: 18499727 DOI: 10.1113/jphysiol.2008.153288] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Short interval intracortical inhibition (SICI) and intracortical facilitation (ICF) were evaluated in the masseter muscles of 12 subjects and the cortical silent period (SP) in nine subjects. Motor evoked potentials (MEPs) were recorded from contralateral (cMM) and ipsilateral (iMM) masseters, activated at 10% of maximal voluntary contraction (MVC). Interstimulus intervals (ISIs) were 2 and 3 ms for SICI, 10 and 15 ms for ICF. TMS of the left masseteric cortex induced MEPs that were larger in the cMM than the iMM; stimulation of right masseteric cortex produced a similar asymmetry in response amplitude. SICI was only observed using a CS intensity of 70% AMT and was equal in both cMM and iMM. SICI was stronger at higher TS intensities, was abolished by muscle activation greater than 10% MVC, and was unaffected by coil orientation changes. Control experiments confirmed that SICI was not contaminated by any inhibitory peripheral reflexes. However, ICF could not be obtained because it was masked by bilateral reflex depression of masseter EMG caused by auditory input from the coil discharge. The SP was bilateral and symmetric; its duration ranged from 35 to 70 ms depending on TS intensity and coil orientation. We conclude that SICI is present in the cortical representation of masseter muscles. The similarity of SICI in cMM and iMM suggests either that a single pool of inhibitory interneurons controls ipsi- and contralateral corticotrigeminal projections or that inhibition is directed to bilaterally projecting corticotrigeminal fibres. Finally, the corticotrigeminal projection seems to be weakly influenced by inhibitory interneurons mediating the cortical SP.
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Affiliation(s)
- Enzo Ortu
- Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, London, UK
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