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Fifer MS, McMullen DP, Osborn LE, Thomas TM, Christie B, Nickl RW, Candrea DN, Pohlmeyer EA, Thompson MC, Anaya MA, Schellekens W, Ramsey NF, Bensmaia SJ, Anderson WS, Wester BA, Crone NE, Celnik PA, Cantarero GL, Tenore FV. Intracortical Somatosensory Stimulation to Elicit Fingertip Sensations in an Individual With Spinal Cord Injury. Neurology 2022; 98:e679-e687. [PMID: 34880087 PMCID: PMC8865889 DOI: 10.1212/wnl.0000000000013173] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 11/19/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The restoration of touch to fingers and fingertips is critical to achieving dexterous neuroprosthetic control for individuals with sensorimotor dysfunction. However, localized fingertip sensations have not been evoked via intracortical microstimulation (ICMS). METHODS Using a novel intraoperative mapping approach, we implanted electrode arrays in the finger areas of left and right somatosensory cortex and delivered ICMS over a 2-year period in a human participant with spinal cord injury. RESULTS Stimulation evoked tactile sensations in 8 fingers, including fingertips, spanning both hands. Evoked percepts followed expected somatotopic arrangements. The subject was able to reliably identify up to 7 finger-specific sites spanning both hands in a finger discrimination task. The size of the evoked percepts was on average 33% larger than a finger pad, as assessed via manual markings of a hand image. The size of the evoked percepts increased modestly with increased stimulation intensity, growing 21% as pulse amplitude increased from 20 to 80 µA. Detection thresholds were estimated on a subset of electrodes, with estimates of 9.2 to 35 µA observed, roughly consistent with prior studies. DISCUSSION These results suggest that ICMS can enable the delivery of consistent and localized fingertip sensations during object manipulation by neuroprostheses for individuals with somatosensory deficits. CLINICALTRIALSGOV IDENTIFIER NCT03161067.
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Affiliation(s)
- Matthew S Fifer
- From the Research and Exploratory Development Department (M.S.F., L.E.O., B.P.C., E.A.P., M.C.T., F.V.T.), Johns Hopkins University Applied Physics Laboratory, Laurel; National Institute of Mental Health (D.P.M.), NIH, Bethesda; Department of Biomedical Engineering (T.M.T., D.N.C.), Department of Physical Medicine and Rehabilitation (R.W.N., M.A.A., P.A.C., G.L.C.), Department of Neurosurgery (W.S.A.), and Department of Neurology (B.A.W., N.E.C.), Johns Hopkins University, Baltimore, MD; UMC Utrecht Brain Center (W.S., N.F.R.), the Netherlands; and Department of Organismal Biology and Anatomy (S.J.B.), University of Chicago, IL.
| | - David P McMullen
- From the Research and Exploratory Development Department (M.S.F., L.E.O., B.P.C., E.A.P., M.C.T., F.V.T.), Johns Hopkins University Applied Physics Laboratory, Laurel; National Institute of Mental Health (D.P.M.), NIH, Bethesda; Department of Biomedical Engineering (T.M.T., D.N.C.), Department of Physical Medicine and Rehabilitation (R.W.N., M.A.A., P.A.C., G.L.C.), Department of Neurosurgery (W.S.A.), and Department of Neurology (B.A.W., N.E.C.), Johns Hopkins University, Baltimore, MD; UMC Utrecht Brain Center (W.S., N.F.R.), the Netherlands; and Department of Organismal Biology and Anatomy (S.J.B.), University of Chicago, IL
| | - Luke E Osborn
- From the Research and Exploratory Development Department (M.S.F., L.E.O., B.P.C., E.A.P., M.C.T., F.V.T.), Johns Hopkins University Applied Physics Laboratory, Laurel; National Institute of Mental Health (D.P.M.), NIH, Bethesda; Department of Biomedical Engineering (T.M.T., D.N.C.), Department of Physical Medicine and Rehabilitation (R.W.N., M.A.A., P.A.C., G.L.C.), Department of Neurosurgery (W.S.A.), and Department of Neurology (B.A.W., N.E.C.), Johns Hopkins University, Baltimore, MD; UMC Utrecht Brain Center (W.S., N.F.R.), the Netherlands; and Department of Organismal Biology and Anatomy (S.J.B.), University of Chicago, IL
| | - Tessy M Thomas
- From the Research and Exploratory Development Department (M.S.F., L.E.O., B.P.C., E.A.P., M.C.T., F.V.T.), Johns Hopkins University Applied Physics Laboratory, Laurel; National Institute of Mental Health (D.P.M.), NIH, Bethesda; Department of Biomedical Engineering (T.M.T., D.N.C.), Department of Physical Medicine and Rehabilitation (R.W.N., M.A.A., P.A.C., G.L.C.), Department of Neurosurgery (W.S.A.), and Department of Neurology (B.A.W., N.E.C.), Johns Hopkins University, Baltimore, MD; UMC Utrecht Brain Center (W.S., N.F.R.), the Netherlands; and Department of Organismal Biology and Anatomy (S.J.B.), University of Chicago, IL
| | - Breanne Christie
- From the Research and Exploratory Development Department (M.S.F., L.E.O., B.P.C., E.A.P., M.C.T., F.V.T.), Johns Hopkins University Applied Physics Laboratory, Laurel; National Institute of Mental Health (D.P.M.), NIH, Bethesda; Department of Biomedical Engineering (T.M.T., D.N.C.), Department of Physical Medicine and Rehabilitation (R.W.N., M.A.A., P.A.C., G.L.C.), Department of Neurosurgery (W.S.A.), and Department of Neurology (B.A.W., N.E.C.), Johns Hopkins University, Baltimore, MD; UMC Utrecht Brain Center (W.S., N.F.R.), the Netherlands; and Department of Organismal Biology and Anatomy (S.J.B.), University of Chicago, IL
| | - Robert W Nickl
- From the Research and Exploratory Development Department (M.S.F., L.E.O., B.P.C., E.A.P., M.C.T., F.V.T.), Johns Hopkins University Applied Physics Laboratory, Laurel; National Institute of Mental Health (D.P.M.), NIH, Bethesda; Department of Biomedical Engineering (T.M.T., D.N.C.), Department of Physical Medicine and Rehabilitation (R.W.N., M.A.A., P.A.C., G.L.C.), Department of Neurosurgery (W.S.A.), and Department of Neurology (B.A.W., N.E.C.), Johns Hopkins University, Baltimore, MD; UMC Utrecht Brain Center (W.S., N.F.R.), the Netherlands; and Department of Organismal Biology and Anatomy (S.J.B.), University of Chicago, IL
| | - Daniel N Candrea
- From the Research and Exploratory Development Department (M.S.F., L.E.O., B.P.C., E.A.P., M.C.T., F.V.T.), Johns Hopkins University Applied Physics Laboratory, Laurel; National Institute of Mental Health (D.P.M.), NIH, Bethesda; Department of Biomedical Engineering (T.M.T., D.N.C.), Department of Physical Medicine and Rehabilitation (R.W.N., M.A.A., P.A.C., G.L.C.), Department of Neurosurgery (W.S.A.), and Department of Neurology (B.A.W., N.E.C.), Johns Hopkins University, Baltimore, MD; UMC Utrecht Brain Center (W.S., N.F.R.), the Netherlands; and Department of Organismal Biology and Anatomy (S.J.B.), University of Chicago, IL
| | - Eric A Pohlmeyer
- From the Research and Exploratory Development Department (M.S.F., L.E.O., B.P.C., E.A.P., M.C.T., F.V.T.), Johns Hopkins University Applied Physics Laboratory, Laurel; National Institute of Mental Health (D.P.M.), NIH, Bethesda; Department of Biomedical Engineering (T.M.T., D.N.C.), Department of Physical Medicine and Rehabilitation (R.W.N., M.A.A., P.A.C., G.L.C.), Department of Neurosurgery (W.S.A.), and Department of Neurology (B.A.W., N.E.C.), Johns Hopkins University, Baltimore, MD; UMC Utrecht Brain Center (W.S., N.F.R.), the Netherlands; and Department of Organismal Biology and Anatomy (S.J.B.), University of Chicago, IL
| | - Margaret C Thompson
- From the Research and Exploratory Development Department (M.S.F., L.E.O., B.P.C., E.A.P., M.C.T., F.V.T.), Johns Hopkins University Applied Physics Laboratory, Laurel; National Institute of Mental Health (D.P.M.), NIH, Bethesda; Department of Biomedical Engineering (T.M.T., D.N.C.), Department of Physical Medicine and Rehabilitation (R.W.N., M.A.A., P.A.C., G.L.C.), Department of Neurosurgery (W.S.A.), and Department of Neurology (B.A.W., N.E.C.), Johns Hopkins University, Baltimore, MD; UMC Utrecht Brain Center (W.S., N.F.R.), the Netherlands; and Department of Organismal Biology and Anatomy (S.J.B.), University of Chicago, IL
| | - Manuel A Anaya
- From the Research and Exploratory Development Department (M.S.F., L.E.O., B.P.C., E.A.P., M.C.T., F.V.T.), Johns Hopkins University Applied Physics Laboratory, Laurel; National Institute of Mental Health (D.P.M.), NIH, Bethesda; Department of Biomedical Engineering (T.M.T., D.N.C.), Department of Physical Medicine and Rehabilitation (R.W.N., M.A.A., P.A.C., G.L.C.), Department of Neurosurgery (W.S.A.), and Department of Neurology (B.A.W., N.E.C.), Johns Hopkins University, Baltimore, MD; UMC Utrecht Brain Center (W.S., N.F.R.), the Netherlands; and Department of Organismal Biology and Anatomy (S.J.B.), University of Chicago, IL
| | - Wouter Schellekens
- From the Research and Exploratory Development Department (M.S.F., L.E.O., B.P.C., E.A.P., M.C.T., F.V.T.), Johns Hopkins University Applied Physics Laboratory, Laurel; National Institute of Mental Health (D.P.M.), NIH, Bethesda; Department of Biomedical Engineering (T.M.T., D.N.C.), Department of Physical Medicine and Rehabilitation (R.W.N., M.A.A., P.A.C., G.L.C.), Department of Neurosurgery (W.S.A.), and Department of Neurology (B.A.W., N.E.C.), Johns Hopkins University, Baltimore, MD; UMC Utrecht Brain Center (W.S., N.F.R.), the Netherlands; and Department of Organismal Biology and Anatomy (S.J.B.), University of Chicago, IL
| | - Nick F Ramsey
- From the Research and Exploratory Development Department (M.S.F., L.E.O., B.P.C., E.A.P., M.C.T., F.V.T.), Johns Hopkins University Applied Physics Laboratory, Laurel; National Institute of Mental Health (D.P.M.), NIH, Bethesda; Department of Biomedical Engineering (T.M.T., D.N.C.), Department of Physical Medicine and Rehabilitation (R.W.N., M.A.A., P.A.C., G.L.C.), Department of Neurosurgery (W.S.A.), and Department of Neurology (B.A.W., N.E.C.), Johns Hopkins University, Baltimore, MD; UMC Utrecht Brain Center (W.S., N.F.R.), the Netherlands; and Department of Organismal Biology and Anatomy (S.J.B.), University of Chicago, IL
| | - Sliman J Bensmaia
- From the Research and Exploratory Development Department (M.S.F., L.E.O., B.P.C., E.A.P., M.C.T., F.V.T.), Johns Hopkins University Applied Physics Laboratory, Laurel; National Institute of Mental Health (D.P.M.), NIH, Bethesda; Department of Biomedical Engineering (T.M.T., D.N.C.), Department of Physical Medicine and Rehabilitation (R.W.N., M.A.A., P.A.C., G.L.C.), Department of Neurosurgery (W.S.A.), and Department of Neurology (B.A.W., N.E.C.), Johns Hopkins University, Baltimore, MD; UMC Utrecht Brain Center (W.S., N.F.R.), the Netherlands; and Department of Organismal Biology and Anatomy (S.J.B.), University of Chicago, IL
| | - William S Anderson
- From the Research and Exploratory Development Department (M.S.F., L.E.O., B.P.C., E.A.P., M.C.T., F.V.T.), Johns Hopkins University Applied Physics Laboratory, Laurel; National Institute of Mental Health (D.P.M.), NIH, Bethesda; Department of Biomedical Engineering (T.M.T., D.N.C.), Department of Physical Medicine and Rehabilitation (R.W.N., M.A.A., P.A.C., G.L.C.), Department of Neurosurgery (W.S.A.), and Department of Neurology (B.A.W., N.E.C.), Johns Hopkins University, Baltimore, MD; UMC Utrecht Brain Center (W.S., N.F.R.), the Netherlands; and Department of Organismal Biology and Anatomy (S.J.B.), University of Chicago, IL
| | - Brock A Wester
- From the Research and Exploratory Development Department (M.S.F., L.E.O., B.P.C., E.A.P., M.C.T., F.V.T.), Johns Hopkins University Applied Physics Laboratory, Laurel; National Institute of Mental Health (D.P.M.), NIH, Bethesda; Department of Biomedical Engineering (T.M.T., D.N.C.), Department of Physical Medicine and Rehabilitation (R.W.N., M.A.A., P.A.C., G.L.C.), Department of Neurosurgery (W.S.A.), and Department of Neurology (B.A.W., N.E.C.), Johns Hopkins University, Baltimore, MD; UMC Utrecht Brain Center (W.S., N.F.R.), the Netherlands; and Department of Organismal Biology and Anatomy (S.J.B.), University of Chicago, IL
| | - Nathan E Crone
- From the Research and Exploratory Development Department (M.S.F., L.E.O., B.P.C., E.A.P., M.C.T., F.V.T.), Johns Hopkins University Applied Physics Laboratory, Laurel; National Institute of Mental Health (D.P.M.), NIH, Bethesda; Department of Biomedical Engineering (T.M.T., D.N.C.), Department of Physical Medicine and Rehabilitation (R.W.N., M.A.A., P.A.C., G.L.C.), Department of Neurosurgery (W.S.A.), and Department of Neurology (B.A.W., N.E.C.), Johns Hopkins University, Baltimore, MD; UMC Utrecht Brain Center (W.S., N.F.R.), the Netherlands; and Department of Organismal Biology and Anatomy (S.J.B.), University of Chicago, IL
| | - Pablo A Celnik
- From the Research and Exploratory Development Department (M.S.F., L.E.O., B.P.C., E.A.P., M.C.T., F.V.T.), Johns Hopkins University Applied Physics Laboratory, Laurel; National Institute of Mental Health (D.P.M.), NIH, Bethesda; Department of Biomedical Engineering (T.M.T., D.N.C.), Department of Physical Medicine and Rehabilitation (R.W.N., M.A.A., P.A.C., G.L.C.), Department of Neurosurgery (W.S.A.), and Department of Neurology (B.A.W., N.E.C.), Johns Hopkins University, Baltimore, MD; UMC Utrecht Brain Center (W.S., N.F.R.), the Netherlands; and Department of Organismal Biology and Anatomy (S.J.B.), University of Chicago, IL
| | - Gabriela L Cantarero
- From the Research and Exploratory Development Department (M.S.F., L.E.O., B.P.C., E.A.P., M.C.T., F.V.T.), Johns Hopkins University Applied Physics Laboratory, Laurel; National Institute of Mental Health (D.P.M.), NIH, Bethesda; Department of Biomedical Engineering (T.M.T., D.N.C.), Department of Physical Medicine and Rehabilitation (R.W.N., M.A.A., P.A.C., G.L.C.), Department of Neurosurgery (W.S.A.), and Department of Neurology (B.A.W., N.E.C.), Johns Hopkins University, Baltimore, MD; UMC Utrecht Brain Center (W.S., N.F.R.), the Netherlands; and Department of Organismal Biology and Anatomy (S.J.B.), University of Chicago, IL
| | - Francesco V Tenore
- From the Research and Exploratory Development Department (M.S.F., L.E.O., B.P.C., E.A.P., M.C.T., F.V.T.), Johns Hopkins University Applied Physics Laboratory, Laurel; National Institute of Mental Health (D.P.M.), NIH, Bethesda; Department of Biomedical Engineering (T.M.T., D.N.C.), Department of Physical Medicine and Rehabilitation (R.W.N., M.A.A., P.A.C., G.L.C.), Department of Neurosurgery (W.S.A.), and Department of Neurology (B.A.W., N.E.C.), Johns Hopkins University, Baltimore, MD; UMC Utrecht Brain Center (W.S., N.F.R.), the Netherlands; and Department of Organismal Biology and Anatomy (S.J.B.), University of Chicago, IL
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Scarpina F, Magnani FG, Tagini S, Priano L, Mauro A, Sedda A. Mental representation of the body in action in Parkinson's disease. Exp Brain Res 2019; 237:2505-2521. [PMID: 31327026 DOI: 10.1007/s00221-019-05608-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 07/17/2019] [Indexed: 12/13/2022]
Abstract
Mixed findings characterize studies in Parkinson's disease (PD): some studies indicate a relationship between physical impairments and the ability to mentally represent the body, while others suggest spared abilities for this cognitive function. To clarify the matter, in the present study we explored the mental representations of the body in action in the same PD patients, taking also into account lateralization of symptoms and visual imagery skills. 10 PD patients with left- (lPD), 10 with right (rPD) lateralized symptoms (lPD), and 20 matched healthy controls have been recruited for the study. All patients were screened for neuropsychological impairments. To explore a more implicit component we used the hand laterality task (HLT), while the mental motor chronometry (MMC) was used to explore a more explicit one. Two control tasks, with objects instead of body parts, were administered to control for visual imagery skills. In the HLT, we detected the effects of biomechanical constraints effects in both controls and PD patients. In the latter group, importantly, this was true independently from lateralization of symptoms. In the MMC, we found the expected positive correlation between executed and imagined movements for both hands in controls only, while all PD patients, again independently form lateralization, only showed this effect for the left hand. In terms of visual imagery, only rPD patients differed from controls when asked to implicitly rotate letters, and in terms of accuracy only. However, this difference is explained by executive functions measured through the neuropsychological assessment rather than by a "pure" visual imagery impairment. In summary, our findings suggest that two different aspects of the mental representations of the body in action, one more implicit and the other more explicit, can be differently affected by PD. These impairments are unlikely explained by a basic visual imagery deficit. When present, impairments concern a higher dimension, related to motor functions and awareness, and not driven by sensory impairments, as shown by the independence of effects from physical laterality of symptoms.
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Affiliation(s)
- Federica Scarpina
- Division of Neurology and Neuro-Rehabilitation, Istituto Auxologico Italiano, IRCCS, Ospedale San Giuseppe, Via Cadorna 90, 28824, Piancavallo, VCO, Italy.
| | - Francesca Giulia Magnani
- Cognitive Neuropsychology Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.,NeuroMi-Milan Center for Neuroscience, University of Milano Bicocca, Milan, Italy
| | - Sofia Tagini
- Division of Neurology and Neuro-Rehabilitation, Istituto Auxologico Italiano, IRCCS, Ospedale San Giuseppe, Via Cadorna 90, 28824, Piancavallo, VCO, Italy.,CIMeC, Center for the Mind/Brain Sciences, University of Trento, Rovereto, Italy
| | - Lorenzo Priano
- Division of Neurology and Neuro-Rehabilitation, Istituto Auxologico Italiano, IRCCS, Ospedale San Giuseppe, Via Cadorna 90, 28824, Piancavallo, VCO, Italy.,"Rita Levi Montalcini" Department of Neuroscience, University of Turin, Turin, Italy
| | - Alessandro Mauro
- Division of Neurology and Neuro-Rehabilitation, Istituto Auxologico Italiano, IRCCS, Ospedale San Giuseppe, Via Cadorna 90, 28824, Piancavallo, VCO, Italy.,"Rita Levi Montalcini" Department of Neuroscience, University of Turin, Turin, Italy
| | - Anna Sedda
- Psychology Department, School of Social Sciences, Heriot Watt University, Edinburgh, UK
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