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Meissner SN, Bächinger M, Kikkert S, Imhof J, Missura S, Carro Dominguez M, Wenderoth N. Self-regulating arousal via pupil-based biofeedback. Nat Hum Behav 2024; 8:43-62. [PMID: 37904022 PMCID: PMC10810759 DOI: 10.1038/s41562-023-01729-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 09/20/2023] [Indexed: 11/01/2023]
Abstract
The brain's arousal state is controlled by several neuromodulatory nuclei known to substantially influence cognition and mental well-being. Here we investigate whether human participants can gain volitional control of their arousal state using a pupil-based biofeedback approach. Our approach inverts a mechanism suggested by previous literature that links activity of the locus coeruleus, one of the key regulators of central arousal and pupil dynamics. We show that pupil-based biofeedback enables participants to acquire volitional control of pupil size. Applying pupil self-regulation systematically modulates activity of the locus coeruleus and other brainstem structures involved in arousal control. Furthermore, it modulates cardiovascular measures such as heart rate, and behavioural and psychophysiological responses during an oddball task. We provide evidence that pupil-based biofeedback makes the brain's arousal system accessible to volitional control, a finding that has tremendous potential for translation to behavioural and clinical applications across various domains, including stress-related and anxiety disorders.
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Affiliation(s)
- Sarah Nadine Meissner
- Neural Control of Movement Laboratory, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.
| | - Marc Bächinger
- Neural Control of Movement Laboratory, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Sanne Kikkert
- Neural Control of Movement Laboratory, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University and ETH Zurich, Zurich, Switzerland
- Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Jenny Imhof
- Neural Control of Movement Laboratory, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University and ETH Zurich, Zurich, Switzerland
| | - Silvia Missura
- Neural Control of Movement Laboratory, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Manuel Carro Dominguez
- Neural Control of Movement Laboratory, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University and ETH Zurich, Zurich, Switzerland
| | - Nicole Wenderoth
- Neural Control of Movement Laboratory, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.
- Neuroscience Center Zurich, University and ETH Zurich, Zurich, Switzerland.
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore.
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2
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Rabe F, Kikkert S, Wenderoth N. Performing a vibrotactile discrimination task modulates finger representations in primary somatosensory cortex. J Neurophysiol 2023; 130:1015-1027. [PMID: 37671429 PMCID: PMC10649835 DOI: 10.1152/jn.00428.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 08/29/2023] [Accepted: 08/31/2023] [Indexed: 09/07/2023] Open
Abstract
It is well established that vibrotactile stimuli are represented in somatotopic maps. However, less is known about whether these somatotopic representations are modulated by task demands and maybe even in the absence of tactile input. Here, we used a vibrotactile discrimination task as a tool to investigate these questions in further detail. Participants were required to actively perceive and process tactile stimuli in comparison to a no-task control condition where identical stimuli were passively perceived (no-memory condition). Importantly, both vibrotactile stimuli were either applied to the right index or little finger, allowing us to investigate whether cognitive task demands shape finger representations in primary somatosensory cortex (S1). Using multivoxel pattern analysis and representational similarity analysis, we found that S1 finger representations were more distinct during the memory than the no-memory condition. Interestingly, this effect was not only observed while tactile stimuli were presented but also during the delay period (i.e., in the absence of tactile stimulation). Our findings imply that when individuals are required to focus on tactile stimuli, retain them in their memory, and engage in active processing of distinctive stimulus features, this exerts a modulatory effect on the finger representations present in S1.NEW & NOTEWORTHY Using multivoxel pattern analysis, we found that discrimination task demands shape finger representations in the contralateral primary somatosensory cortex (S1), and that somatotopic representations are modulated by task demands not only during tactile stimulation but also to a certain extent in the absence of tactile input.
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Affiliation(s)
- Finn Rabe
- Neural Control of Movement Laboratory, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Sanne Kikkert
- Neural Control of Movement Laboratory, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
- Neuroscience Center Zurich (ZNZ), ETH Zurich and University of Zurich, Zurich, Switzerland
| | - Nicole Wenderoth
- Neural Control of Movement Laboratory, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
- Spinal Cord Injury Center, Balgrist University Hospital, University of Zürich, Zurich, Switzerland
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3
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Kikkert S, Sonar HA, Freund P, Paik J, Wenderoth N. Hand and face somatotopy shown using MRI-safe vibrotactile stimulation with a novel soft pneumatic actuator (SPA)-skin interface. Neuroimage 2023; 269:119932. [PMID: 36750151 DOI: 10.1016/j.neuroimage.2023.119932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 01/23/2023] [Accepted: 02/02/2023] [Indexed: 02/07/2023] Open
Abstract
The exact somatotopy of the human facial representation in the primary somatosensory cortex (S1) remains debated. One reason that progress has been hampered is due to the methodological challenge of how to apply automated vibrotactile stimuli to face areas in a manner that is: (1) reliable despite differences in the curvatures of face locations; and (2) MR-compatible and free of MR-interference artefacts when applied in the MR head-coil. Here we overcome this challenge by using soft pneumatic actuator (SPA) technology. SPAs are made of a soft silicon material and can be in- or deflated by means of airflow, have a small diameter, and are flexible in structure, enabling good skin contact even on curved body surfaces (as on the face). To validate our approach, we first mapped the well-characterised S1 finger layout using this novel device and confirmed that tactile stimulation of the fingers elicited characteristic somatotopic finger activations in S1. We then used the device to automatically and systematically deliver somatosensory stimulation to different face locations. We found that the forehead representation was least distant from the representation of the hand. Within the face representation, we found that the lip representation is most distant from the forehead representation, with the chin represented in between. Together, our results demonstrate that this novel MR compatible device produces robust and clear somatotopic representational patterns using vibrotactile stimulation through SPA-technology.
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Affiliation(s)
- Sanne Kikkert
- Neural Control of Movement Laboratory, Department of Health Sciences and Technology, ETH Zürich, Zürich, Switzerland; Spinal Cord Injury Center Balgrist, University Hospital Zürich, University of Zürich, Zürich, Switzerland.
| | | | - Patrick Freund
- Spinal Cord Injury Center Balgrist, University Hospital Zürich, University of Zürich, Zürich, Switzerland
| | - Jamie Paik
- Reconfigurable Robotics Lab, EPFL, Lausanne, Switzerland
| | - Nicole Wenderoth
- Neural Control of Movement Laboratory, Department of Health Sciences and Technology, ETH Zürich, Zürich, Switzerland
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4
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Wesselink DB, Sanders ZB, Edmondson LR, Dempsey-Jones H, Kieliba P, Kikkert S, Themistocleous AC, Emir U, Diedrichsen J, Saal HP, Makin TR. Malleability of the cortical hand map following a finger nerve block. Sci Adv 2022; 8:eabk2393. [PMID: 35452294 PMCID: PMC9032959 DOI: 10.1126/sciadv.abk2393] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Electrophysiological studies in monkeys show that finger amputation triggers local remapping within the deprived primary somatosensory cortex (S1). Human neuroimaging research, however, shows persistent S1 representation of the missing hand's fingers, even decades after amputation. Here, we explore whether this apparent contradiction stems from underestimating the distributed peripheral and central representation of fingers in the hand map. Using pharmacological single-finger nerve block and 7-tesla neuroimaging, we first replicated previous accounts (electrophysiological and other) of local S1 remapping. Local blocking also triggered activity changes to nonblocked fingers across the entire hand area. Using methods exploiting interfinger representational overlap, however, we also show that the blocked finger representation remained persistent despite input loss. Computational modeling suggests that both local stability and global reorganization are driven by distributed processing underlying the topographic map, combined with homeostatic mechanisms. Our findings reveal complex interfinger representational features that play a key role in brain (re)organization, beyond (re)mapping.
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Affiliation(s)
- Daan B. Wesselink
- Institute of Cognitive Neuroscience, University College London, London, UK
- Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
- Department of Neurobiology, Harvard Medical School, Boston, MA, USA
- Corresponding author.
| | - Zeena-Britt Sanders
- Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
| | - Laura R. Edmondson
- Active Touch Laboratory, Department of Psychology, The University of Sheffield, Sheffield, UK
| | - Harriet Dempsey-Jones
- Institute of Cognitive Neuroscience, University College London, London, UK
- Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
- School of Psychology, University of Queensland, Brisbane, Australia
| | - Paulina Kieliba
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Sanne Kikkert
- Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
| | - Andreas C. Themistocleous
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
- Brain Function Research Group, University of the Witwatersrand, Johannesburg, South Africa
| | - Uzay Emir
- Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
| | - Jörn Diedrichsen
- Brain and Mind Institute, University of Western Ontario, London, Canada
| | - Hannes P. Saal
- Active Touch Laboratory, Department of Psychology, The University of Sheffield, Sheffield, UK
| | - Tamar R. Makin
- Institute of Cognitive Neuroscience, University College London, London, UK
- Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
- Wellcome Centre for Human Neuroimaging, University College London, London, UK
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Kikkert S, Pfyffer D, Verling M, Freund P, Wenderoth N. Finger somatotopy is preserved after tetraplegia but deteriorates over time. eLife 2021; 10:e67713. [PMID: 34665133 PMCID: PMC8575460 DOI: 10.7554/elife.67713] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 10/18/2021] [Indexed: 12/12/2022] Open
Abstract
Previous studies showed reorganised and/or altered activity in the primary sensorimotor cortex after a spinal cord injury (SCI), suggested to reflect abnormal processing. However, little is known about whether somatotopically specific representations can be activated despite reduced or absent afferent hand inputs. In this observational study, we used functional MRI and a (attempted) finger movement task in tetraplegic patients to characterise the somatotopic hand layout in primary somatosensory cortex. We further used structural MRI to assess spared spinal tissue bridges. We found that somatotopic hand representations can be activated through attempted finger movements in the absence of sensory and motor hand functioning, and no spared spinal tissue bridges. Such preserved hand somatotopy could be exploited by rehabilitation approaches that aim to establish new hand-brain functional connections after SCI (e.g. neuroprosthetics). However, over years since SCI the hand representation somatotopy deteriorated, suggesting that somatotopic hand representations are more easily targeted within the first years after SCI.
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Affiliation(s)
- Sanne Kikkert
- Neural Control of Movement Laboratory, Department of Health Sciences and Technology, ETH ZürichZürichSwitzerland
- Spinal Cord Injury Center, Balgrist University Hospital, University of ZürichZürichSwitzerland
| | - Dario Pfyffer
- Spinal Cord Injury Center, Balgrist University Hospital, University of ZürichZürichSwitzerland
| | - Michaela Verling
- Neural Control of Movement Laboratory, Department of Health Sciences and Technology, ETH ZürichZürichSwitzerland
| | - Patrick Freund
- Spinal Cord Injury Center, Balgrist University Hospital, University of ZürichZürichSwitzerland
- Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, University College LondonLondonUnited Kingdom
- Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, University College LondonLondonUnited Kingdom
- Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain SciencesLeipzigGermany
| | - Nicole Wenderoth
- Neural Control of Movement Laboratory, Department of Health Sciences and Technology, ETH ZürichZürichSwitzerland
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Mihelj E, Bächinger M, Kikkert S, Ruddy K, Wenderoth N. Mental individuation of imagined finger movements can be achieved using TMS-based neurofeedback. Neuroimage 2021; 242:118463. [PMID: 34384910 DOI: 10.1016/j.neuroimage.2021.118463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 07/09/2021] [Accepted: 08/04/2021] [Indexed: 11/27/2022] Open
Abstract
Neurofeedback (NF) in combination with motor imagery (MI) can be used for training individuals to volitionally modulate sensorimotor activity without producing overt movements. However, until now, NF methods were of limited utility for mentally training specific hand and finger actions. Here we employed a novel transcranial magnetic stimulation (TMS) based protocol to probe and detect MI-induced motor activity patterns in the primary motor cortex (M1) with the aim to reinforce selective facilitation of single finger representations. We showed that TMS-NF training but not MI training with uninformative feedback enabled participants to selectively upregulate corticomotor excitability of one finger, while simultaneously downregulating excitability of other finger representations within the same hand. Successful finger individuation during MI was accompanied by strong desynchronization of sensorimotor brain rhythms, particularly in the beta band, as measured by electroencephalography. Additionally, informative TMS-NF promoted more dissociable EEG activation patterns underlying single finger MI, when compared to MI of the control group where no such feedback was provided. Our findings suggest that selective TMS-NF is a new approach for acquiring the ability of finger individuation even if no overt movements are performed. This might offer new treatment modality for rehabilitation after stroke or spinal cord injury.
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Affiliation(s)
- Ernest Mihelj
- Department of Health Sciences and Technology, Neural Control of Movement Laboratory, ETH Zurich, Auguste-Piccard-Hof 1 Building HPT, Floor EETH, Zurich, Switzerland
| | - Marc Bächinger
- Department of Health Sciences and Technology, Neural Control of Movement Laboratory, ETH Zurich, Auguste-Piccard-Hof 1 Building HPT, Floor EETH, Zurich, Switzerland
| | - Sanne Kikkert
- Department of Health Sciences and Technology, Neural Control of Movement Laboratory, ETH Zurich, Auguste-Piccard-Hof 1 Building HPT, Floor EETH, Zurich, Switzerland
| | - Kathy Ruddy
- Trinity College Institute of Neuroscience and School of Psychology, Trinity College Dublin, Ireland
| | - Nicole Wenderoth
- Department of Health Sciences and Technology, Neural Control of Movement Laboratory, ETH Zurich, Auguste-Piccard-Hof 1 Building HPT, Floor EETH, Zurich, Switzerland; Neuroscience Center Zurich (ZNZ), University of Zurich, Federal Institute of Technology, Zurich, Switzerland; Future Health Technologies, Singapore-ETH Center, Campus for Research Excellence And Technological Enterprise (CREATE), Singapore.
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7
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Kikkert S, Mezue M, O'Shea J, Henderson Slater D, Johansen-Berg H, Tracey I, Makin TR. Neural basis of induced phantom limb pain relief. Ann Neurol 2019; 85:59-73. [PMID: 30383312 PMCID: PMC6492189 DOI: 10.1002/ana.25371] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 10/29/2018] [Accepted: 10/29/2018] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Phantom limb pain (PLP) is notoriously difficult to treat, partly due to an incomplete understanding of PLP-related disease mechanisms. Noninvasive brain stimulation (NIBS) is used to modulate plasticity in various neuropathological diseases, including chronic pain. Although NIBS can alleviate neuropathic pain (including PLP), both disease and treatment mechanisms remain tenuous. Insight into the mechanisms underlying both PLP and NIBS-induced PLP relief is needed for future implementation of such treatment and generalization to related conditions. METHODS We used a within-participants, double-blind, and sham-controlled design to alleviate PLP via task-concurrent NIBS over the primary sensorimotor missing hand cortex (S1/M1). To specifically influence missing hand signal processing, amputees performed phantom hand movements during anodal transcranial direct current stimulation. Brain activity was monitored using neuroimaging during and after NIBS. PLP ratings were obtained throughout the week after stimulation. RESULTS A single session of intervention NIBS significantly relieved PLP, with effects lasting at least 1 week. PLP relief associated with reduced activity in the S1/M1 missing hand cortex after stimulation. Critically, PLP relief and reduced S1/M1 activity correlated with preceding activity changes during stimulation in the mid- and posterior insula and secondary somatosensory cortex (S2). INTERPRETATION The observed correlation between PLP relief and decreased S1/M1 activity confirms our previous findings linking PLP with increased S1/M1 activity. Our results further highlight the driving role of the mid- and posterior insula, as well as S2, in modulating PLP. Lastly, our novel PLP intervention using task-concurrent NIBS opens new avenues for developing treatment for PLP and related pain conditions. ANN NEUROL 2019;85:59-73.
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Affiliation(s)
- Sanne Kikkert
- Wellcome Centre for Integrative Neuroimaging, FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom.,Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, the Netherlands.,Neural Control of Movement Laboratory, Department of Health Sciences and Technology, ETH Zürich, Zürich, Switzerland
| | - Melvin Mezue
- Wellcome Centre for Integrative Neuroimaging, FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Jacinta O'Shea
- Wellcome Centre for Integrative Neuroimaging, FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | | | - Heidi Johansen-Berg
- Wellcome Centre for Integrative Neuroimaging, FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Irene Tracey
- Wellcome Centre for Integrative Neuroimaging, FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Tamar R Makin
- Wellcome Centre for Integrative Neuroimaging, FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom.,Institute of Cognitive Neuroscience, University College London, London, United Kingdom.,Wellcome Centre for Human Neuroimaging, University College London, London, United Kingdom
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8
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Affiliation(s)
- Daan Wesselink
- Institute of Cognitive Neuroscience, University College LondonFMRIB Centre, University of Oxford
| | - Sanne Kikkert
- FMRIB Centre, University of OxfordDonders Institute for Brain, Cognition and Behaviour
| | | | - Tamar Makin
- Institute of Cognitive Neuroscience, University College LondonFMRIB Centre, University of Oxford
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9
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Kikkert S, Johansen-Berg H, Tracey I, Makin TR. Reaffirming the link between chronic phantom limb pain and maintained missing hand representation. Cortex 2018; 106:174-184. [PMID: 30005369 PMCID: PMC6143485 DOI: 10.1016/j.cortex.2018.05.013] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 04/16/2018] [Accepted: 05/23/2018] [Indexed: 12/20/2022]
Abstract
Phantom limb pain (PLP) is commonly considered to be a result of maladaptive brain plasticity. This model proposes that PLP is mainly caused by reorganisation in the primary somatosensory cortex, presumably characterised by functional degradation of the missing hand representation and remapping of other body part representations. In the current study, we replicate our previous results by showing that chronic PLP correlates with maintained representation of the missing hand in the primary sensorimotor missing hand cortex. We asked unilateral upper-limb amputees to move their phantom hand, lips or other body parts and measured the associated neural responses using functional magnetic resonance imaging (fMRI). We confirm that amputees suffering from worse chronic PLP have stronger activity in the primary sensorimotor missing hand cortex while performing phantom hand movements. We find no evidence of lip representation remapping into the missing hand territory, as assessed by measuring activity in the primary sensorimotor missing hand cortex during lip movements. We further show that the correlation between chronic PLP and maintained representation of the missing hand cannot be explained by the experience of chronic non-painful phantom sensations or compensatory usage of the residual arm or an artificial arm (prosthesis). Together, our results reaffirm a likely relationship between persistent peripheral inputs pertaining to the missing hand representation and chronic PLP. Our findings emphasise a need to further study the role of peripheral inputs from the residual nerves to better understand the mechanisms underlying chronic PLP.
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Affiliation(s)
- Sanne Kikkert
- Wellcome Centre for Integrative Neuroimaging, MRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Heidi Johansen-Berg
- Wellcome Centre for Integrative Neuroimaging, MRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Irene Tracey
- Wellcome Centre for Integrative Neuroimaging, MRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom; Nuffield Division of Anaesthetics, University of Oxford, Oxford, United Kingdom
| | - Tamar R Makin
- Wellcome Centre for Integrative Neuroimaging, MRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom; Institute of Cognitive Neuroscience, University College London, London, United Kingdom.
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10
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Kikkert S, Mezue M, Henderson Slater D, Johansen-Berg H, Tracey I, Makin TR. Motor correlates of phantom limb pain. Cortex 2017; 95:29-36. [PMID: 28822914 PMCID: PMC5637164 DOI: 10.1016/j.cortex.2017.07.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 06/12/2017] [Accepted: 07/18/2017] [Indexed: 11/03/2022]
Abstract
Following amputation, individuals ubiquitously report experiencing lingering sensations of their missing limb. While phantom sensations can be innocuous, they are often manifested as painful. Phantom limb pain (PLP) is notorious for being difficult to monitor and treat. A major challenge in PLP management is the difficulty in assessing PLP symptoms, given the physical absence of the affected body part. Here, we offer a means of quantifying chronic PLP by harnessing the known ability of amputees to voluntarily move their phantom limbs. Upper-limb amputees suffering from chronic PLP performed a simple finger-tapping task with their phantom hand. We confirm that amputees suffering from worse chronic PLP had worse motor control over their phantom hand. We further demonstrate that task performance was consistent over weeks and did not relate to transient PLP or non-painful phantom sensations. Finally, we explore the neural basis of these behavioural correlates of PLP. Using neuroimaging, we reveal that slower phantom hand movements were coupled with stronger activity in the primary sensorimotor phantom hand cortex, previously shown to associate with chronic PLP. By demonstrating a specific link between phantom hand motor control and chronic PLP, our findings open up new avenues for PLP management and improvement of existing PLP treatments.
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Affiliation(s)
- Sanne Kikkert
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom; Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Melvin Mezue
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | | | - Heidi Johansen-Berg
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Irene Tracey
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom; Nuffield Division of Anaesthetics, University of Oxford, Oxford, United Kingdom
| | - Tamar R Makin
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom; Institute of Cognitive Neuroscience, University College London, London, United Kingdom.
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11
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Kikkert S, Kolasinski J, Jbabdi S, Tracey I, Beckmann CF, Johansen-Berg H, Makin TR. Revealing the neural fingerprints of a missing hand. eLife 2016; 5. [PMID: 27552053 PMCID: PMC5040556 DOI: 10.7554/elife.15292] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 08/22/2016] [Indexed: 01/06/2023] Open
Abstract
The hand area of the primary somatosensory cortex contains detailed finger topography, thought to be shaped and maintained by daily life experience. Here we utilise phantom sensations and ultra high-field neuroimaging to uncover preserved, though latent, representation of amputees’ missing hand. We show that representation of the missing hand’s individual fingers persists in the primary somatosensory cortex even decades after arm amputation. By demonstrating stable topography despite amputation, our finding questions the extent to which continued sensory input is necessary to maintain organisation in sensory cortex, thereby reopening the question what happens to a cortical territory once its main input is lost. The discovery of persistent digit topography of amputees’ missing hand could be exploited for the development of intuitive and fine-grained control of neuroprosthetics, requiring neural signals of individual digits. DOI:http://dx.doi.org/10.7554/eLife.15292.001 The brain has a remarkable ability to adapt to changes in circumstances. But what happens to the brain when it loses a key source of input, for example, following the amputation of a limb? A region of the brain known as primary somatosensory cortex processes sensory inputs from all over the body. The more sensitive an area of the body is, the more fine-grained its representation is in the cortex. For example, the hand is represented with a highly detailed map, with each finger represented seperately. The brain is thought to require ongoing sensory signals from the body to maintain these detailed representations in the cortex. Indeed, textbooks typically state that the brain will ‘overwrite’ its representation of a body part if input from that area no longer arrives. According to this view, people who have lost a hand should show little or no activity in the area of primary somatosensory cortex that used to represent it. However, many people who have had a limb amputated continue to experience vivid sensations of the missing limb long after its loss. When asked to move their so-called ‘phantom’ limb, these individuals report being able to feel the movement. Kikkert, Kolasinski et al. now show, using advanced imaging techniques, that the brains of individuals with phantom hands continue to represent the missing hand several decades after its loss. Indeed, asking the subjects to move individual fingers of their phantom hand activates fine-grained representations of those fingers, similar to those seen in two-handed controls. By showing that the brain ‘remembers’ an amputated hand, Kikkert, Kolasinski et al. demonstrate that ongoing sensory input is not required to maintain representations of the body in somatosensory cortex. This, in turn, offers new hope for developing prosthetic limbs that are under direct brain control. If the brain continues to represent individual fingers many years after their loss, it should be possible to exploit those pathways to achieve intuitive fine-grained control of artificial fingers. DOI:http://dx.doi.org/10.7554/eLife.15292.002
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Affiliation(s)
- Sanne Kikkert
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom.,Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - James Kolasinski
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom.,University College, Oxford, United Kingdom
| | - Saad Jbabdi
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Irene Tracey
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom.,Nuffield Division of Anaesthetics, University of Oxford, Oxford, United Kingdom
| | - Christian F Beckmann
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom.,Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands.,Department of Cognitive Neuroscience, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Heidi Johansen-Berg
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Tamar R Makin
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
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Correia JM, Jansma B, Hausfeld L, Kikkert S, Bonte M. EEG decoding of spoken words in bilingual listeners: from words to language invariant semantic-conceptual representations. Front Psychol 2015; 6:71. [PMID: 25705197 PMCID: PMC4319403 DOI: 10.3389/fpsyg.2015.00071] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Accepted: 01/13/2015] [Indexed: 11/13/2022] Open
Abstract
Spoken word recognition and production require fast transformations between acoustic, phonological, and conceptual neural representations. Bilinguals perform these transformations in native and non-native languages, deriving unified semantic concepts from equivalent, but acoustically different words. Here we exploit this capacity of bilinguals to investigate input invariant semantic representations in the brain. We acquired EEG data while Dutch subjects, highly proficient in English listened to four monosyllabic and acoustically distinct animal words in both languages (e.g., “paard”–“horse”). Multivariate pattern analysis (MVPA) was applied to identify EEG response patterns that discriminate between individual words within one language (within-language discrimination) and generalize meaning across two languages (across-language generalization). Furthermore, employing two EEG feature selection approaches, we assessed the contribution of temporal and oscillatory EEG features to our classification results. MVPA revealed that within-language discrimination was possible in a broad time-window (~50–620 ms) after word onset probably reflecting acoustic-phonetic and semantic-conceptual differences between the words. Most interestingly, significant across-language generalization was possible around 550–600 ms, suggesting the activation of common semantic-conceptual representations from the Dutch and English nouns. Both types of classification, showed a strong contribution of oscillations below 12 Hz, indicating the importance of low frequency oscillations in the neural representation of individual words and concepts. This study demonstrates the feasibility of MVPA to decode individual spoken words from EEG responses and to assess the spectro-temporal dynamics of their language invariant semantic-conceptual representations. We discuss how this method and results could be relevant to track the neural mechanisms underlying conceptual encoding in comprehension and production.
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Affiliation(s)
- João M Correia
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht Brain Imaging Center (M-BIC), Maastricht University Maastricht, Netherlands
| | - Bernadette Jansma
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht Brain Imaging Center (M-BIC), Maastricht University Maastricht, Netherlands
| | - Lars Hausfeld
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht Brain Imaging Center (M-BIC), Maastricht University Maastricht, Netherlands
| | - Sanne Kikkert
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht Brain Imaging Center (M-BIC), Maastricht University Maastricht, Netherlands
| | - Milene Bonte
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht Brain Imaging Center (M-BIC), Maastricht University Maastricht, Netherlands
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Fakile YF, Jost H, Kikkert S, Hoover KW, Schapiro JM, Novak-Weekley SM, Chow JM, Park IU. P5.091 Head-Head Comparison of Reactivity and Signal Strength Value For Reactivity Among Seven Treponemal Assays: A Preliminary Report. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.1135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Jost H, Kikkert S, Fakile Y, Castro A, Ye T, Zaidi A, Ballard R, Cox D. P3-S6.05 Comparing the analytical sensitivities of six treponemal tests. Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050108.479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Fakile Y, Kikkert S, Ballard R, Cox D. O3-S1.04 Performance characteristics of bioplex 2200 syphilis IgG and Liaison Treponema automated assays for detection of antibodies to Treponema pallidum. Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050109.106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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