Central Processing Of Sensory Stimuli Research Articles

Cortical plasticity causes useless hand syndrome in multiple sclerosis: a neurophysiological study in a rare case

Background Useless Hand Syndrome (UHS) is a rare clinical manifestation of an upper cervical cord lesion, which is most commonly associated with multiple sclerosis (MS). The pathophysiological mechanism underlying UHS remains unclear. Case We report a 25-year-old woman, who described numbness in her left upper extremity. Cervical magnetic resonance imaging revealed a posterior upper cervical cord lesion. There was no cortical lesion that could explain the clinical findings. We measured (1) short-latency afferent inhibition (SAI) by obtaining motor evoked potentials as an indicator of sensorimotor integration and (2) somatosensorial temporal discrimination threshold (STDT) to display central somatosensory pathway function. In the right cerebral hemisphere, we found an excessive increase in STDT and no inhibition in the SAI paradigm. Conclusions These findings indicate that impairment of sensorimotor integration and central processing of sensory stimuli cause useless hand syndrome.

Somatosensory temporal discrimination is impaired in fibromyalgia

ObjectiveFibromyalgia is the prototypical central sensitivity syndrome which is associated with increased sensitivity to pain and other stimuli. In this study, we aimed to evaluate whether somatosensory temporal discrimination ability, which provides information about central processing of sensory stimuli, was impaired in patients with fibromyalgia. MethodsFifteen patients with fibromyalgia and 15 healthy subjects participated in the study. Demographic characteristics of participants and severity for fatigue, sleep quality, cognitive symptoms, somatic symptoms and health-related quality of life in fibromyalgia patients were recorded. Somatosensory temporal discrimination thresholds were measured from the dorsum of the dominant hands of the participants by using a constant current stimulator (Medtronic, Keypoint). ResultsPatients with fibromyalgia had higher somatosensory temporal discrimination thresholds than healthy subjects (p < 0.001). There were significant correlations between STDTs and pain intensity, FIQ scores and symptom severity scale scores in fibromyalgia group (p = 0.006, r = 0.68; p = 0.037, r = 0.54; p = 0.017, r = 0.61 respectively). ConclusionSomatosensory temporal discrimination ability is impaired in fibromyalgia patients compared to healthy subjects. Disrupted somatosensory temporal discrimination ability correlates with increased widespread pain and severity of other symptoms including fatigue, sleep quality, cognitive symptoms, somatic symptoms and decreased functional status. The impaired somatosensory temporal discrimination ability indicates an alteration in higher cognitive sensory processing in fibromyalgia patients.

Is the brain of complex regional pain syndrome patients truly different?

In recent years, changes in brain structure and function have been studied extensively in patients with complex regional pain syndrome (CRPS) following clinical observations of altered central processing of sensory stimuli and motor control. However, concerning MRI data, the evidence is complex to interpret due to heterogeneity in statistical methods and results. The aim of this study was to determine if CRPS patients exhibit specific, clinically relevant changes in brain structure and function in rest. We do this by presenting MRI data on brain structure and function in 19 chronic, female CRPS patients and age- and sex-matched healthy controls (HCs). In addition, we analyse and report the data in multiple ways to make comparison with previous studies possible and to demonstrate the effect of different statistical methods, in particular, concerning the correction for multiple testing. Using family-wise error (FWE) correction for multiple testing, in our group of CRPS patients, we find no specific difference in brain structure or function in rest in comparison to HCs. In addition, we argue that previously found MRI results in the literature are inconsistent in terms of localization, quantity and directionality of the reported changes in brain structure and function. Previously published MRI-based evidence for altered brain structure and function in rest in CRPS patients is not consistent and our data suggests that no such phenomenon exists. WHAT DOES THIS STUDY ADD?: This article does not replicate the previous found results. The reported evidence in MRI literature of aberrant neuroplasticity in CRPS patients is inconsistent in terms of localization, quantity and directionality of changes in brain structure and function.

Presynaptic inhibition of primary afferents by depolarization: observations supporting nontraditional mechanisms

Primary afferent neurotransmission is the fundamental first step in the central processing of sensory stimuli and is controlled by pre- and postsynaptic inhibitory mechanisms. Presynaptic inhibition (PSI) is probably the more powerful form of inhibitory control in all primary afferent fibers. A major mechanism producing afferent PSI is via a channel-mediated depolarization of their intraspinal terminals, which can be recorded extracellularly as a dorsal root potential (DRP). Based on measures of DRP latency it has been inferred that this primary afferent depolarization (PAD) of low-threshold afferents is mediated by minimally trisynaptic pathways with pharmacologically identified GABAergic interneurons forming last-order axo-axonic synapses onto afferent terminals. There is still no "squeaky clean" evidence of this organization. This paper describes recent and historical work that supports the existence of PAD occurring by more direct pathways and with a complex pharmacology that questions the proprietary role of GABA and GABA(A) receptors in this process. Cholinergic transmission in particular may contribute significantly to PAD, including via direct release from primary afferents.

Bicuculline-sensitive primary afferent depolarization remains after greatly restricting synaptic transmission in the mammalian spinal cord.

Primary afferent neurotransmission is the fundamental first step in the central processing of sensory stimuli. A major mechanism producing afferent presynaptic inhibition is via a channel-mediated depolarization of their intraspinal terminals which can be recorded extracellularly as a dorsal root potential (DRP). Based on measures of DRP latency it has been inferred that this primary afferent depolarization (PAD) of low-threshold afferents is mediated by minimally trisynaptic pathways with GABAergic interneurons forming last-order axoaxonic synapses onto afferent terminals. We used an in vitro rat spinal cord preparation under conditions that restrict synaptic transmission to test whether more direct low-threshold pathways can produce PAD. Mephenesin or high divalent cation solutions were used to limit oligosynaptic transmission. Recordings of synaptic currents in dorsal horn neurons and population synaptic potentials in ventral roots provided evidence that conventional transmission was chiefly restricted to monosynaptic actions. Under these conditions, DRP amplitude was largely unchanged but with faster time to peak and reduced duration. Similar results were obtained following stimulation of peripheral nerves. Even following near complete block of transmission with high Mg(2+)/low Ca(2+)-containing solution, the evoked DRP was reduced but not blocked. In comparison, in nominally Ca(2+)-free or EGTA-containing solution, the DRP was completely blocked confirming that Ca(2+) entry mediated synaptic transmission is required for DRP genesis. Overall these results demonstrate that PAD of low-threshold primary afferents can occur by more direct synaptic mechanisms, including the possibility of direct negative-feedback or nonspiking dendroaxonic pathways.

Illusion of Pain: Pre-existing Knowledge Determines Brain Activation of ‘Imagined Allodynia’

Allodynia means that innocuous tactile stimulation is felt as pain. Accordingly, cerebral activations during allodynia or touch should markedly differ. The aim of this study was to investigate whether the imagination of allodynia affects brain processing of touch in healthy subjects. Seventeen healthy subjects divided into 2 subgroups were investigated: The first group (n = 7) was familiar with allodynia, based on previous pain studies, whereas the second group (n = 10) had never knowingly experienced allodynia. Using functional magnetic resonance imaging, 2 experimental conditions were investigated. In one condition the subjects were simply touched at their left hand, whereas during the other condition they were asked to imagine pain (allodynia) during tactile stimulation of the right hand and to estimate the imagined pain on a numeric rating scale. Data processing and analysis were performed with the use of SPM5. The group analysis of all subjects revealed that tactile stimulation activated contralateral somatosensory cortices (S1 [primary] and S2 [secondary]), but the imagination of allodynia led to an additional activation of anterior cingulate cortex and bilateral activation of S2, insular cortex, and prefrontal cortices. Subgroup analysis using rating-weighted predictors revealed activation of the contralateral thalamus, anterior cingulate cortex, and amygdala and a bilateral activation of S1, S2, and insular cortex and prefrontal cortices in allodynia-experienced subjects. In contrast, allodynia-inexperienced subjects only activated contralateral S1 and bilateral S2. Just the imagination that touch is painful is able to partly activate the central pain system, but only when the subject has previous experience of this. According to our results, the medial pain system is involved in the encoding of imagined allodynia. This article reports that pain experience is able to alter central processing of sensory stimuli. Pain knowledge appears to be able to shift "normal" tactile processing to a different quality, resulting in modified brain activity. Therefore, our study may contribute to the current understanding of human pain and will promote future research on this field.

Central hypersensitivity in chronic pain after whiplash injury.

The mechanisms underlying chronic pain after whiplash injury are usually unclear. Injuries may cause sensitization of spinal cord neurons in animals (central hypersensitivity), which results in increased responsiveness to peripheral stimuli. In humans, the responsiveness of the central nervous system to peripheral stimulation may be explored by applying sensory tests to healthy tissues. The hypotheses of this study were: (1) chronic whiplash pain is associated with central hypersensitivity; (2) central hypersensitivity is maintained by nociception arising from the painful or tender muscles in the neck. Comparison of patients with healthy controls. Pain clinic and laboratory for pain research, university hospital. Fourteen patients with chronic neck pain after whiplash injury (car accident) and 14 healthy volunteers. Pain thresholds to: single electrical stimulus (intramuscular), repeated electrical stimulation (intramuscular and transcutaneous), and heat (transcutaneous). Each threshold was measured at neck and lower limb, before and after local anesthesia of the painful and tender muscles of the neck. The whiplash group had significantly lower pain thresholds for all tests. except heat, at both neck and lower limb. Local anesthesia of the painful and tender points affected neither intensity of neck pain nor pain thresholds. The authors found a hypersensitivity to peripheral stimulation in whiplash patients. Hypersensitivity was observed after cutaneous and muscular stimulation, at both neck and lower limb. Because hypersensitivity was observed in healthy tissues, it resulted from alterations in the central processing of sensory stimuli (central hypersensitivity). Central hypersensitivity was not dependent on a nociceptive input arising from the painful and tender muscles.

Sexually dimorphic processing of somatosensory and chemosensory inputs to forebrain luteinizing hormone-releasing hormone neurons in mated ferrets.

The ferret is a reflexively ovulating species in which mating induces a preovulatory LH surge in the estrous female but significantly decreases LH secretion in the breeding male. This sexually dimorphic hormonal response is reflected in a sex difference in Fos-like immunoreactivity (Fos-IR) in forebrain LHRH and non-LHRH neurons after mating. We used dual immunocytochemistry for Fos and LHRH to determine whether the sex dimorphism occurs in the initial detection and transmission or in the central processing of sensory stimuli associated with mating? We also assessed the ability of chemosensory cues alone to augment neuronal Fos-IR in the ferret forebrain. Breeding male and female ferrets were paired, whereupon the male partner achieved an intromission lasting for 16-90 min. Mated male and female subjects were always perfused 90 min after the onset of the male's intromission. Additional male and female subjects were placed alone in a cage in which an opposite sex ferret in breeding condition had been housed for 48 h. Other control ferrets were placed alone in a clean cage. Chemosensory-stimulated and unpaired control subjects were perfused 90 min after being placed in their respective cages. In both sexes mating augmented neuronal Fos-IR in the granular layer of the main olfactory bulb, the caudal thalamic central tegmental field, and the medial amygdala, regions situated early in the putative input pathway to mediobasal hypothalamic LHRH neurons. Neuronal Fos-IR was also increased in these same forebrain regions (the central tegmental field excluded) in both sexes after exposure to chemosensory cues alone. However, more central components of this input pathway, including the preoptic area, the bed nucleus of the stria terminalis, and the ventrolateral portion of the ventromedial hypothalamus as well as the mediobasal hypothalamic LHRH neurons themselves were activated by mating only in the female. In estrous females, exposure only to chemosensory stimuli from a breeding male augmented Fos-IR in the preoptic area and the ventrolateral portion of the ventromedial hypothalamus, but not in the bed nucleus of the stria terminalis or mediobasal hypothalamic LHRH neurons. In breeding males, exposure only to chemosensory cues from an estrous female failed to affect Fos-IR in any of these proximal components of the input pathway or in LHRH neurons themselves. These results suggest that the sex dimorphism in mating-induced LH secretion reflects a sex difference in the central processing of genital-somatosensory stimuli and possibly of chemosensory inputs as well.

Sexually Dimorphic Processing of Somatosensory and Chemosensory Inputs to Forebrain Luteinizing Hormone-Releasing Hormone Neurons in Mated Ferrets

The ferret is a reflexively ovulating species in which mating induces a preovulatory LH surge in the estrous female but significantly decreases LH secretion in the breeding male. This sexually dimorphic hormonal response is reflected in a sex difference in Fos-like immunoreactivity (Fos-IR) in forebrain LHRH and non-LHRH neurons after mating. We used dual immunocytochemistry for Fos and LHRH to determine whether the sex dimorphism occurs in the initial detection and transmission or in the central processing of sensory stimuli associated with mating? We also assessed the ability of chemosensory cues alone to augment neuronal Fos-IR in the ferret forebrain. Breeding male and female ferrets were paired, whereupon the male partner achieved an intromission lasting for 16–90 min. Mated male and female subjects were always perfused 90 min after the onset of the male’s intromission. Additional male and female subjects were placed alone in a cage in which an opposite sex ferret in breeding condition had been housed for 48 h. Other control ferrets were placed alone in a clean cage. Chemosensory-stimulated and unpaired control subjects were perfused 90 min after being placed in their respective cages. In both sexes mating augmented neuronal Fos-IR in the granular layer of the main olfactory bulb, the caudal thalamic central tegmental field, and the medial amygdala, regions situated early in the putative input pathway to mediobasal hypothalamic LHRH neurons. Neuronal Fos-IR was also increased in these same forebrain regions (the central tegmental field excluded) in both sexes after exposure to chemosensory cues alone. However, more central components of this input pathway, including the preoptic area, the bed nucleus of the stria terminalis, and the ventrolateral portion of the ventromedial hypothalamus as well as the mediobasal hypothalamic LHRH neurons themselves were activated by mating only in the female. In estrous females, exposure only to chemosensory stimuli from a breeding male augmented Fos-IR in the preoptic area and the ventrolateral portion of the ventromedial hypothalamus, but not in the bed nucleus of the stria terminalis or mediobasal hypothalamic LHRH neurons. In breeding males, exposure only to chemosensory cues from an estrous female failed to affect Fos-IR in any of these proximal components of the input pathway or in LHRH neurons themselves. These results suggest that the sex dimorphism in mating-induced LH secretion reflects a sex difference in the central processing of genital-somatosensory stimuli and possibly of chemosensory inputs as well.

Asymmetric Central Processing of Sensory Stimuli in Idiopathic Focal Dystonia

Idiopathic torsion dystonia is characterized by persistent abnormalities of posture. We tested the hypothesis that abnormal sensorimotor processing is involved pathophysioiogically by looking for asymmetry of sensory processing in patients with asymmetric symptoms. Sixteen patients with torticollis (ten with head turning to the right and six to the left), seven with simple writer's cramp and 19 healthy control subjects were tested. The tasks involved matching one of five lengths of stick or weights presented to one hand with sticks and weights chosen by the other hand. All experiments were performed with the subject blindfolded. Patients with torticollis tended to underestimate weights presented to the hand away from which the head tended to turn. Control subjects showed no significant tendency to overestimate or underestimate lengths or weights with either hand, and dystonic patients showed no tendency to overestimate or underestimate lengths. Those with writer's cramp underestimated weights when the stimulus was presented to the affected hand. An asymmetry can thus be detected in muscles remote from the site of dystonia, indicating a generalized abnormality of sensorimotor processing.

Asymmetric central processing of sensory stimuli in idiopathic focal dystonia.

Idiopathic torsion dystonia is characterized by persistent abnormalities of posture. We tested the hypothesis that abnormal sensorimotor processing is involved pathophysioiogically by looking for asymmetry of sensory processing in patients with asymmetric symptoms. Sixteen patients with torticollis (ten with head turning to the right and six to the left), seven with simple writer's cramp and 19 healthy control subjects were tested. The tasks involved matching one of five lengths of stick or weights presented to one hand with sticks and weights chosen by the other hand. All experiments were performed with the subject blindfolded. Patients with torticollis tended to underestimate weights presented to the hand away from which the head tended to turn. Control subjects showed no significant tendency to overestimate or underestimate lengths or weights with either hand, and dystonic patients showed no tendency to overestimate or underestimate lengths. Those with writer's cramp underestimated weights when the stimulus was presented to the affected hand. An asymmetry can thus be detected in muscles remote from the site of dystonia, indicating a generalized abnormality of sensorimotor processing.