Contralateral Postcentral Gyrus Research Articles

Brain Function and Upper Limb Deficit in Stroke With Motor Execution and Imagery: A Cross-Sectional Functional Magnetic Resonance Imaging Study

BackgroundMotor imagery training might be helpful in stroke rehabilitation. This study explored if a specific modulation of movement-related regions is related to motor imagery (MI) ability.MethodsTwenty-three patients with subcortical stroke and 21 age-matched controls were recruited. They were subjectively screened using the Kinesthetic and Visual Imagery Questionnaire (KVIQ). They then underwent functional magnetic resonance imaging (fMRI) while performing three repetitions of different motor tasks (motor execution and MI). Two separate runs were acquired [motor execution tasks (ME and rest) and motor imagery (MI and rest)] in a block design. For the different tasks, analyses of cerebral activation and the correlation of motor/imagery task-related activity and KVIQ scores were performed.ResultsDuring unaffected hand (UH) active grasp movement, we observed decreased activations in the contralateral precentral gyrus (PreCG), contralateral postcentral gyrus (PoCG) [p < 0.05, family wise error (FWE) corrected] and a positive correlation with the ability of FMA-UE (PreCG: r = 0.46, p = 0.028; PoCG: r = 0.44, p = 0.040). During active grasp of the affected hand (AH), decreased activation in the contralateral PoCG was observed (p < 0.05, FWE corrected). MI of the UH induced significant activations of the contralateral superior frontal gyrus, opercular region of the inferior frontal gyrus, and ipsilateral ACC and deactivation in the ipsilateral supplementary motor area (p < 0.05, AlphaSim correction). Ipsilateral anterior cingulate cortex (ACC) activity negatively correlated with MI ability (r = =–0.49, p = 0.022). Moreover, we found significant activation of the contralesional middle frontal gyrus (MFG) during MI of the AH.ConclusionOur results proved the dominant effects of MI dysfunction that exist in stroke during the processing of motor execution. In the motor execution task, the enhancement of the contralateral PreCG and PoCG contributed to reversing the motor dysfunction, while in the MI task, inhibition of the contralateral ACC can increase the impaired KVIQ ability. The bimodal balance recovery model can explain our results well. Recognizing neural mechanisms is critical to helping us formulate precise strategies when intervening with electrical or magnetic stimulation.

Brain activation related to the tactile perception of touching ridged texture using fingers.

Humans can recognize the physical properties of objects by touching them, even when vision is unavailable. Tactile perception is important for humans in interacting with the environment. The triangular ridged textures are usually added to surface to improve the grip reliability of products, but the sharp edge of triangular ridge induces sharp and uncomfortable feeling. To study the effect of the edge shape of triangular ridged texture on brain activity, functional magnetic resonance imaging technique was used to obtain the blood oxygen level-dependent (BOLD) signal of subjects during the touching of textured surfaces. Samples with sharp, round, and flat shape ridged textures were chosen as the tactile stimulus. The contralateral postcentral gyrus, the precentral gyrus, the inferior parietal lobule, and the supramarginal gyrus, corresponding with the functional regions of the primary somatosensory cortex (SI), the secondary somatosensory cortex (SII), and the primary motor cortex (MI) were related to the perception of three shape ridged textures. The main brain activation located in the postcentral gyrus and the SI. The tactile information of three shape ridged textures was received by Brodmann area (BA) 3 of the SI, and then inputted to BA 2 of the SI, the further tactile discrimination of shape of ridged textures was involved in BA40 of the SII. The intensity, the areas, and the percent signal change (PSC) of brain activation that were evoked by different shape ridged textures were related to the geometric structures of the ridged textures. The more complex the geometric structures of texture are, the larger the intensity, the area, and the PSC in brain activation are. The negative BOLD responses of the ipsilateral sensory cortex that were evoked by the flat ridged texture indicated the ipsilateral neuronal inhibition within the sensory systems. The bilateral precuneus, the superior parietal gyrus, and the inferior parietal gyrus, corresponding with the functional areas of the SII (BA40) and the SSA(BA7), were involved in the tactile discriminate of the differences in shapes of ridged textures. The differences in brain activation were related to the differences in geometric structures of the ridged texture. The larger the differences in geometric structure of texture are, the larger the differences in brain activation are. This study revealed the activated location of brain related to the tactile stimulation of different edge shape of ridged textures and the relationship between the geometric structures of ridged texture and brain activities. This research contributes to optimize surface tactile characteristics on products, especially effective surface textures design for good grip.

S18. STRUCTURAL COVARIANCE PREDICTORS OF CLINICAL IMPROVEMENT AT 2-YEAR FOLLOW-UP IN FIRST-EPISODE PSYCHOSIS

BackgroundNeural correlates of psychotic disorders encompass multiple brain regions in multiple brain circuits, even at early stages. Previous research has characterized structural brain alterations in first-episode psychosis (FEP), but few studies have focused on the relationship between brain alterations and disease trajectories. First psychotic episodes typically evolve into a chronic course, affecting quality of life of patients and their families, with huge societal costs. Importantly, up to 80% of the patients relapse in the next five years after a first psychotic episode, with a significant risk of developing treatment resistance. Here, we investigated whether disease course may be predicted from brain structural assessments. Specifically, we measured structural covariance, a well-established approach to identify abnormal patterns of volumetric correlation across distant brain regions, which allows to incorporate network-level information to structural assessments. We performed a whole-brain structural covariance assessment of three bilateral regions form to three different cortical networks - dorsolateral prefrontal cortex (dlPFC) for the executive network, posterior cingulate cortex for the default mode network and insulae for the salience network - and subcortical structures (hippocampi, amygdalae and dorsomedial nucleus of the thalamus) that have shown to play a key role in schizophrenia.MethodsWe assessed a sample of 74 subjects from a multicenter, naturalistic, prospective and longitudinal study designed to evaluate clinical, neuropsychological, neuroimaging, biochemical, environmental and pharmacogenetic variables in first episode psychotic patients (PEPs project). Magnetic resonance imaging (MRI) scans were acquired at baseline and at 2-year follow-up, as well as clinical assessments. Psychotic symptoms were assessed using the Positive and Negative Symptom Scale (PANSS) due its widespread use in clinical studies and its reliability in assessing psychopathology across a range of patient populations. The sample was split in two groups as a function of the clinical improvement at 2-year follow-up: responders (i.e. 40% reduction in PANSS global score from baseline; n=29) and non-responders (n=45).ResultsResponder patients showed increase structural covariance between the left dlPFC and the left middle frontal gyrus, and between the right dlPFC and the right middle and superior gyrus, the left rectus and inferior frontal gyrus, the right hippocampus, and the vermis of the cerebellum. In addition, they showed increased structural covariance between the left anterior hippocampus and the ipsilateral middle occipital gyrus and the contralateral postcentral gyrus. Likewise, the structural covariance of right anterior hippocampus with right superior occipital gyrus and precentral gyrus was also increased in responder patients.DiscussionThis study shows, for the first time in the literature, that increased structural covariance at baseline within the executive network and between the hippocampi and posterior brain regions was associated with a superior treatment response at two-year follow-up. These results indicate that the integrity of structural networks should be taken into account to predict treatment outcome in FEP patients.

Alterations in Brain Structural Connectivity After Unilateral Upper-Limb Amputation.

Previous studies have indicated that amputation induces reorganization of functional brain network. However, the influence of amputation on structural brain network remains unclear. In this study, using diffusion tensor imaging (DTI), we aimed to investigate the alterations in fractional anisotropy (FA) network after unilateral upper-limb amputation. We acquired DTI from twenty-two upper-limb amputees (15 dominant-side and 7 nondominant-side amputees) as well as fifteen healthy controls. Using DTI tractography and graph theoretical approaches, we examined the topological changes in FA network of amputees. Compared with healthy controls, dominant-side amputees showed reduced global mean strength, increased characteristic path length, and decreased nodal strength in the contralateral sensorimotor system and visual areas. In particular, the nodal strength of the contralateral postcentral gyrus was negatively correlated with residual limb usage, representing a use-dependent reorganization. In addition, the nodal strength of the contralateral middle temporal gyrus was positively correlated with the magnitude of phantom limb sensation. Our results suggested a degeneration of FA network after dominant-side upper-limb amputation.

Bilateral activations in operculo-insular area show temporal dissociation after peripheral electrical stimulation in healthy adults.

Interhemispheric transfer is necessary for sensory integration and coordination of body sides. We studied how somatosensory input from one body side may reach both body sides. First, we investigated with 17 healthy adults in which uni- and bilateral brain areas were involved in consecutive stages of automatic sensory processing of non-nociceptive peripheral stimulation. Somatosensory evoked fields (SEFs) to electrical stimulation were recorded with 306-channel magnetoencephalography in two conditions. First, SEFs were registered following sensory radial nerve (RN) stimulation to dorsal surface of the right hand and second, following median nerve (MN) stimulation at the right wrist. Cortical activations were located in contralateral postcentral gyrus after MN and RN stimulations and in bilateral operculo-insular area after RN stimulation. First component occurred earlier after MN than RN stimulation. Middle latency components had similar latencies with stronger activation in contralateral postcentral gyrus after MN than RN stimulation. Interestingly, long latency components located in bilateral operculo-insular area after RN stimulation showed latency difference between hemispheres, i.e. activation peaked earlier in contralateral than in ipsilateral side. Additional experiments comparing novel intracutaneous nociceptive, RN and MN electrical stimuli confirmed bilateral long latency activation elicited by each stimulus type and highlighted latency differences between hemispheres. Variations in activation of bilateral operculo-insular areas may corroborate their role in pain network and in multisensory integration. Our findings imply that these areas present a relay station in multisensory stimulus detection.

Neurophysiologic effects of transcutaneous auricular vagus nerve stimulation (taVNS) via electrical stimulation of the tragus: A concurrent taVNS/fMRI study and review

BackgroundElectrical stimulation of the auricular branch of the vagus nerve (ABVN) via transcutaneous auricular vagus nerve stimulation (taVNS) may influence afferent vagal networks. There have been 5 prior taVNS/fMRI studies, with inconsistent findings due to variability in stimulation targets and parameters. ObjectiveWe developed a taVNS/fMRI system to enable concurrent electrical stimulation and fMRI acquisition to compare the effects of taVNS in relation to control stimulation. MethodsWe enrolled 17 healthy adults in this single-blind, crossover taVNS/fMRI trial. Based on parameters shown to affect heart rate in healthy volunteers, participants received either left tragus (active) or earlobe (control) stimulation at 500 μs 25 HZ for 60 s (repeated 3 times over 6 min). Whole brain fMRI analysis was performed exploring the effect of: active stimulation, control stimulation, and the comparison. Region of interest analysis of the midbrain and brainstem was also conducted. ResultsActive stimulation produced significant increased BOLD signal in the contralateral postcentral gyrus, bilateral insula, frontal cortex, right operculum, and left cerebellum. Control stimulation produced BOLD signal activation in the contralateral postcentral gyrus. In the active vs. control contrast, tragus stimulation produced significantly greater BOLD increases in the right caudate, bilateral anterior cingulate, cerebellum, left prefrontal cortex, and mid-cingulate. ConclusionStimulation of the tragus activates the cerebral afferents of the vagal pathway and combined with our review of the literature suggest that taVNS is a promising form of VNS. Future taVNS/fMRI studies should systematically explore various parameters and alternative stimulation targets aimed to optimize this novel form of neuromodulation.

Brain motor functional changes after somatosensory discrimination training.

Somatosensory discrimination training may modulate cognitive processes, such as movement planning and monitoring, which can be useful during active movements. The aim of the study was to assess the effect of somatosensory discrimination training on brain functional activity using functional magnetic resonance imaging (fMRI) during motor and sensory tasks in healthy subjects. Thirty-nine healthy young subjects were randomized into two groups: the experimental group underwent somatosensory discrimination training consisting of shape, surface and two-point distance discrimination; and the control group performed a simple object manipulation. At baseline and after 2weeks of training, subjects underwent sensorimotor evaluations and fMRI tasks consisting of right-hand tactile stimulation, manipulation of a simple object, and complex right-hand motor sequence execution. Right-hand dexterity improved in both groups, but only the experimental group showed improvements in all manual dexterity tests. After training, the experimental group showed: decreased activation of the ipsilateral sensorimotor areas during the tactile stimulation task; increased activation of the contralateral postcentral gyrus and thalamus bilaterally during the manipulation task; and a reduced recruitment of the ipsilateral pre/postcentral gyri and an increased activation of the basal ganglia and cerebellum contralaterally during the complex right-hand motor task. In healthy subjects, sensory discrimination training was associated with lateralization of brain activity in sensorimotor areas during sensory and motor tasks. Further studies are needed to investigate the usefulness of this training in motor rehabilitation of patients with focal lesions in the central nervous system.

Neural Categorization of Vibrotactile Frequency in Flutter and Vibration Stimulations: An fMRI Study.

As the use of wearable haptic devices with vibrating alert features is commonplace, an understanding of the perceptual categorization of vibrotactile frequencies has become important. This understanding can be substantially enhanced by unveiling how neural activity represents vibrotactile frequency information. Using functional magnetic resonance imaging (fMRI), this study investigated categorical clustering patterns of the frequency-dependent neural activity evoked by vibrotactile stimuli with gradually changing frequencies from 20 to 200 Hz. First, a searchlight multi-voxel pattern analysis (MVPA) was used to find brain regions exhibiting neural activities associated with frequency information. We found that the contralateral postcentral gyrus (S1) and the supramarginal gyrus (SMG) carried frequency-dependent information. Next, we applied multidimensional scaling (MDS) to find low-dimensional neural representations of different frequencies obtained from the multi-voxel activity patterns within these regions. The clustering analysis on the MDS results showed that neural activity patterns of 20-100 Hz and 120-200 Hz were divided into two distinct groups. Interestingly, this neural grouping conformed to the perceptual frequency categories found in the previous behavioral studies. Our findings therefore suggest that neural activity patterns in the somatosensory cortical regions may provide a neural basis for the perceptual categorization of vibrotactile frequency.

Cue-related Temporal Factors Modulate Movement-related Beta Oscillatory Activity in the Human Motor Circuit.

In humans, there is a strong beta (15-30 Hz) event-related desynchronization (ERD) that begins before movement, which has been tentatively linked to motor planning operations. The dynamics of this response are strongly modulated by whether a pending movement is cued and the inherent parameters of the cue. However, previous studies have focused on the information content of cues and not on parameters such as the timing of the cue relative to other events. Variations in such timing are critical, as they directly impact the amount of time that participants have to plan pending movements. In this study, participants performed finger-tapping sequences during magnetoencephalography, and we manipulated the amount of time (i.e., "long" vs. "short") between the presentation of the to-be-executed sequence and the cue to initiate the sequence. We found that the beta ERD was stronger immediately after the cue to move in the contralateral postcentral gyrus and bilateral parietal cortices during the short compared with long planning time condition. During movement execution, the beta ERD was stronger in the premotor cortex and the SMA in the short relative to long condition. Finally, peak latency in the SMA significantly correlated with RT, such that the closer the peak beta ERD was to the cue to move, the quicker the participant responded. The results of this study establish that peri-movement beta ERD activity across the cortical motor circuit is highly sensitive to cue-related temporal factors, with a direct link to motor performance.

Decoding Accuracy in Supplementary Motor Cortex Correlates with Perceptual Sensitivity to Tactile Roughness.

Perceptual sensitivity to tactile roughness varies across individuals for the same degree of roughness. A number of neurophysiological studies have investigated the neural substrates of tactile roughness perception, but the neural processing underlying the strong individual differences in perceptual roughness sensitivity remains unknown. In this study, we explored the human brain activation patterns associated with the behavioral discriminability of surface texture roughness using functional magnetic resonance imaging (fMRI). First, a whole-brain searchlight multi-voxel pattern analysis (MVPA) was used to find brain regions from which we could decode roughness information. The searchlight MVPA revealed four brain regions showing significant decoding results: the supplementary motor area (SMA), contralateral postcentral gyrus (S1), and superior portion of the bilateral temporal pole (STP). Next, we evaluated the behavioral roughness discrimination sensitivity of each individual using the just-noticeable difference (JND) and correlated this with the decoding accuracy in each of the four regions. We found that only the SMA showed a significant correlation between neuronal decoding accuracy and JND across individuals; Participants with a smaller JND (i.e., better discrimination ability) exhibited higher decoding accuracy from their voxel response patterns in the SMA. Our findings suggest that multivariate voxel response patterns presented in the SMA represent individual perceptual sensitivity to tactile roughness and people with greater perceptual sensitivity to tactile roughness are likely to have more distinct neural representations of different roughness levels in their SMA.

Sensory processing and the rubber hand illusion--an evoked potentials study.

The rubber hand illusion (RHI) paradigm--in which illusory bodily ownership is induced by synchronous tactile stimulation of a participant's (hidden) hand and a (visible) surrogate--allows one to investigate how the brain resolves conflicting multisensory evidence during perceptual inference. To identify the functional anatomy of the RHI, we used multichannel EEG, acquired under three conditions of tactile stimulation. Evoked potentials were averaged from EEG signals registered to the timing of brushstrokes to the participant's hand. The participant's hand was stroked either in the absence of an artificial hand (REAL) or synchronously with an artificial hand, which either lay in an anatomically plausible (CONGRUENT) or impossible (INCONGRUENT) position. The illusion was reliably elicited in the CONGRUENT condition. For right-hand stimulation, significant differences between conditions emerged at the sensor level around 55 msec after the brushstroke at left frontal and right parietal electrodes. Response amplitudes were smaller for illusory (CONGRUENT) compared with nonillusory (INCONGRUENT and REAL) conditions in the contralateral perirolandic region (pre- and postcentral gyri), superior and inferior parietal lobule, whereas veridical perception of the artificial hand (INCONGRUENT) amplified responses at a scalp region overlying the contralateral postcentral gyrus and inferior parietal lobule compared with the remaining two conditions. Left-hand stimulation produced similar contralateral patterns. These results are consistent with predictive coding models of multisensory integration and may reflect the attenuation of somatosensory precision that is required to resolve perceptual hypotheses about conflicting multisensory input.

An extended motor network generates beta and gamma oscillatory perturbations during development

This study examines the time course and neural generators of oscillatory beta and gamma motor responses in typically-developing children. Participants completed a unilateral flexion–extension task using each index finger as whole-head magnetoencephalography (MEG) data were acquired. These MEG data were imaged in the frequency-domain using spatial filtering and the resulting event-related synchronizations and desynchronizations (ERS/ERD) were subjected to voxel-wise statistical analyses to illuminate time–frequency specific activation patterns. Consistent with adult data, these children exhibited a pre-movement ERD that was strongest over the contralateral post-central gyrus, and a post-movement ERS response with the most prominent peak being in the contralateral precentral gyrus near premotor cortices. We also observed a high-frequency (∼80 Hz) ERS response that coincided with movement onset and was centered on the contralateral precentral gyrus, slightly superior and posterior to the beta ERS. In addition to pre- and post-central gyri activations, these children exhibited beta and gamma activity in supplementary motor areas (SMA) before and during movement, and beta activation in cerebellar cortices before and after movement. We believe the gamma synchronization may be an excellent candidate signal of basic cortical motor control, as the spatiotemporal dynamics indicate the primary motor cortex generates this response (and not the beta oscillations) which is closely yoked to the initial muscle activation. Lastly, these data suggest several additional neural regions including the SMA and cerebellum are involved in basic movements during development.

Lornoxicam characteristically modulates cerebral pain-processing in human volunteers: a functional magnetic resonance imaging study

BackgroundLornoxicam like other non-steroidal anti-inflammatory drugs (NSAIDs) is widely used for postoperative pain therapy. Evaluation of the effect of lornoxicam on cerebral processing of surgical pain was thus the aim of the present functional magnetic resonance imaging (fMRI) study. MethodsAn fMRI-compatible pain model that mimics surgical pain was used to induce pain rated 4–5 on a visual analogue scale (VAS) at the anterior margin of the right tibia in volunteers (n=22) after i.v. administration of saline (n=11) or lornoxicam (0.1 mg kg−1) (n=11). ResultsLornoxicam, which significantly reduced pain sensation [VAS: mean (sd) 4.6 (0.7) vs 1.2 (1.5)], completely suppressed pain-induced activation in the SII/operculum, anterior cingulate cortex, insula, parietal (inferior), prefrontal (inferior, medial), temporal (inferior, medial/superior) lobe, cerebellum, and contralateral (e.g. left-sided) postcentral gyrus (SI). Only the hippocampus and the contralateral superior parietal lobe (BA 7) were activated. ConclusionsAs compared with saline, lornoxicam typically suppressed pain-induced brain activation in all regions except the hippocampus. Furthermore, de novo activation was found in the contralateral, superior parietal lobe (BA 7).

BRAIN ACTIVATION RELATED TO AFFECTIVE DIMENSION DURING THERMAL STIMULATION IN HUMANS: A FUNCTIONAL MAGNETIC RESONANCE IMAGING STUDY

The aim of this study was to identify the activated brain region that is involved with the affective dimension of thermal stimulation (not pain, but innocuous warming) using functional MR imaging. Twelve healthy, right-handed male subjects participated in the study. Thermal stimulation with two different temperatures of 41°C and 34°C was applied to the subjects using a fomentation pack, wrapped around the right lower leg of each subject. On the basis of the subjects’ responses after the scanning sessions, the authors were able to observe that the subjects felt “warm” and “slightly pleasant and comfortable” under the 41°C condition. The experimental results indicated that warm stimulation produced a significant increase of activation compared to thermal neutral stimulation in various regions such as contralateral insular, ipsilateral cerebellum, ipsilateral putamen, contralateral middle frontal gyrus, ipsilateral inferior frontal gyrus, contralateral postcentral gyrus, and contralateral paracentral lobule. The activated regions are known to be related to thermal sensory, affective/emotional awareness, cognitive functions, sensory-discrimination, and emotion/affective processing, and so on. These results suggest that an appropriate thermal stimulation can produce a positive emotion and activate emotion/affect related regions of the brain.

Contribution of the corpus callosum to bilateral representation of the trunk midline in the human brain: an fMRI study of callosotomized patients

Human brain studies have shown that the cutaneous receptors of trunk regions close to the midline are represented in the first somatosensory cortex (SI) of both hemispheres. The present study aims to establish whether in humans, as in non-human primates, the bilateral representation of the trunk midline in area SI depends on the corpus callosum. Data were obtained from eight callosotomized patients: three with complete callosal resection, one with a partial posterior resection including the splenium and the callosal trunk, and four with partial anterior resections sparing the splenium and in one case also the posterior part of the callosal trunk. The investigation was carried out with functional magnetic resonance imaging. Unilateral tactile stimulation was applied by rubbing ventral trunk regions close to the midline (about 20 x 10 cm in width) with a soft cotton pad (frequency 1 Hz). Cortical activation foci elicited by unilateral stimulation of cutaneous regions adjacent to the midline were detected in the contralateral post-central gyrus (PCG), in a region corresponding to the trunk ventral midline representation zone of area SI, as described in a previous study of intact subjects. In most patients, activation foci were also found in the ipsilateral PCG, again as in subjects with an intact corpus callosum. The data confirm that the skin regions adjacent to the trunk midline are represented bilaterally in SI, and indicate that ipsilateral activation is at least partially independent of the corpus callosum.

Spatiotemporal mapping of cortical activity accompanying voluntary movements using an event-related beamforming approach.

We describe a novel spatial filtering approach to the localization of cortical activity accompanying voluntary movements. The synthetic aperture magnetometry (SAM) minimum-variance beamformer algorithm was used to compute spatial filters three-dimensionally over the entire brain from single trial neuromagnetic recordings of subjects performing self-paced index finger movements. Images of instantaneous source power ("event-related SAM") computed at selected latencies revealed activation of multiple cortical motor areas prior to and following left and right index finger movements in individual subjects, even in the presence of low-frequency noise (e.g., eye movements). A slow premovement motor field (MF) reaching maximal amplitude approximately 50 ms prior to movement onset was localized to the hand area of contralateral precentral gyrus, followed by activity in the contralateral postcentral gyrus at 40 ms, corresponding to the first movement-evoked field (MEFI). A novel finding was a second activation of the precentral gyrus at a latency of approximately 150 ms, corresponding to the second movement-evoked field (MEFII). Group averaging of spatially normalized images indicated additional premovement activity in the ipsilateral precentral gyrus and the left inferior parietal cortex for both left and right finger movements. Weaker activations were also observed in bilateral premotor areas and the supplementary motor area. These results show that event-related beamforming provides a robust method for studying complex patterns of time-locked cortical activity accompanying voluntary movements, and offers a new approach for the localization of multiple cortical sources derived from neuromagnetic recordings in single subject and group data.

The Sensory Cortical Representation of the Human Penis: Revisiting Somatotopy in the Male Homunculus

Pioneering mapping studies of the human cortex have established the notion of somatotopy in sensory representation, which transpired into Penfield and Rasmussen's famous sensory homunculus diagram. However, regarding the primary cortical representation of the genitals, classical and modern findings appear to be at odds with the principle of somatotopy, often assigning it to the cortex on the mesial wall. Using functional neuroimaging, we established a mediolateral sequence of somatosensory foot, penis, and lower abdominal wall representation on the contralateral postcentral gyrus in primary sensory cortex and a bilateral secondary somatosensory representation in the parietal operculum.

Apomorphine reduces BOLD signal in fMRI during voluntary movement in Parkinsonian patients.

Our group investigated modulatory effects of apomorphine on cerebral activation patterns during finger tapping movements in seven Parkinson's disease (PD) patients off medication. Cerebral activation was measured according to an established fMRI protocol. Apomorphine application disclosed a reduction of cerebral activation patterns to the contralateral precentral gyrus affecting both clinically affected and unaffected sides; tapping with the unaffected hand additionally revealed activation in the contralateral postcentral gyrus. These findings contradict those of similar functional imaging studies performed in PD to date, which variously found augmentation of cerebral activation patterns in Parkinsonian patients after dopaminergic stimulation. One conceivable explanation for our singular results would be preferred binding of apomorphine to presynaptic dopaminergic receptors, leading to inhibition of endogenous dopamine release and resultant diminished dopaminergic stimulation, reflected in diminished cerebral activation patterns. These findings warrant future consideration and further investigation of possible central inhibitory effects of dopaminergic therapy in functional imaging studies in PD.

SPECT perfusion changes during complex partial seizures in patients with hippocampal sclerosis.

Cerebral perfusion changes reliably reflect changes in neuronal activity. Our aim was to obtain new insights into the pathophysiology of complex partial seizures (CPS) in patients with hippocampal sclerosis (HS) using interictal and ictal single photon emission computed tomography (SPECT). We studied 24 patients with refractory temporal lobe epilepsy (TLE) associated with HS. All had an interictal and ictal SPECT with early injection during a CPS. Images were normalized and co-registered. Using statistical parametric mapping (SPM99), brain regions with significant ictal perfusion changes were determined. To assess possible interrelationships between these regions, Pearson correlation coefficients were calculated. The temporal lobe ipsilateral to the seizure focus, the border of the ipsilateral middle frontal and precentral gyrus, both occipital lobes and two small regions in the contralateral postcentral gyrus showed ictal hyperperfusion. The frontal lobes, contralateral posterior cerebellum and ipsilateral precuneus showed hypoperfusion. Further exploratory analysis suggested an association between ipsilateral temporal lobe hyperperfusion and ipsilateral frontal lobe hypoperfusion, and an inverse association between seizure duration and hyperperfusion in the ipsilateral anterior cerebellum and contralateral postcentral gyrus. We conclude that there is a network of perfusion changes during CPS in patients with HS. Studying a particular seizure type in patients with HS with peri-ictal SPECT performed during a defined time window will allow further analysis of the cerebral network activities, and excitatory, inhibitory and gating mechanisms during seizures associated with HS.

Spatiotemporal Imaging of Electrical Activity Related to Attention to Somatosensory Stimulation

The aim of the present study was to localize the effects of spatial attention on somatosensory stimulation in EEG. Median and tibial nerve were stimulated at all four limbs in a random order. Subjects were instructed to count the events on either the right median or the right tibial nerve. Attention-induced changes in the somatosensory evoked potentials (SEP) were revealed by subtracting the median nerve SEPs recorded while subjects attended to stimuli applied to the tibial nerve from those obtained during attention to the stimulated hand. In a current density reconstruction approach source maxima in the time range from 30 to 260 ms after median nerve stimulation were localized and the time courses of activation were elaborated by dipole modeling. Six regions were identified which contribute significant source activity related to selective spatial attention: contralateral postcentral gyrus (Brodman area (BA) 3), contralateral mesial frontal gyrus (BA 6), right posterior parietal cortex (BA 7), anterior cingulate gyrus (BA 32), and bilateral middle temporal gyrus (BA 21). Activation started at the right posterior parietal cortex, followed by the contralateral middle temporal gyrus, probably representing SII activity, and the middle frontal and anterior cingulate gyrus. Similar regions of source activation were revealed by tibial nerve SEP, but the effect was less pronounced and restricted almost entirely to activation of the contralateral postcentral gyrus (BA 3), anterior cingulate gyrus (BA 32), and ipsilateral middle temporal gyrus (BA 21). Our data provide evidence for a spatially separated frontal generator within the anterior cingulum, dependent on selective attention in the somatosensory modality.