Cortical Representation Research Articles

Personalized functional brain network topography is associated with individual differences in youth cognition

Individual differences in cognition during childhood are associated with important social, physical, and mental health outcomes in adolescence and adulthood. Given that cortical surface arealization during development reflects the brain’s functional prioritization, quantifying variation in the topography of functional brain networks across the developing cortex may provide insight regarding individual differences in cognition. We test this idea by defining personalized functional networks (PFNs) that account for interindividual heterogeneity in functional brain network topography in 9–10 year olds from the Adolescent Brain Cognitive Development℠ Study. Across matched discovery (n = 3525) and replication (n = 3447) samples, the total cortical representation of fronto-parietal PFNs positively correlates with general cognition. Cross-validated ridge regressions trained on PFN topography predict cognition in unseen data across domains, with prediction accuracy increasing along the cortex’s sensorimotor-association organizational axis. These results establish that functional network topography heterogeneity is associated with individual differences in cognition before the critical transition into adolescence.

Serial attentional resource allocation during parallel feature value tracking.

The visual system has evolved the ability to track features like color and orientation in parallel. This property aligns with the specialization of processing these feature dimensions in the visual cortex. But what if we ask to track changing feature-values within the same feature dimension? Parallel tracking would then have to share the same cortical representation, which would set strong limitations on tracking performance. We address this question by measuring the precision of color representations when human observers track the color of two superimposed dot clouds that simultaneously change color along independent trajectories in color-space. We find that tracking precision is highly imbalanced between streams and that tracking precision changes over time by alternating between streams at a rate of ~1 Hz. These observations suggest that, while parallel color tracking is possible, it is highly limited, essentially allowing for only one color-stream to be tracked with precision at a given time.

Alpha/beta oscillations reveal cognitive and affective brain states associated with role taking in a dyadic cooperative game.

Social cooperation often requires taking different roles in order to reach a shared goal. By defining individual tasks, these roles dictate processing demands of the collaborators. The main aim of the present study was to examine the hypothesis that induced alpha and lower beta oscillations provide insights into affective and cognitive brain states during social cooperation. Toward this end, an experimental game was used in which participants had to navigate a Pacman figure through a maze by sending and receiving information about the correct moving direction. Supporting our hypotheses, individual roles taken by the collaborators during gameplay were associated with significant changes in alpha and lower beta power. Furthermore, effects were similar when participants played the Pacman Game with human or computer partners. Findings are discussed from the perspective of the information-via-desynchronization hypothesis proposing that alpha and lower beta power decreases reflect states of enhanced cortical information representation. Overall, experimental games are a useful tool for extending basic research on brain oscillations to the domain of naturalistic social interaction as emphasized by the second-person neuroscience perspective.

The Contribution of the Corpus Callosum to the Symmetrical Representation of Taste in the Human Brain: An fMRI Study of Callosotomized Patients

The present study was designed to establish the contribution of the corpus callosum (CC) to the cortical representation of unilateral taste stimuli in the human primary gustatory area (GI). Unilateral taste stimulation of the tongue was applied to eight patients with partial or total callosal resection by placing a small cotton pad soaked in a salty solution on either side of the tongue. Functional images were acquired with a 1.5 Tesla machine. Diffusion tensor imaging and tractography were also performed. Unilateral taste stimuli evoked bilateral activation of the GI area in all patients, including those with total resection of the CC, with a prevalence in the ipsilateral hemisphere to the stimulated tongue side. Bilateral activation was also observed in the primary somatic sensory cortex (SI) in most patients, which was more intense in the contralateral SI. This report confirms previous functional studies carried out in control subjects and neuropsychological findings in callosotomized patients, showing that gustatory pathways from tongue to cortex are bilaterally distributed, with an ipsilateral predominance. It has been shown that the CC does play a role, although not an exclusive one, in the bilateral symmetrical representation of gustatory sensitivity in the GI area, at least for afferents from one side of the tongue.

Predicting cognitive decline in a low‐dimensional representation of brain morphology

AbstractBackgroundIdentifying early signs of neurodegeneration due to Alzheimer’s disease (AD) is a necessary first step towards preventing cognitive decline. Individual cortical thickness measures, available after processing anatomical magnetic resonance imaging (MRI), are sensitive markers of neurodegeneration. However, cortical decline in aging and high inter‐individual variability complicates the determination of AD‐related neurodegeneration on trajectories. Further, the high‐dimensional nature of these trajectories necessitate the use of a transformation into lower‐dimensional spaces in order to perform comparative statistical analyses, model decline, and identify criteria differentiating pathological from normal trajectories.MethodIn this project, we computed trajectories in a 2D representation of a 62‐dimensional manifold of individual cortical thickness measures. To compute this representation, we used a nonlinear dimension reduction algorithm called Uniform Manifold Approximation and Projection (UMAP). We first created a UMAP embedding on measurements from 6,237 cognitively healthy participants (3,556 women) aged 18 to 100 years old from the NOMIS database. We then projected longitudinal data from 537 mild cognitively impaired (MCI) subjects and 340 AD subjects from ADNI into this embedding. Each participant had multiple visits (n = 2), one year apart. Finally, differences in trajectories were analysed by clustering the reduced data and comparing the positional variations through time between MCI and AD subjects. The validity of the approach was verified through cross‐validation.ResultFirst, the embedding was shown to be positively associated (r = 0.65) with participants' age (see figure 1) in the NOMIS data. When projected in this space, differences between ADNI’s MCI and AD distributions were found (see figure 2). Average trajectories between clusters were shown to be significantly different between MCI and AD subjects (see figure 3). Moreover, we showed that some clusters and trajectories between clusters were more prone to host AD subjects. Finally, cross‐validation showed an accuracy of up to 72% at predicting cognitive decline in MCI participants over 2,000 bootstrap iterations.ConclusionA 2D low‐dimensional cortical thickness representation embeds sufficient discriminatory information as to predict decline to AD in MCI participants with strong accuracy.

Predicting cognitive decline in a low‐dimensional representation of brain morphology

AbstractBackgroundIdentifying early signs of neurodegeneration due to Alzheimer’s disease (AD) is a necessary first step towards preventing cognitive decline. Individual cortical thickness measures, available after processing anatomical magnetic resonance imaging (MRI), are sensitive markers of neurodegeneration. However, cortical decline in aging and high inter‐individual variability complicates the determination of AD‐related neurodegeneration on trajectories. Further, the high‐dimensional nature of these trajectories necessitate the use of a transformation into lower‐dimensional spaces in order to perform comparative statistical analyses, model decline, and identify criteria differentiating pathological from normal trajectories.MethodIn this project, we computed trajectories in a 2D representation of a 62‐dimensional manifold of individual cortical thickness measures. To compute this representation, we used a nonlinear dimension reduction algorithm called Uniform Manifold Approximation and Projection (UMAP). We first created a UMAP embedding on measurements from 6,237 cognitively healthy participants (3,556 women) aged 18 to 100 years old from the NOMIS database. We then projected longitudinal data from 537 mild cognitively impaired (MCI) subjects and 340 AD subjects from ADNI into this embedding. Each participant had multiple visits (n ≥ 2), one year apart. Finally, differences in trajectories were analysed by clustering the reduced data and comparing the positional variations through time between MCI and AD subjects. The validity of the approach was verified through cross‐validation.ResultFirst, the embedding was shown to be positively associated (r = 0.65) with participants' age (see figure 1) in the NOMIS data. When projected in this space, differences between ADNI’s MCI and AD distributions were found (see figure 2). Average trajectories between clusters were shown to be significantly different between MCI and AD subjects (see figure 3). Moreover, we showed that some clusters and trajectories between clusters were more prone to host AD subjects. Finally, cross‐validation showed an accuracy of up to 72% at predicting cognitive decline in MCI participants over 2,000 bootstrap iterations.ConclusionA 2D low‐dimensional cortical thickness representation embeds sufficient discriminatory information as to predict decline to AD in MCI participants with strong accuracy.

Orientation representation in human visual cortices: contributions of non-visual information and action-related process.

Orientation processing in the human brain plays a crucial role in guiding grasping actions toward an object. Remarkably, despite the absence of visual input, the human visual cortex can still process orientation information. Instead of visual input, non-visual information, including tactile and proprioceptive sensory input from the hand and arm, as well as feedback from action-related processes, may contribute to orientation processing. However, the precise mechanisms by which the visual cortices process orientation information in the context of non-visual sensory input and action-related processes remain to be elucidated. Thus, our study examined the orientation representation within the visual cortices by analyzing the blood-oxygenation-level-dependent (BOLD) signals under four action conditions: direct grasp (DG), air grasp (AG), non-grasp (NG), and uninformed grasp (UG). The images of the cylindrical object were shown at +45° or - 45° orientations, corresponding to those of the real object to be grasped with the whole-hand gesture. Participants judged their orientation under all conditions. Grasping was performed without online visual feedback of the hand and object. The purpose of this design was to investigate the visual areas under conditions involving tactile feedback, proprioception, and action-related processes. To address this, a multivariate pattern analysis was used to examine the differences among the cortical patterns of the four action conditions in orientation representation by classification. Overall, significant decoding accuracy over chance level was discovered for the DG; however, during AG, only the early visual areas showed significant accuracy, suggesting that the object's tactile feedback influences the orientation process in higher visual areas. The NG showed no statistical significance in any area, indicating that without the grasping action, visual input does not contribute to cortical pattern representation. Interestingly, only the dorsal and ventral divisions of the third visual area (V3d and V3v) showed significant decoding accuracy during the UG despite the absence of visual instructions, suggesting that the orientation representation was derived from action-related processes in V3d and visual recognition of object visualization in V3v. The processing of orientation information during non-visually guided grasping of objects relies on other non-visual sources and is specifically divided by the purpose of action or recognition.

Sally’s Phantom: A Case Study on Plasticity of Cortical Representation

Sally’s Phantom: A Case Study on Plasticity of Cortical Representation

Hippocampal Functions Modulate Transfer-Appropriate Cortical Representations Supporting Subsequent Memory.

The hippocampus plays a central role as a coordinate system or index of information stored in neocortical loci. Nonetheless, it remains unclear how hippocampal processes integrate with cortical information to facilitate successful memory encoding. Thus, the goal of the current study was to identify specific hippocampal-cortical interactions that support object encoding. We collected fMRI data while 19 human participants (7 female and 12 male) encoded images of real-world objects and tested their memory for object concepts and image exemplars (i.e., conceptual and perceptual memory). Representational similarity analysis revealed robust representations of visual and semantic information in canonical visual (e.g., occipital cortex) and semantic (e.g., angular gyrus) regions in the cortex, but not in the hippocampus. Critically, hippocampal functions modulated the mnemonic impact of cortical representations that are most pertinent to future memory demands, or transfer-appropriate representations Subsequent perceptual memory was best predicted by the strength of visual representations in ventromedial occipital cortex in coordination with hippocampal activity and pattern information during encoding. In parallel, subsequent conceptual memory was best predicted by the strength of semantic representations in left inferior frontal gyrus and angular gyrus in coordination with either hippocampal activity or semantic representational strength during encoding. We found no evidence for transfer-incongruent hippocampal-cortical interactions supporting subsequent memory (i.e., no hippocampal interactions with cortical visual/semantic representations supported conceptual/perceptual memory). Collectively, these results suggest that diverse hippocampal functions flexibly modulate cortical representations of object properties to satisfy distinct future memory demands.Significance Statement The hippocampus is theorized to index pieces of information stored throughout the cortex to support episodic memory. Yet how hippocampal processes integrate with cortical representation of stimulus information remains unclear. Using fMRI, we examined various forms of hippocampal-cortical interactions during object encoding in relation to subsequent performance on conceptual and perceptual memory tests. Our results revealed novel hippocampal-cortical interactions that utilize semantic and visual representations in transfer-appropriate manners: conceptual memory supported by hippocampal modulation of frontoparietal semantic representations, and perceptual memory supported by hippocampal modulation of occipital visual representations. These findings provide important insights into the neural mechanisms underlying the formation of information-rich episodic memory and underscore the value of studying the flexible interplay between brain regions for complex cognition.

Cardiac interoception in Anorexia Nervosa: A resting-state heartbeat-evoked potential study.

A deficit in interoception - the ability to perceive, interpret and integrate afferent signals about the physiological state of the body - has been shown in Anorexia Nervosa (AN), and linked to altered hunger sensations, body dysmorphia, and abnormal emotional awareness. The present high-density electroencephalography (hdEEG) study aims to assess cardiac interoception in AN and to investigate its neural correlates, using an objective neurophysiological measure. Heartbeat-evoked potentials (HEPs) were computed from 5min of resting-state EEG and electrocardiogram (ECG) data and compared between individuals with AN (N=22) and healthy controls (HC) (N=19) with waveform, topographic, and source imaging analyses. Differences in the cortical representation of heartbeats were present between AN and HC at a time window of 332-348ms after the ECG R-peak. Source imaging analyses revealed a right-sided hypoactivation in AN of brain regions linked to interoceptive processing, such as the anterior cingulate and orbitofrontal areas. To the best of our knowledge, this is the first study using hdEEG to localise the underlying sources of HEPs in AN. Results point to altered interoceptive processing during resting-state in AN. As our participants had a short duration of illness, this might not be the consequence of prolonged starvation. Interventions targeted at interoception could provide an additional tool to facilitate recovery.

Motion direction is represented as a bimodal probability distribution in the human visual cortex

Humans infer motion direction from noisy sensory signals. We hypothesize that to make these inferences more precise, the visual system computes motion direction not only from velocity but also spatial orientation signals – a ‘streak’ created by moving objects. We implement this hypothesis in a Bayesian model, which quantifies knowledge with probability distributions, and test its predictions using psychophysics and fMRI. Using a probabilistic pattern-based analysis, we decode probability distributions of motion direction from trial-by-trial activity in the human visual cortex. Corroborating the predictions, the decoded distributions have a bimodal shape, with peaks that predict the direction and magnitude of behavioral errors. Interestingly, we observe similar bimodality in the distribution of the observers’ behavioral responses across trials. Together, these results suggest that observers use spatial orientation signals when estimating motion direction. More broadly, our findings indicate that the cortical representation of low-level visual features, such as motion direction, can reflect a combination of several qualitatively distinct signals.

Harnessing neuroplasticity

Twenty years ago, cognitive impairments were recognized as an unmet treatment need in schizophrenia. Basic science discoveries in neuroplasticity had led to cognitive training approaches for dyslexia. We wondered whether a similar approach could target working memory deficits in schizophrenia by harnessing plasticity in the auditory cortex.Our per protocol experimental therapeutics studies tested the hypothesis that sharpening auditory cortical representations would result in better verbal learning and memory. We also later studied the effects of intensive training of basic social cognitive operations. Our training protocols were deliberately focused, effortful and intensive, since participants were often up against decades of cortical dysplasticity.In studies in different stages of illness, we demonstrated that neuroscience-informed cognitive training was associated with: (1) proximal psychophysical as well as distal cognitive improvements; (2) increases in serum BDNF levels; (3) negative effects of serum anticholinergic burden; (4) electrophysiologic responses and brain activation patterns consistent with restorative neuroplastic changes in cortex; (5) positive cortical and thalamic volumetric changes suggestive of neuroprotection; (6) better 6-month clinical functioning in those with a positive initial response.Taken together, this work indicates how much the field of psychiatry could benefit from a deep understanding of the basic science of cortical neuroplasticity processes and of how they can be deliberately and efficiently harnessed for therapeutic purposes.

Truly pattern: Nonlinear integration of motion signals is required to account for the responses of pattern cells in rat visual cortex.

A key feature of advanced motion processing in the primate dorsal stream is the existence of pattern cells-specialized cortical neurons that integrate local motion signals into pattern-invariant representations of global direction. Pattern cells have also been reported in rodent visual cortex, but it is unknown whether the tuning of these neurons results from truly integrative, nonlinear mechanisms or trivially arises from linear receptive fields (RFs) with a peculiar geometry. Here, we show that pattern cells in rat primary (V1) and lateromedial (LM) visual cortex process motion direction in a way that cannot be explained by the linear spatiotemporal structure of their RFs. Instead, their tuning properties are consistent with and well explained by those of units in a state-of-the-art neural network model of the dorsal stream. This suggests that similar cortical processes underlay motion representation in primates and rodents. The latter could thus serve as powerful model systems to unravel the underlying circuit-level mechanisms.

Empirically Identifying and Computationally Modeling the Brain-Behavior Relationship for Human Scene Categorization.

Humans effortlessly make quick and accurate perceptual decisions about the nature of their immediate visual environment, such as the category of the scene they face. Previous research has revealed a rich set of cortical representations potentially underlying this feat. However, it remains unknown which of these representations are suitably formatted for decision-making. Here, we approached this question empirically and computationally, using neuroimaging and computational modeling. For the empirical part, we collected EEG data and RTs from human participants during a scene categorization task (natural vs. man-made). We then related EEG data to behavior to behavior using a multivariate extension of signal detection theory. We observed a correlation between neural data and behavior specifically between ∼100 msec and ∼200 msec after stimulus onset, suggesting that the neural scene representations in this time period are suitably formatted for decision-making. For the computational part, we evaluated a recurrent convolutional neural network (RCNN) as a model of brain and behavior. Unifying our previous observations in an image-computable model, the RCNN predicted well the neural representations, the behavioral scene categorization data, as well as the relationship between them. Our results identify and computationally characterize the neural and behavioral correlates of scene categorization in humans.

Mapping the Cortical Representation of Paraspinal Muscles Using Transcranial Magnetic Stimulation Optimized in People With Chronic Back Pain.

Chronic low back pain (CLBP) is a global burden with an unknown etiology. Reorganization of the cortical representation of paraspinal muscles in the primary motor cortex (M1) may be related to the pathology. Single-pulse transcranial magnetic stimulation (TMS), commonly used to map the functional organization of M1, is not potent enough to stimulate the cortical maps of paraspinal muscles in M1 in CLBP patients with reduced corticospinal excitability (CSE) with intensities even as high as maximum stimulator output (100% MSO). This makes TMS mapping impractical for these patients. The aim of this study was to increase the practicality of TMS mapping for people with CLBP. This study included eight men and ten women who had CLBP for over three months. A biphasic paired-pulse TMS paradigm, conjunct anticipatory postural adjustment (APA), and maximal voluntary activation of paraspinal muscles (MVC) were used to facilitate TMS mapping. TMS mapping was possible in all CLBP participants, with TMS intensities <50% of the MSO. Reorganization in terms of an anterior and lateral shift of the center of gravity (COG) of the cortical maps of paraspinal muscles was observed in all participants with CLBP, and a reduced number of discrete peaks was found in 33%. The facilitation of the CSE to paraspinal muscles makes TMS mapping more practical and tolerable in people with CLBP, lowering the risk of seizure and discomfort associated with high-intensity TMS pulses. Conventional transcranial magnetic stimulation (TMS) brain mapping is not optimal for patients with Chronic low back pain (CLBP).Paired-pulse TMS dramatically lessens the energy needed for brain mapping.Maximal voluntary contraction of back muscles facilitates TMS mapping.Anticipatory postural activity of back muscles enhances the efficacy of TMS mapping. Chronic low back pain (CLBP) is a social, emotional, and economic burden and the leading cause of disability worldwide. Yet the etiology of the CLBP is unknown. The persistence of aberrant or antalgic movement patterns observed in people with CLBP has been suggested as a possible cause of pain chronification by inducing continuous damage to sensitive structures of the lumbar spine. It is well known that the brain is in charge of the production and planning of movements, so it is likely that abnormal movement patterns also stem from the abnormalities in the brain. However, until recently, human knowledge about the structure and function of the brain has been very limited. The invention of noninvasive and painless brain imaging and stimulating techniques such as transcranial magnetic stimulation (TMS) during the last decades has augmented our knowledge about the structure and function of the brain. Modification in terms of shift, shrinkage, or expansion of areas of the brain devoted to movement control or sensation of the back muscles has been documented in CLBP via these techniques, which are argued to relate to pain chronification but need further clarification. Yet monitoring the course of CLBP via TMS, despite its many potentials, is challenging. This could be due to the reduced cortical drive to back muscles in CLBP patients and the small area devoted to control of back muscles in the brain in general that increases the brain threshold to TMS in people with CLBP. The aim of this study was to tailor an approach to make TMS more applicable for CLBP patients by reducing the threshold to TMS. This could be achieved by engaging back muscles in anticipatory postural activity in combination with maximal voluntary activation of these muscles, along with TMS paradigms that induce intracortical facilitation.

BackWards — Unveiling the brain’s topographic organization of paraspinal sensory input

Cortical reorganization and its potential pathological significance are being increasingly studied in musculoskeletal disorders such as chronic low back pain (CLBP) patients. However, detailed sensory-topographic maps of the human back are lacking, and a baseline characterization of such representations, reflecting the somatosensory organization of the healthy back, is needed before exploring potential sensory map reorganization. To this end, a novel pneumatic vibrotactile stimulation method was used to stimulate paraspinal sensory afferents, while studying their cortical representations in unprecedented detail. In 41 young healthy participants, vibrotactile stimulations at 20 Hz and 80 Hz were applied bilaterally at nine locations along the thoracolumbar axis while functional magnetic resonance imaging (fMRI) was performed. Model-based whole-brain searchlight representational similarity analysis (RSA) was used to investigate the organizational structure of brain activity patterns evoked by thoracolumbar sensory inputs. A model based on segmental distances best explained the similarity structure of brain activity patterns that were located in different areas of sensorimotor cortices, including the primary somatosensory and motor cortices and parts of the superior parietal cortex, suggesting that these brain areas process sensory input from the back in a “dermatomal” manner. The current findings provide a sound basis for testing the “cortical map reorganization theory” and its pathological relevance in CLBP.

Analyzing Thalamocortical Tract-Tracing Experiments in a Common Reference Space

Current mesoscale connectivity atlases provide limited information about the organization of thalamocortical projections in the mouse brain. Labeling the projections of spatially restricted neuron populations in thalamus can provide a functionally relevant level of connectomic analysis, but these need to be integrated within the same common reference space. Here, we present a pipeline for the segmentation, registration, integration and analysis of multiple tract-tracing experiments. The key difference with other workflows is that the data is transformed to fit the reference template. As a test-case, we investigated the axonal projections and intranuclear arrangement of seven neuronal populations of the ventral posteromedial nucleus of the thalamus (VPM), which we labeled with an anterograde tracer. Their soma positions corresponded, from dorsal to ventral, to cortical representations of the whiskers, nose and mouth. They strongly targeted layer 4, with the majority exclusively targeting one cortical area and the ones in ventrolateral VPM branching to multiple somatosensory areas. We found that our experiments were more topographically precise than similar experiments from the Allen Institute and projections to the primary somatosensory area were in agreement with single-neuron morphological reconstructions from publicly available databases. This pilot study sets the basis for a shared virtual connectivity atlas that could be enriched with additional data for studying the topographical organization of different thalamic nuclei. The pipeline is accessible with only minimal programming skills via a Jupyter Notebook, and offers multiple visualization tools such as cortical flatmaps, subcortical plots and 3D renderings and can be used with custom anatomical delineations.

Experimental protocol to investigate cortical, muscular and body representation alterations in adolescents with idiopathic scoliosis.

Adolescent idiopathic scoliosis (AIS) is the most common form of scoliosis. AIS is a three-dimensional morphological spinal deformity that affects approximately 1-3% of adolescents. Not all factors related to the etiology of AIS have yet been identified. The primary aim of this experimental protocol is to quantitatively investigate alterations in body representation in AIS, and to quantitatively and objectively track the changes in body sensorimotor representation due to treatment. Adolescent girls with a confirmed diagnosis of mild (Cobb angle: 10°-20°) or moderate (21°-35°) scoliosis as well as age and sex-matched controls will be recruited. Participants will be asked to perform a 6-min upright standing and two tasks-named target reaching and forearm bisection task. Eventually, subjects will fill in a self-report questionnaire and a computer-based test to assess body image. This evaluation will be repeated after 6 and 12 months of treatment (i.e., partial or full-time brace and physiotherapy corrective postural exercises). We expect that theta brain rhythm in the central brain areas, alpha brain rhythm lateralization and body representation will change over time depending on treatment and scoliosis progression as a compensatory strategy to overcome a sensorimotor dysfunction. We also expect asymmetric activation of the trunk muscle during reaching tasks and decreased postural stability in AIS. Quantitatively assess the body representation at different time points during AIS treatment may provide new insights on the pathophysiology and etiology of scoliosis.

How should we treat painful sensitivity in the hand? An international e-Delphi study

BackgroundEvidence synthesis suggests allodynia resulting from neuropathic pain has few interventions with clear effectiveness. As research continues to build this needed evidence base, expert consensus recommendations can address the conflicting approaches within current hand therapy practice. PurposeThis study aimed to develop consensus recommendations for the clinical management of allodynia from an international panel of hand therapists. Study DesignThis was an international e-Delphi survey study. MethodsWe recruited international hand rehabilitation experts to participate in an e-Delphi survey. Consensus was defined as 75% or more of participants agreeing with a recommendation, and at least 3 rounds of consensus building were anticipated. Experts were identified from 21 countries, and clinical vignettes describing a spectrum of patients with painful sensitivity in the hand were provided to elicit treatment recommendations. Initial recommendations were summarized, and consensus sought for clinical practice recommendations. ResultsSixty-eight participants were invited, with 44 more added through peer nominations. Fifty-four participants from 19 countries completed the initial survey and were invited to participate in all subsequent rounds. Over 900 treatment suggestions were provided from the initial vignettes across domains, including sensory, physical, and functional interventions, education, and cortical representation techniques: 46 ultimately reached consensus. However, important discrepancies in justification (eg, why allodynia should be covered) and implementation of techniques (eg, desensitization, sensory reeducation) were identified as the consensus exercise progressed. ConclusionsExperts recommend individually tailored programs to treat allodynia using a variety of physical/movement, sensory-based, and “top-down” approaches; this is highly aligned with contemporary theories, such as the Neuromatrix Model of Pain. However, consensus was not reached on the justification and implementation of some of these approaches, reflecting the lack of a taxonomy and supporting evidence for tactile stimulation approaches in the current literature. Trials directly comparing the effectiveness of these approaches are needed.

Lateralization and Time-Course of Cortical Phonological Representations during Syllable Production.

Spoken language contains information at a broad range of timescales, from phonetic distinctions on the order of milliseconds to semantic contexts which shift over seconds to minutes. It is not well understood how the brain's speech production systems combine features at these timescales into a coherent vocal output. We investigated the spatial and temporal representations in cerebral cortex of three phonological units with different durations: consonants, vowels, and syllables. Electrocorticography (ECoG) recordings were obtained from five participants while speaking single syllables. We developed a novel clustering and Kalman filter-based trend analysis procedure to sort electrodes into temporal response profiles. A linear discriminant classifier was used to determine how strongly each electrode's response encoded phonological features. We found distinct time-courses of encoding phonological units depending on their duration: consonants were represented more during speech preparation, vowels were represented evenly throughout trials, and syllables during production. Locations of strongly speech-encoding electrodes (the top 30% of electrodes) likewise depended on phonological element duration, with consonant-encoding electrodes left-lateralized, vowel-encoding hemispherically balanced, and syllable-encoding right-lateralized. The lateralization of speech-encoding electrodes depended on onset time, with electrodes active before or after speech production favoring left hemisphere and those active during speech favoring the right. Single-electrode speech classification revealed cortical areas with preferential encoding of particular phonemic elements, including consonant encoding in the left precentral and postcentral gyri and syllable encoding in the right middle frontal gyrus. Our findings support neurolinguistic theories of left hemisphere specialization for processing short-timescale linguistic units and right hemisphere processing of longer-duration units.