Finger Stimulation Research Articles

Sensory incongruence leading to hand disownership modulates somatosensory cortical processing

The sense of body ownership is based on integration of multimodal sensory information, including tactile sensation, proprioception, and vision. Distorted body ownership contributes to the development of chronic pain syndromes and possibly symptoms of psychiatric disease. However, the effects of disownership on cortical processing of somatosensory information are unknown. In the present study, we created a “disownership” condition in healthy individuals by manipulating the visual information indicating the location of the subject's own left hand using a mirror box and examined the influence of this disownership on cortical responses to electrical stimulation of the left index finger using magnetoencephalography (MEG). The event-related magnetic field in the right primary somatosensory cortex at approximately 50 msec (M50) after stimulus was enhanced under the disownership condition. The present results suggest that M50 reflects a cortical incongruence detection mechanism involving integration of sensory inputs from visual and proprioceptive systems. This signal may be valuable for future studies of the mechanisms underlying sense of body ownership and the role that disrupted sense of ownership has in neurological disease.

Expansion of sensorimotor cortical activation for unilateral hand motion during contralateral hand deafferentation

Acute deprivation of unilateral sensory input rapidly enhances contralateral hand motor function, but the underlying mechanisms remain poorly understood. We herein used functional MRI to evaluate, in 14 healthy individuals, motor cortical activation for right finger motion before, during, and after sensory deprivation of left forearm induced by reversible, noninvasive ischemic nerve block (INB). Before INB, the motor task activated the left primary sensorimotor cortex (SM1) as expected. During INB, the volume of the left SM1 activation significantly increased, and, after INB, it returned to the pre-INB, baseline level. The effectiveness of the INB of the left forearm was ensured by confirming disappearance of the activation in right primary sensory cortex that is normally caused by tactile stimulation of the left index finger. These findings demonstrate that acute deafferentation of unilateral forearm causes rapid and reversible changes in the neural substrates for contralateral finger motion, mediated possibly by attenuation of transcallosal interhemispheric inhibition.

Effects of Combining 2 Weeks of Passive Sensory Stimulation with Active Hand Motor Training in Healthy Adults

The gold standard to acquire motor skills is through intensive training and practicing. Recent studies have demonstrated that behavioral gains can also be acquired by mere exposure to repetitive sensory stimulation to drive the plasticity processes. Single application of repetitive electric stimulation (rES) of the fingers has been shown to improve tactile perception in young adults as well as sensorimotor performance in healthy elderly individuals. The combination of repetitive motor training with a preceding rES has not been reported yet. In addition, the impact of such a training on somatosensory tactile and spatial sensitivity as well as on somatosensory cortical activation remains elusive. Therefore, we tested 15 right-handed participants who underwent repetitive electric stimulation of all finger tips of the left hand for 20 minutes prior to one hour of motor training of the left hand over the period of two weeks. Overall, participants substantially improved the motor performance of the left trained hand by 34%, but also showed a relevant transfer to the untrained right hand by 24%. Baseline ipsilateral activation fMRI-magnitude in BA 1 to sensory index finger stimulation predicted training outcome for somatosensory guided movements: those who showed higher ipsilateral activation were those who did profit less from training. Improvement of spatial tactile discrimination was positively associated with gains in pinch grip velocity. Overall, a combination of priming rES and repetitive motor training is capable to induce motor and somatosensory performance increase and representation changes in BA1 in healthy young subjects.

Gamma oscillations in the somatosensory cortex of newborn rats.

Here we addressed a question of whether gamma oscillations previously described in the whisker-related barrel cortex are a universal pattern of activity in the somatosensory cortex of newborn rats. Intracortical recording of local field potentials and action potentials in neurons using multisite silicon electrodes in 2-7-day-old rats showed that mechanical stimulation of single fingers or specific areas on the plantar or back side of the foot evoked early gamma oscillations followed by spindle-burst oscillations in the corresponding regions of the somatosensory cortex. Early gamma oscillations had maximum amplitude in layer IV of the somatosensory cortex and effectively synchronized action potentials in layer IV neurons. It was concluded that early gamma oscillations evoked by activation of the topographic sensory input are a universal activity pattern of the entire somatosensory cortex of newborn rats.

Usage of the middle finger shapes reorganization of the primary somatosensory cortex in patients with index finger amputation.

The primary somatosensory cortex (S1) is somatotopically reorganized after limb amputation. The duration of the amputation, the intensity of phantom limb pain but also a multifactoral model of altered cerebral input have been discussed to be associated with cortical changes. Patients with finger amputation rarely show phantom limb pain, the deafferented cortical area is small but other fingers might well overtake function. We selected a group of index finger amputated patients and performed a high resolution (in plane: 1.5 mm2) S1-mapping during tactile stimulation of finger tips. We found an interhemispheric imbalance of the distance between the thumb and middle finger only for the patient-group. When patients used their middle finger more they showed less interhemispheric imbalance, increased spatial tactile discrimination and increased fMRI-activation in response to stimulation. Phantom limb pain was not associated with somatotopic representation parameters in S1. Overall, our fMRI-data point to a usage dependent plasticity of Brodmann's area 3b in man.

90. Direct finger stimulation for SEP phase reversal during brain surgery in a patient with a casted arm

The Somatosensory Evoked Potential Phase Reversal (SEP-PR) technique is used to identify the Central Sulcus (CS) during brain surgery. A 64-year old man was operated on for a left post-rolandic tumor. The patient had a right arm plaster cast preventing median nerve stimulation at the wrist. We report the results of phase reversal SEPs following index finger stimulation. Electrical stimulation of the right II° finger was delivered by 12 mm needle electrodes (0.2 ms duration, frequency rate 4.7 Hz, threshold intensity 20 mA). Transcranial SEPs were recorded from C3′/Cz′ electrodes. After opening of the dura, a 1 × 8 strip electrode was placed on CS. We obtained good phase reversal across electrode number 4 (motor) and electrode number 5 (sensory). Direct cortical stimulation was delivered by electrode number 4 (train of five stimuli, ISI 4 ms, threshold intensity ranging from 5 to 20 mA at 1 Hz rate) and muscle motor evoked potentials were recorded on biceps brachialis and abductor brevis pollicis muscles. This case report illustrates one of several unusual drawbacks that technicians may face in the operating room. Flexibility on a multimodal intraoperative neurophysiological approach is important to overcome these drawbacks. Finger stimulation can be a reliable alternative to perform SEP-PR whenever direct stimulation of the median nerve at wrist is not feasible.

Event‐related fMRI at 7T reveals overlapping cortical representations for adjacent fingertips in S1 of individual subjects

Recent fMRI studies of the human primary somatosensory cortex have been able to differentiate the cortical representations of different fingertips at a single‐subject level. These studies did not, however, investigate the expected overlap in cortical activation due to the stimulation of different fingers. Here, we used an event‐related design in six subjects at 7 Tesla to explore the overlap in cortical responses elicited in S1 by vibrotactile stimulation of the five fingertips. We found that all parts of S1 show some degree of spatial overlap between the cortical representations of adjacent or even nonadjacent fingertips. In S1, the posterior bank of the central sulcus showed less overlap than regions in the post‐central gyrus, which responded to up to five fingertips. The functional properties of these two areas are consistent with the known layout of cytoarchitectonically defined subareas, and we speculate that they correspond to subarea 3b (S1 proper) and subarea 1, respectively. In contrast with previous fMRI studies, however, we did not observe discrete activation clusters that could unequivocally be attributed to different subareas of S1. Venous maps based on T2*‐weighted structural images suggest that the observed overlap is not driven by extra‐vascular contributions from large veins. Hum Brain Mapp 35:2027–2043, 2014. © 2013 The Authors Human Brain Mapping published by Wiley Periodicals, Inc.

Effect of the number of pins and inter-pin distance on somatosensory evoked magnetic fields following mechanical tactile stimulation

Magnetoencephalography (MEG) recordings were collected to investigate the effect of the number of mechanical pins and inter-pin distance on somatosensory evoked magnetic fields (SEFs) following mechanical stimulation (MS). We used a 306-ch whole-head MEG system. SEFs were elicited through tactile stimuli with 1-, 2-, 3-, 4- and 8-pins using healthy participants. Tactile stimuli were applied to the tip of the right index finger. SEF following electrical stimulation of the index finger was recorded in order to compare the activity in the primary somatosensory cortex (S1) following MS. Prominent SEFs were recorded from the contralateral hemisphere approximately 54ms (P50m) and 125ms (P100m) after MS regardless of the number of pins. Equivalent current dipoles were located in the S1. The source activities for P50m and P100m significantly increased in tandem with the number of pins for MS. However, the increased ratios for the source activities according to the increase in the number of pins were significantly smaller than that induced by electrical stimulation, and when the number of the pins doubled from 1-pin to 2-pins, from 2-pins to 4-pins, and from 4-pins to 8-pins, S1 activities increased by only 130%. Additionally, source activities significantly increased when the inter-pin distance increased from 2.4 to 7.2mm. The number of stimulated receptors was considered to have increased with an increase in the inter-pin distance as well as an increase in the number of pins. These findings clarified the effect of the number of pins and inter-pin distance for MS on SEFs.

Interaction of Finger Representations in the Cortex of Individuals with Autism: A Functional Window into Cortical Inhibition

An established neural biomarker of autism spectrum disorder (ASD) has the potential to provide novel biological and pharmacological targets for treatment. Lower level of inhibition in brain circuits is a leading biomarker candidate. A physiological investigation of the functional levels of inhibition in the cortex of individuals with autism can provide a strong test of the hypothesis. The amplitude of cortical response to the stimulation of adjacent fingers is controlled by the level of cortical inhibition and provides just such a test. Using magnetoencephalography, we recorded the response of the somatosensory cortex to the passive tactile stimulation of the thumb (D1), and index finger (D2), and to the simultaneous stimulation of both fingers combined (D1,D2) of the dominant (right) hand of young subjects with and without autism. For each participant, we measured the response to the stimulation of both fingers combined (D1,D2) relative to the post hoc sum of the responses to the stimulation of each finger alone (D1+D2) in multiple different ways and linearly regressed the ASD and neurotypical (NT) groups' responses. The resulting slopes were then compared: Smaller slope values imply attenuated response to paired finger stimulation, and enhanced levels of inhibition. The short-latency M40 and mid-latency M80 response slopes of the group with autism obtained in different ways were either significantly smaller, or statistically indistinguishable from NT. The result does not support reduced inhibition in the somatosensory cortex of individuals with autism, contrary to the seminal hypothesis of reduced inhibition. Implications are discussed including refinements of current theory.

Short-Latency Afferent Inhibition Modulation during Finger Movement

When somatosensory input via electrical stimulation of a peripheral nerve precedes a transcranial magnetic stimulation (TMS) pulse over the primary motor cortex (M1) the corticospinal output is substantially reduced, a phenomenon known as short-latency afferent inhibition (SAI). The present study investigated SAI during rest and during pre-movement, phasic and tonic components of movement. Participants were required to perform an index finger flexion reaction time task in response to an auditory cue. In a series of experiments, SAI was evoked from the mixed, median nerve at the wrist or the cutaneous, digital nerve stimulation of the index finger. To assess the spinal versus cortical origin of movement-related modulation of SAI, F-wave amplitudes were measured during rest and the three movement components. Results indicated that SAI was reduced during all movement components compared to rest, an effect that occurred for both nerves stimulated. Pre-movement SAI reduction was primarily attributed to reduced cortical inhibition, while increased spinal excitability additionally contributed to reduced SAI during tonic and phasic components of movement. SAI was differentially modulated across movement components with mixed but not cutaneous nerve stimulation. These findings reveal that SAI is reduced during movement and this reduction begins as early as the preparation to move. Further, these data suggest that the degree of SAI reduction during movement may be specific to the volume and/or composition of afferent input carried by each nerve.

No somatotopy of sensorimotor alpha-oscillation responses to differential finger stimulation

The somatotopic layout of the primary somatosensory cortex is known for its fine spatial structure as delineated in single cell recordings and macroscopic EEG evoked responses. While a gross somatotopic layout has been revealed also for neuronal oscillations responding to sensorimotor stimulation of distant body parts (e.g. hand vs. foot), it is still unclear whether these oscillatory dynamics exhibit fine spatial layout comparable to those found in evoked responses. In twelve healthy subjects we applied electric stimuli to the first (D1) and fifth finger (D5) of the same hand while performing high-density electroencephalography. We used Common Spatial Pattern analysis to optimally extract components showing the strongest Event-Related Desynchronization (ERD) in neuronal alpha oscillations. In agreement with the previous studies, dipole locations of Somatosensory Evoked Potentials (SEPs) confirmed the existence of spatially distinct representations of each finger. In contrast, dipole locations of alpha-ERD patterns did not yield spatially different source locations, indicating that the stimulation of different fingers most likely resulted in oscillatory activity of overlapping neuronal populations. When both fingers were stimulated simultaneously the SEP dipole strength was found increased in comparison to a stimulation of either finger alone, in agreement with spatially distinct SEP to finger stimulation. The strength of ERD, on the other hand, was the same regardless of whether either one or both fingers were stimulated. Our findings might reflect anatomical constraints on the sequential temporal activation of fingers' skin where almost simultaneous activation of many fingers usually occurs in everyday activities, such as grasping or holding objects. Such simultaneity is unlikely to benefit from slow amplitude modulation of alpha oscillations, which would rather be beneficial for contrasting somatosensory processing of distinct body parts.

Cortical somatosensory processing measured by magnetoencephalography predicts neurodevelopment in extremely low-gestational-age infants

Higher cortical function during sensory processing can be examined by recording specific somatosensory-evoked magnetic fields (SEFs) with magnetoencephalography (MEG). We evaluated whether, in extremely low-gestational-age (ELGA) infants, abnormalities in MEG-recorded SEFs at term age are associated with adverse neurodevelopment at 2 y of corrected age. SEFs to tactile stimulation of the index finger were recorded at term age in 30 ELGA infants (26.5 ± 1.2 wk, birth weight: 884 g ± 181 g). Neurodevelopment was evaluated at 2 y of corrected age. Controls were 11 healthy term infants. In nine of the ELGA infants (30.0%), SEFs were categorized as abnormal on the basis of lack of response from secondary somatosensory cortex (SII). At 2 y, these infants had a significantly worse mean developmental quotient and locomotor subscale on the Griffiths Mental Development Scales than the ELGA infants with normal responses. Mild white matter abnormalities in magnetic resonance imaging at term age were detected in 21% of infants, but these abnormalities were not associated with adverse neurodevelopment. Abnormal SII responses at term predict adverse neuromotor development at 2 y of corrected age. This adverse development may not be foreseen with conventional neuroimaging methods, suggesting a role for evaluating SII responses in the developmental risk assessment of ELGA infants.

Corticokinematic coherence during active and passive finger movements

Corticokinematic coherence (CKC) refers to coupling between magnetoencephalographic (MEG) brain activity and hand kinematics. For voluntary hand movements, CKC originates mainly from the primary sensorimotor (SM1) cortex.To learn about the relative motor and sensory contributions to CKC, we recorded CKC from 15 healthy subjects during active and passive right index-finger movements. The fingertip was either touching or not touching table, resulting in active-touch, active-no-touch, passive-touch, and passive-no-touch conditions. The kinematics of the index-finger was measured with a 3-axis accelerometer. Beamformer analysis was used to locate brain activations for the movements; somatosensory-evoked fields (SEFs) elicited by pneumatic tactile stimulation of the index finger served as a functional landmark for cutaneous input.All active and passive movements resulted in statistically significant CKC at the movement frequency (F0) and its first harmonic (F1). The main CKC sources at F0 and F1 were in the contralateral SM1 cortex with no spatial differences between conditions, and distinct from the SEF sources. At F1, the coherence was by two thirds stronger for passive than active movements, with no difference between touch vs. no-touch conditions.Our results suggest that the CKC occurring during repetitive finger movements is mainly driven by somatosensory, primarily proprioceptive, afferent input to the SM1 cortex, with negligible effect of cutaneous input.

Skill-specific changes in somatosensory-evoked potentials and reaction times in baseball players

Athletic training is known to induce neuroplastic alterations in specific somatosensory circuits, which are reflected by changes in short-latency somatosensory-evoked potentials (SEPs). The aim of this study is to clarify whether specific training in athletes affects the long-latency SEPs related to information processing of stimulation. The long-latency SEPs P100 and N140 were recorded at midline cortical electrode positions (Fz, Cz, and Pz) in response to stimulation of the index finger of the dominant hand in fifteen baseball players (baseball group) and in fifteen athletes in sports such as swimming, track and field events, and soccer (sports group) that do not require fine somatosensory discrimination or motor control of the hand. The long-latency SEPs were measured under a passive condition (no response required) and a reaction time (RT) condition in which subjects were instructed to rapidly push a button in response to stimulus presentation. The peak P100 and peak N140 latencies and RT were significantly shorter in the baseball group than the sports group. Moreover, there were significant positive correlations between RT and both the peak P100 and the peak N140 latencies. Specific athletic training regimens that involve the hand may induce neuroplastic alterations in the cortical hand representation areas playing a vital role in rapid sensory processing and initiation of motor responses.

Cortical Marker Points to Ketamine’s Antidepressant Effect

Back to table of contents Previous article Next article Clinical & Research NewsFull AccessCortical Marker Points to Ketamine’s Antidepressant EffectLeslie SinclairLeslie SinclairSearch for more papers by this authorPublished Online:19 Oct 2012https://doi.org/10.1176/pn.47.20.psychnews_47_20_17-bAbstractIf the progress made in 2012 is any indication, the availability of rapid-acting antidepressants may be only steps away.It’s been little more than a decade since researchers at the Connecticut Mental Health Center reported the results of the first trial to assess the treatment effects of a single dose of an N-methyl-D-aspartate (NMDA) receptor antagonist—ketamine hydrochloride—in patients with depression. In that study, subjects with depression saw significant improvement in depressive symptoms within 72 hours after a ketamine infusion, as measured by the 25-item Hamilton Depression Rating Scale, suggesting a potential role for NMDA receptor-modulating drugs in the treatment of depression.Carlos Zarate Jr., M.D.Scientists working at the National Institute of Mental Health (NIMH) have focused this year on elucidating that role, with encouraging results. Carlos Zarate Jr., M.D., is the chief of experimental therapeutics in the Mood and Anxiety Disorders Program at NIMH and a clinical professor of psychiatry at George Washington University. In the online January 31 Biological Psychiatry, he and his colleagues reported results of their study of ketamine’s effect on patients with bipolar depression, showing that those who received a single ketamine infusion experienced a rapid and robust antidepressant response. Even more exciting was their unexpected finding that ketamine rapidly improved suicidal ideation in these patients.Then in Biological Psychiatry online April 21, Zarate and his colleagues described results of a study that examined not just for whom such drugs have a therapeutic effect, but how the drugs appear to work.They gave 20 drug-free patients with major depressive disorder a single, open-label intravenous infusion of ketamine. They performed magnetoencephalographic recordings three days before and approximately 6.5 hours after the infusion, monitoring spontaneous activity while the subjects were at rest, as well as activity evoked by passive tactile stimulation to the left and right index fingers.They already knew that by blocking NMDA receptors, ketamine causes an increase in spontaneous electrical signals in a particular frequency range in the brain’s cortex. Hours after ketamine administration—in the time-frame in which ketamine relieves depression—spontaneous electrical activity in people at rest is the same, regardless of whether their depression lifts.But electrical activity evoked by stimulating a finger was different in the two groups. Those who responded to ketamine showed an increased response to the finger stimulation, a greater excitability of the neurons in the somatosensory cortex. Such a change in excitability is likely to result, not from the immediate effects of blocking the receptor, but from other processes downstream, in the cascade of effects set in motion by NMDA blockade, said the researchers. Evidence points to changes in another type of glutamate receptor, the AMPA receptor, raising questions about whether the blocking of NMDA receptors is even necessary for ketamine’s antidepressant effect.If NMDA blockade is just a trigger, then targeting AMPA receptors may prove a more direct way to effect a lifting of depression.“Our findings identify the first cortical marker of the rapid antidepressant effects of ketamine, and they are consistent with the hypothesis that enhanced non-NMDA-receptor-mediated glutamatergic neurotransmission through synaptic potentiation is central to the mechanism of action of ketamine,” they wrote.In addition, Zarate and colleagues published results of their analysis of ketamine metabolites online April 18 in Biological Psychiatry, noting that concentrations of some metabolites were related to nonresponse to ketamine in bipolar depression patients.“We are investigating ketamine in multiple ways—studying genes, gene expression, synapses, cells, circuits, and symptoms with neuroimaging, genetics, electrophysiological measures, and other techniques,” explained Zarate. “These studies hold hope for predicting the likelihood of response and for gaining insights into mechanisms of action.” An abstract of “Replication of Ketamine’s Antidepressant Efficacy in Bipolar Depression: A Randomized, Controlled Add-On Trial” is posted at www.ncbi.nlm.nih.gov/pubmed/22297150. An abstract of “Relationship of Ketamine’s Plasma Metabolites With Response, Diagnosis, and Side Effects in Major Depression” is posted at www.ncbi.nlm.nih.gov/pubmed/22516044. An abstract of “Synaptic Potentiation is Critical for Rapid Antidepressant Response to Ketamine in Treatment-Resistant Major Depression” is posted at www.ncbi.nlm.nih.gov/pubmed/22521148. ISSUES NewArchived

Hydraulic Driven Fast and Precise Nonmagnetic Tactile Stimulator for Neurophysiological and MEG Measurements

Electric stimulation of the peripheral nerves is well established as a diagnostic and research tool to analyze the somatosensory system. However, electric stimulation has some disadvantages. Electric stimulation of the median nerve triggers action potentials in all fiber populations of the nerve. Electric stimulation further creates artifacts and courses discomfort which is usually not well tolerated in the awake child. Therefore, the development of a more specific stimulation has constantly been a goal in recent years. There have been several approaches in the past to deliver somatic stimulation. However, all of them failed short in some aspects. In this study, a new type of somatosensory stimulator device was developed and compared against the gold standard of electric stimulation. The stimulation is achieved by repetitive tactile stimulation of the index finger using a blunt needle. In contrast to all previous approaches, we use a hydraulic system to move the needle up and downward. Given that water is very well suited to conduct pressure pulses it is possible to place the tactile stimulator device holding the needle close to the subject and the hydraulic driving system outside a critical area. Using a phantom, we showed that our stimulator is capable of delivering a stimulus precise on the submillisecond time scale. In addition, we test our stimulator on a healthy adult and compare the results against the electric stimulation. We can show the feasibility of measuring the electric responses of the peripheral nerve and while using MEG also the response of the primary somatosensory cortex. The tactile stimulation showed a more spatial focuses activation of the primary somatosensory cortex when compared against the electric stimulation. The proposed high-precision tactile stimulator will make it possible to analyze the somatosensory system noninvasively in children in the future.

Evoked magnetic fields from primary and secondary somatosensory cortices: A reliable tool for assessment of cortical processing in the neonatal period

ObjectiveTo determine interhemispheric differences and effect of postmenstrual age (PMA), height, and gender on somatosensory evoked magnetic fields (SEFs) from the primary (SI) and secondary (SII) somatosensory cortices in healthy newborns. MethodsWe recorded SEFs to stimulation of the contralateral index finger (right in 46 and left in 12) healthy fullterm newborns and analyzed the magnetic responses with equivalent current dipoles. ResultsActivity from both the SI and SII was consistently detectable in the contralateral hemisphere of the newborns during quiet sleep. No significant interhemispheric differences existed in SI or SII response peak latencies, source strengths, or location (n=8, quiet sleep). SI or SII response peak latency or source strength were not significantly affected by PMA, height, or gender. ConclusionsDuring the neonatal period (PMA 37–44weeks), activity from the contralateral SI and SII can be reliably evaluated with MEG. The somatosensory responses are similar in the left and right hemispheres and no corrections for exact PMA, height, or gender are necessary for interpreting the results. However, the evaluation should be conducted in quiet sleep. SignificanceThe reproducibility of the magnetic SI and SII responses suggests clinical applicability of the presented MEG method.

Effect of afferent input on motor cortex excitability during stroke recovery

ObjectiveAfferent input is proposed to mediate its effect on motor functions by modulating the excitability of the motor cortex. We aimed to clarify – in a longitudinal study – how afferent input affects motor cortex excitability after stroke and how it is associated with recovery of hand function. MethodsThe motor cortex excitability was studied by measuring the reactivity of the motor cortex beta rhythm to somatosensory stimulation. We recorded the amplitude of the suppression and subsequent rebound of the beta oscillations during tactile finger stimulation with MEG in 23 first-ever stroke patients within one week and at 1 and 3months after stroke, with concomitant evaluation of hand function. ResultsThe strength of the beta rhythm rebound, suggested to reflect decreased motor cortex excitability, was weak in the affected hemisphere after stroke and it was subsequently increased during recovery. The rebound strength correlated with hand function tests in all recordings. ConclusionMotor cortex excitability is modulated by afferent input after stroke. The motor cortex excitability is increased in the AH acutely after stroke and decreases in parallel with recovery of hand function. SignificanceThe results implicate the importance of parallel recovery of both sensory and motor systems in functional recovery after stroke.

Rapid enhancement of touch from non-informative vision of the hand

Processing in one sensory modality may modulate processing in another. Here we investigate how simply viewing the hand can influence the sense of touch. Previous studies showed that non-informative vision of the hand enhances tactile acuity, relative to viewing an object at the same location. However, it remains unclear whether this Visual Enhancement of Touch (VET) involves a phasic enhancement of tactile processing circuits triggered by the visual event of seeing the hand, or more prolonged, tonic neuroplastic changes, such as recruitment of additional cortical areas for tactile processing. We recorded somatosensory evoked potentials (SEPs) evoked by electrical stimulation of the right middle finger, both before and shortly after viewing either the right hand, or a neutral object presented via a mirror. Crucially, and unlike prior studies, our visual exposures were unpredictable and brief, in addition to being non-informative about touch. Viewing the hand, as opposed to viewing an object, enhanced tactile spatial discrimination measured using grating orientation judgements, and also the P50 SEP component, which has been linked to early somatosensory cortical processing. This was a trial-specific, phasic effect, occurring within a few seconds of each visual onset, rather than an accumulating, tonic effect. Thus, somatosensory cortical modulation can be triggered even by a brief, non-informative glimpse of one's hand. Such rapid multisensory modulation reveals novel aspects of the specialised brain systems for functionally representing the body.

Phantom digit somatotopy: a functional magnetic resonance imaging study in forearm amputees

Forearm amputees often experience non-painful sensations in their phantom when the amputation stump is touched. Cutaneous stimulation of specific stump areas may be perceived as stimulation of specific phantom fingers (stump hand map). The neuronal basis of referred phantom limb sensations is unknown. We used functional magnetic resonance imaging to demonstrate a somatotopic map of the phantom fingers in the hand region of the primary somatosensory cortex after tactile stump stimulation. The location and extent of phantom finger activation in the primary somatosensory cortex corresponded well to the location of normal fingers in a reference population. Stimulation of the stump hand map resulted in an increased bilateral activation of the primary somatosensory cortex compared with stimulation of forearm regions outside the stump hand map. Increased activation was also seen in contralateral posterior parietal cortex and premotor cortex. Ipsilateral primary somatosensory cortex activation might represent a compensatory mechanism and activation of the non-primary fronto-parietal areas might correspond to awareness of the phantom limb, which is enhanced when experiencing the referred sensations. It is concluded that phantom sensation elicited by stimulation of stump hand map areas is associated with activation of finger-specific somatotopical representations in the primary somatosensory cortex. This suggests that the primary somatosensory cortex could be a neural substrate of non-painful phantom sensations. The stump hand map phenomenon might be useful in the development of prosthetic hand devices.