Multimodal Stimulation Research Articles

STATE OF THE ART AND EFFICIENCY OF ROBOTIC THERAPY IN UPPER LIMB REHABILITATION – A LITERATURE REVIEW

Stroke represents the main cause of disability in adults. The disability is caused by motor or sensitive impairment, loss of interjoint coordination, spasticity and pathological synergies that occur after stroke. The new directions in motor rehabilitation point at facilitating neuroplasticity by multimodal stimulation, like virtual reality, or by active assistance in task specific training, like rehabilitation robots associated or not with functional electrical stimulation (FES). The aim of this article is, on one hand, to analyze the way in which the existing robots face the biomechanical challenges of modeling the upper limb`s movements and, on the other hand, to evaluate the efficiency of robotics in rehabilitation, by pointing out the results of the existing clinical trials. Finally, possible directions for future research are discussed.

The effect of music on weight gain of preterm infants older than 32 weeks: a randomized clinical trial

Objective: To evaluate the effect of recorded music with multimodal stimulation on the weight gain of preterm infants included in the Kangaroo-Mother Program. Methods: Randomized clinical trial with 61 premature infants, of both sexes, with postconceptional age greater or equal to 32 weeks and at least ten days of life, without detected abnormalities in the visual and hearing systems, and hospitalized in the Kangaroo-Mother Unit. Patients were randomized in two groups: of 31 preterm infants received multimodal stimulation with music daily, for seven days; 30 preterm infants received only multimodal stimulation. The following characteristics were evaluated: weight gain, energy consumption, heart rate and respiratory rate, stress signs and feeding method. Comparison between groups was made by Student’s t-test, Mann Whitney test and chi-square test, being significant p<0.05. Results: The two groups did not present significant differences in relation to the feeding method and energy consumption (p=0.46); however, weight gain was greater in the Experimental Group (p=0.002), which also presented better stability in cardiac and respiratory rates (p<0.001) and a significant reduction of stress signs (p=0.007), compared with the Control Group. Conclusions: The recorded music with multimodal stimulation is associated with a greater gain in body weight of hospitalized preterm infants as well as presents a positive influence on vital and stress signs (Clinical Trials Registry - UTN: U1111-1153-9301).

Translating novel findings of perceptual-motor codes into the neuro-rehabilitation of movement disorders

The bidirectional flow of perceptual and motor information has recently proven useful as rehabilitative tool for re-building motor memories. We analyzed how the visual-motor approach has been successfully applied in neurorehabilitation, leading to surprisingly rapid and effective improvements in action execution. We proposed that the contribution of multiple sensory channels during treatment enables individuals to predict and optimize motor behavior, having a greater effect than visual input alone. We explored how the state-of-the-art neuroscience techniques show direct evidence that employment of visual-motor approach leads to increased motor cortex excitability and synaptic and cortical map plasticity. This super-additive response to multimodal stimulation may maximize neural plasticity, potentiating the effect of conventional treatment, and will be a valuable approach when it comes to advances in innovative methodologies.

Virtual Reality Therapy for the Treatment of Alcohol Dependence: A Preliminary Investigation With Positron Emission Tomography/Computerized Tomography.

Virtual reality therapy (VRT) uses multimodal stimulation that includes visual, auditory, olfactory, and gustatory stimuli. The aim of this study was to assess the effectiveness of VRT in treating subjects with alcohol dependence (AD) by evaluating changes in brain metabolism. The VRT protocol consisted of three steps: relaxation, presentation of a high-risk situation, and presentation of an aversive situation. Twelve alcohol-dependent subjects underwent 10 sessions of VRT. The alcohol-dependent subjects were assessed with 18F-fluorodeoxyglucose positron emission tomography images before and after VRT, whereas the control group underwent imaging according to the same protocol only at baseline. Compared with the healthy control group, AD subjects showed higher metabolism in the right lentiform nucleus and right temporal lobe (BA20) at baseline (P(FDR < .05) = .026). In addition, the metabolism in the left anterior cingulate was lower in subjects with AD (P(uncorr) = .001). After VRT, alcohol-dependent subjects showed decreased brain metabolism in the right lentiform nucleus (P(FDR < .05) = .026) and right temporal lobe (BA38, P(FDR < .05) = .032) relative to that at baseline. Our results suggest a neurobiological imbalance, notably, a high sensitivity to stimuli, in the limbic system in subjects with AD. Furthermore, we determined that metabolism decreased in the basal ganglia after VRT, which may explain the limbic-regulated responses of reward and regulation. Therefore, we tentatively recommend VRT to treat AD through its regulating effect on limbic circuits.

Apple Flavor: Linking Sensory Perception to Volatile Release and Textural Properties

AbstractIn apples, consumers predominantly use visual, auditory and texture cues as quality/preference indicators and struggle to describe complex olfactory sensations. This study investigated apple cultivar differentiation using analytical and sensory techniques with the goal of achieving more relevant instrumental characterization. Sensory flavor/odor data were compared with volatile organic compounds (VOCs) measured using proton transfer reaction time‐of‐flight mass spectrometer (PTR‐ToF‐MS) and sensory texture data were compared with mechanical‐acoustic textural parameters obtained using a texture analyzer. Both techniques separated cultivars similarly. PTR‐ToF‐MS data separated cultivars into VOC families that correlated to specific sensory attributes (e.g., butanoate esters to lemon flavor/odor). Analytical and sensory firmness were positively correlated where the former differentiated crunchy from hard‐not crunchy cultivars. Sweet taste did not correlate to soluble solids content but was positively correlated to fruity esters which could indicate a taste‐aroma interaction. This study demonstrates the potential to predict sensory attributes of apples using analytical techniques.Practical ApplicationThe description of apple flavor is challenging for both trained panelists and consumers to describe due to the complexity of the multimodal stimulations that occur within the oral and ortho/retro nasal cavity during consumption that induce odor, taste, flavor and sound perception. Therefore, this study looks at objectively characterizing apple cultivars based solely on instrumental techniques that reflect attributes attained from a descriptive sensory analysis of the same cultivars. The current study found apple cultivars were separated into similar groups when sensory and instrumental texture, physicochemical and VOC data were compared. Specific analytical properties that correlated strongly to sensory attributes could be used as predictors of important sensory attributes that differentiated the samples. Hence, the use of these instrumental techniques to characterize apples could be an option to increase throughput.

The Artistic Infant Directed Performance: A Mycroanalysis of the Adult's Movements and Sounds.

Intersubjectivity experiences established between adults and infants are partially determined by the particular ways in which adults are active in front of babies. An important amount of research focuses on the "musicality" of infant-directed speech (defined melodic contours, tonal and rhythm variations, etc.) and its role in linguistic enculturation. However, researchers have recently suggested that adults also bring a multimodal performance to infants. According to this, some scholars seem to find indicators of the genesis of the performing arts (mainly music and dance) in such a multimodal stimulation. We analyze the adult performance using analytical categories and methodologies of analysis broadly validated in the fields of music performance and movement analysis in contemporary dance. We present microanalyses of an adult-7month old infant interaction scene that evidenced structural aspects of infant directed multimodal performance compatible with music and dance structures, and suggest functions of adult performance similar to performing arts functions or related to them.

SŁUCHOWE POTENCJAŁY WYWOŁANE Z KORY SŁUCHOWEJ U DWÓCH OSÓB DOROSŁYCH Z GŁUCHOTĄ PRELINGWALNĄ

BackgroundIt has been reported that in prelingually deafened adults there is maturation of the late latency response (LLR) after rehabilitation using cochlear implants. Other evidence suggests that the auditory system, like any other sensory system, receives multimodal stimulation, a factor which could help the auditory system mature even in the absence of any auditory input. The current study was done on two prelingually deaf adults who had not received rehabilitation, and their latencies were within the normal mature range, suggesting their auditory cortex responses were maturely developed prior to rehabilitation.Material and MethodsTwo male participants took part in the study: one was 21 years old and the other was 36, and both had congenital profound hearing loss. Using pure tone thresholds obtained earlier, a strong class hearing aid (Siemens Infiniti Pro SP) was programmed using NOAH software and fitted to the right ear using the NALNL-1 fitting formula. As an objective measure of verification of hearing aid effect, auditory P1, N1, P2, and N2 were recorded using the free-field facility available in the IHS SmartEP system: a 1000 Hz pure tone was presented at 70 dB SPL (30 dB SL) and 50 dB SPL (10 dB SL) from a loudspeaker at a distance of 1 m and 45° angle.ResultsThe latencies of P1, N1, P2, and N2 for both participants were recorded for 70 and 90 dB HL; all latencies were well within normal limits.ConclusionsThe results indicate that, with adequate amplification, a mature response from the auditory cortex can be obtained even in adults who have profound hearing loss and who have been deprived of auditory stimuli since a prelingual age

Randomized clinical trial: efficacy and safety of PPC-5650 on experimental esophageal pain and hyperalgesia in healthy volunteers

Objective. Gastroesophageal reflux disease (GERD) is a common condition associated with symptoms as heart burn, regurgitation, chest pain, and gastrointestinal discomfort. PPC-5650 is a new pharmacological agent that can modulate acid-sensing ion channel activity, potentially leading to reduction in the pain signal. In healthy volunteers the esophagus was sensitized with acid to mimic GERD with the aims: 1) to assess the efficacy of a single bolus of PPC-5650 locally applied to the esophagus using multimodal pain stimulations, and 2) to assess the safety profile of PPC-5650. Materials and methods. The study was a randomized, double-blinded, placebo-controlled, crossover trial in healthy males. Esophageal electrical, thermal, mechanical, and chemical stimulations were performed, pain perception was rated, and referred pain areas were drawn. Sensitization was induced by intraluminal esophageal acid perfusions. Adverse events were registered. Results. Twenty-five healthy males completed the study (mean age 23.4 ± 2.0 years). About 90 min after drug administration, PPC-5650 increased the volume tolerated at moderate pain during mechanical stimulation compared to placebo (difference 13.5, 95% CI: 0.58–26.47, p = 0.04), but there was no effects on thermal-, electrical-, and chemical-induced pain (all p > 0.05). PPC-5650 did not affect referred pain areas to any stimulation (all p > 0.05). Ten participants reported adverse events during the placebo treatment period, and nine participants reported adverse events during the PPC-5650 treatment period (p = 0.8). Conclusion. Sensitization to mechanical stimulation of the esophagus was reduced by PPC-5650 compared to placebo. The overall safety and tolerability of PPC-5650 was acceptable. Thus, PPC-5650 may play a role in the future treatment of patients with GERD.

Development of Six Arts, a Culturally Appropriate Multimodal Nonpharmacological Intervention in Dementia.

There is accumulating evidence for the efficacy of nonpharmacological multimodal stimulation interventions in maintaining cognition and improving quality of life in people with mild-to-moderate dementia. However, the complex nature of these interventions limits their application in practice and research. We report here the design and development of a culturally appropriate framework, the Six Arts, to guide delivery of multimodal interventions in a Chinese community. The Six Arts are a core set of Confucian philosophy comprising 6 disciplines of rites, music, archery, charioteering, literacy, and numeracy. They correspond to major mind-body functional domains of social functioning; music and rhythm; visuospatial and fine motor skills; kinesthetic and gross motor skills; language and verbal skills; and executive function. Using Six Arts as a framework, we mapped theoretical principles and evidence-based nonpharmacological interventions of cognitive stimulation, physical exercise, and social activities against the 6 functional domains. From 2011, we field-tested the use of Six Arts in structuring intervention programs in 263 people in a dementia day center in Hong Kong. The Six Arts was operationalized through the development of an intervention activity database, a scoring system for intensity level, and a service delivery model for application in dementia day centers. Six Arts can be used as framework for structuring nonpharmacological group intervention programs in dementia day center in a metropolitan Chinese city. Its cultural appropriateness may facilitate communication and shared decision making with families with dementia in communities influenced by Confucian philosophy.

Efficacy and safety of PPC-5650 on experimental rectal pain in patients with irritable bowel syndrome.

PPC-5650 is a new pharmacological agent that can modulate acid-sensing ion channel activity, leading to a reduction in the pain signal under up-regulated conditions. The non-clinical programme for PPC-5650 supported a role for this novel agent in the treatment of pain in patients with irritable bowel syndrome (IBS). In patients with IBS, the aims of the study were: (1) to assess the efficacy of a single bolus of PPC-5650 locally applied in the rectum using multi-modal stimulations of the recto sigmoid and (2) to assess the safety profile of PPC-5650. The study was a randomized, double-blind, placebo-controlled, cross-over trial in patients with IBS, excluding females of child-bearing potential. The study consisted of a training visit, study visit 1 and 2 and a follow-up visit. Rectosigmoid electrical, thermal and mechanical stimulations were performed, pain perception was rated on a pain intensity scale and referred pain areas were assessed. All adverse events were registered. Twenty-five patients with IBS were enrolled and completed the study (9 women and 16 men; mean age 50.4±12.7years). No effects of the study drug were found on any of the rectal stimulations or for referred pain areas (all p>0.05). No significant or clinically relevant treatment-related differences were seen for the laboratory safety variables or any other reported adverse event. In conclusion, in patients with IBS on rectal sensitivity to multi-modal stimulations, PPC-5650 did not produce efficacy relative to placebo. The overall safety and tolerability of PPC-5650 was acceptable.

Multimodal packaging design: How human motivations moderate the success of a multimodal stimulation

This study aims at better understanding the effect of a multimodal stimulation on liking. So far, most product design and product presentation related research on multimodal stimulation focused on congruence of stimuli intensity or message congruence only. Next to a multimodal stimulation, the product’s ability to activate human motivations/need states can positively influence product liking, too. By taking these insights into consideration, the survey was designed to investigate the effect of a need state congruent stimulation on liking moderated by the target group’s need states. For this purpose, an experiment was carried out in which 360 respondents evaluated face lotion packages. The stimuli combination followed a factorial design, including the sensory modalities optics, haptics, acoustics and olfaction. One half of the stimuli were designed to activate the need for affiliation, the other half to address the need for achievement – both basic motivations to use face lotion. For both need states a moderating effect can be observed, i.e. best results can be stated for need state congruent stimulations that were rated by respondents with a high specific need state.

Pathophysiology of late anorectal dysfunction following external beam radiotherapy for prostate cancer

Background. Patients treated with external beam radiotherapy (EBRT) may suffer from long-term anorectal adverse effects. The purpose of the present study was to assess long-term functional and structural anorectal changes in patients previously treated with EBRT for prostate cancer and to suggest the mechanism behind the development of the adverse effects.Material and methods. Our previously proposed RT-induced anorectal dysfunction (RT-ARD) score, developed with the intention to survey anorectal dysfunction was used to identify patients with and without anorectal symptoms. Among 309 patients surveyed with the questionnaire, we chose 23 patients with the highest RT-ARD score and 19 patients with the lowest RT-ARD score. They were investigated by multimodal rectal sensory stimulation, standard anal physiological tests. Changes of the rectal mucosa were assessed by flexible sigmoidoscopy and graded by the Vienna Rectoscopy Score (VRS).Results. The mean follow-up time was 3.8 (range, 2.8; 8.6) years in patients with high RT-ARD and 3.8 (range, 2.6; 5.9) in patients with low RT-ARD. Endoscopic evaluation revealed higher VRS scores in patients with high RT-ARD compared to patients with low RT-ARD (p = 0.002). Patients with high RT-ARD had increased rectal sensory response to distension manifested both as volume (p = 0.006) and cross-sectional area (p = 0.04), and they had reduced maximum anal resting pressure assessed by anal manometri (p = 0.02).Conclusions. Long-term anorectal symptoms correlate to changes in anorectal biomechanical properties and rectal mucosal injury. Our data suggests that RT-induced long-term anorectal dysfunction is multifactorial caused by injury of the rectal mucosa and the internal anal sphincter combined with increased rectal sensitivity and reduced rectal functional capacity.

Basics of Optogenetics

Optogenetic is a neurostimulation technique which recently becomes common. Optogenetic tools have numerous advantages over conventional neurostimulation techniques in terms of ability of selective neuron stimulation, multifocal and multimodal stimulation, and inhibition. This method which provides valuable contribution for explanation of pathophysiological mechanisms, and treatment of disorders, acquired a wide utilization area in basic medical sciences as well as clinical sciences.

Educating attention

In a longitudinal naturalistic study, we observed German mothers interacting with their infants when they were 3 and 6 months old. Pursuing the idea that infants’ attention is socialized in everyday interactions, we explored whether eye contact is reinforced selectively by behavioral modification in the input provided to infants. Applying a microanalytical approach focusing on the sequential organization of interaction, we explored how the mother draws the infant’s attention to herself and how she tries to maintain attention when the infant is looking at her. Results showed that eye contact is reinforced by specific infant-directed practices: interrogatives and conversational openings, multimodal stimulation, repetition, and imitation. In addition, these practices are contingent on the infant’s own behavior. By comparing the two data points (3 and 6 months), we showed how the education of attention evolves hand-in-hand with the developing capacities of the infant. Keywords: multimodal input; eye contact; interactional adaptation; ecology of attention; social learning

Dissociation of psychophysical and EEG steady-state response measures of cross-modal temporal correspondence for amplitude modulated acoustic and vibrotactile stimulation

Research examining multisensory integration suggests that the correspondence of stimulus characteristics across modalities (cross-modal correspondence) can have a dramatic influence on both neurophysiological and perceptual responses to multimodal stimulation. The current study extends prior research by examining the cross-modal correspondence of amplitude modulation rate for simultaneous acoustic and vibrotactile stimulation using EEG and perceptual measures of sensitivity to amplitude modulation. To achieve this, psychophysical thresholds and steady-state responses (SSRs) were measured for acoustic and vibrotactile amplitude modulated (AM) stimulation for 21 and 40Hz AM rates as a function of the cross-modal correspondence. The study design included three primary conditions to determine whether the changes in the SSR and psychophysical thresholds were due to the cross-modal temporal correspondence of amplitude modulated stimuli: NONE (AM in one modality only), SAME (the same AM rate for each modality) and DIFF (different AM rates for each modality). The results of the psychophysical analysis showed that AM detection thresholds for the simultaneous AM conditions (i.e., SAME and DIFF) were significantly higher (i.e., lower sensitivity) than AM detection thresholds for the stimulation of a single modality (i.e., NONE). SSR results showed significant effects of SAME and DIFF conditions on SSR activity. The different pattern of results for perceptual and SSR measures of cross-modal correspondence of AM rate indicates a dissociation between entrained cortical activity (i.e., SSR) and perception.

Multimodality Neurophysiological Monitoring during Tibial/Fibular Osteotomies for Preventing Peripheral Nerve Injuries

ABSTRACT.Previously, intraoperative neurophysiological monitoring was not used routinely during tibial osteotomies. In an attempt to improve the post-operative outcomes and reduce known neurologic complications, we used discrete multimodality recording and stimulation models to identify areas of motor and sensory function in eighteen (18) pediatric patients presenting with Tibia Vara (Blount's Disease). By using both posterior tibial and peroneal nerves somatosensory evoked potentials (SSEPs) with transcranial electrical motor evoked potentials (TCeMEPs) precise status of sensory and motor pathways was possible during surgical correction. Similarly, spontaneous electromyography (s-EMG) and triggered electromyography (t-EMG) were used to more accurately localize nerve irritation. Concerns during tibial and fibular osteotomies included ipsilateral lower limb motor and sensory function, especially peroneal nerve injuries due to the location of the osteotomy at the fibular neck.Surgical interventions consisting of additional fibular resection were made during the index procedures for four patients because of real-time monitoring changes noted as the peroneal nerve was entrapped in three patients at the osteotomy site. In fourth patient, the tourniquet pressure was the cause for loss of ipsilateral SSEPs and TCeMEPs. After appropriate surgical intervention, monitoring parameters began to normalize and postoperatively the patients presented with no neurologic deficit.In this study, the application of multimodality recording and stimulation models were utilized including posterior tibial nerve and peroneal nerve SSEP with lumbar potential (LP) identification to compare with contralateral limb recordings. In addition, by using spontaneous and triggered EMG and TCeMEP, we were able to perform monitoring with a high level of confidence throughout surgery.

Unilateral cortical hyperexcitability in congenital hydrocephalus: A TMS study

Introduction: Changes in cortical excitability are considered to play an important role in promoting brain plasticity both in healthy people and in neurological diseases. Hydrocephalus is a brain development disorder related to an excessive accumulation of cerebrospinal fluid (CSF) in the ventricular system. The functional relevance of cortical structural changes described in this disease is largely unexplored in human. We investigated cortical excitability using multimodal transcranial magnetic stimulation (TMS) in a case of congenital hydrocephalus with almost no neurological signs. Methods: A caucasian 40 years old, ambidextrous and multilingual woman affected by occult spina bifida and congenital symmetrical hydrocephalous underwent a TMS study. The intracortical and interhemispheric paired pulse paradigms were used, together with the mapping technique. Results: No significant differences were found in the resting motor thresholds between the two hemispheres. Instead, the intracortical excitability curves were statistically different between the two hemispheres (with short intracortical inhibition (SICI) being strongly reduced and intracortical facilitation (ICF) enhanced in the right one), and the interhemispheric curves showed a general hyper-excitability on the right hemisphere (when conditioned by the left one) and a general hypo-excitability in the left hemisphere (when conditioned by the right one). It is noteworthy that an asymmetric right hemisphere (RH) change of excitability was observed by means of mapping technique. Conclusion: We hypothesize that in this ambidextrous subject, the observed RH hyper-excitability could represent a mechanism of plasticity to preserve functionality of specific brain areas possibly devoted to some special skills, such as multilingualism.

Effect of frequency of multimodal coma stimulation on the consciousness levels of traumatic brain injury comatose patients

Objectives: To evaluate the effectiveness of multimodal coma stimulation on the conscious levels of head injury comatose patients and to find out which of the two protocols of coma stimulation, i.e. administrating twice a day or 5-times a day is more beneficial.Methods: Thirty comatose patients with traumatic head injury (GCS < 8) were selected and were divided into three groups randomly. Group A (n = 10) received multimodal coma stimulation 5-times a day (20 minutes each session), Group B (n = 10) received stimulation twice a day (50 minutes each session) and Group C (n = 10) received conventional physiotherapy twice daily. Subjects in all the three groups received treatment for 2 weeks.Results and conclusion: The results showed a significant difference (p < 0.01) for Glasgow Coma Scale as well as Western Neuro Sensory Stimulation Profile scores between Groups A & C and B & C, i.e. multimodal coma stimulation is effective as compared to the control group. The results also revealed a significant difference (p < 0.01) between Groups A, B and C on the Western Neuro Sensory Stimulation Profile but a non-significant difference (p > 0.01) on the Glasgow coma scale. This indicates that short sessions of high frequency can be more beneficial.

Sensorimotor Modulation of Mood and Depression: In Search of an Optimal Mode of Stimulation

Depression involves a dysfunction in an affective fronto-limbic circuitry including the prefrontal cortices, several limbic structures including the cingulate cortex, the amygdala, and the hippocampus as well as the basal ganglia. A major emphasis of research on the etiology and treatment of mood disorders has been to assess the impact of centrally generated (top-down) processes impacting the affective fronto-limbic circuitry. The present review shows that peripheral (bottom-up) unipolar stimulation via the visual and the auditory modalities as well as by physical exercise modulates mood and depressive symptoms in humans and animals and activates the same central affective neurocircuitry involved in depression. It is proposed that the amygdala serves as a gateway by articulating the mood regulatory sensorimotor stimulation with the central affective circuitry by emotionally labeling and mediating the storage of such emotional events in long-term memory. Since both amelioration and aggravation of mood is shown to be possible by unipolar stimulation, the review suggests that a psychophysical assessment of mood modulation by multimodal stimulation may uncover mood ameliorative synergisms and serve as adjunctive treatment for depression. Thus, the integrative review not only emphasizes the relevance of investigating the optimal levels of mood regulatory sensorimotor stimulation, but also provides a conceptual springboard for related future research.

Just watching the game ain't enough: striatal fMRI reward responses to successes and failures in a video game during active and vicarious playing

Although the multimodal stimulation provided by modern audiovisual video games is pleasing by itself, the rewarding nature of video game playing depends critically also on the players' active engagement in the gameplay. The extent to which active engagement influences dopaminergic brain reward circuit responses remains unsettled. Here we show that striatal reward circuit responses elicited by successes (wins) and failures (losses) in a video game are stronger during active than vicarious gameplay. Eleven healthy males both played a competitive first-person tank shooter game (active playing) and watched a pre-recorded gameplay video (vicarious playing) while their hemodynamic brain activation was measured with 3-tesla functional magnetic resonance imaging (fMRI). Wins and losses were paired with symmetrical monetary rewards and punishments during active and vicarious playing so that the external reward context remained identical during both conditions. Brain activation was stronger in the orbitomedial prefrontal cortex (omPFC) during winning than losing, both during active and vicarious playing. In contrast, both wins and losses suppressed activations in the midbrain and striatum during active playing; however, the striatal suppression, particularly in the anterior putamen, was more pronounced during loss than win events. Sensorimotor confounds related to joystick movements did not account for the results. Self-ratings indicated losing to be more unpleasant during active than vicarious playing. Our findings demonstrate striatum to be selectively sensitive to self-acquired rewards, in contrast to frontal components of the reward circuit that process both self-acquired and passively received rewards. We propose that the striatal responses to repeated acquisition of rewards that are contingent on game related successes contribute to the motivational pull of video-game playing.