Cortical plasticity: from synapses to maps

Design and Rationale of the Cognitive Intervention to Improve Memory in Heart Failure Patients Study

BACKGROUND

Memory loss is an independent predictor of mortality among heart failure patients. Twenty-three percent to 50% of heart failure patients have comorbid memory loss, but few interventions are available to treat the memory loss. The aims of this 3-arm randomized controlled trial were to (1) evaluate efficacy of computerized cognitive training intervention using BrainHQ to improve primary outcomes of memory and serum brain-derived neurotrophic factor levels and secondary outcomes of working memory, instrumental activities of daily living, and health-related quality of life among heart failure patients; (2) evaluate incremental cost-effectiveness of BrainHQ; and (3) examine depressive symptoms and genomic moderators of BrainHQ effect.

METHODS

A sample of 264 heart failure patients within 4 equal-sized blocks (normal/low baseline cognitive function and gender) will be randomly assigned to (1) BrainHQ, (2) active control computer-based crossword puzzles, and (3) usual care control groups. BrainHQ is an 8-week, 40-hour program individualized to each patient's performance. Data collection will be completed at baseline and at 10 weeks and 4 and 8 months. Descriptive statistics, mixed model analyses, and cost-utility analysis using intent-to-treat approach will be computed.

CONCLUSIONS

This research will provide new knowledge about the efficacy of BrainHQ to improve memory and increase serum brain-derived neurotrophic factor levels in heart failure. If efficacious, the intervention will provide a new therapeutic approach that is easy to disseminate to treat a serious comorbid condition of heart failure.

Repetitive transcranial magnetic stimulation in stroke rehabilitation: review of the current evidence and pitfalls

Acute brain ischemia causes changes in several neural networks and related cortico-subcortical excitability, both in the affected area and in the apparently spared contralateral hemisphere. The modulation of these processes through modern techniques of noninvasive brain stimulation, namely repetitive transcranial magnetic stimulation (rTMS), has been proposed as a viable intervention that could promote post-stroke clinical recovery and functional independence. This review provides a comprehensive summary of the current evidence from the literature on the efficacy of rTMS applied to different clinical and rehabilitative aspects of stroke patients. A total of 32 meta-analyses published until July 2019 were selected, focusing on the effects on motor function, manual dexterity, walking and balance, spasticity, dysphagia, aphasia, unilateral neglect, depression, and cognitive function after a stroke. Only conventional rTMS protocols were considered in this review, and meta-analyses focusing on theta burst stimulation only were excluded. Overall, both HF-rTMS and LF-rTMS have been shown to be safe and well-tolerated. In addition, the current literature converges on the positive effect of rTMS in the rehabilitation of all clinical manifestations of stroke, except for spasticity and cognitive impairment, where definitive evidence of efficacy cannot be drawn. However, routine use of a specific paradigm of stimulation cannot be recommended yet due to a significant level of heterogeneity of the studies in terms of protocols to be set and outcome measures that have to be used. Future studies need to preliminarily evaluate the most promising protocols before going on to multicenter studies with large cohorts of patients in order to achieve a definitive translation into daily clinical practice.

Repetitive transcranial magnetic stimulation in stroke rehabilitation: review of the current evidence and pitfalls

Acute brain ischemia causes changes in several neural networks and related cortico-subcortical excitability, both in the affected area and in the apparently spared contralateral hemisphere. The modulation of these processes through modern techniques of noninvasive brain stimulation, namely repetitive transcranial magnetic stimulation (rTMS), has been proposed as a viable intervention that could promote post-stroke clinical recovery and functional independence. This review provides a comprehensive summary of the current evidence from the literature on the efficacy of rTMS applied to different clinical and rehabilitative aspects of stroke patients. A total of 32 meta-analyses published until July 2019 were selected, focusing on the effects on motor function, manual dexterity, walking and balance, spasticity, dysphagia, aphasia, unilateral neglect, depression, and cognitive function after a stroke. Only conventional rTMS protocols were considered in this review, and meta-analyses focusing on theta burst stimulation only were excluded. Overall, both HF-rTMS and LF-rTMS have been shown to be safe and well-tolerated. In addition, the current literature converges on the positive effect of rTMS in the rehabilitation of all clinical manifestations of stroke, except for spasticity and cognitive impairment, where definitive evidence of efficacy cannot be drawn. However, routine use of a specific paradigm of stimulation cannot be recommended yet due to a significant level of heterogeneity of the studies in terms of protocols to be set and outcome measures that have to be used. Future studies need to preliminarily evaluate the most promising protocols before going on to multicenter studies with large cohorts of patients in order to achieve a definitive translation into daily clinical practice.

The Dialectics of Free Energy Minimization

Karl Friston’s free energy minimization has been received with great enthusiasm. With good reason: it not only makes the bold claim to a unifying theory of the brain, but it is presented as an a priori principle applicable to living systems in general. In this article, we set out to show how the breadth of scope of Friston’s framework converges with the dialectics of Georg Hegel. Through an appeal to the work of Catherine Malabou, we aim to demonstrate how Friston not only reinvigorates Hegelian dialectics from the perspective of neuroscience, but that the implicit alignment with Hegel necessitates a reading of free energy minimization from the perspective of Hegel’s speculative philosophy. It is this reading that moves beyond the discussion between cognitivism and enactivism surrounding Friston’s framework; beyond the question whether the organism is a secluded entity separated from its surroundings, or whether it is a dynamical system characterized by perpetual openness and mutual exchange. From a Hegelian perspective, it is the tension between both positions itself that is operative at the level of the organism; as a contradiction the organism sustains over the course of its life. Not only does the organism’s secluded existence depend on a perpetual relation with its surroundings, but the condition for there to be such a relation is the existence of a secluded entity. We intend to show how this contradiction—tension internalized—is at the center of Friston’s anticipatory organism; how it is this contradiction that grounds the perpetual process of free energy minimization.

Neuroscientism, the neuroscience of learning

Purpose

Although the field of neuroscience has evolved dramatically, little research has attempted to conceptualize the impact of neuroscience on the field of human resource development (HRD). The purpose of this study is an integrative review of the influential relationship between neuroscience and workplace learning including applicable implications for HRD research and practice.

Design/methodology/approach

By reviewing 93 studies on neuroscience and brain-based learning published between 1995 and 2017, the authors synthesized their findings.

Findings

This study discusses the basic concepts of neuroscience such as the structure and functions of the brain, neuroscientific findings about memory and cognition, the effect of neural transmitters on memory and cognition and the neuroscience of learning. This study also illustrates brain-based learning styles affecting learning and describes various neuroscientific learning principles and models that can be applied to practical planning and the delivery of workplace learning and HRD activities.

Originality/value

This study concludes with brain-based learning principles called neuroscientism compared with traditional learning theories. It also includes several brain-based learning cases from workplace settings and implications for future research and further HRD practices.

Nonmonotonic Plasticity: How Memory Retrieval Drives Learning

What are the principles that govern whether neural representations move apart (differentiate) or together (integrate) as a function of learning? According to supervised learning models that are trained to predict outcomes in the world, integration should occur when two stimuli predict the same outcome. Numerous findings support this, but - paradoxically - some recent fMRI studies have found that pairing different stimuli with the same associate causes differentiation, not integration. To explain these and related findings, we argue that supervised learning needs to be supplemented with unsupervised learning that is driven by spreading activation in a U-shaped way, such that inactive memories are not modified, moderate activation of memories causes weakening (leading to differentiation), and higher activation causes strengthening (leading to integration).

Cellular and Network Mechanisms for Temporal Signal Propagation in a Cortical Network Model

The mechanisms underlying an effective propagation of high intensity information over a background of irregular firing and response latency in cognitive processes remain unclear. Here we propose a SSCCPI circuit to address this issue. We hypothesize that when a high-intensity thalamic input triggers synchronous spike events (SSEs), dense spikes are scattered to many receiving neurons within a cortical column in layer IV, many sparse spike trains are propagated in parallel along minicolumns at a substantially high speed and finally integrated into an output spike train toward or in layer Va. We derive the sufficient conditions for an effective (fast, reliable, and precise) SSCCPI circuit: (i) SSEs are asynchronous (near synchronous); (ii) cortical columns prevent both repeatedly triggering SSEs and incorrectly synaptic connections between adjacent columns; and (iii) the propagator in interneurons is temporally complete fidelity and reliable. We encode the membrane potential responses to stimuli using the non-linear autoregressive integrated process derived by applying Newton's second law to stochastic resilience systems. We introduce a multithreshold decoder to correct encoding errors. Evidence supporting an effective SSCCPI circuit includes that for the condition, (i) time delay enhances SSEs, suggesting that response latency induces SSEs in high-intensity stimuli; irregular firing causes asynchronous SSEs; asynchronous SSEs relate to healthy neurons; and rigorous SSEs relate to brain disorders. For the condition (ii) neurons within a given minicolumn are stereotypically interconnected in the vertical dimension, which prevents repeated triggering SSEs and ensures signal parallel propagation; columnar segregation avoids incorrect synaptic connections between adjacent columns; and signal propagation across layers overwhelmingly prefers columnar direction. For the condition (iii), accumulating experimental evidence supports temporal transfer precision with millisecond fidelity and reliability in interneurons; homeostasis supports a stable fixed-point encoder by regulating changes to synaptic size, synaptic strength, and ion channel function in the membrane; together all-or-none modulation, active backpropagation, additive effects of graded potentials, and response variability functionally support the multithreshold decoder; our simulations demonstrate that the encoder-decoder is temporally complete fidelity and reliable in special intervals contained within the stable fixed-point range. Hence, the SSCCPI circuit provides a possible mechanism of effective signal propagation in cortical networks.

Enrichment drives emergence of functional columns and improves sensory coding in the whisker map in L2/3 of mouse S1

Sensory maps in layer (L) 2/3 of rodent cortex lack precise functional column boundaries, and instead exhibit locally heterogeneous (salt-and-pepper) tuning superimposed on smooth global topography. Could this organization be a byproduct of impoverished experience in laboratory housing? We compared whisker map somatotopy in L2/3 and L4 excitatory cells of somatosensory (S1) cortex in normally housed vs. tactile-enriched mice, using GCaMP6s imaging. Normally housed mice had a dispersed, salt-and-pepper whisker map in L2/3, but L4 was more topographically precise. Enrichment (P21 to P46-71) sharpened whisker tuning and decreased, but did not abolish, local tuning heterogeneity. In L2/3, enrichment strengthened and sharpened whisker point representations, and created functional boundaries of tuning similarity and noise correlations at column edges. Thus, enrichment drives emergence of functional columnar topography in S1, and reduces local tuning heterogeneity. These changes predict better touch detection by neural populations within each column.

The Neural Basis of Timing: Distributed Mechanisms for Diverse Functions

Timing is critical to most forms of learning, behavior, and sensory-motor processing. Converging evidence supports the notion that, precisely because of its importance across a wide range of brain functions, timing relies on intrinsic and general properties of neurons and neural circuits; that is, the brain uses its natural cellular and network dynamics to solve a diversity of temporal computations. Many circuits have been shown to encode elapsed time in dynamically changing patterns of neural activity-so-called population clocks. But temporal processing encompasses a wide range of different computations, and just as there are different circuits and mechanisms underlying computations about space, there are a multitude of circuits and mechanisms underlying the ability to tell time and generate temporal patterns.

Tool Use Modulates Somatosensory Cortical Processing in Humans

Tool use leads to plastic changes in sensorimotor body representations underlying tactile perception. The neural correlates of this tool-induced plasticity in humans have not been adequately characterized. This study used ERPs to investigate the stage of sensory processing modulated by tool use. Somatosensory evoked potentials, elicited by median nerve stimulation, were recorded before and after two forms of object interaction: tool use and hand use. Compared with baseline, tool use-but not use of the hand alone-modulated the amplitude of the P100. The P100 is a mid-latency component that indexes the construction of multisensory models of the body and has generators in secondary somatosensory and posterior parietal cortices. These results mark one of the first demonstrations of the neural correlates of tool-induced plasticity in humans and suggest that tool use modulates relatively late stages of somatosensory processing outside primary somatosensory cortex. This finding is consistent with what has been observed in tool-trained monkeys and suggests that the mechanisms underlying tool-induced plasticity have been preserved across primate evolution.

Rapid Turnover of Cortical NCAM1 Regulates Synaptic Reorganization after Peripheral Nerve Injury

Peripheral nerve injury can induce pathological conditions that lead to persistent sensitized nociception. Although there is evidence that plastic changes in the cortex contribute to this process, the underlying molecular mechanisms are unclear. Here, we find that activation of the anterior cingulate cortex (ACC) induced by peripheral nerve injury increases the turnover of specific synaptic proteins in a persistent manner. We demonstrate that neural cell adhesion molecule 1 (NCAM1) is one of the molecules involved and show that it mediates spine reorganization and contributes to the behavioral sensitization. We show striking parallels in the underlying mechanism with the maintenance of NMDA-receptor- and protein-synthesis-dependent long-term potentiation (LTP) in the ACC. Our results, therefore, demonstrate a synaptic mechanism for cortical reorganization and suggest potential avenues for neuropathic pain treatment.

Blocking tactile input to one finger using anaesthetic enhances touch perception and learning in other fingers

Brain plasticity is a key mechanism for learning and recovery. A striking example of plasticity in the adult brain occurs following input loss, for example, following amputation, whereby the deprived zone is “invaded” by new representations. Although it has long been assumed that such reorganization leads to functional benefits for the invading representation, the behavioral evidence is controversial. Here, we investigate whether a temporary period of somatosensory input loss to one finger, induced by anesthetic block, is sufficient to cause improvements in touch perception (“direct” effects of deafferentation). Further, we determine whether this deprivation can improve touch perception by enhancing sensory learning processes, for example, by training (“interactive” effects). Importantly, we explore whether direct and interactive effects of deprivation are dissociable by directly comparing their effects on touch perception. Using psychophysical thresholds, we found brief deprivation alone caused improvements in tactile perception of a finger adjacent to the blocked finger but not to non-neighboring fingers. Two additional groups underwent minimal tactile training to one finger either during anesthetic block of the neighboring finger or a sham block with saline. Deprivation significantly enhanced the effects of tactile perceptual training, causing greater learning transfer compared with sham block. That is, following deafferentation and training, learning gains were seen in fingers normally outside the boundaries of topographic transfer of tactile perceptual learning. Our results demonstrate that sensory deprivation can improve perceptual abilities, both directly and interactively, when combined with sensory learning. This dissociation provides novel opportunities for future clinical interventions to improve sensation.

Perceptual Function and Category-Selective Neural Organization in Children with Resections of Visual Cortex

The consequences of cortical resection, a treatment for humans with pharmaco-resistant epilepsy, provide a unique opportunity to advance our understanding of the nature and extent of cortical (re)organization. Despite the importance of visual processing in daily life, the neural and perceptual sequellae of occipitotemporal resections remain largely unexplored. Using psychophysical and fMRI investigations, we compared the neural and visuoperceptual profiles of 10 children or adolescents following unilateral cortical resections and their age- and gender-matched controls. Dramatically, with the exception of two individuals, both of whom had relatively greater cortical alterations, all patients showed normal perceptual performance on tasks of intermediate- and high-level vision, including face and object recognition. Consistently, again with the exception of the same two individuals, both univariate and multivariate fMRI analyses revealed normal selectivity and representational structure of category-selective regions. Furthermore, the spatial organization of category-selective regions obeyed the typical medial-to-lateral topographic organization albeit unilaterally in the structurally preserved hemisphere rather than bilaterally. These findings offer novel insights into the malleability of cortex in the pediatric population and suggest that, although experience may be necessary for the emergence of neural category-selectivity, this emergence is not necessarily contingent on the integrity of particular cortical structures.SIGNIFICANCE STATEMENT One approach to reduce seizure activity in patients with pharmaco-resistant epilepsy involves the resection of the epileptogenic focus. The impact of these resections on the perceptual behaviors and organization of visual cortex remain largely unexplored. Here, we characterized the visuoperceptual and neural profiles of ventral visual cortex in a relatively large sample of post-resection pediatric patients. Two major findings emerged. First, most patients exhibited preserved visuoperceptual performance across a wide-range of visual behaviors. Second, normal topography, magnitude, and representational structure of category-selective organization were uncovered in the spared hemisphere. These comprehensive imaging and behavioral investigations uncovered novel evidence concerning the neural representations and visual functions in children who have undergone cortical resection, and have implications for cortical plasticity more generally.

Longitudinal Evidence for Increased Functional Response in Frontal Cortex for Older Adults with Hippocampal Atrophy and Memory Decline

The functional organization of the frontal cortex is dynamic. Age-related increases in frontal functional responses have been shown during various cognitive tasks, but the cross-sectional nature of most past studies makes it unclear whether these increases reflect reorganization or stable individual differences. Here, we followed 130 older individuals' cognitive trajectories over 20-25 years with repeated neuropsychological assessments every 5th year, and identified individuals with stable or declining episodic memory. Both groups displayed significant gray matter atrophy over 2 successive magnetic resonance imaging sessions 4 years apart, but the decline group also had a smaller volume of the right hippocampus. Only individuals with declining memory demonstrated increased prefrontal functional responses during memory encoding and retrieval over the 4-year interval. Regions with increased functional recruitment were located outside, or on the borders of core task-related networks, indicating an expansion of these over time. These longitudinal findings offer novel insight into the mechanisms behind age-associated memory loss, and are consistent with a theoretical model in which hippocampus atrophy, past a critical threshold, induces episodic-memory decline and altered prefrontal functional organization.

Improving cognitive training for schizophrenia using neuroplasticity enhancers: Lessons from decades of basic and clinical research

Mounting evidence indicates that schizophrenia is a disorder that stems from maladaptive plasticity within neural circuits and produces broad cognitive deficits leading to loss of autonomy. A large number of studies have identified abnormalities spanning many neurotransmitter systems in schizophrenia, and as a result, a variety of drugs have been developed to attempt to treat these abnormalities and enhance cognition. Unfortunately, positive results have been limited so far. This may be in part because the scope of abnormalities in the schizophrenic brain requires a treatment capable of engaging many different neurotransmitter systems. One approach to achieving this kind of treatment has been to use neuroplasticity-based computerized cognitive training programs to stimulate the formation of more adaptive circuits. Although the number of studies implementing this approach has increased exponentially in recent years, effect sizes for cognitive gains have been modest and adherence to treatment remains an important challenge in many studies, as patients are often required to train for 40 h or more. In the present paper, we argue that cognitive training protocols will benefit from the addition of cognitive enhancers to produce more robust and longer lasting targeted neuroplasticity. Indeed, recent data from animal studies have provided support for combining plasticity-enhancing drugs with tailored behavioral training paradigms to restore normal function within dysfunctioning neural circuits. The advantages and challenges of applying this approach to patients with schizophrenia will be discussed.

Ubiquitous Neocortical Decoding of Tactile Input Patterns

Whereas functional localization historically has been a key concept in neuroscience, direct neuronal recordings show that input of a particular modality can be recorded well outside its primary receiving areas in the neocortex. Here, we wanted to explore if such spatially unbounded inputs potentially contain any information about the quality of the input received. We utilized a recently introduced approach to study the neuronal decoding capacity at a high resolution by delivering a set of electrical, highly reproducible spatiotemporal tactile afferent activation patterns to the skin of the contralateral second digit of the forepaw of the anesthetized rat. Surprisingly, we found that neurons in all areas recorded from, across all cortical depths tested, could decode the tactile input patterns, including neurons of the primary visual cortex. Within both somatosensory and visual cortical areas, the combined decoding accuracy of a population of neurons was higher than for the best performing single neuron within the respective area. Such cooperative decoding indicates that not only did individual neurons decode the input, they also did so by generating responses with different temporal profiles compared to other neurons, which suggests that each neuron could have unique contributions to the tactile information processing. These findings suggest that tactile processing in principle could be globally distributed in the neocortex, possibly for comparison with internal expectations and disambiguation processes relying on other modalities.

Neuroplasticity of Language Networks in Aphasia: Advances, Updates, and Future Challenges

Researchers have sought to understand how language is processed in the brain, how brain damage affects language abilities, and what can be expected during the recovery period since the early 19th century. In this review, we first discuss mechanisms of damage and plasticity in the post-stroke brain, both in the acute and the chronic phase of recovery. We then review factors that are associated with recovery. First, we review organism intrinsic variables such as age, lesion volume and location and structural integrity that influence language recovery. Next, we review organism extrinsic factors such as treatment that influence language recovery. Here, we discuss recent advances in our understanding of language recovery and highlight recent work that emphasizes a network perspective of language recovery. Finally, we propose our interpretation of the principles of neuroplasticity, originally proposed by Kleim and Jones (1) in the context of extant literature in aphasia recovery and rehabilitation. Ultimately, we encourage researchers to propose sophisticated intervention studies that bring us closer to the goal of providing precision treatment for patients with aphasia and a better understanding of the neural mechanisms that underlie successful neuroplasticity.

Targeted Vagus Nerve Stimulation for Rehabilitation After Stroke

Stroke is a leading cause of disability worldwide, and in approximately 60% of individuals, upper limb deficits persist 6 months after stroke. These deficits adversely affect the functional use of the upper limb and restrict participation in day to day activities. An important goal of stroke rehabilitation is to improve the quality of life by enhancing functional independence and participation in activities. Since upper limb deficits are one of the best predictors of quality of life after stroke, effective interventions targeting these deficits may represent a means to improve quality of life. An increased understanding of the neurobiological processes underlying stroke recovery has led to the development of targeted approaches to improve motor deficits. One such targeted strategy uses brief bursts of Vagus Nerve Stimulation (VNS) paired with rehabilitation to enhance plasticity and support recovery of upper limb function after chronic stroke. Stimulation of the vagus nerve triggers release of plasticity promoting neuromodulators, such as acetylcholine and norepinephrine, throughout the cortex. Timed engagement of neuromodulators concurrent with motor training drives task-specific plasticity in the motor cortex to improve function and provides the basis for paired VNS therapy. A number of studies in preclinical models of ischemic stroke demonstrated that VNS paired with rehabilitative training significantly improved the recovery of forelimb motor function compared to rehabilitative training without VNS. The improvements were associated with synaptic reorganization of cortical motor networks and recruitment of residual motor neurons controlling the impaired forelimb, demonstrating the putative neurobiological mechanisms underlying recovery of motor function. These preclinical studies provided the basis for conducting two multi-site, randomized controlled pilot trials in individuals with moderate to severe upper limb weakness after chronic ischemic stroke. In both studies, VNS paired with rehabilitation improved motor deficits compared to rehabilitation alone. The trials provided support for a 120-patient pivotal study designed to evaluate the efficacy of paired VNS therapy in individuals with chronic ischemic stroke. This manuscript will discuss the neurobiological rationale for VNS therapy, provide an in-depth discussion of both animal and human studies of VNS therapy for stroke, and outline the challenges and opportunities for the future use of VNS therapy.

Optogenetic Stimulation Enhanced Neuronal Plasticities in Motor Recovery after Ischemic Stroke

Motor capability recovery after ischemic stroke involves dynamic remodeling processes of neural connectomes in the nervous system. Various neuromodulatory strategies combining direct stimulating interventions with behavioral trainings for motor recovery after ischemic stroke have been developed. However, the effectiveness of these interventions varies widely due to unspecific activation or inhibition of undefined neuronal subtypes. Optogenetics is a functional and structural connection-based approach that can selectively activate or inhibit specific subtype neurons with a higher precision, and it has been widely applied to build up neuronal plasticities of the nervous system, which shows a great potential in restoring motor functions in stroke animal models. Here, we reviewed neurobiological mechanisms of enhanced brain plasticities underlying motor recovery through the optogenetic stimulation after ischemic stroke. Several brain sites and neural circuits that have been previously proven effective for motor function rehabilitation were identified, which would be helpful for a more schematic understanding of effective neuronal connectomes in the motor function recovery after ischemic stroke.

Visual cortex recruitment during language processing in blind individuals is explained by Hebbian learning

In blind people, the visual cortex takes on higher cognitive functions, including language. Why this functional reorganisation mechanistically emerges at the neuronal circuit level is still unclear. Here, we use a biologically constrained network model implementing features of anatomical structure, neurophysiological function and connectivity of fronto-temporal-occipital areas to simulate word-meaning acquisition in visually deprived and undeprived brains. We observed that, only under visual deprivation, distributed word-related neural circuits 'grew into' the deprived visual areas, which therefore adopted a linguistic-semantic role. Three factors are crucial for explaining this deprivation-related growth: changes in the network's activity balance brought about by the absence of uncorrelated sensory input, the connectivity structure of the network, and Hebbian correlation learning. In addition, the blind model revealed long-lasting spiking neural activity compared to the sighted model during word recognition, which is a neural correlate of enhanced verbal working memory. The present neurocomputational model offers a neurobiological account for neural changes following sensory deprivation, thus closing the gap between cellular-level mechanisms, system-level linguistic and semantic function.

Cortical Reorganization of Peripheral Vision Induced by Simulated Central Vision Loss

When one's central vision is deprived, a spared part of the peripheral retina acts as a pseudofovea for fixation. The neural mechanisms underlying this compensatory adjustment remain unclear. Here we report cortical reorganization induced by simulated central vision loss. Human subjects of both sexes learned to place the target at an eccentric retinal locus outside their blocked visual field for object tracking. Before and after training, we measured visual crowding-a bottleneck of object identification in peripheral vision, using psychophysics and fMRI. We found that training led to an axis-specific reduction of crowding. The change of the crowding effect was reflected in the change of BOLD signal, as a release of cortical suppression in multiple visual areas starting as early as V1. Our findings suggest that the adult visual system is capable of reshaping its oculomotor control and sensory coding to adapt to impoverished visual input.SIGNIFICANCE STATEMENT By simulating central vision loss in normally sighted adults, we found that oculomotor training not only induces PRL, but also facilitates form processing in peripheral vision. As subjects learned to place the target at an eccentric retinal locus, "visual crowding"-the detrimental effect of clutter on peripheral object identification-was reduced. The reduction of the crowding effect was accompanied by a release of response suppression in the visual cortex. These findings indicate that the adult visual system is capable of reshaping the peripheral vision to adapt to central vision loss.

Motion-Induced Scotoma

We investigated artificial scotomas created when a moving object instantaneously crossed a gap, jumping ahead and continuing its otherwise smooth motion. Gaps of up to 5.1 degrees of visual angle, presented at 18° eccentricity, either closed completely or appeared much shorter than when the same gap was crossed by two-point apparent motion, or crossed more slowly, mimicking occlusion. Prolonged exposure to motion trajectories with a gap in most cases led to further shrinking of the gap. The same gap-shrinking effect has previously been observed in touch. In both sensory modalities, it implicates facilitation among codirectional local motion detectors and motion neurons with receptive fields larger than the gap. Unlike stimuli that simply deprive a receptor surface of input, suggesting it is insentient, our motion pattern skips a section in a manner that suggests a portion of the receptor surface has been excised, and the remaining portions stitched back together. This makes it a potentially useful tool in the experimental study of plasticity in sensory maps.

Selective Strengthening of Intracortical Excitatory Input Leads to Receptive Field Refinement during Auditory Cortical Development

In the primary auditory cortex (A1) of rats, refinement of excitatory input to layer (L)4 neurons contributes to the sharpening of their frequency selectivity during postnatal development. L4 neurons receive both feedforward thalamocortical and recurrent intracortical inputs, but how potential developmental changes of each component can account for the sharpening of excitatory input tuning remains unclear. By combining in vivo whole-cell recording and pharmacological silencing of cortical spiking in young rats of both sexes, we examined developmental changes at three hierarchical stages: output of auditory thalamic neurons, thalamocortical input and recurrent excitatory input to an A1 L4 neuron. In the thalamus, the tonotopic map matured with an expanded range of frequency representations, while the frequency tuning of output responses was unchanged. On the other hand, the tuning shape of both thalamocortical and intracortical excitatory inputs to a L4 neuron became sharpened. In particular, the intracortical input became better tuned than thalamocortical excitation. Moreover, the weight of intracortical excitation around the optimal frequency was selectively strengthened, resulting in a dominant role of intracortical excitation in defining the total excitatory input tuning. Our modeling work further demonstrates that the frequency-selective strengthening of local recurrent excitatory connections plays a major role in the refinement of excitatory input tuning of L4 neurons.SIGNIFICANCE STATEMENT During postnatal development, sensory cortex undergoes functional refinement, through which the size of sensory receptive field is reduced. In the rat primary auditory cortex, such refinement in layer (L)4 is mainly attributed to improved selectivity of excitatory input a L4 neuron receives. In this study, we further examined three stages along the hierarchical neural pathway where excitatory input refinement might occur. We found that developmental refinement takes place at both thalamocortical and intracortical circuit levels, but not at the thalamic output level. Together with modeling results, we revealed that the optimal-frequency-selective strengthening of intracortical excitation plays a dominant role in the refinement of excitatory input tuning.

Age-dependent differences in learning to control a robot arm using a body-machine interface

Body-machine interfaces, i.e. interfaces that rely on body movements to control external assistive devices, have been proposed as a safe and robust means of achieving movement and mobility; however, how children learn these novel interfaces is poorly understood. Here we characterized the learning of a body-machine interface in young unimpaired adults, two groups of typically developing children (9-year and 12-year olds), and one child with congenital limb deficiency. Participants had to control the end-effector of a robot arm in 2D using movements of the shoulder and torso. Results showed a striking effect of age - children had much greater difficulty in learning the task compared to adults, with a majority of the 9-year old group unable to even complete the task. The 12-year olds also showed poorer task performance compared to adults (as measured by longer movement times and greater path lengths), which were associated with less effective search strategies. The child with congenital limb deficiency showed superior task performance compared to age-matched children, but had qualitatively distinct coordination strategies from the adults. Taken together, these results imply that children have difficulty learning non-intuitive interfaces and that the design of body-machine interfaces should account for these differences in pediatric populations.

Sensory-targeted cognitive training for schizophrenia

INTRODUCTION

Auditory and visual dysfunctions are key pathophysiological features of schizophrenia (Sz). Therefore, remedial interventions that directly target such impairments could potentially drive gains in higher-order cognition (e.g., memory, executive functions, emotion processing), symptoms and functional outcome, in addition to improving sensory abilities in this population. Here, we reviewed available sensory-targeted cognitive training (S-TCT) programs that were investigated so far in Sz patients. Area covered: A systematic review of the literature was conducted following PRISMA guidelines. Twenty-seven relevant records were included. The superiority of S-TCT over control conditions on higher-order cognition measures was repeatedly demonstrated, but mostly lost significance at later endpoints of evaluation. Clinical symptoms and functional outcome were improved in a minority of studies. S-TCT interventions were associated with the relative normalization of several neurobiological biomarkers of neuroplasticity and sensory mechanisms. Expert commentary: S-TCT, although time-intensive, is a cost-efficient, safe and promising technique for Sz treatment. Its efficacy on higher-order cognition opens a critical window for clinical and functional improvement. The biological impact of S-TCT may allow for the identification of therapeutic biomarkers to further precision-medicine. Additional research is required to investigate the long-term effects of S-TCT, optimal training parameters and potential confounding factors associated with the illness.

Neurod1 Is Essential for the Primary Tonotopic Organization and Related Auditory Information Processing in the Midbrain

Hearing depends on extracting frequency, intensity, and temporal properties from sound to generate an auditory map for acoustical signal processing. How physiology intersects with molecular specification to fine tune the developing properties of the auditory system that enable these aspects remains unclear. We made a novel conditional deletion model that eliminates the transcription factor NEUROD1 exclusively in the ear. These mice (both sexes) develop a truncated frequency range with no neuroanatomically recognizable mapping of spiral ganglion neurons onto distinct locations in the cochlea nor a cochleotopic map presenting topographically discrete projections to the cochlear nuclei. The disorganized primary cochleotopic map alters tuning properties of the inferior colliculus units, which display abnormal frequency, intensity, and temporal sound coding. At the behavioral level, animals show alterations in the acoustic startle response, consistent with altered neuroanatomical and physiological properties. We demonstrate that absence of the primary afferent topology during embryonic development leads to dysfunctional tonotopy of the auditory system. Such effects have never been investigated in other sensory systems because of the lack of comparable single gene mutation models.SIGNIFICANCE STATEMENT All sensory systems form a topographical map of neuronal projections from peripheral sensory organs to the brain. Neuronal projections in the auditory pathway are cochleotopically organized, providing a tonotopic map of sound frequencies. Primary sensory maps typically arise by molecular cues, requiring physiological refinements. Past work has demonstrated physiologic plasticity in many senses without ever molecularly undoing the specific mapping of an entire primary sensory projection. We genetically manipulated primary auditory neurons to generate a scrambled cochleotopic projection. Eliminating tonotopic representation to auditory nuclei demonstrates the inability of physiological processes to restore a tonotopic presentation of sound in the midbrain. Our data provide the first insights into the limits of physiology-mediated brainstem plasticity during the development of the auditory system.

When pain gets stuck: the evolution of pain chronification and treatment resistance

It is well-recognized that, despite similar pain characteristics, some people with chronic pain recover, whereas others do not. In this review, we discuss possible contributions and interactions of biological, social, and psychological perturbations that underlie the evolution of treatment-resistant chronic pain. Behavior and brain are intimately implicated in the production and maintenance of perception. Our understandings of potential mechanisms that produce or exacerbate persistent pain remain relatively unclear. We provide an overview of these interactions and how differences in relative contribution of dimensions such as stress, age, genetics, environment, and immune responsivity may produce different risk profiles for disease development, pain severity, and chronicity. We propose the concept of "stickiness" as a soubriquet for capturing the multiple influences on the persistence of pain and pain behavior, and their stubborn resistance to therapeutic intervention. We then focus on the neurobiology of reward and aversion to address how alterations in synaptic complexity, neural networks, and systems (eg, opioidergic and dopaminergic) may contribute to pain stickiness. Finally, we propose an integration of the neurobiological with what is known about environmental and social demands on pain behavior and explore treatment approaches based on the nature of the individual's vulnerability to or protection from allostatic load.

Increased Excitability Induced in the Primary Motor Cortex by Transcranial Ultrasound Stimulation

Background: Transcranial Ultrasound Stimulation (tUS) is an emerging technique that uses ultrasonic waves to noninvasively modulate brain activity. As with other forms of non-invasive brain stimulation (NIBS), tUS may be useful for altering cortical excitability and neuroplasticity for a variety of research and clinical applications. The effects of tUS on cortical excitability are still unclear, and further complications arise from the wide parameter space offered by various types of devices, transducer arrangements, and stimulation protocols. Diagnostic ultrasound imaging devices are safe, commonly available systems that may be useful for tUS. However, the feasibility of modifying brain activity with diagnostic tUS is currently unknown. Objective: We aimed to examine the effects of a commercial diagnostic tUS device using an imaging protocol on cortical excitability. We hypothesized that imaging tUS applied to motor cortex could induce changes in cortical excitability as measured using a transcranial magnetic stimulation (TMS) motor evoked potential (MEP) paradigm. Methods: Forty-three subjects were assigned to receive either verum (n = 21) or sham (n = 22) diagnostic tUS in a single-blind design. Baseline motor cortex excitability was measured using MEPs elicited by TMS. Diagnostic tUS was subsequently administered to the same cortical area for 2 min, immediately followed by repeated post-stimulation MEPs recorded up to 16 min post-stimulation. Results: Verum tUS increased excitability in the motor cortex (from baseline) by 33.7% immediately following tUS (p = 0.009), and 32.4% (p = 0.047) 6 min later, with excitability no longer significantly different from baseline by 11 min post-stimulation. By contrast, subjects receiving sham tUS showed no significant changes in MEP amplitude. Conclusion: These findings demonstrate that tUS delivered via a commercially available diagnostic imaging ultrasound system transiently increases excitability in the motor cortex as measured by MEPs. Diagnostic tUS devices are currently used for internal imaging in many health care settings, and the present results suggest that these same devices may also offer a promising tool for noninvasively modulating activity in the central nervous system. Further studies exploring the use of diagnostic imaging devices for neuromodulation are warranted.

Visual search task immediate training effects on task-related functional connectivity

Brain plasticity occurs over the course of the human lifetime. Learning and training modify our neuronal synapses and adapt our brain activity, from priming effects in modal areas to higher-order changes in the association cortex. The current state of the art suggests that learning and training effects might induce large-scale brain connectivity changes. Here, we used task-fMRI data and graph-based approaches to study the immediate brain changes in functional connections associated with training on a visual search task, and the individual differences in learning were studied by means of brain-behavior correlations. In a previous work, we found that trained participants improved their response speed on a visual search task by 31%, whereas the control group hardly changed. In the present study, we showed that trained individuals changed regional connections (local links) in cortical areas devoted to the specific visual search processes and to areas that support information integration, and largely modified distributed connections (distant links) linking primary visual areas to specific attentional and cognitive control areas. In addition, we found that the individuals with the most enhanced connectivity in the dorsolateral prefrontal cortex performed the task faster after training. The observed behavioral and brain connectivity findings expand our understanding of large-scale dynamic readjustment of the human brain after learning experiences.

Rejuvenation of plasticity in the brain: opening the critical period

Cortical circuits are particularly sensitive to incoming sensory information during well-defined intervals of postnatal development called 'critical periods'. The critical period for cortical plasticity closes in adults, thus restricting the brain's ability to indiscriminately store new sensory information. For example, children acquire language in an exposure-based manner, whereas learning language in adulthood requires more effort and attention. It has been suggested that pairing sounds with the activation of neuromodulatory circuits involved in attention reopens this critical period. Here, we review two critical period hypotheses related to neuromodulation: cortical disinhibition and thalamic adenosine. We posit that these mechanisms co-regulate the critical period for auditory cortical plasticity. We also discuss ways to reopen this period and rejuvenate cortical plasticity in adults.

Altered connectivity patterns among resting state networks in patients with ischemic white matter lesions

White matter lesions (WMLs) have been associated with cognitive and motor decline. Resting state networks (RSNs) are spatially coherent patterns in the human brain and their interactions sustain our daily function. Therefore, investigating the altered intra- and inter-network connectivity among the RSNs may help to understand the association of WMLs with impaired cognitive and motor function. Here, we assessed alterations in functional connectivity patterns based on six well-defined RSNs-the default mode network (DMN), dorsal attention network (DAN), frontal-parietal control network (FPCN), auditory network (AN), sensory motor network (SMN) and visual network (VN)-in 15 patients with ischemic WMLs and 15 controls. In the patients, Spearman's correlation analysis was further performed between these alterations and cognitive test scores, including Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores. Our results showed wide alterations of inter-network connectivity mainly involving the SMN, DMN, FPCN and DAN, and some alterations correlated with cognitive test scores in the patients. The reduced functional connectivities in the SMN-AN, SMN-VN, FPCN-AN, DAN-VN pairs may account for the cognitive and motor decline in patients with ischemic WMLs, while the increased functional connectivities in the DMN-AN, DMN-FPCN and DAN-FPCN pairs may reflect a functional network reorganization after damage to white matter. It is unexpected that altered intra-network connectivities were found within the AN and VN, which may explain the impairments in verbal fluency and information retrieval associated with WMLs. This study highlights the importance of functional connectivity in understanding how WMLs influence cognitive and behavior dysfunction.

Functional Relevance of Endocannabinoid-Dependent Synaptic Plasticity in the Central Nervous System

The endocannabinoid (eCB) signaling system plays a key role in short-term and long-term synaptic plasticity in brain regions involved in various neural functions ranging from action selection to appetite control. This review will explore the role of eCBs in shaping neural circuit function to regulate behaviors. In particular, we will discuss the behavioral consequences of eCB mediated long-term synaptic plasticity in different brain regions. This review brings together evidence from in vitro and ex vivo studies and points out the need for more in vivo studies.

Conditioning sharpens the spatial representation of rewarded stimuli in mouse primary visual cortex

Reward is often employed as reinforcement in behavioral paradigms but it is unclear how the visuospatial aspect of a stimulus-reward association affects the cortical representation of visual space. Using a head-fixed paradigm, we conditioned mice to associate the same visual pattern in adjacent retinotopic regions with availability and absence of reward. Time-lapse intrinsic optical signal imaging under anesthesia showed that conditioning increased the spatial separation of mesoscale cortical representations of reward predicting- and non-reward predicting stimuli. Subsequent in vivo two-photon calcium imaging revealed that this improved separation correlated with enhanced population coding for retinotopic location, specifically for the trained orientation and spatially confined to the V1 region where rewarded and non-rewarded stimulus representations bordered. These results are corroborated by conditioning-induced differences in the correlation structure of population activity. Thus, the cortical representation of visual space is sharpened as consequence of associative stimulus-reward learning while the overall retinotopic map remains unaltered.

Development and validation of Cognitive Training Intervention for Alzheimer's disease (CTI-AD): A picture-based interventional program

Introduction

Alzheimer’s disease is a gradual and progressive disorder which cripples the person’s functionality due to cognitive decline. Many clinicopathological and pharmacological therapy has the potential to slow down the progression of the disease but has limited efficacy. One complimentary approach that has emerged is cognitive training interventions which have shown synergistic effect with the drug therapy. Nevertheless, many cognitive interventions lack on specificities of the intervention due to which its efficacy gets scrutinized.

Objective

To describe the foundation, content, and development of Cognitive Training Intervention for Alzheimer’s disease (CTI-AD) along with the treatment feasibility based on a pilot study.

Materials and methods

A culture-specific picture-based eight weeks cognitive training manual was developed based on extensive review and focused group discussions. It was standardized on 63 older participants (48 healthy controls (HC); 15 early Alzheimer’s disease cases).

Results

All the tasks were progressive in nature and were found effective in discriminating the cognitive performance of early Alzheimer’s disease and HC throughout the intervention period. Moreover, it also improved early Alzheimer’s disease performance on the memory (HC: 1st week/8th week = 21.6 ± 5.7/57.3 ± 19.0; early Alzheimer’s disease: 1st week/8th week = 48.5 ± 22.9/60.5 ± 21.8); attention (HC: 1st week/8th week = 90.2 ± 18.0/196.9 ± 28.0; early Alzheimer’s disease: 1st week/8th week = 216.6 ± 78.2/286.8 ± 87.0) and language (HC: 1st week/8th week = 29.8 ± 9.4/115.3 ± 31.1; early Alzheimer’s disease: 1st week/8th week = 211.8 ± 68.4/270.4 ± 104.9) domains, respectively, from the baseline level.

Conclusion

The current manual (CTI-AD) is one of the first promising non-pharmacological program developed nationally with a strong theoretical base to cater to the tertiary needs of the older adults with early Alzheimer’s disease.

Infant brain responses to felt and observed touch of hands and feet: an MEG study

There is growing interest concerning the ways in which the human body, both one's own and that of others, is represented in the developing human brain. In two experiments with 7-month-old infants, we employed advances in infant magnetoencephalography (MEG) brain imaging to address novel questions concerning body representations in early development. Experiment 1 evaluated the spatiotemporal organization of infants' brain responses to being touched. A punctate touch to infants' hands and feet produced significant activation in the hand and foot areas of contralateral primary somatosensory cortex as well as in other parietal and frontal areas. Experiment 2 explored infant brain responses to visually perceiving another person's hand or foot being touched. Results showed significant activation in early visual regions and also in regions thought to be involved in multisensory body and self-other processing. Furthermore, observed touch of the hand and foot activated the infant's own primary somatosensory cortex, although less consistently than felt touch. These findings shed light on aspects of early social cognition, including action imitation, which may build, at least in part, on infant neural representations that map equivalences between the bodies of self and other.

Effects of Temporary Functional Deafferentation in Chronic Stroke Patients: Who Profits More?

Temporary functional deafferentation (TFD) by an anesthetic cream on the stroke-affected forearm was shown to improve sensorimotor abilities of stroke patients. The present study investigated different predictors for sensorimotor improvements during TFD and indicated outcome differences between patients grouped in subcortical lesions only and lesions with any cortical involvement. Thirty-four chronic stroke patients were temporarily deafferented on the more affected forearm by an anesthetic cream. Somatosensory performance was assessed using von Frey Hair and grating orientation task; motor performance was assessed by a shape-sorter-drum task. Seven potential predictors were entered into three linear multiple regression models. Furthermore, effects of TFD on outcome variables for the two groups (cortical versus subcortical lesion) were compared. Sex and sensory deficit were significant predictors for changes in motor function while age accounted for changes in grating orienting task. Males, patients with a stronger sensory deficit, and older patients profited more. None of the potential predictors made significant contributions to changes in threshold for touch. Furthermore, there were no differences in sensorimotor improvement between lesion site groups. The effects of TFD together with the low predictability of the investigated parameters suggest that characteristics of patients alone are not suitable to exclude some patients from TFD.

Beyond Rehabilitation of Acuity, Ocular Alignment, and Binocularity in Infantile Strabismus

Infantile strabismus impairs the perception of all attributes of the visual scene. High spatial frequency components are no longer visible, leading to amblyopia. Binocularity is altered, leading to the loss of stereopsis. Spatial perception is impaired as well as detection of vertical orientation, the fastest movements, directions of movement, the highest contrasts and colors. Infantile strabismus also affects other vision-dependent processes such as control of postural stability. But presently, rehabilitative therapies for infantile strabismus by ophthalmologists, orthoptists and optometrists are restricted to preventing or curing amblyopia of the deviated eye, aligning the eyes and, whenever possible, preserving or restoring binocular vision during the critical period of development, i.e., before ~10 years of age. All the other impairments are thus ignored; whether they may recover after strabismus treatment even remains unknown. We argue here that medical and paramedical professionals may extend their present treatments of the perceptual losses associated with infantile strabismus. This hypothesis is based on findings from fundamental research on visual system organization of higher mammals in particular at the cortical level. In strabismic subjects (as in normal-seeing ones), information about all of the visual attributes converge, interact and are thus inter-dependent at multiple levels of encoding ranging from the single neuron to neuronal assemblies in visual cortex. Thus if the perception of one attribute is restored this may help to rehabilitate the perception of other attributes. Concomitantly, vision-dependent processes may also improve. This could occur spontaneously, but still should be assessed and validated. If not, medical and paramedical staff, in collaboration with neuroscientists, will have to break new ground in the field of therapies to help reorganize brain circuitry and promote more comprehensive functional recovery. Findings from fundamental research studies in both young and adult patients already support our hypothesis and are reviewed here. For example, presenting different contrasts to each eye of a strabismic patient during training sessions facilitates recovery of acuity in the amblyopic eye as well as of 3D perception. Recent data also demonstrate that visual recoveries in strabismic subjects improve postural stability. These findings form the basis for a roadmap for future research and clinical development to extend presently applied rehabilitative therapies for infantile strabismus.

Mental Imagery Follows Similar Cortical Reorganization as Perception: Intra-Modal and Cross-Modal Plasticity in Congenitally Blind

Cortical plasticity in congenitally blind individuals leads to cross-modal activation of the visual cortex and may lead to superior perceptual processing in the intact sensory domains. Although mental imagery is often defined as a quasi-perceptual experience, it is unknown whether it follows similar cortical reorganization as perception in blind individuals. In this study, we show that auditory versus tactile perception evokes similar intra-modal discriminative patterns in congenitally blind compared with sighted participants. These results indicate that cortical plasticity following visual deprivation does not influence broad intra-modal organization of auditory and tactile perception as measured by our task. Furthermore, not only the blind, but also the sighted participants showed cross-modal discriminative patterns for perception modality in the visual cortex. During mental imagery, both groups showed similar decoding accuracies for imagery modality in the intra-modal primary sensory cortices. However, no cross-modal discriminative information for imagery modality was found in early visual cortex of blind participants, in contrast to the sighted participants. We did find evidence of cross-modal activation of higher visual areas in blind participants, including the representation of specific-imagined auditory features in visual area V4.

Neural Correlates of Consciousness Meet the Theory of Identity

One of the greatest challenges of consciousness research is to understand the relationship between consciousness and its implementing substrate. Current research into the neural correlates of consciousness regards the biological brain as being this substrate, but largely fails to clarify the nature of the brain-consciousness connection. A popular approach within this research is to construe brain-consciousness correlations in causal terms: the neural correlates of consciousness are the causes of states of consciousness. After introducing the notion of the neural correlate of consciousness, we argue (see Against Causal Accounts of NCCs) that this causal strategy is misguided. It implicitly involves an undesirable dualism of matter and mind and should thus be avoided. A non-causal account of the brain-mind correlations is to be preferred. We favor the theory of the identity of mind and brain, according to which states of phenomenal consciousness are identical with their neural correlates. Research into the neural correlates of consciousness and the theory of identity (in the philosophy of mind) are two major research paradigms that hitherto have had very little mutual contact. We aim to demonstrate that they can enrich each other. This is the task of the third part of the paper in which we show that the identity theory must work with a suitably defined concept of type. Surprisingly, neither philosophers nor neuroscientists have taken much care in defining this central concept; more often than not, the term is used only implicitly and vaguely. We attempt to open a debate on this subject and remedy this unhappy state of affairs, proposing a tentative hierarchical classification of phenomenal and neurophysiological types, spanning multiple levels of varying degrees of generality. The fourth part of the paper compares the theory of identity with other prominent conceptions of the mind-body connection. We conclude by stressing that scientists working on consciousness should engage more with metaphysical issues concerning the relation of brain processes and states of consciousness. Without this, the ultimate goals of consciousness research can hardly be fulfilled.

Adding electrical stimulation during standard rehabilitation after stroke to improve motor function. A systematic review and meta-analysis

BACKGROUND

Clinical studies have shown that sensory input improves motor function when added to active training after neurological injuries in the spinal cord.

OBJECTIVE

We aimed to determine the effect on motor function of extremities of adding an electrical sensory modality without motor recruitment before or with routine rehabilitation for hemiparesis after stroke by a comprehensive systematic review and meta-analysis.

METHODS

We searched databases including MEDLINE via PubMed and the Cochrane Central Register of Controlled Trials from 1978 to the end of November 2017 for reports of randomized controlled trials or controlled studies of patients with a clinical diagnosis of stroke who underwent 1) transcutaneous electrical nerve stimulation (TENS) or peripheral electromyography-triggered sensory stimulation over a peripheral nerve and associated muscles or 2) acupuncture to areas that produced sensory effects, without motor recruitment, along with routine rehabilitation. Outcome measures were motor impairment, activity, and participation outcomes defined by the International Classification of Functioning, Disability and Health.

RESULTS

The search yielded 11studies with data that could be included in a meta-analysis. Electrical sensory inputs, when paired with routine therapy, improved peak torque dorsiflexion (mean difference [MD] 2.44 Nm, 95% confidence interval [CI] 0.26-4.63). On subgroup analysis, the combined therapy yielded a significant difference in terms of sensory stimulation without motor recruitment only on the Timed Up and Go test in the chronic phase of stroke (MD 3.51sec, 95% CI 3.05-3.98). The spasticity score was reduced but not significantly (MD-0.83 points, 95% CI -1.77-0.10).

CONCLUSION

Electrical sensory input can contribute to routine rehabilitation to improve early post-stroke lower-extremity impairment and late motor function, with no change in spasticity. Prolonged periods of sensory stimulation such as TENS combined with activity can have beneficial effects on impairment and function after stroke.

Neural representations of the body in 60-day-old human infants

The organization of body representations in the adult brain has been well documented. Little is understood about this aspect of brain organization in human infancy. The current study employed electroencephalography (EEG) with 60-day-old infants to test the distribution of brain responses to tactile stimulation of three different body parts: hand, foot, and lip. Analyses focused on a prominent positive response occurring at 150-200 ms in the somatosensory evoked potential at central and parietal electrode sites. The results show differential electrophysiological signatures for touch of these three body parts. Stimulation of the left hand was associated with greater positive amplitude over the lateral central region contralateral to the side stimulated. Left foot stimulation was associated with greater positivity over the midline parietal site. Stimulation of the midline of the upper lip was associated with a strong bilateral response over the central region. These findings provide new insights into the neural representation of the body in infancy and shed light on research and theories about the involvement of somatosensory cortex in infant imitation and social perception.

Acute and long-lasting cortical thickness changes following intensive first-person action videogame practice

Recent evidence shows how an extensive gaming experience might positively impact cognitive and perceptual functioning, leading to brain structural changes observed in cross-sectional studies. Importantly, changes seem to be game-specific, reflecting gameplay styles and therefore opening to the possibility of tailoring videogames according to rehabilitation and enhancement purposes. However, whether if such brain effects can be induced even with limited gaming experience, and whether if they can outlast the gaming period, is still unknown. Here we quantified both cognitive and grey matter thickness changes following 15 daily gaming sessions based on a modified version of a 3D first-person shooter (FPS) played in laboratory settings. Twenty-nine healthy participants were randomly assigned to a control or a gaming group and underwent a cognitive assessment, an in-game performance evaluation and structural magnetic resonance imaging before (T0), immediately after (T1) and three months after the end of the experiment (T2). At T1, a significant increase in thickness of the bilateral parahippocampal cortex (PHC), somatosensory cortex (S1), superior parietal lobule (SPL) and right insula were observed. Changes in S1 matched the hand representation bilaterally, while PHC changes corresponded to the parahippocampal place area (PPA). Surprisingly, changes in thickness were still present at T2 for S1, PHC, SPL and right insula as compared to T0. Finally, surface-based regression identified the lingual gyrus as the best predictor of changes in game performance at T1. Results stress the specific impact of core game elements, such as spatial navigation and visuomotor coordination on structural brain properties, with effects outlasting even a short intensive gaming period.

CB1 Cannabinoid Receptor Expression in the Barrel Field Region Is Associated with Mouse Learning

We found previously that fear conditioning by combined stimulation of a row B facial vibrissae (conditioned stimulus, CS) with a tail shock (unconditioned stimulus, UCS) leads to expansion of the cortical representation of the "trained" row, labeled with 2-deoxyglucose (2DG), in the layer IIIb/IV of the adult mouse the primary somatosensory cortex (S1) 24 h later. We have observed that these learning-dependent plastic changes are manifested by increased expression of somatostatin, cholecystokinin (SST+, CCK+) but not parvalbumin (PV+) immunopositive interneurons We have expanded this research and quantified a numerical value of CB1-expressing and PV-expressing GABAergic axon terminals (CB1+ and PV+ immunopositive puncta) that innervate different segments of postsynaptic cells in the barrel hollows of S1 cortex. We used 3D microscopy to identify the CB+ and PV+ puncta in the barrel cortex "trained" and the control hemispheres CS+UCS group and in controls: Pseudoconditioned, CS-only, UCS-only, and naive animals. We have identified that (i) the association between whisker-shock "trained" barrel B hollows and CB1+, but not PV+ puncta expression remained significant after Bonferroni correction, (ii) CS+UCS has had a significant increasing effect on expression of CB1+ but not PV+ puncta in barrel cortex "trained" hemisphere, and (iii) the pseudoconditioning had a significant decreasing effect on expression of CB1+, but not on PV+ puncta in barrel cortex, both trained and untrained hemispheres. It is correlated to disturbing behaviors. The results suggest that CB1+ puncta regulation is specifically linked with mechanisms leading to learning-dependent plasticity in S1 cortex.

Cortical Plasticity After Surgical Tendon Transfer in Tetraplegics

Background: Developmental cortical plasticity with reorganization of cerebral cortex, has been known to occur in young and adult animals after permanent, restricted elimination of afferent (visual or somatosensory) input. In animals, cortical representation of unaffected muscles or sensory areas has been shown to invade the neighboring cortex when this is deprived of its normal sensory input or motor functions. Some studies indicate that similar cortical plasticity may take place in adult humans. Methods: In patients with a high cervical spinal cord injury leaving the patient without any movements of the fingers, we performed fMRI studies of the cortical representation of an elbow flexor muscle before and after a surgical procedure that changed its function to a thumb flexor, thus providing the patient with a useful grip. Results: Preoperatively, the elbow flexion movement was elicited from a cortical area corresponding with the "elbow area" in healthy individuals. Despite the fact that an elbow flexor was used for the post-operative key-grip, this movement in the tetraplegic patients was elicited from a similar brain region as in healthy controls (the "hand area"). This supports our hypothesis that control of that muscle shifts from a brain region typically associated with elbow movement, to one typically associated with wrist movements. Conclusion: The findings presented here show with fMRI that the human cortex is capable of reorganizing itself spatially after a relatively acute change in the periphery.

The search of "canonical" explanations for the cerebral cortex

This paper addresses a fundamental line of research in neuroscience: the identification of a putative neural processing core of the cerebral cortex, often claimed to be "canonical". This "canonical" core would be shared by the entire cortex, and would explain why it is so powerful and diversified in tasks and functions, yet so uniform in architecture. The purpose of this paper is to analyze the search for canonical explanations over the past 40 years, discussing the theoretical frameworks informing this research. It will highlight a bias that, in my opinion, has limited the success of this research project, that of overlooking the dimension of cortical development. The earliest explanation of the cerebral cortex as canonical was attempted by David Marr, deriving putative cortical circuits from general mathematical laws, loosely following a deductive-nomological account. Although Marr's theory turned out to be incorrect, one of its merits was to have put the issue of cortical circuit development at the top of his agenda. This aspect has been largely neglected in much of the research on canonical models that has followed. Models proposed in the 1980s were conceived as mechanistic. They identified a small number of components that interacted as a basic circuit, with each component defined as a function. More recent models have been presented as idealized canonical computations, distinct from mechanistic explanations, due to the lack of identifiable cortical components. Currently, the entire enterprise of coming up with a single canonical explanation has been criticized as being misguided, and the premise of the uniformity of the cortex has been strongly challenged. This debate is analyzed here. The legacy of the canonical circuit concept is reflected in both positive and negative ways in recent large-scale brain projects, such as the Human Brain Project. One positive aspect is that these projects might achieve the aim of producing detailed simulations of cortical electrical activity, a negative one regards whether they will be able to find ways of simulating how circuits actually develop.

A mechanism for spatial perception on human skin

Our perception of where touch occurs on our skin shapes our interactions with the world. Most accounts of cutaneous localisation emphasise spatial transformations from a skin-based reference frame into body-centred and external egocentric coordinates. We investigated another possible method of tactile localisation based on an intrinsic perception of 'skin space'. The arrangement of cutaneous receptive fields (RFs) could allow one to track a stimulus as it moves across the skin, similarly to the way animals navigate using path integration. We applied curved tactile motions to the hands of human volunteers. Participants identified the location midway between the start and end points of each motion path. Their bisection judgements were systematically biased towards the integrated motion path, consistent with the characteristic inward error that occurs in navigation by path integration. We thus showed that integration of continuous sensory inputs across several tactile RFs provides an intrinsic mechanism for spatial perception.