Discovering the somatotopic organization of the motor areas of the medial wall using low-frequency BOLD fluctuations

A dual larynx motor networks hypothesis

Humans are vocal modulators par excellence. This ability is supported in part by the dual representation of the laryngeal muscles in the motor cortex. Movement, however, is not the product of motor cortex alone but of a broader motor network. This network consists of brain regions that contain somatotopic maps that parallel the organization in motor cortex. We therefore present a novel hypothesis that the dual laryngeal representation is repeated throughout the broader motor network. In support of the hypothesis, we review existing literature that demonstrates the existence of network-wide somatotopy and present initial evidence for the hypothesis' plausibility. Understanding how this uniquely human phenotype in motor cortex interacts with broader brain networks is an important step toward understanding how humans evolved the ability to speak. We further suggest that this system may provide a means to study how individual components of the nervous system evolved within the context of neuronal networks. This article is part of the theme issue 'Voice modulation: from origin and mechanism to social impact (Part I)'.

Interhemispheric co-alteration of brain homotopic regions

Asymmetries in gray matter alterations raise important issues regarding the pathological co-alteration between hemispheres. Since homotopic areas are the most functionally connected sites between hemispheres and gray matter co-alterations depend on connectivity patterns, it is likely that this relationship might be mirrored in homologous interhemispheric co-altered areas. To explore this issue, we analyzed data of patients with Alzheimer’s disease, schizophrenia, bipolar disorder and depressive disorder from the BrainMap voxel-based morphometry database. We calculated a map showing the pathological homotopic anatomical co-alteration between homologous brain areas. This map was compared with the meta-analytic homotopic connectivity map obtained from the BrainMap functional database, so as to have a meta-analytic connectivity modeling map between homologous areas. We applied an empirical Bayesian technique so as to determine a directional pathological co-alteration on the basis of the possible tendencies in the conditional probability of being co-altered of homologous brain areas. Our analysis provides evidence that: the hemispheric homologous areas appear to be anatomically co-altered; this pathological co-alteration is similar to the pattern of connectivity exhibited by the couples of homologues; the probability to find alterations in the areas of the left hemisphere seems to be greater when their right homologues are also altered than vice versa, an intriguing asymmetry that deserves to be further investigated and explained.

Network-based brain computer interfaces: principles and applications

Brain-computer interfaces (BCIs) make possible to interact with the external environment by decoding the mental intention of individuals. BCIs can therefore be used to address basic neuroscience questions but also to unlock a variety of applications from exoskeleton control to neurofeedback (NFB) rehabilitation. In general, BCI usability critically depends on the ability to comprehensively characterize brain functioning and correctly identify the user's mental state. To this end, much of the efforts have focused on improving the classification algorithms taking into account localized brain activities as input features. Despite considerable improvement BCI performance is still unstable and, as a matter of fact, current features represent oversimplified descriptors of brain functioning. In the last decade, growing evidence has shown that the brain works as a networked system composed of multiple specialized and spatially distributed areas that dynamically integrate information. While more complex, looking at how remote brain regions functionally interact represents a grounded alternative to better describe brain functioning. Thanks to recent advances in network science, i.e. a modern field that draws on graph theory, statistical mechanics, data mining and inferential modelling, scientists have now powerful means to characterize complex brain networks derived from neuroimaging data. Notably, summary features can be extracted from these networks to quantitatively measure specific organizational properties across a variety of topological scales. In this topical review, we aim to provide the state-of-the-art supporting the development of a network theoretic approach as a promising tool for understanding BCIs and improve usability.

Functional parcellation of the hippocampus by semi-supervised clustering of resting state fMRI data

Many unsupervised methods are widely used for parcellating the brain. However, unsupervised methods aren’t able to integrate prior information, obtained from such as exiting functional neuroanatomy studies, to parcellate the brain, whereas the prior information guided semi-supervised method can generate more reliable brain parcellation. In this study, we propose a novel semi-supervised clustering method for parcellating the brain into spatially and functionally consistent parcels based on resting state functional magnetic resonance imaging (fMRI) data. Particularly, the prior supervised and spatial information is integrated into spectral clustering to achieve reliable brain parcellation. The proposed method has been validated in the hippocampus parcellation based on resting state fMRI data of 20 healthy adult subjects. The experimental results have demonstrated that the proposed method could successfully parcellate the hippocampus into head, body and tail parcels. The distinctive functional connectivity patterns of these parcels have further demonstrated the validity of the parcellation results. The effects of aging on the three hippocampus parcels’ functional connectivity were also explored across the healthy adult subjects. Compared with state-of-the-art methods, the proposed method had better performance on functional homogeneity. Furthermore, the proposed method had good test–retest reproducibility validated by parcellating the hippocampus based on three repeated resting state fMRI scans from 24 healthy adult subjects.

Aging Changes Effective Connectivity of Motor Networks During Motor Execution and Motor Imagery

Age-related neurodegenerative and neurochemical changes are considered to be the basis for the decline of motor function; however, the change of effective connections in cortical motor networks that come with aging remains unclear. Here, we investigated the age-related changes of the dynamic interaction between cortical motor regions. Twenty young subjects and 20 older subjects underwent both right hand motor execution (ME) and right hand motor imagery (MI) tasks by using functional magnetic resonance imaging. Conditional Granger causality analysis (CGCA) was used to compare young and older adults’ effective connectivity among regions of the motor network during the tasks. The more effective connections among motor regions in older adults were found during ME; however, effective within-domain hemisphere connections were reduced, and the blood oxygenation level dependent (BOLD) signal was significantly delayed in older adults during MI. Supplementary motor area (SMA) had a significantly higher In+Out degree within the network during ME and MI in older adults. Our results revealed a dynamic interaction within the motor network altered with aging during ME and MI, which suggested that the interaction with cortical motor neurons caused by the mental task was more difficult with aging. The age-related effects on the motor cortical network provide a new insight into our understanding of neurodegeneration in older individuals.

Experience-dependent neuroplasticity in trained musicians modulates the effects of chronic pain on insula-based networks - A resting-state fMRI study

Recent resting-state fMRI studies associated extensive musical training with increased insula-based connectivity in large-scale networks involved in salience, emotion, and higher-order cognitive processes. Similar changes have also been found in chronic pain patients, suggesting that both types of experiences can have comparable effects on insula circuitries. Based on these observations, the current study asked the question whether, and if so in what way, different forms of experience-dependent neuroplasticity may interact. Here we assessed insula-based connectivity during fMRI resting-state between musicians and non-musicians both with and without chronic pain, and correlated the results with clinical pain duration and intensity. As expected, insula connectivity was increased in chronic pain non-musicians relative to healthy non-musicians (with cingulate cortex and supplementary motor area), yet no differences were found between chronic pain non-musicians and healthy musicians. In contrast, musicians with chronic pain showed decreased insula connectivity relative to both healthy musicians (with sensorimotor and memory regions) and chronic pain non-musicians (with the hippocampus, inferior temporal gyrus, and orbitofrontal cortex), as well as lower pain-related inferences with daily activities. Pain duration correlated positively with insula connectivity only in non-musicians, whereas pain intensity exhibited distinct relationships across groups. We conclude that although music-related sensorimotor training and chronic pain, taken in isolation, can lead to increased insula-based connectivity, their combination may lead to higher-order plasticity (metaplasticity) in chronic pain musicians, engaging brain mechanisms that can modulate the consequences of maladaptive experience-dependent neural reorganization (i.e., pain chronification).

Egomotion-related visual areas respond to active leg movements

Monkey neurophysiology and human neuroimaging studies have demonstrated that passive viewing of optic flow stimuli activates a cortical network of temporal, parietal, insular, and cingulate visual motion regions. Here, we tested whether the human visual motion areas involved in processing optic flow signals simulating self-motion are also activated by active lower limb movements, and hence are likely involved in guiding human locomotion. To this aim, we used a combined approach of task-evoked activity and resting-state functional connectivity by fMRI. We localized a set of six egomotion-responsive visual areas (V6+, V3A, intraparietal motion/ventral intraparietal [IPSmot/VIP], cingulate sulcus visual area [CSv], posterior cingulate sulcus area [pCi], posterior insular cortex [PIC]) by using optic flow. We tested their response to a motor task implying long-range active leg movements. Results revealed that, among these visually defined areas, CSv, pCi, and PIC responded to leg movements (visuomotor areas), while V6+, V3A, and IPSmot/VIP did not (visual areas). Functional connectivity analysis showed that visuomotor areas are connected to the cingulate motor areas, the supplementary motor area, and notably to the medial portion of the somatosensory cortex, which represents legs and feet. We suggest that CSv, pCi, and PIC perform the visual analysis of egomotion-like signals to provide sensory information to the motor system with the aim of guiding locomotion.

Testing the diagnostic accuracy of [18F]FDG-PET in discriminating spinal- and bulbar-onset amyotrophic lateral sclerosis

PURPOSE

The role for [18F]FDG-PET in supporting amyotrophic lateral sclerosis (ALS) diagnosis is not fully established. In this study, we aim at evaluating [18F]FDG-PET hypo- and hyper-metabolism patterns in spinal- and bulbar-onset ALS cases, at the single-subject level, testing the diagnostic value in discriminating the two conditions, and the correlations with core clinical symptoms severity.

METHODS

We included 95 probable-ALS patients with [18F]FDG-PET scan and clinical follow-up. [18F]FDG-PET images were analyzed with an optimized voxel-based-SPM method. The resulting single-subject SPM-t maps were used to: (a) assess brain regional hypo- and hyper-metabolism; (b) evaluate the accuracy of regional hypo- and hyper metabolism in discriminating spinal vs. bulbar-onset ALS; (c) perform correlation analysis with motor symptoms severity, as measured by ALS-FRS-R.

RESULTS

Primary motor cortex showed the most frequent hypo-metabolism in both spinal-onset (∼57%) and bulbar-onset (∼64%) ALS; hyper-metabolism was prevalent in the cerebellum in both spinal-onset (∼56.5%) and bulbar-onset (∼55.7%) ALS, and in the occipital cortex in bulbar-onset (∼62.5%) ALS. Regional hypo- and hyper-metabolism yielded a very low accuracy (AUC < 0.63) in discriminating spinal- vs. bulbar-onset ALS, as obtained from single-subject SPM-t-maps. Severity of motor symptoms correlated with hypo-metabolism in sensorimotor cortex in spinal-onset ALS, and with cerebellar hyper-metabolism in bulbar-onset ALS.

CONCLUSIONS

The high variability in regional hypo- and hyper-metabolism patterns, likely reflecting the heterogeneous pathology and clinical phenotypes, limits the diagnostic potential of [18F]FDG-PET in discriminating spinal and bulbar onset patients.

Functional connectivity corresponding to the tonotopic differentiation of the human auditory cortex

Recent research has demonstrated that resting-state functional connectivity (RS-FC) within the human auditory cortex (HAC) is frequency-selective, but whether RS-FC between the HAC and other brain areas is differentiated by frequency remains unclear. Three types of data were collected in this study, including resting-state functional magnetic resonance imaging (fMRI) data, task-based fMRI data using six pure tone stimuli (200, 400, 800, 1,600, 3,200, and 6,400 Hz), and structural imaging data. We first used task-based fMRI to identify frequency-selective cortical regions in the HAC. Six regions of interest (ROIs) were defined based on the responses of 50 participants to the six pure tone stimuli. Then, these ROIs were used as seeds to determine RS-FC between the HAC and other brain regions. The results showed that there was RS-FC between the HAC and brain regions that included the superior temporal gyrus, dorsolateral prefrontal cortex (DL-PFC), parietal cortex, occipital lobe, and subcortical structures. Importantly, significant differences in FC were observed among most of the brain regions that showed RS-FC with the HAC. Specifically, there was stronger RS-FC between (1) low-frequency (200 and 400 Hz) regions and brain regions including the premotor cortex, somatosensory/-association cortex, and DL-PFC; (2) intermediate-frequency (800 and 1,600 Hz) regions and brain regions including the anterior/posterior superior temporal sulcus, supramarginal gyrus, and inferior frontal cortex; (3) intermediate/low-frequency regions and vision-related regions; (4) high-frequency (3,200 and 6,400 Hz) regions and the anterior cingulate cortex or left DL-PFC. These findings demonstrate that RS-FC between the HAC and other brain areas is frequency selective.

Corticospinal excitability for hand muscles during motor imagery of foot changes with imagined force level

The object of this study was to clarify whether corticospinal excitability controlling hand muscles changes concurrently with increases in the imagined contraction level of foot dorsiflexion. Twelve participants performed actual and imagined dorsiflexion of their right foot at three different EMG levels (10, 40 or 80% of the maximum voluntary contraction). During isometric actual- or imagined- dorsiflexion, transcranial magnetic stimulation (TMS) was delivered to the right hand area of the left primary motor cortex. Motor evoked potentials (MEPs) were recorded from the right extensor carpi radialis (ECR) and flexor carpi radialis (FCR). During actual contraction, MEP amplitudes of ECR and FCR increased with an increased EMG level of dorsiflexion. Similarly, during imagery contraction, MEP amplitudes of ECR and FCR increased with the intensity of imagery contraction. Furthermore, a correlation between MEP amplitude during actual contraction and imagery contraction was observed for both ECR and FCR. Motor imagery of foot contraction induced an enhancement of corticospinal excitability for hand muscles that was dependent on the imagined contraction levels, just as what was observed when there was an actual contraction.

Multi-parametric analysis assists in STN localization in Parkinson's patients

BACKGROUND

Initial subthalamic nucleus (STN) localization is based on MRI and an anatomical atlas and then refined intraoperatively using electrophysiological mapping with microelectrode recordings (IOA - intraoperative multi-unit activity) during deep brain stimulation (DBS) in Parkinson's disease (PD). IOA is time consuming and subjective. The purpose of this study was to assess the value of high frequency multi-unit background activity (MUA, frequency >500Hz), and local field potentials (LFP, frequency 5-500Hz) in detection of the STN borders.

METHODS

This was a retrospective, single center study. 18 leads in ten PD patients that underwent STN DBS surgery were evaluated. IOA, MUA and LFP have been compared in detection of the STN. IOA using single train spikes analysis have been used as a gold standard.

RESULTS

Both LFP in beta range (20-35Hz) and MUA increased as the microelectrode entered the STN and their increase correlated with dorsal/ventral STN borders. The differences (mean±sd) were: between IOA and MUA of the dorsal/ventral border 0.20±0.76/0.28±0.30mm; between IOA and LFP of the dorsal/ventral border 0.08±0.94/0.05±0.53mm. Using Bland-Altman statistics, only 2/36 (5.6%) differences between IOA and MUA and also 2/36 differences between IOA and LFP (one for the dorsal border and one for the ventral border) were out of ±1.96 SD line of measurement differences. Correlation between dorsal border/ventral border positions obtained by IOA and MUA was 0.86, p<0.000005/0.97, p<10(-11); by IOA and LFP was 0.78, p<0.00015/0.88, p<0.000001.

CONCLUSIONS

Both MUA and LFP are characteristically elevated in the STN compared to neighboring structures. They may provide fast, real-time, objective and reliable markers of STN borders.

Resection extent of the supplementary motor area and post-operative neurological deficits in glioma surgery

Objective The supplementary motor area (SMA) is important for the prediction of post-operative symptoms after surgical resection of gliomas. We investigated the relationships between clinical factors and the resection range of SMA gliomas, and the post-operative neurological symptoms. Methods We retrospectively studied 18 consecutive surgeries for gliomas involving the SMA proper performed in 13 patients. Seven cases were recurrence of the tumour. Clinical factors and details of specific resection of the SMA proper (resection of posterior part, medial wall) and cingulate motor area (CMA) were examined. Results Eight cases suffered new post-operative neurological deficits. Six of these eight cases had transient deficits. Permanent deficits persisted in two cases with partial weakness or paresis, after rapid improvement of post-operative global weakness or hemiplegia, respectively. The risk of post-operative neurological deficits was not associated with the resection of the posterior part of the SMA proper or the CMA, but was associated with resection of the medial wall of the SMA proper. Surgery for recurrent tumour was associated with post-operative neurological deficits. The medial wall was frequently resected in recurrent cases. Discussion The frequency of post-operative neurological symptoms, including SMA syndrome, may be higher after resection of the medial wall of the SMA proper compared with the resection of only the lateral surface of the SMA proper.

Altered sensorimotor activation patterns in idiopathic dystonia-an activation likelihood estimation meta-analysis of functional brain imaging studies

Dystonia is characterized by sustained or intermittent muscle contractions causing abnormal, often repetitive, movements or postures. Functional neuroimaging studies have yielded abnormal task‐related sensorimotor activation in dystonia, but the results appear to be rather variable across studies. Further, study size was usually small including different types of dystonia. Here we performed an activation likelihood estimation (ALE) meta‐analysis of functional neuroimaging studies in patients with primary dystonia to test for convergence of dystonia‐related alterations in task‐related activity across studies. Activation likelihood estimates were based on previously reported regional maxima of task‐related increases or decreases in dystonia patients compared to healthy controls. The meta‐analyses encompassed data from 179 patients with dystonia reported in 18 functional neuroimaging studies using a range of sensorimotor tasks. Patients with dystonia showed bilateral increases in task‐related activation in the parietal operculum and ventral postcentral gyrus as well as right middle temporal gyrus. Decreases in task‐related activation converged in left supplementary motor area and left postcentral gyrus, right superior temporal gyrus and dorsal midbrain. Apart from the midbrain cluster, all between‐group differences in task‐related activity were retrieved in a sub‐analysis including only the 14 studies on patients with focal dystonia. For focal dystonia, an additional cluster of increased sensorimotor activation emerged in the caudal cingulate motor zone. The results show that dystonia is consistently associated with abnormal somatosensory processing in the primary and secondary somatosensory cortex along with abnormal sensorimotor activation of mesial premotor and right lateral temporal cortex. Hum Brain Mapp 37:547–557, 2016. © 2015 Wiley Periodicals, Inc.

Somatotopic organization of the white matter tracts underpinning motor control in humans: an electrical stimulation study

The somatotopic organization of the primary motor cortex is well documented. However, a possible somatotopy of the network involved in motor control, i.e., eliciting negative motor phenomena during electrostimulation, is unknown in humans, particularly at the subcortical level. Here, we performed electrical stimulation mapping in awake patients operated for gliomas, to study the distribution of the white matter tracts subserving movement control of the lower limb, upper limb(s), and speech. Eighteen patients underwent awake surgery for frontal low-grade gliomas, by using intraoperative subcortical electrostimulation mapping to search interference with movement of the leg, arm(s), and face. We assessed the negative motor responses and their distribution throughout the tracts located under premotor areas. The corresponding stimulation sites were reported on a standard brain template for visual analysis and between-subjects comparisons. During stimulation of the white matter underneath the dorsal premotor cortex and supplementary motor area, rostral to the corticospinal tracts, all patients experienced cessation of the movement of lower and upper limbs, of bimanual coordination, and/or speech. These subcortical sites were somatotopically distributed. Indeed, stimulation of the fibers from mesial to lateral directions and from posterior to anterior directions evoked arrest of movement of the lower limb (mesially and posteriorly), upper limb(s), and face/speech (laterally and anteriorly). There were no postoperative permanent deficits. This is the first evidence of a somatotopic organization of the white matter bundles underpinning movement control in humans. A better knowledge of the distribution of this motor control network may be helpful in neurosciences and neurosurgery.

Can passive mobilization provide clinically-relevant brain stimulation? A pilot EEG and NIRS study on healthy subjects

Lower limb rehabilitation is a fundamental part of post-acute care in neurological disease. Early commencement of active workout is often prevented by paresis, thus physical treatment may be delayed until patients regain some voluntary command of their muscles. Passive mobilization of the affected joints is mostly delivered in order to safeguard tissue properties and shun circulatory problems. The present paper investigates the potential role of early passive motion in stimulating cortical areas of the brain devoted to the control of the lower limb. An electro-mechanical mobilizer for the ankle joint (Toe-Up!) was implemented utilizing specially-designed shape-memory-alloy-based actuators. This device was constructed to be usable by bedridden subjects. Besides, the slowness and gentleness of the imparted motion, make it suitable for patients in a very early stage of their recovery. The mobilizer underwent technical checks to confirm reliability and passed the required safety tests for electric biomedical devices. Four healthy volunteers took part in the pre-clinical phase of the study. The protocol consisted in measuring of brain activity by EEG and NIRS in four different conditions: rest, active dorsiflexion of the ankle, passive mobilization of the ankle, and assisted motion of the same joint. The acquired data were processed to obtain maps of cortical activation, which were then compared. The measurements collected so far show that there is a similar pattern of activity between active and passive/assisted particularly in the contralateral premotor areas. This result, albeit based on very few observations, might suggest that passive motion provides somatosensory afferences that are processed in a similar manner as for voluntary control. Should this evidence be confirmed by further trials on healthy individuals and neurological patients, it could form a basis for a clinical use of early passive exercise in supporting central functional recovery.

New whole-body sensory-motor gradients revealed using phase-locked analysis and verified using multivoxel pattern analysis and functional connectivity

Topographic organization is one of the main principles of organization in the human brain. Specifically, whole-brain topographic mapping using spectral analysis is responsible for one of the greatest advances in vision research. Thus, it is intriguing that although topography is a key feature also in the motor system, whole-body somatosensory-motor mapping using spectral analysis has not been conducted in humans outside M1/SMA. Here, using this method, we were able to map a homunculus in the globus pallidus, a key target area for deep brain stimulation, which has not been mapped noninvasively or in healthy subjects. The analysis clarifies contradictory and partial results regarding somatotopy in the caudal-cingulate zone and rostral-cingulate zone in the medial wall and in the putamen. Most of the results were confirmed at the single-subject level and were found to be compatible with results from animal studies. Using multivoxel pattern analysis, we could predict movements of individual body parts in these homunculi, thus confirming that they contain somatotopic information. Using functional connectivity, we demonstrate interhemispheric functional somatotopic connectivity of these homunculi, such that the somatotopy in one hemisphere could have been found given the connectivity pattern of the corresponding regions of interest in the other hemisphere. When inspecting the somatotopic and nonsomatotopic connectivity patterns, a similarity index indicated that the pattern of connected and nonconnected regions of interest across different homunculi is similar for different body parts and hemispheres. The results show that topographical gradients are even more widespread than previously assumed in the somatosensory-motor system. Spectral analysis can thus potentially serve as a gold standard for defining somatosensory-motor system areas for basic research and clinical applications.

Frequency Selectivity of Voxel-by-Voxel Functional Connectivity in Human Auditory Cortex

While functional connectivity in the human cortex has been increasingly studied, its relationship to cortical representation of sensory features has not been documented as much. We used functional magnetic resonance imaging to demonstrate that voxel-by-voxel intrinsic functional connectivity (FC) is selective to frequency preference of voxels in the human auditory cortex. Thus, FC was significantly higher for voxels with similar frequency tuning than for voxels with dissimilar tuning functions. Frequency-selective FC, measured via the correlation of residual hemodynamic activity, was not explained by generic FC that is dependent on spatial distance over the cortex. This pattern remained even when FC was computed using residual activity taken from resting epochs. Further analysis showed that voxels in the core fields in the right hemisphere have a higher frequency selectivity in within-area FC than their counterpart in the left hemisphere, or than in the noncore-fields in the same hemisphere. Frequency-selective FC is consistent with previous findings of topographically organized FC in the human visual and motor cortices. The high degree of frequency selectivity in the right core area is in line with findings and theoretical proposals regarding the asymmetry of human auditory cortex for spectral processing.

Motor execution and motor imagery: a comparison of functional connectivity patterns based on graph theory

Motor execution and imagery (ME and MI), as the basic abilities of human beings, have been considered to be effective strategies in motor skill learning and motor abilities rehabilitation. Neuroimaging studies have revealed several critical regions from functional activation for ME as well as MI. Recently, investigations have probed into functional connectivity of ME; however, few explorations compared the functional connectivity between the two tasks. With betweenness centrality (BC) of graph theory, we explored and compared the functional connectivity between two finger tapping tasks of ME and MI. Our results showed that using BC, the key node for the ME task mainly focused on the supplementary motor area, while the key node for the MI task mainly located in the right premotor area. These results characterized the connectivity patterns of ME and MI and may provide new insights into the neural mechanism underlying motor execution and imagination of movements.

Functional MRI-navigated repetitive transcranial magnetic stimulation over supplementary motor area in chronic tic disorders

BACKGROUND

Open label studies have shown repetitive transcranial magnetic stimulation to be effective in reducing tics.

OBJECTIVES

To determine whether 8 sessions of continuous theta burst stimulation (cTBS) over supplementary motor area (SMA) given over 2 days may reduce tics and motor cortical network activity in Tourette syndrome/chronic tic disorders.

METHODS

This was a randomized (1:1), double-blind, sham-controlled trial of functional MRI (fMRI)-navigated, 30 Hz cTBS at 90% of resting motor threshold (RMT) over SMA in 12 patients ages 10-22 years. Comorbid ADHD (n = 8), OCD (n = 8), and stable concurrent medications (n = 9) were permitted. Neuro-navigation utilized each individual's event-related fMRI signal. Primary clinical and cortical outcomes were: 1) Yale Global Tic Severity Scale (YGTSS) at one week; 2) fMRI event-related signal in SMA and primary motor cortex (M1) during a finger-tapping motor task.

RESULT

Baseline characteristics were not statistically different between groups (age, current tic/OCD/ADHD severities, tic-years, number of prior medication trials, RMT). Mean YGTSS scores decreased in both active (27.5 ± 7.4 to 23.2 ± 9.8) and sham (26.8 ± 4.8 to 21.7 ± 7.7) groups. However, no significant difference in video-based tic severity rating was detected between the two groups. Two-day post-treatment fMRI activation during finger tapping decreased significantly in active vs. sham groups for SMA (P = 0.02), left M1 (P = 0.0004), and right M1 (P < 0.0001). No serious adverse events occurred.

CONCLUSION

Active, fMRI-navigated cTBS administered in 8 sessions over 2 days to the SMA induced significant inhibition in the motor network (SMA, bilateral M1). However, both groups on average experienced tic reduction at 7 days. Larger sample size and protocol modifications may be needed to produce clinically significant tic reduction beyond placebo effect.

Functional anatomy of writing with the dominant hand

While writing performed by any body part is similar in style, indicating a common program, writing with the dominant hand is particularly skilled. We hypothesized that this skill utilizes a special motor network supplementing the motor equivalence areas. Using functional magnetic resonance imaging in 13 normal subjects, we studied nine conditions: writing, zigzagging and tapping, each with the right hand, left hand and right foot. We identified brain regions activated with the right (dominant) hand writing task, exceeding the activation common to right-hand use and the writing program, both identified without right-hand writing itself. Right-hand writing significantly differed from the other tasks. First, we observed stronger activations in the left dorsal prefrontal cortex, left intraparietal sulcus and right cerebellum. Second, the left anterior putamen was required to initiate all the tested tasks, but only showed sustained activation during the right-hand writing condition. Lastly, an exploratory analysis showed clusters in the left ventral premotor cortex and inferior and superior parietal cortices were only significantly active for right-hand writing. The increased activation with right-hand writing cannot be ascribed to increased effort, since this is a well-practiced task much easier to perform than some of the other tasks studied. Because parietal-premotor connections code for particular skills, it would seem that the parietal and premotor regions, together with basal ganglia-sustained activation likely underlie the special skill of handwriting with the dominant hand.

Functional anatomy of cortical areas characterized by Von Economo neurons

Von Economo's neurons (VENs) are large, bipolar or corkscrew-shaped neurons located in layers III and V of the frontoinsular and the anterior cingulate cortices. VENs are reported to be altered in pathologies such as frontotemporal dementia and autism, in which the individual's self control is seriously compromised. To investigate the role of VENs in the active human brain, we have explored the functional connectivity of brain areas containing VENs by analyzing resting state functional connectivity (rsFC) in 20 healthy volunteers. Our results show that cortical areas containing VENs form a network of frontoparietal functional connectivity. With the use of fuzzy clustering techniques, we find that this network comprises four sub-networks: the first network cluster resembles a "saliency detection" attentional network, which includes superior frontal cortex (Brodmann's Area, BA 10), inferior parietal lobe, anterior insula, and dorsal anterior cingulate cortex; the second cluster, part of a "sensory-motor network", comprises the superior temporal, precentral and postcentral areas; the third cluster consists of frontal ventromedial and ventrodorsal areas constituted by parts of the "anterior default mode network"; and the fourth cluster encompasses dorsal anterior cingulate cortex, dorsomedial prefrontal, and superior frontal (BA 10) areas, resembling the anterior part of the "dorsal attentional network". Thus, the network that emerges from analyzing functional connectivity among areas that are known to contain VENs is primarily involved in functions of saliency detection and self-regulation. In addition, parts of this network constitute sub-networks that partially overlap with the default mode, the sensory-motor and the dorsal attentional networks.

Optimal coil orientation for transcranial magnetic stimulation

We study the impact of coil orientation on the motor threshold (MT) and present an optimal coil orientation for stimulation of the foot. The result can be compared to results of models that predict this orientation from electrodynamic properties of the media in the skull and from orientations of cells, respectively. We used a robotized TMS system for precise coil placement and recorded motor-evoked potentials with surface electrodes on the abductor hallucis muscle of the right foot in 8 healthy control subjects. First, we performed a hot-spot search in standard (lateral) orientation and then rotated the coil in steps of 10° or 20°. At each step we estimated the MT. For navigated stimulation and for correlation with the underlying anatomy a structural MRI scan was obtained. Optimal coil orientation was 33.1±18.3° anteriorly in relation to the standard lateral orientation. In this orientation the threshold was 54±18% in units of maximum stimulator output. There was a significant difference of 8.0±5.9% between the MTs at optimal and at standard orientation. The optimal coil orientations were significantly correlated with the direction perpendicular to the postcentral gyrus (). Robotized TMS facilitates sufficiently precise coil positioning and orientation to study even small variations of the MT with coil orientation. The deviations from standard orientation are more closely matched by models based on field propagation in media than by models based on orientations of pyramidal cells.

Task- and resting-state functional connectivity of brain regions related to affection and susceptible to concurrent cognitive demand

A recent fMRI-study revealed neural responses for affective processing of stimuli for which overt attention irrespective of stimulus valence was required in the orbitofrontal cortex (OFC) and bilateral amygdala (AMY): activation decreased with increasing cognitive demand. To further characterize the network putatively related to this attenuation, we here characterized these regions with respect to their functional properties and connectivity patterns in task-dependent and task-independent states. All experiments of the BrainMap database activating the seed regions OFC and bilateral AMY were identified. Their functional characteristics were quantitatively inferred using the behavioral meta-data of the retrieved experiments. Task-dependent functional connectivity was characterized by meta-analytic connectivity modeling (MACM) of significant co-activations with these seed regions. Task-independent resting-state functional connectivity analysis in a sample of 100 healthy subjects complemented these analyses. All three seed regions co-activated with subgenual cingulum (SGC), precuneus (PCu) and nucleus accumbens (NAcc) in the task-dependent MACM analysis. Task-independent resting-state connectivity revealed significant coupling of the seeds only with the SGC, but not the PCu and the NAcc. The former region (SGC) moreover was shown to feature significant resting-state connectivity with all other regions implicated in the network connected to regions where emotional processing may be modulated by a cognitive distractor. Based on its functional profile and connectivity pattern, we suggest that the SGC might serve as a key hub in the identified network, as such linking autobiographic information [PCu], reward [NAcc], (reinforce) values [OFC] and emotional significance [AMY]. Such a role, in turn, may allow the SGC to influence the OFC and AMY to modulate affective processing.

The topographic connectome

Central to macro-connectomics and much of systems neuroscience is the idea that we can summarise macroscopic brain connectivity using a network of 'nodes' and 'edges'--functionally distinct brain regions and the connections between them. This is an approach that allows a deep understanding of brain dynamics and how they relate to brain circuitry. This approach, however, ignores key features of anatomical connections, such as spatial arrangement and topographic mappings. In this article, we suggest an alternative to this paradigm. We propose that connection topographies can inform us about brain networks in ways that are complementary to the concepts of 'nodes' and 'edges'. We also show that current neuroimaging technology is capable of revealing details of connection topographies in vivo. These advances, we hope, will allow us to explore brain connectivity in novel ways in the immediate future.

Differential grey matter changes in sensorimotor cortex related to exceptional fine motor skills

Functional changes in sensorimotor representation occur in response to use and lesion throughout life. Emerging evidence suggests that functional changes are paralleled by respective macroscopic structural changes. In the present study we used voxel-based morphometry to investigate sensorimotor cortex in subjects with congenitally malformed upper extremities. We expected increased or decreased grey matter to parallel the enlarged or reduced functional representations we reported previously. More specifically, we expected decreased grey matter values in lateral sensorimotor cortex related to compromised hand function and increased grey matter values in medial sensorimotor cortex due to compensatory foot use. We found a medial cluster of grey matter increase in subjects with frequent, hand-like compensatory foot use. This increase was predominantly seen for lateral premotor, supplementary motor, and motor areas and only marginally involved somatosensory cortex. Contrary to our expectation, subjects with a reduced number of fingers, who had shown shrinkage of the functional hand representation previously, did not show decreased grey matter values within lateral sensorimotor cortex. Our data suggest that functional plastic changes in sensorimotor cortex can be associated with increases in grey matter but may also occur in otherwise macroscopically normal appearing grey matter volumes. Furthermore, macroscopic structural changes in motor and premotor areas may be observed without respective changes in somatosensory cortex.

Double representation of the wrist and elbow in human motor cortex

Movements of the fingers, hand and arm involve overlapping neural representations in primary motor cortex (M1). Monkey M1 exhibits a core-surround organisation in which cortical representation of the hand and fingers is surrounded by representations of the wrist, elbow and shoulder. A potentially homologous organisation in human M1 has only been observed in a single study, a functional MRI (fMRI) study by [J.D. Meier, T.N. Aflalo, S. Kastner & M.S. Graziano.(2008) J Neurophysiol, 100(4), 1800-1812]. The results of their study suggested a double representation of the wrist in human M1, an unprecedented finding. Our purpose was to document and simultaneously provide evidence that would extend the presence of double representation of the wrist to that of the elbow. Using fMRI, we observed somatotopic maps in M1 and the supplementary motor area (SMA), the only other cortical area that showed robust within-limb somatotopy during self-timed finger, wrist and elbow movements. We observed double wrist and elbow representation that bracketed finger fMRI responses in M1 and the SMA. Our results show that the cortical locations of these double representations are well predicted by local cortical anatomy. Double representation of the wrist and elbow is important because it violates the traditional somatotopic progression in M1 but it is consistent with the representation of synergistic movements involving adjacent effectors.

Parallel alterations of functional connectivity during execution and imagination after motor imagery learning

BACKGROUND

Neural substrates underlying motor learning have been widely investigated with neuroimaging technologies. Investigations have illustrated the critical regions of motor learning and further revealed parallel alterations of functional activation during imagination and execution after learning. However, little is known about the functional connectivity associated with motor learning, especially motor imagery learning, although benefits from functional connectivity analysis attract more attention to the related explorations. We explored whether motor imagery (MI) and motor execution (ME) shared parallel alterations of functional connectivity after MI learning.

METHODOLOGY/PRINCIPAL FINDINGS

Graph theory analysis, which is widely used in functional connectivity exploration, was performed on the functional magnetic resonance imaging (fMRI) data of MI and ME tasks before and after 14 days of consecutive MI learning. The control group had no learning. Two measures, connectivity degree and interregional connectivity, were calculated and further assessed at a statistical level. Two interesting results were obtained: (1) The connectivity degree of the right posterior parietal lobe decreased in both MI and ME tasks after MI learning in the experimental group; (2) The parallel alterations of interregional connectivity related to the right posterior parietal lobe occurred in the supplementary motor area for both tasks.

CONCLUSIONS/SIGNIFICANCE

These computational results may provide the following insights: (1) The establishment of motor schema through MI learning may induce the significant decrease of connectivity degree in the posterior parietal lobe; (2) The decreased interregional connectivity between the supplementary motor area and the right posterior parietal lobe in post-test implicates the dissociation between motor learning and task performing. These findings and explanations further revealed the neural substrates underpinning MI learning and supported that the potential value of MI learning in motor function rehabilitation and motor skill learning deserves more attention and further investigation.

Frontal white matter integrity is related to psychomotor retardation in major depression

Altered frontal white matter integrity has been reported in major depression. Still, the behavioral correlates of these alterations are not established. In healthy subjects, motor activity correlated with white matter integrity in the motor system. To explore the relation of white matter integrity and motor activity in major depressive disorder, we investigated 21 medicated patients with major depressive disorder and 21 matched controls using diffusion tensor imaging and wrist actigraphy at the same day. Patients had lower activity levels (AL) compared with controls. Fractional anisotropy (FA) differed between groups in frontal white matter regions and the posterior cingulum. AL was linearly associated with white matter integrity in two clusters within the motor system. Controls had an exclusive positive association of FA and AL in white matter underneath the right dorsal premotor cortex. Only patients had a positive association within the posterior cingulum. Furthermore, patients had negative associations of FA and AL underneath the left primary motor cortex and within the left parahippocampal gyrus white matter. These differences in the associations between structure and behavior may contribute to well-known impaired motor planning or gait disturbances in major depressive disorder. Therefore, signs of psychomotor slowing in major depressive disorder may be linked to changes of the white matter integrity of the motor system.

Different functions in the cingulate cortex, a meta-analytic connectivity modeling study

The cingulate cortex is a structurally heterogeneous brain region involved in emotional, cognitive and motor tasks. With the aim of identifying which behavioral domains are associated with the activation of the cingulate cortex, we performed a structure based-meta-analysis using the activation likelihood estimation (ALE), which assesses statistical significant convergence of neuroimaging studies using the BrainMap database. To map the meta-analytic coactivation maps of the cingulate cortex (MACM), we subdivided the parenchyma along the rostro-caudal axis in 12 bilateral equispaced ROIs. ROIs were not chosen according to previously suggested subdivisions, as to obtain a completely data-driven result. Studies were included with one or more activation coordinates in at least one of the 12 pre-defined ROIs. The meta-analytic connectivity profile and behavioral domains profiles were identified for each ROI. Cluster analysis was then performed on the MACM and behavioral domains to group together ROIs with similar profiles. The results showed that the cingulate cortex can be divided in three clusters according to the MACM parcellation and in four according to the behavioral domain-based parcellation. In addition, a behavioral-domain based meta-analysis was conducted and the spatial consistency of functional connectivity patterns across different domain-related ALE results was evaluated by computing probabilistic maps. These maps identified some portions of the cingulate cortex as involved in several tasks. Our results showed the existence of a more specific functional characterization of some portions of the cingulate cortex but also a great multifunctionality of others. By analyzing a large number of studies, structure based meta-analysis can greatly contribute to new insights in the functional significance of brain activations and in the role of specific brain areas in behavior.