The interaction of the somatosensory evoked potentials to simultaneous finger stimuli in the human central nervous system. A study using direct recordings

Descending motor command to prime mover of dependent finger induces tactile gating in target and distant non-target finger

This study examined whether tactile gating induced by the descending motor command to one finger spreads out to the other fingers to which the command is not delivered and whether this gating is dependent on the target finger to which the command is delivered. The change in perceptual threshold to the digital nerve stimulation of one finger induced by tonic contraction of the first dorsal interosseous or abductor digiti minimi muscle was examined. The perceptual threshold to the digital nerve stimulation of the thumb or little finger was increased by tonic contraction of the abductor digiti minimi muscle. This finding indicates that the descending motor command to the prime mover of the little finger abduction induces tactile gating not only in the finger to which the command is delivered but also in the other finger to which the command is not delivered. Tonic contraction of the first dorsal interosseous muscle did not change the perceptual threshold to the digital nerve stimulation in any finger. This finding means that tactile gating occurs particularly when the descending motor command is delivered to the dependent finger. Spreading out of tactile gating of one finger, to which the descending motor command is not delivered, is likely mediated by surround inhibition.

Central sensitization mechanisms in chronic migraine with medication overuse headache: a study of thalamocortical activation and lateral cortical inhibition

BACKGROUND

It is unclear whether cortical hyperexcitability in chronic migraine with medication overuse headache (CM-MOH) is due to increased thalamocortical drive or aberrant cortical inhibitory mechanisms.

METHODS

Somatosensory evoked potentials (SSEP) were performed by electrical stimulation of the median nerve (M), ulnar nerve (U) and simultaneous stimulation of both nerves (MU) in 27 patients with CM-MOH and, for comparison, in 23 healthy volunteers (HVs) of a comparable age distribution. We calculated the degree of cortical lateral inhibition using the formula: 100 - [MU/(M + U) × 100] and the level of thalamocortical activation by analyzing the high frequency oscillations (HFOs) embedded in parietal N20 median SSEPs.

RESULTS

Compared to HV, CM-MOH patients showed higher lateral inhibition (CM-MOH 52.2% ± 15.4 vs. HV 40.4% ± 13.3; p = 0.005), which positively correlated with monthly headache days, and greater amplitude of pre-synaptic HFOs (p = 0.010) but normal post-synaptic HFOs (p = 0.122).

CONCLUSION

Our findings suggest that central neuronal circuits are highly sensitized in CM-MOH patients, at both thalamocortical and cortical levels. The observed changes could be due to the combination of dysfunctional central pain control mechanisms, hypersensitivity and hyperresponsiveness directly linked to the chronic intake of acute migraine drugs.

Afferent volley from the digital nerve induces short-latency facilitation of perceptual sensitivity and primary sensory cortex excitability

The present study examined whether the perceptual sensitivity and excitability of the primary sensory cortex are modulated by the afferent volley from the digital nerve of a conditioned finger within a short period of time. The perceptual threshold of an electrical stimulus to the index finger (test stimulus) was decreased by a conditioning stimulus to the index finger 4 or 6 ms before the test stimulus, or by a stimulus to the middle or ring finger 2 ms before that. This is explained by the view that the afferent volleys from the digital nerves of the fingers converge in the somatosensory areas, causing spatial summation of the afferent inputs through a small number of synaptic relays, leading to the facilitation of perceptual sensitivity. The N20 component of the somatosensory-evoked potential was facilitated by a conditioning stimulus to the middle finger 4 ms before a test stimulus or to the thumb 2 ms before the test stimulus. This is explained by the view that the afferent volley from the digital nerve of the finger adjacent to the tested finger induces lateral facilitation of the representation of the tested finger in the primary sensory cortex through a small number of synaptic relays.

The Thalamic and Intracortical Inhibitory Function of Somatosensory System Is Unchanged in Mesial Temporal Lobe Epilepsy With Hippocampal Sclerosis

PURPOSE

In mesial temporal lobe epilepsy with hippocampal sclerosis, there is parietal atrophy and cognitive involvement in related domains. In this context, we hypothesized that inhibitory input into somatosensory cortex and thalamus may be increased in these patients, which could improve after epilepsy surgery. Thus, we analyzed the inhibitory function of somatosensory system by studying surround inhibition (SI) and recovery function of somatosensory evoked potentials in patients with mesial temporal lobe epilepsy with hippocampal sclerosis.

METHODS

Nine patients with unoperated mesial temporal lobe epilepsy with hippocampal sclerosis, 10 patients who underwent epilepsy surgery, and 12 healthy subjects were included. For SI of somatosensory evoked potentials, we recorded somatosensory evoked potentials after stimulating median or ulnar nerve at wrist separately and after median and ulnar nerves simultaneously and calculated SI% in all participants. For recovery function of somatosensory evoked potentials, paired stimulation of median nerve at 40- and 100-millisecond intervals was performed. We compared the findings among groups. As a secondary analysis, we determined the outliers in the patient group and analyzed the relation to the clinical findings.

RESULTS

The mean SI% or recovery function was similar among three groups. However, there were five patients with SI loss on normal side in the patient group, which was related to the antiseizure drugs.

CONCLUSIONS

In contrast to our hypothesis, both intracortical (SI) and thalamic/striatal (recovery function) inhibitory modulation of the somatosensory cortex was not altered in mesial temporal lobe epilepsy with hippocampal sclerosis and did not differ in surgical and nonsurgical groups.

Reconstructing subcortical and cortical somatosensory activity via the RAMUS inverse source analysis technique using median nerve SEP data

This study concerns reconstructing brain activity at various depths based on non-invasive EEG (electroencephalography) scalp measurements. We aimed at demonstrating the potential of the RAMUS (randomized multiresolution scanning) technique in localizing weakly distinguishable far-field sources in combination with coinciding cortical activity. As we have shown earlier theoretically and through simulations, RAMUS is a novel mathematical method that by employing the multigrid concept, allows marginalizing noise and depth bias effects and thus enables the recovery of both cortical and subcortical brain activity. To show this capability with experimental data, we examined the 14-30 ms post-stimulus somatosensory evoked potential (SEP) responses of human median nerve stimulation in three healthy adult subjects. We aim at reconstructing the different response components by evaluating a RAMUS-based estimate for the primary current density in the nervous tissue. We present source reconstructions obtained with RAMUS and compare them with the literature knowledge of the SEP components and the outcome of the unit-noise gain beamformer (UGNB) and standardized low-resolution brain electromagnetic tomography (sLORETA). We also analyzed the effect of the iterative alternating sequential technique, the optimization technique of RAMUS, compared to the classical minimum norm estimation (MNE) technique. Matching with our previous numerical studies, the current results suggest that RAMUS could have the potential to enhance the detection of simultaneous deep and cortical components and the distinction between the evoked sulcal and gyral activity.

Surround inhibition in patients with juvenile myoclonic epilepsy

OBJECTIVE

In healthy subjects, there is a reduction in the amplitudes of somatosensory-evoked potentials (SEPs) after the simultaneous stimulation of two nerves compared to the sum of separate stimulations. This reduction is due to the inhibition of one area in the cortex after stimulation of the neighboring area, which results from the surround inhibition (SI) phenomenon. In this study, we aimed to investigate whether there was a decrease in SI of SEP in patients with juvenile myoclonic epilepsy (JME).

METHODS

We included 17 patients with JME and 18 healthy subjects. Groups were similar in terms of age and gender. We recorded SEPs after stimulating (i) median nerve (mSEP), (ii) ulnar nerve (uSEP), (iii) median and ulnar nerves simultaneously (muSEP) at wrist. The arithmetic sum (aSEP) of amplitudes of mSEP and uSEP was compared with the amplitudes of muSEP. We also calculated SI%.

RESULTS

The amplitudes of SEPs were significantly higher in the JME group than in the healthy subjects (mSEP, p = 0.005; uSEP, p = 0.032; muSEP, p = 0.014). In healthy subjects and the JME group, the amplitude of muSEP was significantly lower than the aSEP (p = 0.014; p = 0.001, respectively). However, SI% was significantly higher in the JME group (p = 0.010).

SIGNIFICANCE

Although the SI is maintained in JME patients, the higher SI% indicates an impairment relative to healthy subjects.

Somatosensory evoked potentials that index lateral inhibition are modulated according to the mode of perceptual processing: comparing or combining multi-digit tactile motion

Many perceptual studies focus on the brain's capacity to discriminate between stimuli. However, our normal experience of the world also involves integrating multiple stimuli into a single perceptual event. Neural mechanisms such as lateral inhibition are believed to enhance local differences between sensory inputs from nearby regions of the receptor surface. However, this mechanism would seem dysfunctional when sensory inputs need to be combined rather than contrasted. Here, we investigated whether the brain can strategically regulate the strength of suppressive interactions that underlie lateral inhibition between finger representations in human somatosensory processing. To do this, we compared sensory processing between conditions that required either comparing or combining information. We delivered two simultaneous tactile motion trajectories to index and middle fingertips of the right hand. Participants had to either compare the directions of the two stimuli, or to combine them to form their average direction. To reveal preparatory tuning of somatosensory cortex, we used an established event-related potential design to measure the interaction between cortical representations evoked by digital nerve shocks immediately before each tactile stimulus. Consistent with previous studies, we found a clear suppression between cortical activations when participants were instructed to compare the tactile motion directions. Importantly, this suppression was significantly reduced when participants had to combine the same stimuli. These findings suggest that the brain can strategically switch between a comparative and a combinative mode of somatosensory processing, according to the perceptual goal, by preparatorily adjusting the strength of a process akin to lateral inhibition.

Somatosensory Evoked Potentials following upper limb noninvasive electrical stimulation: a case study

Lack of sensory feedback is one of the main issues contributing to lack of control and embodiment for upper-limb prostheses. Noninvasive nerve stimulation may help amputees overcome such limitations by providing a degree of somatotopic feedback, however its neural correlates have been only partly characterized so far. While the effects of median nerve stimulation have been studied, little attention has been given to ulnar nerve and bipolar stimulation, which might provide a finer modulation of the somatotopic sensation. Here, monopolar and bipolar transcutaneous electrical nerve stimulation (TENS) is repeatedly applied to the ulnar and median nerves and elicited Somatosensory Evoked Potentials (SEPs) are characterized by means of electroencephalography (EEG). Clear P50, P150 and P270 SEPs were outlined, with significantly different amplitudes between configurations. In each case scalp topographies showed a strong contralateral activation in the early phase after the stimulus onset (40-100 ms), compatible with generators in the somatosensory cortex and in accordance to previous literature on actual tactile stimuli, which gives way to a frontal-central distribution at long latencies (130-190 ms). These findings, although needing further validation with a larger pool of subjects, show that bipolar TENS could have potential applications in improving prosthesis control with tactile feedback.

Advances in the pathophysiology of adult-onset focal dystonias: recent neurophysiological and neuroimaging evidence

Focal dystonia is a movement disorder characterized by involuntary muscle contractions that determine abnormal postures. The traditional hypothesis that the pathophysiology of focal dystonia entails a single structural dysfunction (i.e. basal ganglia) has recently come under scrutiny. The proposed network disorder model implies that focal dystonias arise from aberrant communication between various brain areas. Based on findings from animal studies, the role of the cerebellum has attracted increased interest in the last few years. Moreover, it has been increasingly reported that focal dystonias also include nonmotor disturbances, including sensory processing abnormalities, which have begun to attract attention. Current evidence from neurophysiological and neuroimaging investigations suggests that cerebellar involvement in the network and mechanisms underlying sensory abnormalities may have a role in determining the clinical heterogeneity of focal dystonias.

Why the whole is more than the sum of its parts: Salience-driven overestimation in aggregated tactile sensations

Experimental psychology often studies perception analytically, reducing its focus to minimal sensory units, such as thresholds or just noticeable differences in a single stimulus. Here, in contrast, we examine a synthetic aspect: how multiple inputs to a sensory system are aggregated into an overall percept. Participants in three experiments judged the total stimulus intensity for simultaneous electrical shocks to two digits. We tested whether the integration of component somatosensory stimuli into a total percept occurs automatically, or rather depends on the ability to consciously perceive discrepancy among components (Experiment 1), whether the discrepancy among these components influences sensitivity or/and perceptual bias in judging totals (Experiment 2), and whether the salience of each individual component stimulus affects perception of total intensity (Experiment 3). Perceptual aggregation of two simultaneous component events occurred both when participants could perceptually discriminate the two intensities, and also when they could not. Further, the actual discrepancy between the stimuli modulated both participants' sensitivity and perceptual bias: increasing discrepancies produced a systematic and progressive overestimation of total intensity. The degree of this bias depended primarily on the salience of the stronger stimulus in the pair. Overall, our results suggest that important nonlinear mechanisms contribute to sensory aggregation. The mind aggregates component inputs into a coherent and synthetic perceptual experience in a salience-weighted fashion that is not based on simple summation of inputs.

Sub-Second Temporal Integration of Vibro-Tactile Stimuli: Intervals between Adjacent, Weak, and Within-Channel Stimuli Are Underestimated

Tactile estimation of sub-second time is essential for correct recognition of sensory inputs and dexterous manipulation of objects. Despite our intuitive understanding that time is robustly estimated in any situation, tactile sub-second time is altered by, for example, body movement, similar to how visual time is modulated by eye movement. The effects of simpler factors, such as stimulus location, intensity, and frequency, have also been reported in temporal tasks in other modalities, but their effects on tactile sub-second interval estimation remain obscure. Here, we were interested in whether a perceived short interval presented by tactile stimuli is altered only by changing stimulus features. The perceived interval between a pair of stimuli presented on the same finger apparently became short relative to that on different fingers; that of a weak-intensity pair relative to that of a pair with stronger intensity was decreased; and that of a pair with the same frequency relative to one with different frequencies was underestimated. These findings can be ascribed to errors in encoding temporal relationships: nearby-space/weak-intensity/similar-frequency stimuli presented within a short time difference are likely to be integrated into a single event and lead to relative time compression.

Effects of 12 Weeks of Chiropractic Care on Central Integration of Dual Somatosensory Input in Chronic Pain Patients: A Preliminary Study

OBJECTIVE

The purpose of this preliminary study was to assess whether the dual somatosensory evoked potential (SEP) technique is sensitive enough to measure changes in cortical intrinsic inhibitory interactions in patients with chronic neck or upper extremity pain and, if so, whether changes are associated with changes in pain scores.

METHODS

The dual peripheral nerve stimulation SEP ratio technique was used for 6 subjects with a history of chronic neck or upper limb pain. SEPs were recorded after left or right median and ulnar nerve stimulation at the wrist. SEP ratios were calculated for the N9, N13, P14-18, N20-P25, and P22-N30 peak complexes from SEP amplitudes obtained from simultaneous median and ulnar stimulation divided by the arithmetic sum of SEPs obtained from individual stimulation of the median and ulnar nerves. Outcome measures of SEP ratios and subjects' visual analog scale rating of pains were recorded at baseline, after a 2-week usual care control period, and after 12 weeks of multimodal chiropractic care (chiropractic spinal manipulation and 1 or more of the following: exercises, peripheral joint adjustments/manipulation, soft tissue therapy, and pain education).

RESULTS

A significant decrease in the median and ulnar to median plus ulnar ratio and the median and ulnar amplitude for the cortical P22-N30 SEP component was observed after 12 weeks of chiropractic care, with no changes after the control period. There was a significant decrease in visual analog scale scores (both for current pain and for pain last week).

CONCLUSION

The dual SEP ratio technique appears to be sensitive enough to measure changes in cortical intrinsic inhibitory interactions in patients with chronic neck pain. The observations in 6 subjects revealed that 12 weeks of chiropractic care improved suppression of SEPs evoked by dual upper limb nerve stimulation at the level of the motor cortex, premotor areas, and/or subcortical areas such as basal ganglia and/or thalamus. It is possible that these findings explain one of the mechanisms by which chiropractic care improves function and reduces pain for chronic pain patients.

Subliminal stimulation and somatosensory signal detection

Only a small fraction of sensory signals is consciously perceived. The brain's perceptual systems may include mechanisms of feedforward inhibition that protect the cortex from subliminal noise, thus reserving cortical capacity and conscious awareness for significant stimuli. Here we provide a new view of these mechanisms based on signal detection theory, and gain control. We demonstrated that subliminal somatosensory stimulation decreased sensitivity for the detection of a subsequent somatosensory input, largely due to increased false alarm rates. By delivering the subliminal somatosensory stimulus and the to-be-detected somatosensory stimulus to different digits of the same hand, we show that this effect spreads across the sensory surface. In addition, subliminal somatosensory stimulation tended to produce an increased probability of responding "yes", whether the somatosensory stimulus was present or not. Our results suggest that subliminal stimuli temporarily reduce input gain, avoiding excessive responses to further small inputs. This gain control may be automatic, and may precede discriminative classification of inputs into signals or noise. Crucially, we found that subliminal inputs influenced false alarm rates only on blocks where the to-be-detected stimuli were present, and not on pre-test control blocks where they were absent. Participants appeared to adjust their perceptual criterion according to a statistical distribution of stimuli in the current context, with the presence of supraliminal stimuli having an important role in the criterion-setting process. These findings clarify the cognitive mechanisms that reserve conscious perception for salient and important signals.

A spatiotemporal signature of cortical pain relief by tactile stimulation: An MEG study

Recently, the cortical mechanisms of tactile-induced analgesia have been investigated; however, spatiotemporal characteristics have not been fully elucidated. The insular-opercular region integrates multiple sensory inputs, and nociceptive modulation by other sensory inputs occurs in this area. In this study, we focused on the insular-opercular region to characterize the spatiotemporal signature of tactile-induced analgesia using magnetoencephalography in 11 healthy subjects. Aδ (intra-epidermal electrical stimulation) inputs were modified by Aβ (mechanical tactile stimulation) selective stimulation, either independently or concurrently, to the right forearm. The optimal inter-stimulus interval (ISI) for cortical level modulation was determined after comparing the 40-, 60-, and 80-ms ISI conditions, and the calculated cortical arrival time difference between Aδ and Aβ inputs. Subsequently, we adopted a 60-ms ISI for cortical modulation and a 0-ms ISI for spinal level modulation. Source localization using minimum norm estimates demonstrated that pain-related activity was located in the posterior insula, whereas tactile-related activity was estimated in the parietal operculum. We also found significant inhibition of pain-related activity in the posterior insula due to cortical modulation. In contrast, spinal modulation was observed both in the posterior insula and parietal operculum. Subjective pain, as evaluated by the visual analog scale, also showed significant reduction in both conditions. Therefore, our results demonstrated that the multisensory integration within the posterior insula plays a key role in tactile-induced analgesia.

Lateral inhibition in the somatosensory cortex during and between migraine without aura attacks: Correlations with thalamocortical activity and clinical features

Background

We studied lateral inhibition in the somatosensory cortex of migraineurs during and between attacks, and searched for correlations with thalamocortical activity and clinical features.

Participants and methods

Somatosensory evoked potentials (SSEP) were obtained by electrical stimulation of the right median (M) or ulnar (U) nerves at the wrist or by simultaneous stimulation of both nerves (MU) in 41 migraine without aura patients, 24 between (MO), 17 during attacks, and in 17 healthy volunteers (HVs). We determined the percentage of lateral inhibition of the N20–P25 component by using the formula [(100)–MU/(M + U)*100]. We also studied high-frequency oscillations (HFOs) reflecting thalamocortical activation.

Results

In migraine, both lateral inhibition (MO 27.9% vs HVs 40.2%; p = 0.009) and thalamocortical activity (MO 0.5 vs HVs 0.7; p = 0.02) were reduced between attacks, but not during. In MO patients, the percentage of lateral inhibition negatively correlated with days elapsed since the last migraine attack ( r = −0.510, p = 0.01), monthly attack duration ( r = −0.469, p = 0.02) and severity ( r = −0.443, p = 0.03), but positively with thalamocortical activity ( r = −0.463, p = 0.02).

Conclusions

We hypothesize that abnormal migraine cycle-dependent dynamics of connectivity between subcortical and cortical excitation/inhibition networks may contribute to clinical features of MO and recurrence of attacks.

Electrical noise modulates perception of electrical pulses in humans: sensation enhancement via stochastic resonance

Although noise is usually considered to be harmful for signal detection and information transmission, stochastic resonance (SR) describes the counterintuitive phenomenon of noise enhancing the detection and transmission of weak input signals. In mammalian sensory systems, SR-related phenomena may arise both in the peripheral and the central nervous system. Here, we investigate behavioral SR effects of subliminal electrical noise stimulation on the perception of somatosensory stimuli in humans. We compare the likelihood to detect near-threshold pulses of different intensities applied on the left index finger during presence vs. absence of subliminal noise on the same or an adjacent finger. We show that (low-pass) noise can enhance signal detection when applied on the same finger. This enhancement is strong for near-threshold pulses below the 50% detection threshold and becomes stronger when near-threshold pulses are applied as brief trains. The effect reverses at pulse intensities above threshold, especially when noise is replaced by subliminal sinusoidal stimulation, arguing for a peripheral direct current addition. Unfiltered noise applied on longer pulses enhances detection of all pulse intensities. Noise applied to an adjacent finger has two opposing effects: an inhibiting effect (presumably due to lateral inhibition) and an enhancing effect (most likely due to SR in the central nervous system). In summary, we demonstrate that subliminal noise can significantly modulate detection performance of near-threshold stimuli. Our results indicate SR effects in the peripheral and central nervous system.

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

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

Interaction of finger representations in the cortex of individuals with autism: a functional window into cortical inhibition

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

kinesiotaping reduces pain and modulates sensory function in patients with focal dystonia: a randomized crossover pilot study

BACKGROUND

Pain is one of the most common and disabling "nonmotor" symptoms in patients with dystonia. No recent study evaluated the pharmacological or physical therapy approaches to specifically treat dystonic pain symptoms.

OBJECTIVE

To evaluate the effectiveness of KinesioTaping in patients with cervical dystonia (CD) and focal hand dystonia (FHD) on self-reported pain (primary objective) and on sensory functions (secondary objective).

METHODS

Twenty-five dystonic patients (14 with CD and 11 FHD) entered a randomized crossover pilot study. The patients were randomized to 14-day treatment with KinesioTaping or ShamTaping over neck (in CD) or forearm muscles (in FHD), and after a 30-day washout period, they received the other treatment. The

MAIN OUTCOME MEASURES

were 3 visual analog scales (VASs) for usual pain, worst pain, and pain relief. Disease severity changes were evaluated by means of the Toronto Western Spasmodic Torticollis Rating Scale (CD) and the Writer's Cramp Rating Scale (FHD). Furthermore, to investigate possible KinesioTaping-induced effects on sensory functions, we evaluated the somatosensory temporal discrimination threshold.

RESULTS

Treatment with KinesioTape induced a decrease in the subjective sensation of pain and a modification in the ability of sensory discrimination, whereas ShamTaping had no effect. A significant, positive correlation was found in both groups of patients between the improvement in the subjective sensation of pain and the reduction of somatosensory temporal discrimination threshold values induced by KinesioTaping.

CONCLUSIONS

These preliminary results suggest that KinesioTaping may be useful in treating pain in patients with dystonia.

Somatotopic finger mapping using MEG: toward an optimal stimulation paradigm

OBJECTIVE

In non-invasive somatotopic mapping based on neuromagnetic source analysis, the recording time can be shortened and accuracy improved by applying simultaneously vibrotactile stimuli at different frequencies to multiple body sites and recording multiple steady-state responses. This study compared the reliability of sensory evoked responses, source localization performance, and reproducibility of digit maps for three different stimulation paradigms.

METHODS

Vibrotactile stimuli were applied to the fingertip and neuromagnetic steady-state responses were recorded. Index and middle fingers were stimulated either sequentially in separate blocks, simultaneously at different frequencies, or in alternating temporal order within a block.

RESULTS

Response amplitudes were largest and source localization was most accurate between 21 and 23 Hz. Separation of adjacent digits was significant for all paradigms in all participants. Suppressive interactions occurred between simultaneously applied stimuli. However, when frequently alternating between stimulus sites, the higher stimulus novelty resulted in increased amplitudes and superior localization performance.

CONCLUSIONS

When receptive fields are strongly overlapping, the alternating stimulation is preferable over recording multiple steady state responses.

SIGNIFICANCE

The new paradigm improved the measurement of the distance of somatotopic finger representation in human primary somatosensory cortex, which is an important metric for neuroplastic reorganization after learning and rehabilitation training.

The functional architecture of S1 during touch observation described with 7 T fMRI

Recent studies indicate that the primary somatosensory cortex (S1) is active not only when touch is physically perceived but also when it is merely observed to be experienced by another person. This social responsivity of S1 has important implications for our understanding of S1 functioning. However, S1 activity during touch observation has not been characterized in great detail to date. We focused on two features of the S1 functional architecture during touch observation, namely the topographical arrangement of index and middle finger receptive fields (RFs), and their dynamic shrinkage during concurrent activation. Both features have important implications for human behavior. We conducted two fMRI studies at 7 T, one where touch was physically perceived, and one where touch was observed. In the two experiments, participants either had their index finger and/or middle finger stimulated using paintbrushes, or just observed similar touch events on video. Our data show that observing and physically experiencing touch elicits overlapping activity changes in S1. In addition, observing touch to the index finger or the middle finger alone evoked topographically arranged activation foci in S1. Importantly, when co-activated, the index and middle finger RFs not only shrank during physical touch perception, but also during touch observation. Our data, therefore, indicate a similarity between the functional architecture of S1 during touch observation and physical touch perception with respect to single-digit topography and RF shrinkage. These results may allow the tentative conclusion that even primary somatosensory experiences, such as physical touch perception, can be shared amongst individuals.

Targeting the Pedunculopontine Nucleus

BACKGROUND:

Pedunculopontine tegmental nucleus (PPTg) deep brain stimulation (DBS) has been used in patients with Parkinson disease.

OBJECTIVE:

To verify the position of the DBS lead within the pons during PPTg targeting.

METHODS:

In 10 Parkinson disease patients undergoing electrode implantation in the PPTg, somatosensory evoked potentials were recorded after median nerve stimulation from the 4 DBS electrode contacts and from 2 scalp leads placed in the frontal and parietal regions.

RESULTS:

The DBS electrode recorded a P16 potential (latency at contact 0, 16.33 ± 0.76 ms). There was a P16 latency shift of 0.18 ± 0.07 ms from contact 0 (lower) to contact 3 (upper). The scalp electrodes recorded the P14 far-field response (latency, 15.44 ± 0.63 ms) and the cortical N20 potential (latency, 21.58 ± 1.42 ms). The P16 potentials recorded by the intracranial electrode contacts are generated by the volley traveling along the medial lemniscus, whereas the scalp P14 potential represents a far-field response generated at the Obex level. Considering that the distance between the electrode contacts 0 and 3 is 6 mm, the distance of the electrode contact 0 from the Obex (ΔObex) was calculated by the equation: ΔObex = 6 × Δlatency P14- PPTg0/Δlatency PPTg0-PPTg3. The Obex-to-brainstem electrode distance obtained by the neurophysiological method confirmed that the electrode was located within the pons in all patients. Moreover, this distance was very similar to that issued from the individual brain magnetic resonance imaging.

CONCLUSION:

Somatosensory evoked potentials may be a helpful tool for calculating the macroelectrode position within the pons during PPTg targeting.

Vision of the body modulates somatosensory intracortical inhibition

The magnitude of somatosensory evoked potentials (SEPs) elicited by simultaneous electrical stimulation of adjacent digits is generally less than the sum of potentials evoked by stimulation of each digit individually. This under-additivity suggests suppression between representations of adjacent skin regions and may reflect a process of lateral inhibition by interneurons in somatosensory cortex. Given that simply viewing the body enhances tactile acuity and that tactile acuity depends on cortical lateral inhibition, we investigated how viewing the body modulates suppressive interactions between simultaneous afferent volleys from adjacent fingers. We recorded SEPs evoked by electrical stimulation of the right index and middle fingers, either individually or simultaneously, while participants viewed either their own hand or an object. In between trains of electrical stimuli, participants discriminated the orientation of tactile gratings applied to either finger. Consistent with previous findings, viewing the hand enhanced tactile acuity. Furthermore, viewing the hand increased the suppression of the P50 potential due to simultaneous electrical stimulation of both fingers. Moreover, the visual enhancement of tactile performance correlated across participants with the visual modulation of suppression. These results demonstrate that vision enhances somatosensation by modulating activity of inhibitory interneuronal circuits in the somatosensory cortex.

Altered central integration of dual somatosensory input after cervical spine manipulation

OBJECTIVE

The aim of the current study was to investigate changes in the intrinsic inhibitory interactions within the somatosensory system subsequent to a session of spinal manipulation of dysfunctional cervical joints.

METHOD

Dual peripheral nerve stimulation somatosensory evoked potential (SEP) ratio technique was used in 13 subjects with a history of reoccurring neck stiffness and/or neck pain but no acute symptoms at the time of the study. Somatosensory evoked potentials were recorded after median and ulnar nerve stimulation at the wrist (1 millisecond square wave pulse, 2.47 Hz, 1 x motor threshold). The SEP ratios were calculated for the N9, N11, N13, P14-18, N20-P25, and P22-N30 peak complexes from SEP amplitudes obtained from simultaneous median and ulnar (MU) stimulation divided by the arithmetic sum of SEPs obtained from individual stimulation of the median (M) and ulnar (U) nerves.

RESULTS

There was a significant decrease in the MU/M + U ratio for the cortical P22-N30 SEP component after chiropractic manipulation of the cervical spine. The P22-N30 cortical ratio change appears to be due to an increased ability to suppress the dual input as there was also a significant decrease in the amplitude of the MU recordings for the same cortical SEP peak (P22-N30) after the manipulations. No changes were observed after a control intervention.

CONCLUSION

This study suggests that cervical spine manipulation may alter cortical integration of dual somatosensory input. These findings may help to elucidate the mechanisms responsible for the effective relief of pain and restoration of functional ability documented after spinal manipulation treatment.

Transient and steady-state responses to mechanical stimulation of different fingers reveal interactions based on lateral inhibition

OBJECTIVE

Simultaneous tactile finger stimulation evokes transient ERP responses that are smaller than the linear summation of ERP responses to individual stimulation. Occlusion and lateral inhibition are two possible mechanisms responsible for this effect. The present study disentangles these two effects using steady-state somatosensory evoked potentials (SSSEP). Simultaneous stimulation on adjacent and distant finger pairs with the same and different stimulation frequencies are compared.

METHODS

The index finger (IF), middle finger (MF) and little finger (LF) were mechanically stimulated with a frequency of 18, 22 or 26Hz, respectively. Stimulation was applied for each finger separately, and for the IF (18Hz) in combination with either the MF or LF for 22 and 26Hz, respectively. A measure for interaction (IR) was calculated for the P60 component and the SSSEP amplitude.

RESULTS

Significant interactions were found in both the P60 response and in the SSSEP response. Stimulation of adjacent finger combinations caused more interaction than distant finger combinations. No difference was found between stimulation of two fingers with the same or a different frequency.

CONCLUSIONS

Our results indicate that lateral inhibition is mainly responsible for the interaction effect.

SIGNIFICANCE

These observations provide further insight in the mechanisms behind interaction between somatosensory inputs.

Cutaneous stimulation of the digits and lips evokes responses with different adaptation patterns in primary somatosensory cortex

Neuromagnetic evoked fields were recorded to compare the adaptation of the primary somatosensory cortex (SI) response to tactile stimuli delivered to the glabrous skin at the fingertips of the first three digits (condition 1) and between midline upper and lower lips (condition 2). The stimulation paradigm allowed to characterize the response adaptation in the presence of functional integration of tactile stimuli from adjacent skin areas in each condition. At each stimulation site, cutaneous stimuli (50 ms duration) were delivered in three runs, using trains of 6 pulses with regular stimulus onset asynchrony (SOA). The pulses were separated by SOAs of 500 ms, 250 ms or 125 ms in each run, respectively, while the inter-train interval was fixed (5s) across runs. The evoked activity in SI (contralateral to the stimulated hand, and bilaterally for lips stimulation) was characterized from the best-fit dipoles of the response component peaking around 70 ms for the hand stimulation, and 8 ms earlier (on average) for the lips stimulation. The SOA-dependent long-term adaptation effects were assessed from the change in the amplitude of the responses to the first stimulus in each train. The short-term adaptation was characterized by the lifetime of an exponentially saturating model function fitted to the set of suppression ratios of the second relative to the first SI response in each train. Our results indicate: 1) the presence of a rate-dependent long-term adaptation effect induced only by the tactile stimulation of the digits; and 2) shorter recovery lifetimes for the digits compared with the lips stimulation.

Responses of areas 3b and 1 in anesthetized squirrel monkeys to single- and dual-site stimulation of the digits

Stimulation of the skin evokes topographically organized activation in somatosensory cortex. This representation is context dependent, however, since a different cortical topography is observed in area 3b when stimulated with complex tactile stimuli that evoke the von Békésy funneling illusion. Here we report on the population responses, as observed with intrinsic optical imaging, of area 1 and area 3b in the anesthetized squirrel monkey to pressure indentation of distal finger pads. Individual finger pad stimulation revealed that area 1 exhibited a smaller magnification factor than 3b, as evidenced by a smaller area of activation elicited by distal finger pad stimulation. Effects of paired finger pad stimulation produced largely similar effects in area 1 and area 3b. Paired finger pad stimulation produced reductions in the area of digit activation in area 1, suggesting the presence of lateral inhibition and funneling of information in area 1. Suppressive effects were stronger for paired stimulations at adjacent than at nonadjacent sites. Single-unit recordings revealed a mixture of either a summation or a suppression of the response to paired finger stimulation, compared with single finger pad stimulation of the primary digit. However, the average population response showed that paired finger pad stimulation resulted in response suppression. Based on this study and previous studies, we suggest the presence of at least three distinct ranges of lateral inhibition in areas 3b and 1.

Subcortical Interactions Between Somatosensory Stimuli of Different Modalities and Their Temporal Profile

Interactions between inputs of different sensory modality occur along the sensory pathway, including the thalamus. However, the temporal profile of such interaction has not been fully studied. In eight patients who had been implanted an intrathalamic electrode for deep brain stimulation as symptomatic treatment of tremor, we investigated the interactions between mechanical taps and electrical nerve stimuli. Somatosensory evoked potentials (SEPs) were recorded from Erb's point, cervical spinal cord, nucleus ventrointermedialis of the thalamus, and parietal cortex. A handheld electronic reflex hammer was used to deliver a mechanical tap to the skin overlying the first dorsal interosseous muscle and to trigger an ipsilateral digital median nerve electrical stimulus time-locked to the mechanical tap with a variable delay of 0 to 50 ms. There were significant time-dependent interactions between the two sensory volleys at the subcortical level. Thalamic SEPs were decreased in amplitude at interstimulus intervals (ISIs) from 10 to 40 ms with maximum effect at 20 ms (−42.8 ± 10.5%; P < 0.001). A similar decrease was also seen in the number and frequency of the high-frequency components of thalamic SEPs (−25 ± 4%). A smaller reduction (−18.1 ± 5.8%; P < 0.001) was present in upper cervical response at ISI = 20 ms. There were no changes in peripheral responses. Cortical SEPs were almost completely absent in some subjects at ISIs from 20 to 50 ms. There were no changes in SEP latencies. Our results indicate that significant time-dependent interactions between sensory volleys occur at the subcortical level. These observations provide further insight into the physiological mechanisms underlying afferent gating between sensory volleys of different modality.

Inhibitory impact of subliminal electrical finger stimulation on SI representation and perceptual sensitivity of an adjacent finger

Simultaneous stimulation of two adjacent fingers above sensory perception threshold (supraliminal stimulation) leads to an inhibitory interaction effect on responses in primary somatosensory cortex (SI). Moreover, during electrical finger stimulation closely below threshold for conscious perception (subliminal stimulation) inhibitory interneurons in cortical layer 4 are assumed to be activated preferentially as compared to excitatory interneurons. Using fMRI in humans, here we show that interspersed subliminal electrical stimulation of an adjacent finger reduces the response to target finger stimulation in contralateral SI. This effect was shown in a complementary study to be associated behaviorally with a diminished detectability of test pulses on the target finger. We propose the mechanism underlying this lateral inhibitory effect to be related to a representational overlap of inhibitory interneurons in SI based on the divergence of thalamocortical feedforward projections, or to intracortical lateral inhibitory projections targeting juxtaposed receptive fields, or both.

Conditioning transcutaneous electrical nerve stimulation induces delayed gating effects on cortical response: A magnetoencephalographic study

The present study was undertaken to investigate after-effects of 7 Hz non-painful prolonged stimulation of the median nerve on somatosensory-evoked fields (SEFs). The working hypothesis that conditioning peripheral stimulations might produce delayed interfering ("gating") effects on the response of somatosensory cortex to test stimuli was evaluated. In the control condition, electrical thumb stimulation induced SEFs in ten subjects. In the experimental protocol, a conditioning median nerve stimulation at wrist preceded 6 electrical thumb stimulations. Equivalent current dipoles fitting SEFs modeled responses of contralateral primary area (SI) and bilateral secondary somatosensory areas (SII) following control and experimental conditions. Compared to the control condition, conditioning stimulation induced no amplitude modulation of SI response at the initial stimulus-related peak (20 ms). In contrast, later response from SI (35 ms) and response from SII were significantly weakened in amplitude. Gradual but fast recovery towards control amplitude levels was observed for the response from SI-P35, while a slightly slower cycle was featured from SII. These findings point to a delayed "gating" effect on the synchronization of somatosensory cortex after peripheral conditioning stimulations. This effect was found to be more lasting in SII area, as a possible reflection of its integrative role in sensory processing.

Altered cortical integration of dual somatosensory input following the cessation of a 20 min period of repetitive muscle activity

The adult human central nervous system (CNS) retains its ability to reorganize itself in response to altered afferent input. Intracortical inhibition is thought to play an important role in central motor reorganization. However, the mechanisms responsible for altered cortical sensory maps remain more elusive. The aim of the current study was to investigate changes in the intrinsic inhibitory interactions within the somatosensory system subsequent to a period of repetitive contractions. To achieve this, the dual peripheral nerve stimulation somatosensory evoked potential (SEP) ratio technique was utilized in 14 subjects. SEPs were recorded following median and ulnar nerve stimulation at the wrist (1 ms square wave pulse, 2.47 Hz, 1x motor threshold). SEP ratios were calculated for the N9, N11, N13, P14-18, N20-P25 and P22-N30 peak complexes from SEP amplitudes obtained from simultaneous median and ulnar (MU) stimulation divided by the arithmetic sum of SEPs obtained from individual stimulation of the median (M) and ulnar (U) nerves. There was a significant increase in the MU/M + U ratio for both cortical SEP components following the 20 min repetitive contraction task, i.e. the N20-P25 complex, and the P22-N30 SEP complex. These cortical ratio changes appear to be due to a reduced ability to suppress the dual input, as there was also a significant increase in the amplitude of the MU recordings for the same two cortical SEP peaks (N20-P25 and P22-N30) following the typing task. No changes were observed following a control intervention. The N20 (S1) changes may reflect the mechanism responsible for altering the boundaries of cortical sensory maps, changing the way the CNS perceives and processes information from adjacent body parts. The N30 changes may be related to the intracortical inhibitory changes shown previously with both single and paired pulse TMS. These findings may have implications for understanding the role of the cortex in the initiation of overuse injuries.

Sensory-motor interaction in primary hand cortical areas: A magnetoencephalography assessment

Movement control requires continuous and reciprocal exchange of information between activities of motor areas involved in the task program execution and those elaborating proprioceptive sensory information. Our aim was to investigate the sensorimotor interactions in the region dedicated to hand control in healthy humans, focusing onto primary sensory and motor cortices, by selecting the time window at very early latencies. Through magnetoencephalographic recordings, we obtained a simultaneous assessment of sensory cortex activity modulation due to movement and of motor cortex activity modulation due to sensory stimulation, by eliciting a galvanic stimulation to the nerve (the median nerve) innervating a muscle (the opponens pollicis), at rest or during voluntary contraction. The primary sensory and motor cortices activities were investigated respectively through excitability in response to sensory stimulation and the cortico-muscular coherence. The task was performed bilaterally. A clear reduction of the cortico-muscular coherence was found in the short time window following stimuli (between around 150-450 ms). In the same time period, the motor control of isometric contraction was preserved. This could suggest that cortical component of voluntary movement control was transiently mediated by neuronal firing rate tuning more than by cortico-muscular synchronization. In addition to the known primary sensory cortex inhibition due to movement, a more evident reduction was found for the component known to include a contribution from primary motor areas. Gating effects were lower in the dominant left hemisphere, suggesting that sensorimotor areas dominant for hand control benefit of narrowing down gating effects.

Sub-area-specific Suppressive Interaction in the BOLD responses to simultaneous finger stimulation in human primary somatosensory cortex: evidence for increasing rostral-to-caudal convergence

In the primary somatosensory cortex (SI) of non-human primates, receptive field properties have been shown to differ between its sub-areas with increasing convergence in areas 1 and 2 as compared with area 3b. In this study, we searched for a similar functional organization of human SI. We performed fMRI in healthy subjects during separate or simultaneous electrical stimulation of the second and third finger of the right hand. Activation patterns in response to stimulation of single fingers reflected the somatotopical arrangement within the hand area of SI. Somatotopy was more clear-cut in area 3b as compared with areas 1 and 2. The response to simultaneous stimulation was considerably smaller than the summed responses to separate stimulation of each finger alone, pointing to a suppressive interaction effect. A region-of-interest analysis in the representational areas of the second and third finger revealed sub-area-specific differential suppressive interaction with an increase along the rostral-caudal axis (areas 3b, 1 and 2: 26, 32.7 and 42.2%, respectively). These findings on differences in the topographic as well as functional organization between sub-areas of SI support the notion of increasing convergence and integration from area 3b to areas 1 and 2 in human subjects.

Dissociated effects of diazepam and lorazepam on short-latency afferent inhibition

Peripheral nerve inputs have an inhibitory effect on motor cortex excitability at short intervals (short-latency afferent inhibition, SAI). This can be tested by coupling electrical stimulation of peripheral nerve with transcranial magnetic stimulation (TMS) of the motor cortex. SAI is reduced by the anticholinergic drug scopolamine, and in patients with Alzheimer's disease. Therefore, it is possible that SAI is a marker of central cholinergic activity important for memory function. The benzodiazepine lorazepam also reduces SAI. Since benzodiazepines impair memory formation, but do not do so uniformly, with a maximum amnesic effect after lorazepam but less or no effect after diazepam, we were interested in testing in this non-behavioural study to what extent the effects of lorazepam and diazepam on circuits involved in SAI could be dissociated. In addition, and for control, we tested the effects of lorazepam and diazepam on short-interval intracortical inhibition (SICI), a motor cortical inhibition mediated through the GABA(A) receptor. Lorazepam markedly reduced SAI, whereas diazepam slightly increased it. In contrast, both benzodiazepines uniformly increased SICI. Our findings demonstrate opposite effects of lorazepam and diazepam on SAI, an inhibition modulated by central cholinergic activity, but the same effects on SICI, a marker of neurotransmission through the GABA(A) receptor. This dissociation suggests, for the first time, that TMS measures of cortical inhibition provide the opportunity to segregate differences of benzodiazepine action in human central nervous system circuits.

Sensorimotor integration to cutaneous afferents in humans: the effect of the size of the receptive field

Transcranial magnetic stimulation (TMS) can be used to study sensorimotor integration in humans non-invasively. Motor excitability has been found to be inhibited when afferent stimuli are given to a peripheral nerve and precede TMS at interstimulus intervals (ISIs) of 20-50 ms. This phenomenon has been referred to as short-latency afferent inhibition (SAI). To better understand the functional meaning of these phenomena, we examined the effect of the size of the receptive field on SAI to cutaneous afferents in upper-limb sensorimotor areas in humans. We examined the effect of the stimulation of the isolated right first (D1), second (D2) and third finger (D3), the right second and third finger together (D23) and the right first three fingers together (D123) on the amplitude of motor evoked potentials (MEPs) to TMS in hand and forearm muscles. We examined the right abductor pollicis brevis (APB), first dorsal interosseous (FDI), extensor carpi radialis (ECR) and flexor carpi radialis (FCR) muscles. Digital stimulation preceded TMS at ISIs of 20-50 ms. The effect of D2 stimulation was MEP inhibition (SAI), which was more marked and consistent in APB and FDI muscles than in ECR and FCR muscles. Similarly, D1 and D3 stimulation caused MEP reduction, while no MEP enhancement could be found to single finger stimulation. In contrast, D123 stimulation induced less effective SAI in upper-limb muscles. MEP potentiation was recorded in some muscles to D123 stimulation. A significant difference between D2 and D123 stimulation was found in APB (ISIs = 30-50 ms) and FDI (ISIs = 40-50 ms) muscles, but not in forearm muscles. The effect to D23stimulation on MEP amplitude was intermediate between those to D2 and D123 stimulation. Our data suggest that motor excitability to cutaneous afferents may be influenced by the size of the receptive fields, this effect being the result of increasing convergence between hand afferents in the somatosensory system. These phenomena appear to be topographically arranged across the representation of upper-limb muscles. These findings may help to understand the functional significance of SAI in normal physiology and pathophysiology.

Attention induces reciprocal activity in the human somatosensory cortex enhancing relevant- and suppressing irrelevant inputs from fingers

OBJECTIVE

We studied whether attention regulates information processing in the human primary somatosensory cortex (SI) by selective enhancement of relevant- and suppression of irrelevant information.

METHODS

Under successive and simultaneous electric stimuli to both the right index and middle fingers, tactile stimuli were randomly (20%) presented on one of the two fingers in separate two runs exchanging the finger. Subjects were requested to discriminate the tactile stimuli in an attention task to induce attention to one finger and to ignore the stimuli in a control task to avoid such an attention focus. Somatosensory evoked magnetic fields were measured only for the two-finger electric stimulation and an early component (M50) was analyzed.

RESULTS

In spite of the two-finger simultaneous stimulation, attention to either the index or middle finger lowered or heightened the M50-sourse location, respectively. The attention task did not increase the M50 amplitude.

CONCLUSIONS

Attention to a finger enhanced selectively the representation of the finger in the SI cortex. However, this SI activity did not increase the M50 amplitude, suggesting that the attention suppressed another finger region receiving the unattended inputs.

SIGNIFICANCE

Attention regulates the SI activity by selectively enhancing the task-relevant information and by filtering out other noise inputs.

“Gating” effects of simultaneous peripheral electrical stimulations on human secondary somatosensory cortex: a whole-head MEG study

The secondary somatosensory cortex (SII) is strongly involved in the processing of somatosensory tactile and nociceptive sensations. We investigated the effect on SII responses of simultaneous painful and nonpainful electrical stimulations delivered to the thumb and little finger. According to the "bimodal" (i.e., nociceptive, tactile) organization of SII, it was expected that simultaneous painful and nonpainful stimulations would lead to modality interference with a marked reduction ("gating") of somatosensory evoked fields (SEFs) generated in SII. Eight different stimulus conditions were studied. Two conditions were simultaneous "unimodal" (thumb and little finger nonpainful; thumb and little finger painful) and two conditions were simultaneous "bimodal" (thumb nonpainful and little finger painful; thumb painful and little finger nonpainful). As a reference, four conditions included stimulations at single sites (thumb nonpainful, little finger nonpainful, thumb painful, little finger painful). The gating phenomenon was defined as the percentage of difference between the intensities of SII activation after simultaneous compared to the sum of the separate stimulations. Results showed that simultaneous stimulations induced gating effects on SEFs generated by SII. No significant gating differences were observed after the two unimodal stimulations, suggesting a negligible effect of global energy on gating. Instead, the gating effects on bilateral SII activity were stronger after simultaneous bimodal when compared to unimodal stimulations. Our findings hint that there could be a greater level of integration/convergence of painful and nonpainful stimuli in SII with respect to SI. Future studies should explore if it could have an important role in exploring pain relief.

Hand posture modulates neuronal interaction in the primary somatosensory cortex of humans

OBJECTIVE

To investigate the effects of hand posture on the modulation of neuronal interactions in the cortical finger regions of the human somatosensory cortex.

METHODS

Neuronal magnetic fields, evoked by electrical stimuli to the thumb and/or to the index finger of the right hand, were recorded in different hand postures ('OPEN': opened hand and 'CLOSE': both fingers in opposite position to pick up something) by using a whole head type magnetoencephalography. The equivalent current dipole (ECD) for components in the primary (SI) and secondary somatosensory cortices (SII) was calculated. The interaction ratio (IR) was calculated as a ratio of the vector sum of ECD moments evoked by respective stimulation of each finger to the ECD moment evoked by simultaneous stimulation of both fingers.

RESULTS

The mean IR of N20m was significantly larger in CLOSE than in OPEN (p=0.033, ANOVA). On the contrary, the IR of P40m was larger in OPEN than in CLOSE (p=0.042). The IR of SII components was not significantly different between the different hand postures (p=0.35).

CONCLUSIONS

Neuronal interaction between the thumb and index finger in the human SI is modulated by hand posture. Provided that forming hand posture is related to receiving sensory input, the interaction modulation may play a role in the facilitation of somatosensory processing.

SIGNIFICANCE

Our results suggest experimental evidence for the immediate modulation of neuronal activity in the somatosensory area.

Finger movement is associated with attenuated cutaneous reflexes recorded from human first dorsal interosseous muscle

Cutaneomuscular reflexes (CMR) have been recorded from the first dorsal interosseous muscle (1DI) of the preferred hand, somatosensory evoked potentials (SEP) were recorded from the contralateral sensory cortex and the sensory nerve action potential (SNAP) was recorded from the median nerve of 15 adult subjects whilst electrically stimulating the digital nerves of the index finger. Subjects performed the following tasks (a) a sustained abduction of the index finger against resistance at 10-20 % maximum voluntary contraction (MVC), and (b) abduction of the index finger as in (a) whilst performing self paced low amplitude tapping of the (i) index finger, (ii) thumb, (iii) middle finger, (iv) little finger and (v) ipsilateral foot. The E2 component of the CMR and the N20/P25 components of the SEP were significantly reduced during finger tapping (P < 0.05). This reduction was independent of which finger was tapping (P > 0.05). There was a significant (qualitative) relationship between the decrease in the size of the E2 component of the CMR and the N20/P25 components of the SEP ((2) test; P < 0.05). There were no significant changes in E1 and I1 (P > 0.05). The size of the SNAP was independent of task (P > 0.05). The size of the E1, I1, E2 components of the CMR, and the N20/P25 components of the SEP were unaltered during foot tapping (P > 0.05, n = 4). We conclude that the decrease in size of the E2 component associated with finger tapping results from gating of the digital nerve input.

Neural mechanisms for generation of tactile interference effects on somatosensory evoked magnetic fields in humans

OBJECTIVES

We examined modification of somatosensory evoked fields following electric middle finger stimulation with interference to the same and surrounding digits in 13 subjects.

METHODS

During electric middle finger stimulation, concurrent tactile stimulation was applied to the middle finger, to the index and ring fingers, and to the thumb and the little finger, individually.

RESULTS

The amplitudes of the N20m and the P30m were significantly reduced by the interference to the middle finger, and to the index and ring fingers. The former interference induced more prominent attenuation than the latter. The amplitudes of the P60m did not show significant changes by any kind of the interference.

CONCLUSIONS

The N20m and the P30m were attenuated according to the cortical distance between electrically and mechanically activated 3b areas. Pyramidal neurons are interconnected by intrinsic horizontal collaterals, even if their representations are segregated. The activation of the intrinsic collaterals induces direct excitation and indirect inhibition (via inhibitory interneurons) to the target pyramidal neurons. The result indicates that the activation of the intrinsic collaterals inhibits, on balance, the postsynaptic pyramidal targets, thereby generating the attenuation of the N20m and P30m.