Homuncular organization of human motor cortex as indicated by neuromagnetic recordings

Neurophysiological Basis of Deep Brain Stimulation and Botulinum Neurotoxin Injection for Treating Oromandibular Dystonia

Oromandibular dystonia (OMD) induces severe motor impairments, such as masticatory disturbances, dysphagia, and dysarthria, resulting in a serious decline in quality of life. Non-invasive brain-imaging techniques such as electroencephalography (EEG) and magnetoencephalography (MEG) are powerful approaches that can elucidate human cortical activity with high temporal resolution. Previous studies with EEG and MEG have revealed that movements in the stomatognathic system are regulated by the bilateral central cortex. Recently, in addition to the standard therapy of botulinum neurotoxin (BoNT) injection into the affected muscles, bilateral deep brain stimulation (DBS) has been applied for the treatment of OMD. However, some patients' OMD symptoms do not improve sufficiently after DBS, and they require additional BoNT therapy. In this review, we provide an overview of the unique central spatiotemporal processing mechanisms in these regions in the bilateral cortex using EEG and MEG, as they relate to the sensorimotor functions of the stomatognathic system. Increased knowledge regarding the neurophysiological underpinnings of the stomatognathic system will improve our understanding of OMD and other movement disorders, as well as aid the development of potential novel approaches such as combination treatment with BoNT injection and DBS or non-invasive cortical current stimulation therapies.

Beyond language: The unspoken sensory-motor representation of the tongue in non-primates, non-human and human primates

The English idiom "on the tip of my tongue" commonly acknowledges that something is known, but it cannot be immediately brought to mind. This phrase accurately describes sensorimotor functions of the tongue, which are fundamental for many tongue-related behaviors (e.g., speech), but often neglected by scientific research. Here, we review a wide range of studies conducted on non-primates, non-human and human primates with the aim of providing a comprehensive description of the cortical representation of the tongue's somatosensory inputs and motor outputs across different phylogenetic domains. First, we summarize how the properties of passive non-noxious mechanical stimuli are encoded in the putative somatosensory tongue area, which has a conserved location in the ventral portion of the somatosensory cortex across mammals. Second, we review how complex self-generated actions involving the tongue are represented in more anterior regions of the putative somato-motor tongue area. Finally, we describe multisensory response properties of the primate and non-primate tongue area by also defining how the cytoarchitecture of this area is affected by experience and deafferentation.

A review of magnetoencephalography use in pediatric epilepsy: an update on best practice

Introduction: Magnetoencephalography (MEG) is a noninvasive technique that is used for presurgical evaluation of children with drug-resistant epilepsy (DRE).Areas covered: The contributions of MEG for localizing the epileptogenic zone are discussed, in particular in extra-temporal lobe epilepsy and focal cortical dysplasia, which are common in children, as well as in difficult to localize epilepsy such as operculo-insular epilepsy. Further, the authors review current evidence on MEG for mapping eloquent cortex, its performance, application in clinical practice, and potential challenges.Expert opinion: MEG could change the clinical management of children with DRE by directing placement of intracranial electrodes thereby enhancing their yield. With improved identification of a circumscribed epileptogenic zone, MEG could render more patients as suitable candidates for epilepsy surgery and increase utilization of surgery.

Feasibility and Challenges of Performing Magnetoencephalography Experiments in Children With Arthrogryposis Multiplex Congenita

Arthrogryposis multiplex congenita (AMC) has recently drawn substantial attention from researchers and clinicians. New effective surgical and physiotherapeutic methods have been developed to improve the quality of life of patients with AMC. While it is clear that all these interventions should strongly rely on the plastic reorganization of the central nervous system, almost no studies have investigated this topic. The present study demonstrates the feasibility of using magnetoencephalography (MEG) to investigate brain activity in young AMC patients. We also outlined the general challenges and limitations of electrophysiological investigations on patients with arthrogryposis. We conducted MEG recordings using a 306-channel Elekta Neuromag VectorView system during a cued motor task performance in four patients with arthrogryposis, five normally developed children, and five control adults. Following the voice command of the experimenter, each subject was asked to bring their hand toward their mouth to imitate the self-feeding process. Two patients had latissimus dorsi transferred to the biceps brachii position, one patient had a pectoralis major transferred to the biceps brachii position, and one patient had no elbow flexion restoration surgery before the MEG investigation. Three patients who had undergone autotransplantation prior to the MEG investigation demonstrated activation in the sensorimotor area contralateral to the elbow flexion movement similar to the healthy controls. One patient who was recorded before the surgery demonstrated subjectively weak distributed bilateral activation during both left and right elbow flexion. Visual inspection of MEG data suggested that neural activity associated with motor performance was less pronounced and more widely distributed across the cortical areas of patients than of healthy control subjects. In general, our results could serve as a proof of principle in terms of the application of MEG in studies on cortical activity in patients with AMC. Reported trends might be consistent with the idea that prolonged motor deficits are associated with more difficult neuronal recruitment and the spatial heterogeneity of neuronal sources, most likely reflecting compensatory neuronal mechanisms. On the practical side, MEG could be a valuable technique for investigating the neurodynamics of patients with AMC as a function of postoperative abilitation.

Response certainty during bimanual movements reduces gamma oscillations in primary motor cortex

Even when movement outputs are identical, the neural responses supporting them might differ substantially in order to adapt to changing environmental contexts. Despite the essential nature of this adaptive capacity of the human motor system, little is known regarding the effects of contextual response (un)certainty on the neural dynamics known to serve motor processing. In this study, we use a novel bimanual motor task and neuroimaging with magnetoencephalography (MEG) to examine the effects of contextual response certainty on the dynamic neural responses that are important for proper movement. Significant neural responses were identified in the time-frequency domain at the sensor-level and imaged to the cortex using a spectrally resolved beamformer. Combined frequentist and Bayesian statistical testing between neural motor responses under certain and uncertain conditions indicated evidence for no conditional effect on the peri-movement beta desynchronization (18 - 28 Hz; -100 to 300 ms). In contrast, the movement-related gamma synchronization (MRGS; 66 - 86 Hz; -50 to 150 ms) exhibited a robust effect of motor certainty, such that increased contextual response certainty reduced the amplitude of this response. Interestingly, the peak frequency of the MRGS was unaffected by response certainty. These findings both advance our understanding of the neural processes required to adapt our movements under altered environmental contexts, and support the growing conceptualization of the MRGS as being reflective of ongoing higher cognitive processes during movement execution.

Beta-Range Corticomuscular Coupling Reflects Asymmetries in Hand Movement

Hand movement in humans is verified as asymmetries and lateralization, and two hemispheres make some distinct but complementary contributions in the control of hand movement. However, little research has been done on whether the information transfer of the motor system is different between left and right hand movement. Considering the importance of functional corticomuscular coupling (FCMC) between the motor cortex and contralateral muscle in movement assessment, this study aimed to explore the differences between left and right hand by investigating the interaction between muscle and brain activity. Here, we applied the transfer spectral entropy (TSE) algorithm to quantize the connection between electroencephalogram (EEG) over the brain scalp and electromyogram (EMG) from extensor digitorum (ED) and flexor digitorum superficialis (FDS) muscles recorded simultaneously during a gripping task. Eight healthy subjects were enrolled in this study. Results showed that left hand yielded narrower and lower beta synchronization compared to the right. Further analysis indicated coupling strength in EEG-EMG(FDS) combination was higher at beta band than that in EEG-EMG(ED) combination, and exhibited distinct differences between descending (EEG to EMG direction) and ascending (EMG to EEG direction) direction. This study presents the distinctions of beta-range FCMC between left and right hand, and confirms the importance of beta synchronization in understanding the mechanism of motor stability control. The cortex-muscle FCMC might be used as an evaluation approach to explore the difference between left and right movement system.

Corticomotor reorganization during short-term visuomotor training in the lower back: A randomized controlled study

INTRODUCTION

Accumulating evidence suggests that motor skill training is associated with structural and functional reorganization of the primary motor cortex. However, previous studies have focussed primarily upon the upper limb, and it is unclear whether comparable reorganization occurs following training of other regions, such as the lower back. Although this holds important implications for rehabilitation, no studies have examined corticomotor adaptations following short-term motor training in the lower back.

METHOD

The aims of this study were to (a) determine whether a short-term lumbopelvic tilt visuomotor task induced reorganization of the corticomotor representations of lower back muscles, (b) quantify the variability of corticomotor responses to motor training, and (c) determine whether any improvements in task performance were correlated with corticomotor reorganization. Participants were allocated randomly to perform a lumbopelvic tilt motor training task (n = 15) or a finger abduction control task involving no lumbopelvic movement (n = 15). Transcranial magnetic stimulation was used to map corticomotor representations of the lumbar erector spinae before, during, and after repeated performance of the allocated task.

RESULTS

No relationship between corticomotor reorganization and improved task performance was identified. Substantial variability was observed in terms of corticomotor responses to motor training, with approximately 50% of participants showing no corticomotor reorganization despite significant improvements in task performance.

CONCLUSION

These findings suggest that short-term improvements in lower back visuomotor task performance may be driven by changes in remote subcortical and/or spinal networks rather than adaptations in corticomotor pathways. However, further research using tasks of varying complexities and durations is required to confirm this hypothesis.

Shining a Light on Awareness: A Review of Functional Near-Infrared Spectroscopy for Prolonged Disorders of Consciousness

Qualitative clinical assessments of the recovery of awareness after severe brain injury require an assessor to differentiate purposeful behavior from spontaneous behavior. As many such behaviors are minimal and inconsistent, behavioral assessments are susceptible to diagnostic errors. Advanced neuroimaging tools can bypass behavioral responsiveness and reveal evidence of covert awareness and cognition within the brains of some patients, thus providing a means for more accurate diagnoses, more accurate prognoses, and, in some instances, facilitated communication. The majority of reports to date have employed the neuroimaging methods of functional magnetic resonance imaging, positron emission tomography, and electroencephalography (EEG). However, each neuroimaging method has its own advantages and disadvantages (e.g., signal resolution, accessibility, etc.). Here, we describe a burgeoning technique of non-invasive optical neuroimaging—functional near-infrared spectroscopy (fNIRS)—and review its potential to address the clinical challenges of prolonged disorders of consciousness. We also outline the potential for simultaneous EEG to complement the fNIRS signal and suggest the future directions of research that are required in order to realize its clinical potential.

Comparison of Brain Activation during Motor Imagery and Motor Movement Using fNIRS

Motor-activity-related mental tasks are widely adopted for brain-computer interfaces (BCIs) as they are a natural extension of movement intention, requiring no training to evoke brain activity. The ideal BCI aims to eliminate neuromuscular movement, making motor imagery tasks, or imagined actions with no muscle movement, good candidates. This study explores cortical activation differences between motor imagery and motor execution for both upper and lower limbs using functional near-infrared spectroscopy (fNIRS). Four simple finger- or toe-tapping tasks (left hand, right hand, left foot, and right foot) were performed with both motor imagery and motor execution and compared to resting state. Significant activation was found during all four motor imagery tasks, indicating that they can be detected via fNIRS. Motor execution produced higher activation levels, a faster response, and a different spatial distribution compared to motor imagery, which should be taken into account when designing an imagery-based BCI. When comparing left versus right, upper limb tasks are the most clearly distinguishable, particularly during motor execution. Left and right lower limb activation patterns were found to be highly similar during both imagery and execution, indicating that higher resolution imaging, advanced signal processing, or improved subject training may be required to reliably distinguish them.

Cortical Mechanisms of Tongue Sensorimotor Functions in Humans: A Review of the Magnetoencephalography Approach

The tongue plays important roles in a variety of critical human oral functions, including speech production, swallowing, mastication and respiration. These sophisticated tongue movements are in part finely regulated by cortical entrainment. Many studies have examined sensorimotor processing in the limbs using magnetoencephalography (MEG), which has high spatiotemporal resolution. Such studies have employed multiple methods of analysis, including somatosensory evoked fields (SEFs), movement-related cortical fields (MRCFs), event-related desynchronization/synchronization (ERD/ERS) associated with somatosensory stimulation or movement and cortico-muscular coherence (CMC) during sustained movement. However, the cortical mechanisms underlying the sensorimotor functions of the tongue remain unclear, as contamination artifacts induced by stimulation and/or muscle activity within the orofacial region complicates MEG analysis in the oral region. Recently, several studies have obtained MEG recordings from the tongue region using improved stimulation methods and movement tasks. In the present review, we provide a detailed overview of tongue sensorimotor processing in humans, based on the findings of recent MEG studies. In addition, we review the clinical applications of MEG for sensory disturbances of the tongue caused by damage to the lingual nerve. Increased knowledge of the physiological and pathophysiological mechanisms underlying tongue sensorimotor processing may improve our understanding of the cortical entrainment of human oral functions.

Somatotopic Semantic Priming and Prediction in the Motor System

The recognition of action-related sounds and words activates motor regions, reflecting the semantic grounding of these symbols in action information; in addition, motor cortex exerts causal influences on sound perception and language comprehension. However, proponents of classic symbolic theories still dispute the role of modality-preferential systems such as the motor cortex in the semantic processing of meaningful stimuli. To clarify whether the motor system carries semantic processes, we investigated neurophysiological indexes of semantic relationships between action-related sounds and words. Event-related potentials revealed that action-related words produced significantly larger stimulus-evoked (Mismatch Negativity-like) and predictive brain responses (Readiness Potentials) when presented in body-part-incongruent sound contexts (e.g., “kiss” in footstep sound context; “kick” in whistle context) than in body-part-congruent contexts, a pattern reminiscent of neurophysiological correlates of semantic priming. Cortical generators of the semantic relatedness effect were localized in areas traditionally associated with semantic memory, including left inferior frontal cortex and temporal pole, and, crucially, in motor areas, where body-part congruency of action sound–word relationships was indexed by a somatotopic pattern of activation. As our results show neurophysiological manifestations of action-semantic priming in the motor cortex, they prove semantic processing in the motor system and thus in a modality-preferential system of the human brain.

Reappraisal of field dynamics of motor cortex during self-paced finger movements

BACKGROUND

The exact origin of neuronal responses in the human sensorimotor cortex subserving the generation of voluntary movements remains unclear, despite the presence of characteristic but robust waveforms in the records of electroencephalography or magnetoencephalography (MEG).

AIMS

To clarify this fundamental and important problem, we analyzed MEG in more detail using a multidipole model during pulsatile extension of the index finger, and made some important new findings.

RESULTS

Movement-related cerebral fields (MRCFs) were confirmed over the sensorimotor region contralateral to the movement, consisting of a temporal succession of the first premovement component termed motor field, followed by two or three postmovement components termed movement evoked fields. A source analysis was applied to separately model each of these field components. Equivalent current diploes of all components of MRCFs were estimated to be located in the same precentral motor region, and did not differ with respect to their locations and orientations. The somatosensory evoked fields following median nerve stimulation were used to validate these findings through comparisons of the location and orientation of composite sources with those specified in MRCFs. The sources for the earliest components were evoked in Brodmann's area 3b located lateral to the sources of MRCFs, and those for subsequent components in area 5 and the secondary somatosensory area were located posterior to and inferior to the sources of MRCFs, respectively. Another component peaking at a comparable latency with the area 3b source was identified in the precentral motor region where all sources of MRCFs were located.

CONCLUSION

These results suggest that the MRCF waveform reflects a series of responses originating in the precentral motor area.

Neuromagnetic activation following active and passive finger movements

The detailed time courses of cortical activities and source localizations following passive finger movement were studied using whole-head magnetoencephalography (MEG). We recorded motor-related cortical magnetic fields following voluntary movement and somatosensory-evoked magnetic fields following passive movement (PM) in 13 volunteers. The most prominent movement-evoked magnetic field (MEF1) following active movement was obtained approximately 35.3 ± 8.4 msec after movement onset, and the equivalent current dipole (ECD) was estimated to be in the primary motor cortex (Brodmann area 4). Two peaks of MEG response associated with PM were recorded from 30 to 100 msec after movement onset. The earliest component (PM1) peaked at 36.2 ± 8.2 msec, and the second component (PM2) peaked at 86.1 ± 12.1 msec after movement onset. The peak latency and ECD localization of PM1, estimated to be in area 4, were the same as those of the most prominent MEF following active movement. ECDs of PM2 were estimated to be not only in area 4 but also in the supplementary motor area (SMA) and the posterior parietal cortex (PPC) over the hemisphere contralateral to the movement, and in the secondary somatosensory cortex (S2) of both hemispheres. The peak latency of each source activity was obtained at 54-109 msec in SMA, 64-114 msec in PPC, and 84-184 msec in the S2. Our results suggest that the magnetic waveforms at middle latency (50-100 msec) after PM are different from those after active movement and that these waveforms are generated by the activities of several cortical areas, that is, area 4 and SMA, PPC, and S2. In this study, the time courses of the activities in SMA, PPC, and S2 accompanying PM in humans were successfully recorded using MEG with a multiple dipole analysis system.

Corticomotor plasticity induced by tongue-task training in humans: a longitudinal fMRI study

Corticomotor pathways may undergo neuroplastic changes in response to acquisition of new motor skills. Little is known about the motor control strategies for learning new tongue tasks. The aim of this study was to investigate the longitudinal effect of novel tongue-task training on corticomotor neuroplasticity. Thirteen healthy, right-handed men, aged 24-35 years (mean age ± SD: 27.3 ± 0.3 years), performed a training task consisting of standardized tongue protrusion onto a force transducer. The tongue task consisted of a relax-protrude-hold-relax cycle with 1.0 N as the target at the hold phase lasting for 1.5 s. Subjects repeated this task for 1 h. Functional magnetic resonance imaging was carried out before the tongue-task training (baseline), 1-h after the training, and one-day and one-week follow-up. During scanning, the subjects performed tongue protrusion in blocks interspersed with rest. A region-of-interest (ROI) approach and an explorative search were implemented for the analysis of corticomotor activity across conditions. All subjects completed the tongue-task training (mean success rate 43.0 ± 13.2%). In the baseline condition, tongue protrusion resulted in bilateral activity in regions most typically associated with a motor task including medial frontal gyrus (supplementary motor area [SMA]), precentral gyrus (tongue motor cortex), putamen, thalamus, and cerebellum. The ROI analysis revealed increased activity in the precentral gyrus already 1 h post-training. One day after the training, increased activity was observed in the precentral gyrus, SMA, putamen, and cerebellum. No increase was found 1 week after training. Correlation analyses between changes in success rates and changes in the numbers of voxels showed robust associations for left Area 4a in primary motor cortex 1 h, 1 day, and 1 week after the tongue-task training and for the left Area 4p in primary motor cortex and the left lateral premotor cortex 1 day after the training. In the unrestricted analysis, increased activity was found in the parahippocampal gyrus 1 h after the tongue-task training and remained for a week. Decreased activity was found in right post-central and middle frontal gyri 1 h and 1 week post-training. The results verified the involvement of specific corticomotor areas in response to tongue protrusion. Short-term tongue-task training was associated with longer-lasting (up to 1 week) changes in motor-related brain activity. The results suggested that primary motor areas are involved in the early and late stages, while other motor areas mainly are engaged in the later stage of corticomotor neuroplasticity of the tongue.

Functional motor-cortex mapping using corticokinematic coherence

We present a novel method, corticokinematic coherence (CKC), for functional mapping of the motor cortex by computing coherence between cortical magnetoencephalographic (MEG) signals and the kinematics of voluntary movements. Ten subjects performed self-paced flexion-extensions of the right-hand fingers at about 3 Hz, with a three-axis accelerometer attached to the index finger. Cross-correlogram and coherence spectra were computed between 306 MEG channels and the accelerometer signals. In all subjects, accelerometer and coherence spectra showed peaks around 3-5 Hz and 6-10 Hz, corresponding to the movement frequencies. The coherence was statistically significant (P<0.05) in all subjects, with sources at the hand area of the primary motor cortex contralateral to the movement. CKC appears to be a promising and robust method for reliable and convenient functional mapping of the human motor cortex.

Robot-assisted image-guided transcranial magnetic stimulation for somatotopic mapping of the motor cortex: a clinical pilot study

Purpose

Shape and exact location of motor cortical areas varies among individuals. The exact knowledge of these locations is crucial for planning of neurosurgical procedures. In this study, we have used robot-assisted image-guided transcranial magnetic stimulation (Ri-TMS) to elicit MEP response recorded for individual muscles and reconstruct functional motor maps of the primary motor cortex.

Methods

One healthy volunteer and five patients with intracranial tumors neighboring the precentral gyrus were selected for this pilot study. Conventional MRI and fMRI were obtained. Transcranial magnetic stimulation was performed using a MagPro X100 stimulator and a standard figure-of-eight coil positioned by an Adept Viper s850 robot. The fMRI activation/Ri-TMS response pattern were compared. In two cases, Ri-TMS was additionally compared to intraoperative direct electrical cortical stimulation.

Results

Maximal MEP response of the m. abductor digiti minimi was located in an area corresponding to the “hand knob” of the precentral gyrus for both hemispheres. Repeated Ri-TMS measurements showed a high reproducibility. Simultaneous registration of the MEP response for m. brachioradialis, m. abductor pollicis brevis, and m. abductor digiti minimi demonstrated individual peak areas of maximal MEP response for the individual muscle groups. Ri-TMS mapping was compared to the corresponding fMRI studies. The areas of maximal MEP response localized within the “finger tapping” activated areas by fMRI in all six individuals.

Conclusions

Ri-TMS is suitable for high resolution non-invasive preoperative somatotopic mapping of the motor cortex. Ri-TMS may help in the planning of neurosurgical procedures and may be directly used in navigation systems.

Preoperative localization of hand motor cortex by adaptive spatial filtering of magnetoencephalography data

Object

The goal of this study was to examine the sensitivity and specificity in preoperative localization of hand motor cortex by imaging regional event-related desynchronization (ERD) of brainwaves in the β frequency band (15–25 Hz) involved in self-paced movement.

Methods

Using magnetoencephalography (MEG), the authors measured ERD that occurred before self-paced unilateral index finger flexion in 66 patients with brain tumors, epilepsy, and arteriovenous malformations.

Results

The authors applied an adaptive spatial filtering algorithm to MEG data and found that peaks of the tomographic distribution of β-band ERD sources reliably localized hand motor cortex compared with electrical cortical stimulation. They also observed high specificity in estimating contralateral hand motor cortical representations relative to somatosensory cortex. Neither presence nor location of tumor changed the qualitative or quantitative location of motor cortex relative to somatosensory cortex.

Conclusions

An imaging protocol using ERD obtained by adaptive spatial filtering of MEG data can be used for extremely reliable preoperative localization of hand motor cortex.

Cortical neuromagnetic activation accompanying two types of voluntary finger extension

We examined the amplitude and latency of movement-related cerebral field (MRCF) waveforms, the generator and afferent feedback of movement-evoked field 1 (MEF1), and the relationship between motor field neuromagnetic activity and electromyographic activity during performance of two types of voluntary index extension. Eight healthy, right-handed male volunteers participated in this study. Experiments for each subject consisted of recording of MRCFs following two types of finger movement. One (Task 1) involved voluntary extension of the right index finger to about 40 degrees . In the second (Task 2), an elastic band was placed on the right index fingertip, producing a resistance of about 1.5 times the electromyographic activity associated with the voluntary movement yielding extension to approximately 40 degrees . Peak amplitude and the ECD moment of the motor field differed significantly between the two tasks. In Task 2, the electromechanical delay from EMG onset to movement onset (77.8+/-16.2) was longer than in Task 1 (44.4+/-10.4). However, the latency from EMG onset to MEF1 peak was 87.6+/-8.5 ms in Task 2, and did not differ significantly from that in Task 1 (88.6+/-8.5). The ECDs of MEF1 were located significantly medial to N20 m and lateral and posterior to the motor field. These findings suggest that the ECD of MEF1 is located in area 3b, but is slightly different from N20 m, and that this MEF1 component activation is due not to the onset of joint movement but to that of muscular contraction.

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.

Evaluation of different cortical source localization methods using simulated and experimental EEG data

Different cortical source localization methods have been developed to directly link the scalp potentials with the cortical activities. Up to now, these methods are the only possible solution to noninvasively investigate cortical activities with both high spatial and time resolutions. However, the application of these methods is hindered by the fact that they have not been rigorously evaluated nor compared. In this paper, the performances of several source localization methods (moving dipoles, minimum Lp norm, and low resolution tomography (LRT) with Lp norm, p equal to 1, 1.5, and 2) were evaluated by using simulated scalp EEG data, scalp somatosensory evoked potentials (SEPs), and upper limb motor-related potentials (MRPs) obtained on human subjects (all with 163 scalp electrodes). By using simulated EEG data, we first evaluated the source localization ability of the above methods quantitatively. Subsequently, the performance of the various methods was evaluated qualitatively by using experimental SEPs and MRPs. Our results show that the overall LRT Lp norm method with p equal to 1 has a better source localization ability than any of the other investigated methods and provides physiologically meaningful reconstruction results. Our evaluation results provide useful information for choosing cortical source localization approaches for future EEG/MEG studies.

Absence of localized grey matter volume changes in the motor cortex following spinal cord injury

The consequences of spinal cord injury (SCI) have considerable effects on motor function, typically resulting in functional impairment. Pathological changes have been studied at the site of trauma, rostrocaudally within the cord, and in the periphery. Few studies, however, have investigated the consequences of SCI at the cortical level. Magnetic resonance imaging (MRI) was used to explore the morphological changes in the grey and white matter within the primary motor (M1) cortex of individuals with cervical SCI. The "precentral knob," a landmark of M1 cortex dedicated to hand function, was selected for regionally specific measurements of change. Thirty-one hemispheres of SCI subjects and 28 hemispheres of control subjects were compared using a manual measurement after the images were segmented into grey matter, white matter, and cerebral spinal fluid (CSF). No significant differences in grey matter area measured at the precentral knob were found with the manual approach. An automated voxel-based morphometric analysis was also performed and demonstrated no significant differences in grey or white matter volume within an M1 region of interest. These data suggest that there is no gross anatomical change within M1 following cervical SCI. Our previously reported findings of reorganization of cortical motor output maps following SCI therefore likely result from changes in functional organization rather than anatomical changes.

Magnetoencephalography indicates finger motor somatotopy

The existence or non-existence of fine-scale motor somatotopy of the hand is a fundamental problem with regard to the functioning of the human brain. In contrast to seldom contradicted early twentieth century descriptions of activation overlap, descriptions of finger motor somatotopy faced disagreement. Recent blood-flow-related brain mapping data achieved with functional magnetic resonance imaging (fMRI) argue in favour of fine-scale somatotopy. However, considerable discrepancies between blood oxygen-level-dependent fMRI activations and intracortically recorded neuronal activity have been reported and it is unclear whether the blood flow results truly reflect the neuronal situation. We have used recent advances in magnetoencephalography to detect signals deriving directly from neuronal tissue. Besides replication of the overlap aspect, we found statistically significant evidence for the existence of a somatotopic aspect of human hand motor representation when comparing the fifth and first finger motor dipoles along the superior-inferior axis. The average location of the fifth finger was found to be 2.31 mm superior to the first finger.

Magnetoencephalographic representation of the sensorimotor hand area in cases of intracerebral tumour

OBJECTIVE

To assess the clinical value of magnetoencephalography (MEG) in localising the primary hand motor area and evaluating cortical distortion of the sensorimotor cortices in patients with intracerebral tumour.

METHODS

10 normal volunteers (controls) and 14 patients with an intracerebral tumour located around the central region were studied. Somatosensory evoked magnetic fields (SEFs) following median nerve stimulation, and movement related cerebral magnetic fields (MRCFs) following index finger extension, were measured in all subjects and analysed by the equivalent current dipole (ECD) method to ascertain the neuronal sources of the primary sensory and motor components (N20m and MF, respectively). These ECD locations were defined as the primary hand sensory and motor areas and the positional relations between these two functional areas in controls and patients were investigated.

RESULTS

The standard range of ECD locations of MF to N20m was determined in controls. In 11 of the 14 patients, MRCFs could identify the primary motor hand area. ECD locations of MF were significantly closer to the N20m in the medial-lateral direction in patients than in controls. In patients with a tumour located below the sensorimotor hand area, relative ECD locations of MF to N20m moved anteriorly over the standard range determined in the control subjects. These MEG findings correlated well with radiological tumour locations. The mean estimated ECD strength of MF was significantly lower in patients than in controls.

CONCLUSIONS

MRCF was useful in localising the primary motor hand area in patients with intracerebral tumour. The relative ECD locations of MF to N20m describe the anatomical distortion of the sensorimotor cortex.

Stimulation-induced within-representation and across-representation plasticity in human motor cortex

The human motor cortex contains a dynamic and distributed network of motor representations. Formation, maintenance, and modification of these representations is an activity-driven process. Repeated stimulation of one representation results in increased motor output from this representation, a process referred to as "within-representation plasticity." We showed previously that within-representation plasticity of the upper arm representation occurs when repetitive transcranial magnetic stimulation (rTMS) is delivered to that representation during transient ischemic nerve block (INB) of the contralateral hand. INB reduces inhibition in the motor cortex and thus lowers the threshold for stimulation-induced plasticity. Here we studied the effects of rTMS delivered to nearby body part representations on the motor output from the upper arm representation. Six healthy subjects underwent INB-alone (control), or INB plus 30 min of focal 0.1 Hz rTMS of either the face, hand, arm, leg, or overlap arm/hand representations in motor cortex. INB-alone and rTMS of the leg representation resulted in only a short-lasting (< 20 min) increase in motor output from the arm representation, as measured by motor evoked potentials in the biceps. rTMS of arm and arm/hand representations induced a prolonged (> 60 min) within-representation increase. In contrast, rTMS of face or hand representations canceled the short-lasting increase and even led to a long-lasting decrease of motor output from the arm representation. Therefore, rTMS of the experimentally disinhibited motor cortex induces within-representation increase, and across-representation decrease of motor cortical output. This bidirectional plasticity might be used for purposeful modulation of human cortical function.

Postoperative changes on functional mapping of the motor cortex in patients with brachial plexus injury: comparative study of magnetoencephalography and functional magnetic resonance imaging

Using magnetoencephalography (MEG) and functional magnetic resonance imaging (f-MRI), we investigated the areas of the cerebral cortex that were activated when patients with brachial plexus injuries performed elbow flexion, a motion re-acquired through nerve transfer surgery. In all patients, elbow flexion on the operated side and on the unaffected side led to the activation of an area in the motor cortex, with these areas being located almost symmetrically on either side of the sagittal midline. These findings suggest that the activity center for the transferred intercostal nerves shifted to the motor cortex for the elbow, from the original intercostal nerve site.

Constraints on somatotopic organization in the primary motor cortex

Since the 1870s, the primary motor cortex (M1) has been known to have a somatotopic organization, with different regions of cortex participating in control of face, arm, and leg movements. Through the middle of the 20th century, it seemed possible that the principle of somatotopic organization extended to the detailed representation of different body parts within each of the three major representations. The arm region of M1, for example, was thought to contain a well-ordered, point-to-point representation of the movements or muscles of the thumb, index, middle, ring, and little fingers, the wrist, elbow, and shoulder, as conveyed by the iconic homunculus and simiusculus. In the last quarter of the 20th century, however, experimental evidence has accumulated indicating that within-limb somatotopy in M1 is not spatially discrete nor sequentially ordered. Rather, beneath gradual somatotopic gradients of representation, the representations of different smaller body parts or muscles each are distributed widely within the face, arm, or leg representation, such that the representations of any two smaller parts overlap extensively. Appreciation of this underlying organization will be essential to further understanding of the contribution to control of movement made by M1. Because no single experiment disproves a well-ordered within-limb somatotopic organization in M1, here I review the accumulated evidence, using a framework of six major features that constrain the somatotopic organization of M1: convergence of output, divergence of output, horizontal interconnections, distributed activation, effects of lesions, and ability to reorganize. Review of the classic experiments that led to development of the homunculus and simiusculus shows that these data too were consistent with distributed within-limb somatotopy. I conclude with speculations on what the constrained somatotopy of M1 might tell us about its contribution to control of movement.

Movement-related magnetic fields to tongue protrusion

Movement-related magnetic fields (MRFs) associated with tongue protrusion were measured in five normal subjects using a helmet-shaped magnetoencephalography system. Bihemispherical two-dipolar patterns appeared from approximately -2000 or -1000 to 0 ms to the trigger signal indicating when protrusion of the tongue tip reached the frontal part of the palate. Equivalent current dipoles (ECDs) for the MRFs were localized on the central sulcus, 14.4 +/- 6.1 mm inferior (P < 0.0001) and 7.6 +/- 6.9 mm anterior (P < 0.01) to the ECD for the N20m in the somatosensory evoked fields for median nerve stimuli. The ECD orientations of MRFs were anterior and perpendicular to the central sulcus. These results correspond to the movement-related potentials for tongue protrusion previously recorded from subdural electrodes in patients with epilepsy. Magnetoencephalography can be applied to analyze cortical functions related to tongue movement with high resolution in time and space in normal subjects.

Walking or talking? Behavioral and neurophysiological correlates of action verb processing

Brain activity elicited by visually presented words was investigated using behavioral measures and current source densities calculated from high-resolution EEG recordings. Verbs referring to actions usually performed with different body parts were compared. Behavioral data indicated faster processing of verbs referring to actions performed with the face muscles and articulators (face-related words) compared to verbs referring to movements involving the lower half of the body (leg-related words). Significant topographical differences in brain activity elicited by verb types were found starting approximately 250 ms after word onset. Differences were seen at recording sites located over the motor strip and adjacent frontal cortex. At the vertex, close to the cortical representation of the leg, leg-related verbs (for example, to walk) produced strongest in-going currents, whereas for face-related verbs (for example, to talk) the most in-going activity was seen at more lateral electrodes placed over the left Sylvian fissure, close to the representation of the articulators. Thus, action words caused differential activation along the motor strip, with strongest in-going activity occurring close to the cortical representation of the body parts primarily used for carrying out the actions the verbs refer to. Topographically specific physiological signs of word processing started earlier for face-related words and lasted longer for verbs referring to leg movements. We conclude that verb types can differ in their processing speed and can elicit neurophysiological activity with different cortical topographies. These behavioral and physiological differences can be related to cognitive processes, in particular to lexical semantic access. Our results are consistent with associative theories postulating that words are organized in the brain as distributed cell assemblies whose cortical distributions reflect the words' meanings.

Finger Somatotopy in Human Motor Cortex

Although qualitative reports about somatotopic representation of fingers in the human motor cortex exist, up to now no study could provide clear statistical evidence. The goal of the present study was to reinvestigate finger motor somatotopy by means of a thorough investigation of standardized movements of the index and little finger of the right hand. Using high resolution fMRI at 3 Tesla, blood oxygenation level-dependent (BOLD) responses in a group of 26 subjects were repeatedly measured to achieve reliable statistical results. The center of mass of all activated voxels within the primary motor cortex was calculated for each finger and each run. Results of all runs were averaged to yield an individual index and little finger representation for each subject. The mean center of mass localizations for all subjects were then submitted to a paired t test. Results show a highly significant though small scale somatotopy of fingerspecific activation patterns in the order indicated by Penfields motor homunculus. In addition, considerable overlap of finger specific BOLD responses was found. Comparing various methods of analysis, the mean center of mass distance for the two fingers was 2--3 mm with overlapping voxels included and 4--5 mm with overlapping voxels excluded. Our data may be best understood in the context of the work of Schieber (1999) who recently described overlapping somatotopic gradients in lesion studies with humans.

Supplementary motor area activation preceding voluntary movement is detectable with a whole-scalp magnetoencephalography system

Despite the fact that the knowledge about the structure and the function of the supplementary motor area (SMA) is steadily increasing, the role of the SMA in the human brain, e.g., the contribution of the SMA to the Bereitschaftspotential, still remains unclear and controversial. The goal of this study was to contribute further to this discussion by taking advantage of the increased spatial information of a whole-scalp magnetoencephalography (MEG) system enabling us to record the magnetic equivalent of the Bereitschaftspotential 1, the Bereitschaftsfeld 1 (BF 1) or readiness field 1. Five subjects performed a complex, and one subject a simple, finger-tapping task. It was possible to record the BF 1 for all subjects. The first appearance of the BF 1 was in the range of -1.9 to -1.7 s prior to movement onset, except for the subject performing the simple task (-1 s). Analysis of the development of the magnetic field distribution and the channel waveforms showed the beginning of the Bereitschaftsfeld 2 (BF 2) or readiness field 2 at about -0.5 s prior to movement onset. In the time range of BF 1, dipole source analysis localized the source in the SMA only, whereas dipole source analysis containing also the time range of BF 2 resulted in dipole models, including dipoles in the primary motor area. In summary, with a whole-head MEG system, it was possible for the first time to detect SMA activity in healthy subjects with MEG.

Neuroimage of voluntary movement: topography of the Bereitschaftspotential, a 64-channel DC current source density study

The Bereitschaftspotential (BP) was recorded at 56 scalp positions when 17 healthy subjects performed brisk extensions of the right index finger. Aim of the study was to contribute to our understanding of the physiology underlying the BP and, in particular, to specify the situation at BP onset. For this purpose, the spatial pattern of the BP was analyzed in short time intervals (35 and/or 70 ms) starting 2.51 s before movement onset. For each time segment a spherical model of the BP was calculated by using spline interpolation. Then the spatial distribution of the electric potential at the scalp surface was transformed into a spatial distribution of current source densities (CSD map). Onset times of the BP and onset times of initial CSD-activity ranged between 2.23 and 1.81 s before movement onset. We selected a time window between 1.6 and 1.5 s before movement onset in order to analyze the spatial CSD pattern in each subject. In 10 subjects there was a significant current sink in the scalp area located over medial-wall motor areas (pre-SMA, SMA proper and anterior cingulate cortex: electrode positions C1, C2, FCz, Cz) in the absence of a significant current sink over the primary motor cortex (MI: electrode positions C3, CP3, and CP5). In three subjects significant current sinks were present at both sites and in another three subjects a current sink only over the lateral motor cortex was observed. In one subject no significant current sinks were measured. It is concluded that there is a large group of subjects (13/17) in whom BP at onset is associated with a current sink over medial-wall motor areas. At a later time interval (0.6 to 0.5 s before movement onset), significant current sinks were found in 13 subjects in medial and in 10 subjects in lateral recordings. These data were considered to be consistent with the hypothesis that, at least in a majority of subjects, medial-wall motor areas are activated earlier than lateral motor areas when organizing the initiation of a simple self-paced movement. Surface-recordings of the EEG do not allow further specification of cortical areas, which contribute to the current sinks. But in context with the current literature of the electrophysiology of nonhuman primates and of brain imaging in humans it is suggested that SMA and anterior cingulate cortex contribute to the current sink, the fronto-central midline, and that the primary motor cortex (MI) contributes to the current sink in the scalp area, which is located above MI and closely posterior to it.

Anatomical congruence of metabolic and electromagnetic activation signals during a self-paced motor task: a combined PET-MEG study

We have investigated the degree of spatial correlation between the cerebral blood flow variations measured by positron emission tomography (PET) and the electromagnetic sources as measured by magnetoencephalography (MEG) in five subjects while performing a self-paced right index finger tapping task. Data were processed independently for each technique using both single-case and intersubject analysis. PET and MEG were coregistered with anatomical magnetic resonance images for each subject. Both extension and flexion motor-related fields were extracted from the MEG signal. Using the single dipole model we identified the motor evoked field 1 (MEF1) in all subjects and the motor field (MF) in three subjects. Individual and intersubject averaged PET data showed consistent contralateral primary sensorimotor (PSM) hand area and bilateral supplementary motor area activation. MEG individual and intersubject averaged results demonstrated that both MEF1 and MF dipoles were localized within the PSM PET activated area. Individual PSM mass center to dipole distance was 12 and 15.3 mm on average for the MEF1 and the MF component, respectively. For the same components, the intersubject averaged analysis shows distances between the PET Z-score maximum and the dipole locations of 6.3 and 15.0 mm, respectively. These results show that PET and MEG MEF1 activation signals spatially coincide within instrumental, registration, and modeling errors.

Somatotopy in the human motor cortex hand area. A high-resolution functional MRI study

Fine-scale somatotopic encoding in brain areas devoted to sensorimotor processing has recently been questioned by functional neuroimaging studies which suggested its absence within the hand area of the human primary motor cortex. We re-examined this issue by addressing somatotopy both in terms of functional segregation and of cortical response preference using oxygenation-sensitive magnetic resonance imaging at high spatial resolution. In a first step, spatial representations of self-paced isolated finger movements were mapped by using motor rest as a control state. A subsequent experimental design studied the predominance of individual finger movements by using contrasting finger movements as the control task. While the first approach confirmed previous reports of extensive overlap in spatial representations, the second approach revealed foci of differential activation which displayed an orderly mediolateral progression in accordance with the classical cortical motor homunculus. We conclude that somatotopy within the hand area of the primary motor cortex does not present as qualitative functional segregation but as quantitative predominance of certain movement or digit representation embedded in an overall joint hand area.

Reliability of dipole localization for the movement-evoked field component MEF I

The movement-evoked field I (MEF I) component is the largest and most stable neuromagnetic component accompanying self-paced movements. In order to use MEG for studying dynamic changes in the cortical organization of movements, data about the reliability and variability of these neuromagnetic components for individual subjects must be established during different sessions. For this aim, three male subjects were requested to perform self-paced flexions of their index finger and thumb in repeated sessions while the MEG was recorded by a 31 channel system. The MEF I was identified for each session and a single equivalent dipole was calculated for this component. The dipole localizations of the various sessions were compared. The standard deviation of the localization for all persons and all values amounts to 4.0-5.2 mm for the three spatial dimensions. Our data suggest that the spatial distance between two single focal sources fitted to the MEF I must be greater than 14 mm to be interpreted as distinct. However, the neuromagnetic field structure and the resulting dipole localization of the MEF I component are quite stable and could be used for the evaluation of cortical plasticity.

Magnetoencephalographic mapping: basic of a new functional risk profile in the selection of patients with cortical brain lesions

OBJECTIVE

Surgical management of cortical lesions adjacent to or within the eloquent cerebral cortex requires a critical risk: benefit analysis of the procedure before intervention. This study introduced a measure of surgical risk, based on preoperative magnetoencephalographic (MEG) sensory and motor mapping, and tested its value in predicting surgical morbidity.

METHODS

Forty patients (21 men and 19 women; mean age, 36.5 yr) with cortical lesions (12 arteriovenous malformations and 28 tumors) in the vicinity of the sensorimotor cortex were classified into high-, medium-, or low-risk categories by using the MEG-defined functional risk profile (FRP). This was based on the minimal distance between the lesion margin and the sensory and motor MEG sources, superimposed on a magnetic resonance imaging scan. Case management decisions were based on the MEG mapping-derived FRP in combination with biopsy pathological findings, radiographic findings, and anatomic characteristics of the lesion. A recently developed protocol was used to transform MEG source locations into the stereotactic coordinate system. This procedure provided intraoperative access to MEG data in combination with stereotactic anatomic data displays routinely available on-line during surgery.

RESULTS

It was determined that 11 patients diagnosed as having gliomas had high FRPs. The margin of the lesion was less than 4 mm from the nearest MEG dipole or involved the central sulcus directly. A nonoperative approach was used for six patients of this group, based on the MEG mapping-derived FRP. In the group with arteriovenous malformations, 6 of 12 patients with high or medium FRPs underwent nonoperative therapy. The remaining 28 patients, whose lesions showed satisfactory FRPs, underwent uneventful lesion resection, without postoperative neurological deficits.

CONCLUSION

Our results suggest that MEG mapping-derived FRPs can serve as powerful tools for use in presurgical planning and during surgery.