Neural correlates of crossmodal visual-tactile extinction and of tactile awareness revealed by fMRI in a right-hemisphere stroke patient

A neurocomputational analysis of visual bias on bimanual tactile spatial perception during a crossmodal exposure

Vision and touch both support spatial information processing. These sensory systems also exhibit highly specific interactions in spatial perception, which may reflect multisensory representations that are learned through visuo-tactile (VT) experiences. Recently, Wani and colleagues reported that task-irrelevant visual cues bias tactile perception, in a brightness-dependent manner, on a task requiring participants to detect unimanual and bimanual cues. Importantly, tactile performance remained spatially biased after VT exposure, even when no visual cues were presented. These effects on bimanual touch conceivably reflect cross-modal learning, but the neural substrates that are changed by VT experience are unclear. We previously described a neural network capable of simulating VT spatial interactions. Here, we exploited this model to test different hypotheses regarding potential network-level changes that may underlie the VT learning effects. Simulation results indicated that VT learning effects are inconsistent with plasticity restricted to unisensory visual and tactile hand representations. Similarly, VT learning effects were also inconsistent with changes restricted to the strength of inter-hemispheric inhibitory interactions. Instead, we found that both the hand representations and the inter-hemispheric inhibitory interactions need to be plastic to fully recapitulate VT learning effects. Our results imply that crossmodal learning of bimanual spatial perception involves multiple changes distributed over a VT processing cortical network.

Electrical Stimulation of the Motor Cortex or Paretic Muscles Improves Strength Production in Stroke Patients: A Systematic Review and Meta-Analysis

OBJECTIVE

Transcranial direct current stimulation (tDCS) and functional electrical stimulation (FES) are two widely applied methods of electrical stimulation for motor recovery among stroke patients. This systematic review and meta-analysis investigated the efficacy of tDCS and FES for strength production in stroke patients. TYPE: Systematic review.

LITERATURE SURVEY

Studies that explored the effects of tDCS or FES on the strength production of paralyzed muscles in stroke patients were retrieved on a comprehensive set of three databases: (1) Google Scholar, (2) PubMed, and (3) the Cochrane Database of Systematic Reviews until July 2019.

METHODOLOGY

Systematic study retrieval led to the inclusion of 15 studies that reported on strength production effects after tDCS and FES interventions among stoke patients. A sham control group and randomization were used in each study. The 15 studies included 20 comparisons with sham controls, 7 of which involved tDCS and 13 of which involved FES.

SYNTHESIS

Random-effects models showed that strength production was improved after tDCS (effect size [ES] = 0.52, 95% confidence interval [CI] = 0.35-0.69, P < .001, Z = 6.05) and FES (ES = 0.47, 95% CI = 0.16-0.78, P < .003, Z = 2.99). Additionally, tDCS was shown to improve strength production in the acute (ES = 0.52, 95% CI = 0.24-0.80, P < .001, Z = 3.65), subacute (ES = 0.85, 95% CI = 0.37-1.32, P < .001, Z = 3.51), but not chronic (ES = 0.06, 95% CI = -0.47-0.60, P = .82, Z = 0.23) phases of stroke recovery. Out of the 13 studies involving FES, 12 investigated strength production in the chronic phase and one investigated in the acute phase, showing a positive effect in these two stages.

CONCLUSIONS

The results of the meta-analysis showed that tDCS and FES successfully improved strength production in stroke patients.

Theta-burst stimulation causally affects side perception in the Deutsch's octave illusion

Deutsch’s octave illusion is produced by a sequence of two specular dichotic stimuli presented in alternation to the left and right ear causing an illusory segregation of pitch (frequency) and side (ear of origin). Previous studies have indicated that illusory perception of pitch takes place in temporo-frontal areas, whereas illusory perception of side is primarily associated to neural activity in parietal cortex and in particular in the inferior parietal lobule (IPL). Here we investigated the causal role of left IPL in the perception of side (ear of origin) during the octave illusion by following its inhibition through continuous theta-burst stimulation (cTBS), as compared to the left posterior intraparietal sulcus (pIPS), whose activity is thought to be unrelated to side perception during the illusion. We observed a prolonged modification in the side of the illusory perceived tone during the first 10 minutes following the stimulation. Specifically, while after cTBS over the left IPS subjects reported to perceive the last tone more often at the right compared to the left ear, cTBS over left IPL significantly reverted this distribution, as the number of last perceived tones at the right ear was smaller than at the left ear. Such alteration was not maintained in the successive 10 minutes. These results provide the first evidence of the causal involvement of the left IPL in the perception of side during the octave illusion.

Neuroimaging somatosensory perception and masking

The specific cortical and subcortical regions involved in conscious perception and masking are uncertain. This study sought to identify brain areas involved in conscious perception of somatosensory stimuli during a masking task using functional magnetic resonance (fMRI) to contrast perceived vs. non-perceived targets. Electrical trains were delivered to the right index finger for targets and to the left index finger for masks. Target intensities were adjusted to compensate for threshold drift. Sham target trials were given in ~10% of the trials, and target stimuli without masks were delivered in one of the five runs (68 trials/run). When healthy dextral adult volunteers (n=15) perceived right hand targets, greater left- than right-cerebral activations were seen with similar patterns across the parietal cortex, thalamus, insula, claustrum, and midbrain. When targets were not perceived, left/right cerebral activations were similar overall. Directly comparing perceived vs. non-perceived stimuli with similar intensities in the masking task revealed predominate activations contralateral to masks. In contrast, activations were greater contralateral to perceived targets if no masks were given or if masks were given but target stimulus intensities were greater for perceived than non-perceived targets. The novel aspects of this study include: 1) imaging of cortical and subcortical activations in healthy humans related to somatosensory perception during a masking task, 2) activations in the human thalamus and midbrain related to perception of stimuli compared to matched non-perceived stimuli, and 3) similar left/right cerebral activation patterns across cortical, thalamic and midbrain structures suggesting interactions across all three levels during conscious perception in humans.

Emergence of virtual reality as a tool for upper limb rehabilitation: incorporation of motor control and motor learning principles

The primary focus of rehabilitation for individuals with loss of upper limb movement as a result of acquired brain injury is the relearning of specific motor skills and daily tasks. This relearning is essential because the loss of upper limb movement often results in a reduced quality of life. Although rehabilitation strives to take advantage of neuroplastic processes during recovery, results of traditional approaches to upper limb rehabilitation have not entirely met this goal. In contrast, enriched training tasks, simulated with a wide range of low- to high-end virtual reality-based simulations, can be used to provide meaningful, repetitive practice together with salient feedback, thereby maximizing neuroplastic processes via motor learning and motor recovery. Such enriched virtual environments have the potential to optimize motor learning by manipulating practice conditions that explicitly engage motivational, cognitive, motor control, and sensory feedback-based learning mechanisms. The objectives of this article are to review motor control and motor learning principles, to discuss how they can be exploited by virtual reality training environments, and to provide evidence concerning current applications for upper limb motor recovery. The limitations of the current technologies with respect to their effectiveness and transfer of learning to daily life tasks also are discussed.

Intracranial cortical responses during visual-tactile integration in humans

Sensory integration of touch and sight is crucial to perceiving and navigating the environment. While recent evidence from other sensory modality combinations suggests that low-level sensory areas integrate multisensory information at early processing stages, little is known about how the brain combines visual and tactile information. We investigated the dynamics of multisensory integration between vision and touch using the high spatial and temporal resolution of intracranial electrocorticography in humans. We present a novel, two-step metric for defining multisensory integration. The first step compares the sum of the unisensory responses to the bimodal response as multisensory responses. The second step eliminates the possibility that double addition of sensory responses could be misinterpreted as interactions. Using these criteria, averaged local field potentials and high-gamma-band power demonstrate a functional processing cascade whereby sensory integration occurs late, both anatomically and temporally, in the temporo-parieto-occipital junction (TPOJ) and dorsolateral prefrontal cortex. Results further suggest two neurophysiologically distinct and temporally separated integration mechanisms in TPOJ, while providing direct evidence for local suppression as a dominant mechanism for synthesizing visual and tactile input. These results tend to support earlier concepts of multisensory integration as relatively late and centered in tertiary multimodal association cortices.

Neural correlates of consciousness

Jon Driver's scientific work was characterized by an innovative combination of new methods for studying mental processes in the human brain in an integrative manner. In our collaborative work, he applied this approach to the study of attention and awareness, and their relationship to neural activity in the human brain. Here I review Jon's scientific work that relates to the neural basis of human consciousness, relating our collaborative work to a broader scientific context. I seek to show how his insights led to a deeper understanding of the causal connections between distant brain structures that are now believed to characterize the neural underpinnings of human consciousness.

Neural correlates of visual extinction or awareness in a series of patients with right temporoparietal damage

Patients with visual extinction following right-hemisphere damage can typically detect left visual field stimulation when it is presented in isolation, but tend to miss this when it is paired with competing concurrent right visual stimulation. Some single-case studies have provided preliminary evidence that right visual cortex may show residual activation for contralesional, extinguished visual stimuli. Here we go beyond prior work by using individual retinotopic mapping and online eye-tracking during fMRI to study activity in stimulus-responsive retinotopic visual cortex for a case series of four extinction patients. We found consistent activation of retinotopic right visual cortex for bilateral visual stimulation that resulted in left extinction. This residual unconscious activation included areas V1 to V3 and was not due to inadvertent eye movements. We also provide further evidence for the emerging view that awareness may require activity of frontal and parietal regions well beyond visual cortex.

Mapping the functional neuroanatomy of spatial neglect and human parietal lobe functions: progress and challenges

Spatial neglect is generally defined by various deficits in processing information from one (e.g., left) side of space contralateral to focal (e.g., right) hemisphere damage. Although classically associated with parietal lobe functions, there is now compelling evidence that neglect can follow lesions in many different cortical and subcortical sites, suggesting a dysfunction in distributed brain networks. In addition, neglect is likely to result from a combination of distinct deficits that co-occur due to concomitant damage affecting juxtaposed brain areas and their connections, but the exact nature of core deficits and their neural substrates still remains unclear. The present review describes recent progress in identifying functional components of the neglect syndrome and relating them to distinct subregions of parietal cortex. A comprehensive understanding of spatial neglect will require a more precise definition of cognitive processes implicated in different behavioral manifestations, as well as meticulous mapping of these processes onto specific brain circuits, while taking into account functional changes in activity that may arise in structurally intact areas subsequent to damage in distant portions of the relevant networks.

Common and distinct neural mechanisms of visual and tactile extinction: A large scale VBM study in sub-acute stroke

Extinction is diagnosed when patients respond to a single contralesional item but fail to detect this item when an ipsilesional item is present concurrently. Extinction has been studied mainly in the visual modality but it occurs also in other sensory modalities (touch, audition) and hence can be considered a multisensory phenomenon. The functional and neuroanatomical relations between extinction in different modalities are poorly understood. Here, we used voxel-based mophometry (VBM) to examine the neuronal substrates of visual versus tactile extinction in a large group of sub-acute patients (n = 454) with strokes affecting different vascular territories. We found that extinction deficits in tactile and visual modalities were significantly correlated (r = 0.341; p < 0.01). Several lesions within the right hemisphere were linked to extinction including the inferior parietal lobule, the superior parietal lobule, the middle frontal and occipital gyri, while lesions involving the superior temporal gyrus, inferior temporal gyrus and putamen were associated with tactile extinction. Damage within the middle temporal gyrus and superior temporal sulcus was linked to both deficits. We conclude that extinction in different modalities emerges after damage to both common (supra-modal) and distinct (modality specific) brain regions, and that contrasting sites emerge after damage to different vascular territories. We discuss the implications for understanding extinction as a multisensory disorder.

Consciousness and the prefrontal parietal network: insights from attention, working memory, and chunking

Consciousness has of late become a “hot topic” in neuroscience. Empirical work has centered on identifying potential neural correlates of consciousness (NCCs), with a converging view that the prefrontal parietal network (PPN) is closely associated with this process. Theoretical work has primarily sought to explain how informational properties of this cortical network could account for phenomenal properties of consciousness. However, both empirical and theoretical research has given less focus to the psychological features that may account for the NCCs. The PPN has also been heavily linked with cognitive processes, such as attention. We describe how this literature is under-appreciated in consciousness science, in part due to the increasingly entrenched assumption of a strong dissociation between attention and consciousness. We argue instead that there is more common ground between attention and consciousness than is usually emphasized: although objects can under certain circumstances be attended to in the absence of conscious access, attention as a content selection and boosting mechanism is an important and necessary aspect of consciousness. Like attention, working memory and executive control involve the interlinking of multiple mental objects and have also been closely associated with the PPN. We propose that this set of cognitive functions, in concert with attention, make up the core psychological components of consciousness. One related process, chunking, exploits logical or mnemonic redundancies in a dataset so that it can be recoded and a given task optimized. Chunking has been shown to activate PPN particularly robustly, even compared with other cognitively demanding tasks, such as working memory or mental arithmetic. It is therefore possible that chunking, as a tool to detect useful patterns within an integrated set of intensely processed (attended) information, has a central role to play in consciousness. Following on from this, we suggest that a key evolutionary purpose of consciousness may be to provide innovative solutions to complex or novel problems.

The sound of consciousness: neural underpinnings of auditory perception

The neural correlates of consciousness (NCC), i.e., patterns of brain activity that specifically accompany a particular conscious experience, have been investigated mainly in the visual system using particularly suited paradigms, such as binocular rivalry and multistable percepts in combination with neural recordings or neuroimaging. Through the same principles, we look here for possible NCC in the auditory modality exploiting the properties of the Deutsch's illusion, a stimulation condition in which a sequence of two specular dichotic stimuli presented in alternation causes an illusory segregation of pitch and side (ear of origin), which can yield up to four different auditory percepts per dichotic stimulus. Using magnetoencephalography in humans, we observed cortical activity specifically accompanying conscious experience of pitch inside an early bilateral network, including the Heschl's gyrus, the middle temporal gyrus, the right inferior, and the superior frontal gyri. The conscious experience of perceived side was instead accompanied by later activity observed bilaterally in the inferior parietal lobe and in the superior frontal gyrus. These results suggest that the NCC are not independent of stimulus features and modality and that, even at the higher cortical levels, the different aspects of a single perceptual scene may not be simultaneously processed.

Touch to see: neuropsychological evidence of a sensory mirror system for touch

The observation of touch can be grounded in the activation of brain areas underpinning direct tactile experience, namely the somatosensory cortices. What is the behavioral impact of such a mirror sensory activity on visual perception? To address this issue, we investigated the causal interplay between observed and felt touch in right brain-damaged patients, as a function of their underlying damaged visual and/or tactile modalities. Patients and healthy controls underwent a detection task, comprising visual stimuli depicting touches or without a tactile component. Touch and No-touch stimuli were presented in egocentric or allocentric perspectives. Seeing touches, regardless of the viewing perspective, differently affects visual perception depending on which sensory modality is damaged: In patients with a selective visual deficit, but without any tactile defect, the sight of touch improves the visual impairment; this effect is associated with a lesion to the supramarginal gyrus. In patients with a tactile deficit, but intact visual perception, the sight of touch disrupts visual processing, inducing a visual extinction-like phenomenon. This disruptive effect is associated with the damage of the postcentral gyrus. Hence, a damage to the somatosensory system can lead to a dysfunctional visual processing, and an intact somatosensory processing can aid visual perception.

Auditory Stimulus Timing Influences Perceived duration of Co-Occurring Visual Stimuli

There is increasing interest in multisensory influences upon sensory-specific judgments, such as when auditory stimuli affect visual perception. Here we studied whether the duration of an auditory event can objectively affect the perceived duration of a co-occurring visual event. On each trial, participants were presented with a pair of successive flashes and had to judge whether the first or second was longer. Two beeps were presented with the flashes. The order of short and long stimuli could be the same across audition and vision (audio–visual congruent) or reversed, so that the longer flash was accompanied by the shorter beep and vice versa (audio–visual incongruent); or the two beeps could have the same duration as each other. Beeps and flashes could onset synchronously or asynchronously. In a further control experiment, the beep durations were much longer (tripled) than the flashes. Results showed that visual duration discrimination sensitivity (d′) was significantly higher for congruent (and significantly lower for incongruent) audio–visual synchronous combinations, relative to the visual-only presentation. This effect was abolished when auditory and visual stimuli were presented asynchronously, or when sound durations tripled those of flashes. We conclude that the temporal properties of co-occurring auditory stimuli influence the perceived duration of visual stimuli and that this can reflect genuine changes in visual sensitivity rather than mere response bias.

Studying Multisensory Processing and Its Role in the Representation of Space through Pathological and Physiological Crossmodal Extinction

The study of crossmodal extinction has brought a considerable contribution to our understanding of how the integration of stimuli perceived in multiple sensory modalities is used by the nervous system to build coherent representations of the space that directly surrounds us. Indeed, by revealing interferences between stimuli in a disturbed system, extinction provides an invaluable opportunity to investigate the interactions that normally exist between those stimuli in an intact system. Here, we first review studies on pathological crossmodal extinction, from the original demonstration of its existence, to its role in the exploration of the multisensory neural representation of space and the current theoretical accounts proposed to explain the mechanisms involved in extinction and multisensory competition. Then, in the second part of this paper, we report recent findings showing that physiological multisensory competition phenomena resembling clinical crossmodal extinction exist in the healthy brain. We propose that the development of a physiological model of sensory competition is fundamental to deepen our understanding of the cerebral mechanisms of multisensory perception and integration. In addition, a similar approach to develop a model of physiological sensory competition in non-human primates should allow combining functional neuroimaging with more invasive techniques, such as transient focal lesions, in order to bridge the gap between works done in the two species and at different levels of analysis.

Organization, maturation, and plasticity of multisensory integration: insights from computational modeling studies

In this paper, we present two neural network models – devoted to two specific and widely investigated aspects of multisensory integration – in order to evidence the potentialities of computational models to gain insight into the neural mechanisms underlying organization, development, and plasticity of multisensory integration in the brain. The first model considers visual–auditory interaction in a midbrain structure named superior colliculus (SC). The model is able to reproduce and explain the main physiological features of multisensory integration in SC neurons and to describe how SC integrative capability – not present at birth – develops gradually during postnatal life depending on sensory experience with cross-modal stimuli. The second model tackles the problem of how tactile stimuli on a body part and visual (or auditory) stimuli close to the same body part are integrated in multimodal parietal neurons to form the perception of peripersonal (i.e., near) space. The model investigates how the extension of peripersonal space – where multimodal integration occurs – may be modified by experience such as use of a tool to interact with the far space. The utility of the modeling approach relies on several aspects: (i) The two models, although devoted to different problems and simulating different brain regions, share some common mechanisms (lateral inhibition and excitation, non-linear neuron characteristics, recurrent connections, competition, Hebbian rules of potentiation and depression) that may govern more generally the fusion of senses in the brain, and the learning and plasticity of multisensory integration. (ii) The models may help interpretation of behavioral and psychophysical responses in terms of neural activity and synaptic connections. (iii) The models can make testable predictions that can help guiding future experiments in order to validate, reject, or modify the main assumptions.

Passive tactile recognition of geometrical shape in humans: An fMRI study

Tactile shape discrimination involves frontal other than somatosensory cortex (Palva et al., 2005 [48]), but it is unclear if this frontal activity is related to exploratory concomitants. In this study, we investigated topographical details of prefrontal, premotor, and parietal areas during passive tactile recognition of 2D geometrical shapes in conditions avoiding exploratory movements. Functional magnetic resonance imaging (fMRI) was performed while the same wooden 2D geometrical shapes were blindly pressed on subjects' passive right palm in three conditions. In the RAW condition, shapes were pressed while subjects were asked to attend to the stimuli but were not trained to recognize them. After a brief training, in the SHAPE condition subjects were asked to covertly recognize shapes. In the RECOGNITION condition, they were asked to overtly recognize shapes, using response buttons with their opposite hand. Results showed that somatosensory cortex including contralateral SII, contralateral SI, and left insula was active in all conditions, confirming its importance in processing tactile shapes. In the RAW vs. SHAPE contrast, bilateral posterior parietal, insular, premotor, prefrontal, and (left) Broca's areas were more active in the latter. In the RECOGNITION, activation of (left) Broca's area correlated with correct responses. These results suggest that, even without exploratory movements, passive recognition of tactile geometrical shapes involves prefrontal and premotor as well as somatosensory regions. In this framework, Broca's area might be involved in a successful selection and/or execution of the correct responses.

Visuotactile representation of peripersonal space: a neural network study

Neurophysiological and behavioral studies suggest that the peripersonal space is represented in a multisensory fashion by integrating stimuli of different modalities. We developed a neural network to simulate the visual-tactile representation of the peripersonal space around the right and left hands. The model is composed of two networks (one per hemisphere), each with three areas of neurons: two are unimodal (visual and tactile) and communicate by synaptic connections with a third downstream multimodal (visual-tactile) area. The hemispheres are interconnected by inhibitory synapses. We applied a combination of analytic and computer simulation techniques. The analytic approach requires some simplifying assumptions and approximations (linearization and a reduced number of neurons) and is used to investigate network stability as a function of parameter values, providing some emergent properties. These are then tested and extended by computer simulations of a more complex nonlinear network that does not rely on the previous simplifications. With basal parameter values, the extended network reproduces several in vivo phenomena: multisensory coding of peripersonal space, reinforcement of unisensory perception by multimodal stimulation, and coexistence of simultaneous right- and left-hand representations in bilateral stimulation. By reducing the strength of the synapses from the right tactile neurons, the network is able to mimic the responses characteristic of right-brain-damaged patients with left tactile extinction: perception of unilateral left tactile stimulation, cross-modal extinction and cross-modal facilitation in bilateral stimulation. Finally, a variety of sensitivity analyses on some key parameters was performed to shed light on the contribution of single-model components in network behaviour. The model may help us understand the neural circuitry underlying peripersonal space representation and identify its alterations explaining neurological deficits. In perspective, it could help in interpreting results of psychophysical and behavioral trials and clarifying the neural correlates of multisensory-based rehabilitation procedures.

Now you'll feel it, now you won't: EEG rhythms predict the effectiveness of perceptual masking

Do ongoing brain states determine conscious perception of an upcoming stimulus? Using the high temporal resolution of EEG, we investigated the relationship between prestimulus neuronal oscillations and the perceptibility of two competing somatosensory stimuli embedded in a backward masking paradigm. We identified two prestimulus EEG signatures predictive for a suprathreshold yet weak target stimulus to become perceptually resistant against masking by a stronger distractor stimulus: (i) over left frontal cortex a desynchronization of the regional beta rhythm (approximately 20 Hz) 500 msec prior to a perceived target, and (ii) a subsequent additional attenuation of both mu (approximately 10 Hz) and beta "idling" rhythms over those pericentral sensorimotor cortices which are going to process the upcoming target stimulus. Furthermore, across subjects the probability for target perception strongly correlates with the individual absolute level of pre-target amplitudes in these frequency bands and locations. These signatures significantly differed from the EEG characteristics preceding detected and undetected single stimuli. We suggest that the early activation of left frontal areas involved in top-down attentional control is critical for preventing backward masking and leads the preparation of primary sensory cortices: The ensuing prestimulus suppression of sensory idling rhythms warrants an intensified poststimulus processing, and thus, effectively promotes conscious perception of suprathreshold target stimuli embedded into an ecologically relevant condition featuring competing environmental stimuli.

Crossmodal links between vision and touch in spatial attention: a computational modelling study

Many studies have revealed that attention operates across different sensory modalities, to facilitate the selection of relevant information in the multimodal situations of every-day life. Cross-modal links have been observed either when attention is directed voluntarily (endogenous) or involuntarily (exogenous). The neural basis of cross-modal attention presents a significant challenge to cognitive neuroscience. Here, we used a neural network model to elucidate the neural correlates of visual-tactile interactions in exogenous and endogenous attention. The model includes two unimodal (visual and tactile) areas connected with a bimodal area in each hemisphere and a competition between the two hemispheres. The model is able to explain cross-modal facilitation both in exogenous and endogenous attention, ascribing it to an advantaged activation of the bimodal area on the attended side (via a top-down or bottom-up biasing), with concomitant inhibition towards the opposite side. The model suggests that a competitive/cooperative interaction with biased competition may mediate both forms of cross-modal attention.

Crossmodal visual-tactile extinction: Modulation by posture implicates biased competition in proprioceptively reconstructed space

Extinction is a common consequence of unilateral brain injury: contralesional events can be perceived in isolation, yet are missed when presented concurrently with competing events on the ipsilesional side. This can arise crossmodally, where a contralateral touch is extinguished by an ipsilateral visual event. Recent studies showed that repositioning the hands in visible space, or making visual events more distant, can modulate such crossmodal extinction. Here, in a detailed single-case study, we implemented a novel spatial manipulation when assessing crossmodal extinction. This was designed not only to hold somatosensory inputs and hand/arm-posture constant, but also to hold (retinotopic) visual inputs constant, yet while still changing the spatial relationship of tactile and visual events in the external world. Our right hemisphere patient extinguished left-hand touches due to visual stimulation of the right visual field (RVF) when tested in the usual default posture with eyes/head directed straight ahead. But when her eyes/head were turned to the far left (and any visual events shifted along with this), such that the identical RVF retinal stimulation now fell at the same external location as the left-hand touch, crossmodal extinction was eliminated. Since only proprioceptive postural cues could signal this changed spatial relationship for the critical condition, our results show for the first time that such postural cues alone are sufficient to modulate crossmodal extinction. Identical somatosensory and retinal inputs can lead to severe crossmodal extinction, or none, depending on current posture.

A signal detection study of the Colavita visual dominance effect

When presented with auditory, visual, or bimodal audiovisual stimuli in a speeded detection/discrimination task, participants fail to respond to the auditory component of the bimodal targets significantly more often than they fail to respond to the visual component. Signal detection theory (SDT) was used to explore the contributions of perceptual (sensitivity shifts) and decisional (shifts in response criteria) factors to this effect, known as the Colavita visual dominance effect. Participants performed a version of the Colavita task that had been modified to allow for SDT analyses. The participants had to detect auditory and visual targets (presented unimodally or bimodally) at their individually determined 75% detection thresholds. The results showed a significant decrease in participants' sensitivity to auditory stimuli when presented concurrently with visual stimuli (in the absence of any significant change in their response criterion), suggesting that Colavita visual dominance does not simply reflect a decisional effect, but can be explained, at least in part, as a truly perceptual phenomenon. The decrease in sensitivity (to auditory stimuli) may be attributable to the exogenous capture of participants' attention by the visual component of the bimodal target, thus leaving fewer attentional resources for the processing of the auditory stimulus. The reduction in auditory sensitivity reported here may be considered an example of crossmodal masking.

Interhemispheric effect of parietal TMS on somatosensory response confirmed directly with concurrent TMS-fMRI

Transcranial magnetic stimulation (TMS) has been used to document some apparent interhemispheric influences behaviorally, with TMS over the right parietal cortex reported to enhance processing of touch for the ipsilateral right hand (Seyal et al., 1995). However, the neural bases of such apparent interhemispheric influences from TMS remain unknown. Here, we studied this directly by combining TMS with concurrent functional magnetic resonance imaging (fMRI). We applied bursts of 10 Hz TMS over right parietal cortex, at a high or low intensity, during two sensory contexts: either without any other stimulation, or while participants received median nerve stimulation to the right wrist, which projects to left primary somatosensory cortex (SI). TMS to right parietal cortex affected the blood oxygenation level-dependent signal in left SI, with high- versus low-intensity TMS increasing the left SI signal during right-wrist somatosensory input, but decreasing this in the absence of somatosensory input. This state-dependent modulation of SI by parietal TMS over the other hemisphere was accompanied by a related pattern of TMS-induced influences in the thalamus, as revealed by region-of-interest analyses. A behavioral experiment confirmed that the same right parietal TMS protocol of 10 Hz bursts led to enhanced detection of perithreshold electrical stimulation of the right median nerve, which is initially processed in left SI. Our results confirm directly that TMS over right parietal cortex can affect processing in left SI of the other hemisphere, with rivalrous effects (possibly transcallosal) arising in the absence of somatosensory input, but facilitatory effects (possibly involving thalamic circuitry) in the presence of driving somatosensory input.

Explaining the Colavita visual dominance effect

The last couple of years have seen a resurgence of interest in the Colavita visual dominance effect. In the basic experimental paradigm, a random series of auditory, visual, and audiovisual stimuli are presented to participants who are instructed to make one response whenever they see a visual target and another response whenever they hear an auditory target. Many studies have now shown that participants sometimes fail to respond to auditory targets when they are presented at the same time as visual targets (i.e., on the bimodal trials), despite the fact that they have no problems in responding to the auditory and visual stimuli when they are presented individually. The existence of the Colavita visual dominance effect provides an intriguing contrast with the results of the many other recent studies showing the superiority of multisensory (over unisensory) information processing in humans. Various accounts have been put forward over the years in order to try and explain the effect, including the suggestion that it reflects nothing more than an underlying bias to attend to the visual modality. Here, the empirical literature on the Colavita visual dominance effect is reviewed and some of the key factors modulating the effect highlighted. The available research has now provided evidence against all previous accounts of the Colavita effect. A novel explanation of the Colavita effect is therefore put forward here, one that is based on the latest findings highlighting the asymmetrical effect that auditory and visual stimuli exert on people's responses to stimuli presented in the other modality.

Functional imaging of stroke recovery: what have we learnt and where do we go from here?

Functional brain imaging techniques have been used to visualise patterns of activity following stroke and to characterise how these patterns change with recovery or rehabilitation. Some consensus is now emerging on patterns that are predictive of improved outcome, and therapeutic strategies are beginning to be guided by such findings. However, patient heterogeneity predicts that the same approach will not be appropriate for all. Future studies should aim to characterise the factors that influence this heterogeneity, and to individualise rehabilitation strategies based in part on early imaging findings. Functional imaging studies of stroke should also embrace recent methodological and conceptual advances that allow for fuller characterisation of the structural and functional properties of distributed brain networks.

The cognitive and neural correlates of “tactile consciousness”: A multisensory perspective

People's awareness of tactile stimuli has been investigated in far less detail than their awareness of stimuli in other sensory modalities. In an attempt to fill this gap, we provide an overview of studies that are pertinent to the topic of tactile consciousness. We discuss the results of research that has investigated phenomena such as "change blindness", phantom limb sensations, and numerosity judgments in tactile perception, together with the results obtained from the study of patients affected by deficits that can adversely affect tactile perception such as neglect, extinction, and numbsense. The similarities as well as some of the important differences that have emerged when visual and tactile conscious information processing have been compared using similar experimental procedures are highlighted. We suggest that conscious information processing in the tactile modality cannot be separated completely from the more general processing of spatial information in the brain. Finally, the importance of considering tactile consciousness within the larger framework of multisensory information processing is also discussed.

Functional MRI of the primary somatosensory cortex in extinction to simultaneous bilateral tactile stimuli due to right temporal lobe stroke

Patients with right posterior temporoparietal cortical lesions often exhibit extinction to tactile double simultaneous stimuli (EDSS). It is not known whether sensory unawareness-extinction results from suppression of sensory input into the somatosensory cortex (SI), inhibition of SI, or interference which prevents SI output from activating and being fully processed by association areas. A patient with EDSS due to a right temporal stroke sparing SI and posterior parietal cortex and eight age-matched healthy controls were studied with fMRI during tactile stimulation. The volume of activation of SI during tactile stimulation of the right hand, the left hand and both hands was measured and the patient's volume of activation was compared to that of the control subjects in each of these stimulus conditions. Although the patient demonstrated behavioral EDSS, during fMRI the patient's activation of SI on both sides was within the range of the control participants' volumes of activation. These findings suggest that EDSS in patients with a right temporal lobe stroke results from processing abnormalities that occur after these afferent tactile stimuli are processed by SI.

Tool use changes multisensory interactions in seconds: evidence from the crossmodal congruency task

Active tool use in human and non-human primates has been claimed to alter the neural representations of multisensory peripersonal space. To date, most studies suggest that a short period of tool use leads to an expansion or elongation of these spatial representations, which lasts several minutes after the last tool use action. However, the possibility that multisensory interactions also change on a much shorter time scale following or preceding individual tool use movements has not yet been investigated. We measured crossmodal (visual-tactile) congruency effects as an index of multisensory integration during two tool use tasks. In the regular tool use task, the participants used one of two tools in a spatiotemporally predictable sequence after every fourth crossmodal congruency trial. In the random tool use task, the required timing and spatial location of the tool use task varied unpredictably. Multisensory integration effects increased as a function of the number of trials since tool use in the regular tool use group, but remained relatively constant in the random tool use group. The spatial distribution of these multisensory effects, however, was unaffected by tool use predictability, with significant spatial interactions found only near the hands and at the tips of the tools. These data suggest that endogenously preparing to use a tool enhances visual-tactile interactions near the tools. Such enhancements are likely due to the increased behavioural relevance of visual stimuli as each tool use action is prepared before execution.

Assessing the role of stimulus probability on the Colavita visual dominance effect

Participants presented with unimodal auditory (A), unimodal visual (V), or bimodal audiovisual stimuli (AV) in a task in which they have to identify the modality of the targets as rapidly as possible, fail to respond to the auditory component of bimodal targets significantly more often than they fail to respond to the visual component. In the majority of published studies on this phenomenon, known as the Colavita effect, the auditory, visual, and bimodal stimuli have been presented in the ratio 40A:40V:20AV. In the present study, we investigated whether the relatively low frequency with which the bimodal targets in previous studies have been presented may have contributed to participants' difficulty in responding to such targets correctly. We manipulated the bimodal target probability by presenting the stimuli in the ratios 20A:20V:60AV, in Experiment 1; 5A:5V:90AV, 25A:25V:50AV, and 45A:45V:10AV, in Experiment 2. A significant Colavita visual dominance effect was observed when the bimodal targets were presented on 60% of the trials or less. We suggest that increasing the frequency of bimodal targets may have provided an exogenous cue to performance, that reduced the necessity for endogenous attention when selecting the appropriate response to make to bimodal targets.