Is most of neural plasticity in the thalamus cortical?

Association that Neuroimaging and Clinical Measures Have with Change in Arm Impairment in a Phase 3 Stroke Recovery Trial

OBJECTIVE

Vagus nerve stimulation (VNS) paired with rehabilitation therapy improved motor status compared to rehabilitation alone in the phase III VNS-REHAB stroke trial, but treatment response was variable and not associated with any clinical measures acquired at baseline, such as age or side of paresis. We hypothesized that neuroimaging measures would be associated with treatment-related gains, examining performance of regional injury measures versus global brain health measures in parallel with clinical measures.

METHODS

Baseline magnetic resonance imaging (MRI) scans in the VNS-REHAB trial were used to derive regional injury measures (extent of injury to corticospinal tract, the primary regional measure; plus extent of injury to precentral gyrus and postcentral gyrus; lesion volume; and lesion topography) and global brain health measures (degree of white matter hyperintensities, the primary global brain measure; plus volumes of cerebrospinal fluid, cortical gray matter, white matter, each thalamus, and total brain). Eight clinical measures assessed at baseline were also evaluated (treatment group, age, race, gender, paretic side, pre-stroke dominant hand, time since stroke, and baseline Fugl-Meyer upper extremity score). Bivariate analyses compared each measure with the primary trial end point (change in Fugl-Meyer upper extremity score from baseline to end of 6 weeks of treatment) across all subjects, with secondary analyses examining trial groups separately.

RESULTS

MRIs were available from 80 patients (age = 59.8 ± 9.5 years, 29 women). Across all patients, less white matter hyperintensities (r = -0.25, p = 0.028) at baseline was associated with larger Fugl-Meyer score change. In the VNS group, less white matter hyperintensities (r = -0.37, p = 0.018) and larger ipsilesional thalamus volume (r = 0.33, p = 0.046) were each associated with larger Fugl-Meyer score change. Analysis of covariance (ANCOVA) analyses tested the interaction that each baseline measure had with treatment group and found that the model examining white matter hyperintensities had a significant interaction term, indicating 2.3 less change in Fugl-Meyer Upper Extremity (FM-UE) points in the VNS group relative to the control group for each point increase in modified Fazekas scale.

INTERPRETATION

Neuroimaging measures are associated with extent of gains on the primary endpoint of a phase III stroke recovery trial. Among the neuroimaging measures examined, a measure of global brain health (extent of white matter hyperintensities) was better at explaining the change in arm impairment as compared with measures of regional injury; this was true when examining all study subjects as well as only those in the VNS group and is consistent with the global mechanism of action that VNS has throughout the cerebrum. Future studies can evaluate additional measures that further predict response to VNS therapy. The current findings suggest that individual patient neuroimaging results may be useful for a personalized medicine approach to stroke recovery therapeutics. ANN NEUROL 2025;97:709-719.

How the forebrain transitions to adulthood: developmental plasticity markers in a long-lived rodent reveal region diversity and the uniqueness of adolescence

Maturation of the forebrain involves transitions from higher to lower levels of synaptic plasticity. The timecourse of these changes likely differs between regions, with the stabilization of some networks scaffolding the development of others. To gain better insight into neuroplasticity changes associated with maturation to adulthood, we examined the distribution of two molecular markers for developmental plasticity. We conducted the examination on male and female degus (Octodon degus), a rodent species with a relatively long developmental timecourse that offers a promising model for studying both development and age-related neuropathology. Immunofluorescent staining was used to measure perineuronal nets (PNNs), an extracellular matrix structure that emerges during the closure of critical plasticity periods, as well as microglia, resident immune cells that play a crucial role in synapse remodeling during development. PNNs (putatively restricting plasticity) were found to be higher in non-juvenile (>3 month) degus, while levels of microglia (putatively mediating plasticity) decreased across ages more gradually, and with varying timecourses between regions. Degus also showed notable variation in PNN levels between cortical layers and hippocampal subdivisions that have not been previously reported in other species. These results offer a glimpse into neuroplasticity changes occurring during degu maturation and highlight adolescence as a unique phase of neuroplasticity, in which PNNs have been established but microglia remain relatively high.

Thalamic structural connectivity profiles in blepharospam/Meige's syndrome

BACKGROUND

Blepharospasm is a debilitating focal dystonia characterized by involuntary eyelid spasms that can be accompanied by oromandibular muscle involvement (Meige's syndrome). Frequently observed abnormality in functional neuroimaging hints at an important position of the thalamus, that relays involved cortico-basal ganglia-cortical and cortico-cerebello-cortical circuits, within the abnormal network in blepharospasm.

OBJECTIVE

To characterize abnormal cortico-thalamic structural/streamline connectivity (SC) patterns in the disease, as well as their potential co-occurrence with abnormal subcortico-thalamo-cortical projections using diffusion tractography.

METHODS

Diffusion imaging was obtained in 17 patients with blepharospasm (5 with mild lower facial involvement) and 17 healthy controls. Probabilistic tractography was used for quantification of SC between six cortical regions and thalamus, and voxel-level thalamic SC mapping as well as evaluation of the thalamic SC distributions' topography by center-of-gravity analysis was performed. Post-hoc, correlations of SC with clinical parameters were evaluated. Further, white matter integrity was investigated within representative segments of the dentato-thalamo-cortical and pallido-thalamo-cortical tract.

RESULTS

Connectivity mapping showed significant reduction of right (pre)motor- and left occipital-thalamic SC, as well as a topographic shift of the left occipital-thalamic SC distribution in patients. Significant positive correlation of occipital-thalamic SC with disease severity was found. Post-hoc analysis revealed significantly reduced mean fractional anisotropy in patients within the dentato-thalamo-cortical trajectory connecting to right (pre)motor and left occipital cortex.

CONCLUSION

Abnormal occipital/motor SC provides evidence for dysfunction of the thalamus-relayed visual and motor network as a key aspect in the disease. Concurrent impairment of microstructural integrity within the dentato-thalamic trajectories targeting those cortices hints at cerebellar contribution.

The role of afferent input in postamputation pain: a randomized, double-blind, placebo-controlled crossover study

In this randomized, double-blind, placebo-controlled crossover study, we investigated whether a peripheral nerve block could temporarily eliminate phantom and stump pain after amputation. Amputees with constant postamputation pain were included and randomized to receive a nerve block with lidocaine 2% with adrenaline or saline in a crossover design. Spontaneous phantom and stump pain and evoked responses were assessed at baseline and at fixed time-points until 120 minutes after lidocaine or saline injection. The primary outcome was the difference in absolute change between worst pain intensity, either phantom or stump pain, at baseline and at 30 minutes after lidocaine or saline injection. Twelve amputees were randomized and 9 patients were included in the analysis. The absolute change in median worst pain intensity between lidocaine and saline injection was -2.0 (interquartile range, -4.0 to 0.0) (n = 9, P = 0.12). Nine of 9 patients reported at least some pain relief after lidocaine injection compared with only 2 of 9 patients after saline injection (P = 0.02). Phantom pain intensity was significantly reduced after lidocaine compared with saline injection (P = 0.04), whereas there was no significant change in stump pain intensity between the 2 interventions (P = 0.17). In all 9 amputees, evoked responses were eliminated after lidocaine injection. Thus, our findings suggest that afferent input from the peripheral nervous system plays an important role in postamputation pain.

Early recovery of neuronal functioning in the sensory cortex after nerve reconstruction surgery

BACKGROUND

Nerve reconstructive surgery induces a transient loss and a prolonged and a gradual return of sensory inputs to the brain. It is unknown whether, following this massive peripheral denervation, the brain will experience a prolonged period of severe, intrinsic dysfunction.

OBJECTIVE

We aim to investigate the mechanisms of return of processing function in cortical neurons.

METHODS

We used the whisker model in rats to evaluate the functional recovery in the somatosensory cortex after a nerve reconstruction surgery. Multi-unit recording in the barrel cortex was performed in lightly anesthetized rats while their whiskers were stimulated by a whisker stimulator.

RESULTS

We observed a loss of neuronal responses to whisker stimulation 1 week after surgery, which started to recover 2 weeks after surgery. Following the surgery, only 11.8% of units had principle whiskers (PWs) returned to their original status while 17.7% had PWs different from their original status, indicating the effect of aberrant reinnervation on the whisker response map.

CONCLUSIONS

Robust neuronal responses to sensory stimulation even when only sparse sensory inputs are available in the early recovery phase. During this phase, aberrant reinnervation induces disorganized whisker tuning, a finding that might be account for the hypoesthesia and paresthesia during early recovery after nerve reconstruction.

Does Size Really Matter? The Role of Tonotopic Map Area Dynamics for Sound Learning in Mouse Auditory Cortex

This commentary centers on the novel findings by Shepard et al. (2016) published in eNeuro. The authors interrogated tonotopic map dynamics in auditory cortex (ACtx) by employing a natural sound-learning paradigm, where mothers learn the importance of pup ultrasonic vocalizations (USVs), allowing Shepard et al. to probe the role of map area expansion for auditory learning. They demonstrate that auditory learning in this paradigm does not rely on map expansion but is facilitated by increased inhibition of neurons tuned to low-frequency sounds. Here, we discuss the findings in light of the emerging enthusiasm for cortical inhibitory interneurons for circuit function and hypothesize how a particular interneuron type might be causally involved for the intriguing results obtained by Shepard et al.

Phoneme restoration and empirical coverage of Interactive Activation and Adaptive Resonance models of human speech processing

Magnuson [J. Acoust. Soc. Am. 137, 1481-1492 (2015)] makes claims for Interactive Activation (IA) models and against Adaptive Resonance Theory (ART) models of speech perception. Magnuson also presents simulations that claim to show that the TRACE model can simulate phonemic restoration, which was an explanatory target of the cARTWORD ART model. The theoretical analysis and review herein show that these claims are incorrect. More generally, the TRACE and cARTWORD models illustrate two diametrically opposed types of neural models of speech and language. The TRACE model embodies core assumptions with no analog in known brain processes. The cARTWORD model defines a hierarchy of cortical processing regions whose networks embody cells in laminar cortical circuits as part of the paradigm of laminar computing. cARTWORD further develops ART speech and language models that were introduced in the 1970s. It builds upon Item-Order-Rank working memories, which activate learned list chunks that unitize sequences to represent phonemes, syllables, and words. Psychophysical and neurophysiological data support Item-Order-Rank mechanisms and contradict TRACE representations of time, temporal order, silence, and top-down processing that exhibit many anomalous properties, including hallucinations of non-occurring future phonemes. Computer simulations of the TRACE model are presented that demonstrate these failures.

How Does the Cerebral Cortex Work? Development, Learning, Attention, and 3-D Vision by Laminar Circuits of Visual Cortex

A key goal of behavioral and cognitive neuroscience is to link brain mechanisms to behavioral functions. The present article describes recent progress toward explaining how the visual cortex sees. Visual cortex, like many parts of perceptual and cognitive neocortex, is organized into six main layers of cells, as well as characteristic sublamina. Here it is proposed how these layered circuits help to realize processes of development, learning, perceptual grouping, attention, and 3-D vision through a combination of bottom-up, horizontal, and top-down interactions. A main theme is that the mechanisms which enable development and learning to occur in a stable way imply properties of adult behavior. These results thus begin to unify three fields: infant cortical development, adult cortical neurophysiology and anatomy, and adult visual perception. The identified cortical mechanisms promise to generalize to explain how other perceptual and cognitive processes work.

Tactile representation in somatosensory thalamus (VPL) and cortex (S1) of awake primate and the plasticity induced by VPL neuroprosthetic stimulation

To further understand how tactile information is carried in somatosensory cortex (S1) and the thalamus (VPL), and how neuronal plasticity after neuroprosthetic stimulation affects sensory encoding, we chronically implanted microelectrode arrays across hand areas in both S1 and VPL, where neuronal activities were simultaneously recorded during tactile stimulation on the finger pad of awake monkeys. Tactile information encoded in the firing rate of individual units (rate coding) or in the synchrony of unit pairs (synchrony coding) was quantitatively assessed within the information theoretic-framework. We found that tactile information encoded in VPL was higher than that encoded in S1 for both rate coding and synchrony coding; rate coding carried greater information than synchrony coding for the same recording area. With the aim for neuroprosthetic stimulation, plasticity of the circuit was tested after 30 min of VPL electrical stimulation, where stimuli were delivered either randomly or contingent on the spiking of an S1 unit. We showed that neural encoding in VPL was more stable than in S1, which depends not only on the thalamic input but also on recurrent feedback. The percent change of mutual-information after stimulation was increased with closed-loop stimulation, but decreased with random stimulation. The underlying mechanisms during closed-loop stimulation might be spike-timing-dependent plasticity, while frequency-dependent synaptic plasticity might play a role in random stimulation. Our results suggest that VPL could be a promising target region for somatosensory stimulation with closed-loop brain-machine-interface applications.

Improvement in Touch Sensation after Stroke is Associated with Resting Functional Connectivity Changes

Background

Distributed brain networks are known to be involved in facilitating behavioral improvement after stroke, yet few, if any, studies have investigated the relationship between improved touch sensation after stroke and changes in functional brain connectivity.

Objective

We aimed to identify how recovery of somatosensory function in the first 6 months after stroke was associated with functional network changes as measured using resting-state connectivity analysis of functional magnetic resonance imaging (fMRI) data.

Methods

Ten stroke survivors underwent clinical testing and resting-state fMRI scans at 1 and 6 months post-stroke. Ten age-matched healthy participants were included as controls.

Results

Patients demonstrated a wide range of severity of touch impairment 1 month post-stroke, followed by variable improvement over time. In the stroke group, significantly stronger interhemispheric functional correlations between regions of the somatosensory system, and with visual and frontal areas, were found at 6 months than at 1 month post-stroke. Clinical improvement in touch discrimination was associated with stronger correlations at 6 months between contralesional secondary somatosensory cortex (SII) and inferior parietal cortex and middle temporal gyrus, and between contralesional thalamus and cerebellum.

Conclusion

The strength of connectivity between somatosensory regions and distributed brain networks, including vision and attention networks, may change over time in stroke survivors with impaired touch discrimination. Connectivity changes from contralesional SII and contralesional thalamus are associated with improved touch sensation at 6 months post-stroke. These functional connectivity changes could represent future targets for therapy.

Effect of deafferentation from spinal anesthesia on pain sensitivity and resting-state functional brain connectivity in healthy male volunteers

Patients may perceive paradoxical heat sensation during spinal anesthesia. This could be due to deafferentation-related functional changes at cortical, subcortical, or spinal levels. In the current study, the effect of spinal deafferentation on sensory (pain) sensitivity was studied and linked to whole-brain functional connectivity as assessed by resting-state functional magnetic resonance imaging (RS-fMRI) imaging. Deafferentation was induced by sham or spinal anesthesia (15 mg bupivacaine injected at L3-4) in 12 male volunteers. RS-fMRI brain connectivity was determined in relation to eight predefined and seven thalamic resting-state networks (RSNs) and measured before, and 1 and 2 h after spinal/sham injection. To measure the effect of deafferentation on pain sensitivity, responses to heat pain were measured at 15-min intervals on nondeafferented skin and correlated to RS-fMRI connectivity data. Spinal anesthesia altered functional brain connectivity within brain regions involved in the sensory discriminative (i.e., pain intensity related) and affective dimensions of pain perception in relation to somatosensory and thalamic RSNs. A significant enhancement of pain sensitivity on nondeafferented skin was observed after spinal anesthesia compared to sham (area-under-the-curve [mean (SEM)]: 190.4 [33.8] versus 13.7 [7.2]; p<0.001), which significantly correlated to functional connectivity changes observed within the thalamus in relation to the thalamo-prefrontal network, and in the anterior cingulate cortex and insula in relation to the thalamo-parietal network. Enhanced pain sensitivity from spinal deafferentation correlated with functional connectivity changes within brain regions involved in affective and sensory pain processing and areas involved in descending control of pain.

Measuring individual morphological relationship of cortical regions

BACKGROUND

Although local features of brain morphology have been widely investigated in neuroscience, the inter-regional relations in brain morphology have rarely been investigated, especially not for individual participants.

NEW METHOD

In this paper, we proposed a novel framework for investigating this relation based on an individual's magnetic resonance imaging (MRI) data. The key idea was to estimate the probability density function (PDF) of local morphological features within a brain region to provide a global description of this region. Then, the inter-regional relations were quantified by calculating the similarity of the PDFs for pairs of regions based on the Kullback-Leibler (KL) divergence.

RESULTS

For illustration, we applied this approach to a pre-post intervention study to investigate the longitudinal changes in morphological relations after long-term sleep deprivation. The results suggest the potential application of this new method for studies on individual differences in brain structure.

COMPARISON WITH EXISTING METHODS

The current method can be employed to estimate individual morphological relations between regions, which have been largely ignored by previous studies.

CONCLUSIONS

Our morphological relation metric, as a novel quantitative biomarker, can be used to investigate normal individual variability and even within-individual alterations/abnormalities in brain structure.

Genes contributing to subcortical volumes and intellectual ability implicate the thalamus

It has been shown that brain volume and general intellectual ability are to a significant extent influenced by the same genetic factors. Several cortical regions of the brain also show a genetic correlation with intellectual ability, demonstrating that intellectual functioning is probably represented in a heritable distributed network of cortical regions throughout the brain. This study is the first to investigate a genetic association between subcortical volumes and intellectual ability, taking into account the thalamus, caudate nucleus, putamen, globus pallidus, hippocampus, amygdala, and nucleus accumbens using an extended twin design. Genetic modeling was performed on a healthy adult twin sample consisting of 106 twin pairs and 30 of their siblings, IQ data was obtained from 132 subjects. Our results demonstrate that of all subcortical volumes measured, only thalamus volume is significantly correlated with intellectual functioning. Importantly, the association found between thalamus volume and intellectual ability is significantly influenced by a common genetic factor. This genetic factor is also implicated in cerebral brain volume. The thalamus, with its widespread cortical connections, may thus play a key role in human intelligence.

In vivo Large-Scale Cortical Mapping Using Channelrhodopsin-2 Stimulation in Transgenic Mice Reveals Asymmetric and Reciprocal Relationships between Cortical Areas

We have mapped intracortical activity in vivo independent of sensory input using arbitrary point channelrhodopsin-2 (ChR2) stimulation and regional voltage sensitive dye imaging in B6.Cg-Tg (Thy1-COP4/EYFP)18Gfng/J transgenic mice. Photostimulation of subsets of deep layer pyramidal neurons within forelimb, barrel, or visual primary sensory cortex led to downstream cortical maps that were dependent on synaptic transmission and were similar to peripheral sensory stimulation. ChR2-evoked maps confirmed homotopic connections between hemispheres and intracortical sensory and motor cortex connections. This ability of optogentically activated subpopulations of neurons to drive appropriate downstream maps suggests that mechanisms exist to allow prototypical cortical maps to self-assemble from the stimulation of neuronal subsets. Using this principle of map self-assembly, we employed ChR2 point stimulation to map connections between cortical areas that are not selectively activated by peripheral sensory stimulation or behavior. Representing the functional cortical regions as network nodes, we identified asymmetrical connection weights in individual nodes and identified the parietal association area as a network hub. Furthermore, we found that the strength of reciprocal intracortical connections between primary and secondary sensory areas are unequal, with connections from primary to secondary sensory areas being stronger than the reciprocal.

Gene expression analysis of the embryonic subplate

The subplate layer of the cerebral cortex is comprised of a heterogeneous population of cells and contains some of the earliest-generated neurons. In the embryonic brain, subplate cells contribute to the guidance and areal targeting of thalamocortical axons. At later developmental stages, they are predominantly involved in the maturation and plasticity of the cortical circuitry and the establishment of functional modules. We aimed to further characterize the embryonic murine subplate population by establishing a gene expression profile at embryonic day (E) 15.5 using laser capture microdissection and microarrays. The microarray identified over 300 transcripts with higher expression in the subplate compared with the cortical plate at this stage. Using quantitative reverse transcription-polymerase chain reaction, in situ hybridization (ISH), and immunohistochemistry (IHC), we have confirmed specific expression in the E15.5 subplate for 13 selected genes, which have not been previously associated with this compartment (Abca8a, Cdh10, Cdh18, Csmd3, Gabra5, Kcnt2, Ogfrl1, Pls3, Rcan2, Sv2b, Slc8a2, Unc5c, and Zdhhc2). In the reeler mutant, the expression of the majority of these genes (9 of 13) was shifted in accordance with the altered position of subplate. These genes belong to several functional groups and likely contribute to synapse formation and axonal growth and guidance in subplate cells.

Targeted mini-strokes produce changes in interhemispheric sensory signal processing that are indicative of disinhibition within minutes

Most processing of sensation involves the cortical hemisphere opposite (contralateral) to the stimulated limb. Stroke patients can exhibit changes in the interhemispheric balance of sensory signal processing. It is unclear whether these changes are the result of poststroke rewiring and experience, or whether they could result from the immediate effect of circuit loss. We evaluated the effect of mini-strokes over short timescales (<2 h) where cortical rewiring is unlikely by monitoring sensory-evoked activity throughout much of both cortical hemispheres using voltage-sensitive dye imaging. Blockade of a single pial arteriole within the C57BL6J mouse forelimb somatosensory cortex reduced the response evoked by stimulation of the limb contralateral to the stroke. However, after stroke, the ipsilateral (uncrossed) forelimb response within the unaffected hemisphere was spared and became independent of the contralateral forelimb cortex. Within the unaffected hemisphere, mini-strokes in the opposite hemisphere significantly enhanced sensory responses produced by stimulation of either contralateral or ipsilateral pathways within 30-50 min of stroke onset. Stroke-induced enhancement of responses within the spared hemisphere was not reproduced by inhibition of either cortex or thalamus using pharmacological agents in nonischemic animals. I/LnJ acallosal mice showed similar rapid interhemispheric redistribution of sensory processing after stroke, suggesting that subcortical connections and not transcallosal projections were mediating the novel activation patterns. Thalamic inactivation before stroke prevented the bilateral rearrangement of sensory responses. These findings suggest that acute stroke, and not merely loss of activity, activates unique pathways that can rapidly redistribute function within the spared cortical hemisphere.

Relationship between touch impairment and brain activation after lesions of subcortical and cortical somatosensory regions

BACKGROUND

The neural basis underlying somatosensory impairment and recovery poststroke is virtually unexplored.

OBJECTIVE

To investigate the relationship between touch discrimination impairment and task-related brain activation in stroke survivors with somatosensory impairment following subcortical or cortical lesions.

METHODS

A total of 19 stroke survivors with touch impairment were investigated using fMRI and a touch discrimination paradigm 1-month poststroke; 11 had subcortical and 8 cortical sensory lesions; 12 age-matched healthy controls were also studied. Mean task-related contrast images were regressed with sensory impairment using random effects analysis for each subgroup and the total group.

RESULTS

There was no significant difference in touch impairment between stroke subgroups. Touch discrimination of the affected hand correlated negatively with task-related activation in the ipsilesional primary somatosensory cortex (SI; adjacent to the SI hand area activated in healthy controls); ipsilesional secondary somatosensory cortex (SII); contralesional thalamus; and attention-related frontal and occipital regions in the subcortical group. In contrast, the cortical group did not show significant correlated activity. Yet there was no significant between-group difference in a priori somatosensory regions: only in the superior medial frontal gyrus. A negative correlation was observed in the contralesional thalamus for the total group, irrespective of lesion type.

CONCLUSION

The findings provide novel evidence of neural correlates of poststroke touch impairment involving a distributed network of ipsilesional SI and SII, the contralesional thalamus, and frontal attention regions, particularly following subcortical lesions. Further systematic investigation of a modulatory role for ipsilesional SI, the thalamus, and frontal attention regions in sensory processing and recovery is warranted, particularly given implications for rehabilitation.

Interhemispheric neuroplasticity following limb deafferentation detected by resting-state functional connectivity magnetic resonance imaging (fcMRI) and functional magnetic resonance imaging (fMRI)

Functional connectivity magnetic resonance imaging (fcMRI) studies in rat brain show brain reorganization following peripheral nerve injury. Subacute neuroplasticity was observed 2 weeks following transection of the four major nerves of the brachial plexus. Direct stimulation of the intact radial nerve reveals a functional magnetic resonance imaging (fMRI) activation pattern in the forelimb regions of the sensory and motor cortices that is significantly different from that observed in normal rats. Results of this fMRI experiment were used to determine seed voxel regions for fcMRI analysis. Intrahemispheric connectivities in the sensorimotor forelimb representations in both hemispheres are largely unaffected by deafferentation, whereas substantial disruption of interhemispheric sensorimotor cortical connectivity occurs. In addition, significant intra- and interhemispheric changes in connectivities of thalamic nuclei were found. These are the central findings of the study. They could not have been obtained from fMRI studies alone-both fMRI and fcMRI are needed. The combination provides a general marker for brain plasticity. The rat visual system was studied in the same animals as a control. No neuroplastic changes in connectivities were found in the primary visual cortex upon forelimb deafferentation. Differences were noted in regions responsible for processing multisensory visual-motor information. This incidental discovery is considered to be significant. It may provide insight into phantom limb epiphenomena.

Chapter 27: Neural plasticity after nerve injury and regeneration

Injuries to the peripheral nerves result in partial or total loss of motor, sensory, and autonomic functions in the denervated segments of the body due to the interruption of axons, degeneration of distal nerve fibers, and eventual death of axotomized neurons. Functional deficits caused by nerve injuries can be compensated by reinnervation of denervated targets by regenerating injured axons or by collateral branching of undamaged axons, and remodeling of nervous system circuitry related to the lost functions. Plasticity of central connections may compensate functionally for the lack of adequate target reinnervation; however, plasticity has limited effects on disturbed sensory localization or fine motor control after injuries, and may even result in maladaptive changes, such as neuropathic pain and hyperreflexia. After axotomy, neurons shift from a transmitter to a regenerative phenotype, activating molecular pathways that promote neuronal survival and axonal regeneration. Peripheral nerve injuries also induce a cascade of events, at the molecular, cellular, and system levels, initiated by the injury and progressing throughout plastic changes at the spinal cord, brainstem nuclei, thalamus, and brain cortex. Mechanisms involved in these changes include neurochemical changes, functional alterations of excitatory and inhibitory synaptic connections, sprouting of new connections, and reorganization of sensory and motor central maps. An important direction for research is the development of therapeutic strategies that enhance axonal regeneration, promote selective target reinnervation, and are also able to modulate central nervous system reorganization, amplifying positive adaptive changes that improve functional recovery and also reducing undesirable effects.

The motor cortex and its role in phantom limb phenomena

Limb amputation results in plasticity of connections between the brain and muscles; the cortical motor representation of the missing limb seemingly disappears. The disappearance of the hand's motor representation is, however, difficult to reconcile with evidence that a perceptual representation of the missing limb persists in the form of a phantom limb endowed with sensory and motor qualities. Here, we argue that despite considerable reorganization within the motor cortex of upper-limb amputees, the representation of the amputated hand does not disappear. We hypothesize that two levels of hand-movement representation coexist within the primary motor cortex; at one level, limb movements are specified in terms of arm and hand motor commands, and at another level, limb movements are specified as muscles synergies. We propose that primary motor cortex reorganization after amputation concerns primarily the upper limb's muscular map but not its motor command map and that the integrity of the motor command map underlies the existence of the phantom limb.

Neural plasticity after peripheral nerve injury and regeneration

Injuries to the peripheral nerves result in partial or total loss of motor, sensory and autonomic functions conveyed by the lesioned nerves to the denervated segments of the body, due to the interruption of axons continuity, degeneration of nerve fibers distal to the lesion and eventual death of axotomized neurons. Injuries to the peripheral nervous system may thus result in considerable disability. After axotomy, neuronal phenotype switches from a transmitter to a regenerative state, inducing the down- and up-regulation of numerous cellular components as well as the synthesis de novo of some molecules normally not expressed in adult neurons. These changes in gene expression activate and regulate the pathways responsible for neuronal survival and axonal regeneration. Functional deficits caused by nerve injuries can be compensated by three neural mechanisms: the reinnervation of denervated targets by regeneration of injured axons, the reinnervation by collateral branching of undamaged axons, and the remodeling of nervous system circuitry related to the lost functions. Plasticity of central connections may compensate functionally for the lack of specificity in target reinnervation; plasticity in human has, however, limited effects on disturbed sensory localization or fine motor control after injuries, and may even result in maladaptive changes, such as neuropathic pain, hyperreflexia and dystonia. Recent research has uncovered that peripheral nerve injuries induce a concurrent cascade of events, at the systemic, cellular and molecular levels, initiated by the nerve injury and progressing throughout plastic changes at the spinal cord, brainstem relay nuclei, thalamus and brain cortex. Mechanisms for these changes are ubiquitous in central substrates and include neurochemical changes, functional alterations of excitatory and inhibitory connections, atrophy and degeneration of normal substrates, sprouting of new connections, and reorganization of somatosensory and motor maps. An important direction for ongoing research is the development of therapeutic strategies that enhance axonal regeneration, promote selective target reinnervation, but are also able to modulate central nervous system reorganization, amplifying those positive adaptive changes that help to improve functional recovery but also diminishing undesirable consequences.

Phantom limb pain: cortical plasticity and novel therapeutic approaches

Phantom limb pain is still a very frequent consequence of peripheral deafferentation or amputation of a limb. Recent findings from animal and neuroimaging studies suggest that phantom limb pain might be a central phenomenon, related to changes in the cortical, thalamic and spinal representation of the painful limb, and might be a type of somatosensory pain memory. Based on these assumptions, new treatment approaches focus on sensory discrimination training or motor cortex stimulation in an effort to influence cortical reorganization. Prevention of perpetuation of a somatosensory pain memory might also be possible through pharmacological agents such as N-methyl-D-aspartate antagonists and gamma-aminobutyric acid agonists, substances that have been shown to influence and prevent cortical reorganization.

Phantom limb pain: a case of maladaptive CNS plasticity?

Phantom pain refers to pain in a body part that has been amputated or deafferented. It has often been viewed as a type of mental disorder or has been assumed to stem from pathological alterations in the region of the amputation stump. In the past decade, evidence has accumulated that phantom pain might be a phenomenon of the CNS that is related to plastic changes at several levels of the neuraxis and especially the cortex. Here, we discuss the evidence for putative pathophysiological mechanisms with an emphasis on central, and in particular cortical, changes. We cite both animal and human studies and derive suggestions for innovative interventions aimed at alleviating phantom pain.

Neural dynamics of autistic behaviors: cognitive, emotional, and timing substrates

What brain mechanisms underlie autism, and how do they give rise to autistic behavioral symptoms? This article describes a neural model, called the Imbalanced Spectrally Timed Adaptive Resonance Theory (iSTART) model, that proposes how cognitive, emotional, timing, and motor processes that involve brain regions such as the prefrontal and temporal cortex, amygdala, hippocampus, and cerebellum may interact to create and perpetuate autistic symptoms. These model processes were originally developed to explain data concerning how the brain controls normal behaviors. The iSTART model shows how autistic behavioral symptoms may arise from prescribed breakdowns in these brain processes, notably a combination of underaroused emotional depression in the amygdala and related affective brain regions, learning of hyperspecific recognition categories in the temporal and prefrontal cortices, and breakdowns of adaptively timed attentional and motor circuits in the hippocampal system and cerebellum. The model clarifies how malfunctions in a subset of these mechanisms can, through a systemwide vicious circle of environmentally mediated feedback, cause and maintain problems with them all.

The effect of repetitive electrical stimulation on the motor evoked hemodynamic responses

The aim of this study was to investigate the influence of short-term repetitive electrical stimulation (rES training session) on the motor-evoked hemodynamic responses. The fMRI echo-planar images (EPI) were recorded before and after the rES training. The right median nerve (MN) was stimulated during rES. The rES training resulted in a significant increase in activity in a number of supraspinal regions, including sensorimotor and associative cortical areas. On the subcortical level, the effect was also found in the cerebellum, the midbrain, and the thalamus. Possible mechanisms of the neuronal plastic changes observed after rES, and memory processes involved in learning are discussed.

Cortical influences on sizes and rapid plasticity of tactile receptive fields in the dorsal column nuclei

The cerebral cortex influences subcortical processing. In the somatosensory system, descending cortical inputs contribute in specific ways to the sizes and plasticity of tactile receptive fields (RFs) in the thalamus, but less is known about cortical influences on these aspects of brainstem RFs. The present studies evaluated how loss of cortical inputs affects sizes and plasticity of RFs in the brainstem dorsal column nuclei (DCN) when peripheral inputs were normal and when peripheral inputs were acutely disrupted. Loss of cortical inputs was produced by acute lesion of somatosensory, motor, and adjacent cortex, whereas disruption of peripheral inputs was produced by cutaneous microinjection of lidocaine (LID). Modest or no changes in sizes of DCN RFs, comparable to changes during control periods of no treatment, were seen in response to cortical lesion. LID caused rapid enlargements in RFs when cortex was intact. LID also caused rapid RF enlargements after cortical lesion, and these enlargements were greater than post-LID enlargements when cortex was intact. These results indicate that normally sized RFs continue to be produced in the DCN after loss of cortical input. Cortex is also not required for RF enlargements after LID; however, cortical inputs have a constraining effect on these enlargements. Considered with findings from previous thalamic studies, these results suggest that cortical influences on RF size and plasticity in the DCN and thalamus differ in some respects.

Changes in corticothalamic modulation of receptive fields during peripheral injury-induced reorganization

The influence of corticothalamic projections on the thalamus during different stages of reorganization was determined in anesthetized raccoons that had undergone previous removal of a single forepaw digit. Single-unit recordings were made from 522 sites in the somatosensory nucleus of the thalamus (ventroposterior lateral nucleus) before and after lesioning parts of primary somatosensory cortex. In those parts of ventroposterior lateral nucleus that had intact input from the periphery, the cortical lesion resulted in an immediate 85% increase in receptive field (RF) size. In animals studied 2-6 weeks after digit amputation, peripherally denervated thalamic neurons had unique RFs that were larger than normal, and these were not further enlarged by cortical lesion. However, at longer periods of reorganization (>4 mo), when the new RFs of denervated neurons had decreased in size, cortical lesion again produced expansion of RF size. These data demonstrate that corticothalamic fibers modulate the spatial extent of thalamic RFs in intact animals, probably by controlling intrathalamic inhibition. This corticothalamic modulation is ineffective during the early stages of injury-induced reorganization when new RFs are being formed, but is reinstated after the new RFs have become stabilized. The fact that neurons in the denervated thalamic region retained their unique RFs after cortical lesion indicates that their new inputs are not being relayed from a reorganized cortex and support the view that some plasticity occurs in or below the thalamus.

Local circuit properties underlying cortical reorganization

Peripheral denervation has been shown to cause reorganization of the deafferented somatotopic region in primary somatosensory cortex (S1). However, the basic mechanisms that underlie reorganization are not well understood. In the experiments described in this paper, a novel in vivo/in vitro preparation of adult rat S1 was used to determine changes in local circuit properties associated with the denervation-induced plasticity of the cortical representation in rat S1. In the present studies, deafferentation of rat S1 was induced by cutting the radial and median nerves in the forelimb of adult rats, resulting in a rapid shift of the location of the forepaw/lower jaw border; the amount of the shift increased over the times assayed, through 28 days after denervation. The locations of both borders (i.e., original and reorganized) were marked with vital dyes, and slices from the marked region were used for whole-cell recording. Responses were evoked using electrical stimulation of supragranular S1 and recorded in supragranular neurons close to either the original or reorganized border. For each neuron, postsynaptic potentials (PSPs) were evoked by stimulation of fibers that crossed the border site (CB stim) and by equivalent stimulation that did not cross (NCB stim). Monosynaptic inhibitory postsynaptic potentials (IPSPs) were also examined after blocking excitatory transmission with 15 microM CNQX plus 100 microM DL-APV. The amplitudes of PSPs and IPSPs were compared between CB and NCB stimulation to quantify effects of the border sites on excitation and inhibition. Previous results using this preparation in the normal (i.e., without induced plasticity) rat S1 demonstrated that at a normal border both PSPs and IPSPs were smaller when evoked with CB stimulation than with NCB stimulation. For most durations of denervation, a similar bias (i.e., smaller responses with CB stimulation) for PSPs and IPSPs was observed at the site of the novel reorganized border, while no such bias was observed at the suppressed original border site. Thus changes in local circuit properties (excitation and inhibition) can reflect larger-scale changes in cortical organization. However, specific dissociations between these local circuit properties and the presence of the novel border at certain durations of denervation were also observed, suggesting that there are several intracortical processes contributing to cortical reorganization over time and that excitation and inhibition may contribute differentially to them.

Chemical network of the living human brain. Evidence of reorganization with aging

We recently described the chemical network properties of the human brain using in vivo proton magnetic resonance spectroscopy ((1)H MRS). In a separate study of aging we found increased concentration of chemicals in the prefrontal and sensorimotor cortices up to the third decade of life, and subsequent decrease of chemical concentrations in the same brain regions after the third decade between young and middle age. We anticipated that these age-dependent differences in chemical concentrations might be a reflection of the chemical network reorganization of the brain during aging. The pattern of chemical connectivity within and across brain regions for all regional chemicals, and specific patterns of chemical connectivity for each chemical type were examined for young and middle age groups using (1)H MRS and correlation analysis. For all studied ages, the dominant positive correlations occurred within brain regions and negative correlations were seen across brain regions. However, the pattern of negative chemical connectivity across brain regions was weaker in middle-aged group (F = 40.4, P < 10(-7) comparing r-values between the two age groups, ANOVA). Within brain regions, the age effects on chemical correlations were seen in the cingulate cortex (46% decrease in the middle-aged group, F = 7.2, P < 0.007) and sensorimotor cortex (SMC) (27% decrease, F = 8.9, P<0.003). Between brain regions, the age effects on chemical correlations were seen in the chemical interactions between the thalamus (433.3% increase in the middle-aged group, F = 11.7, P < 0.003), SMC (280% increase, F=20.1, P < 10(-5)), cingulate cortex (100.7% increase, F = 21.3, P < 10(-7)), and other brain regions. We found also age-differential patterns of chemical connectivity across the studied brain regions for most chemical types. The results provide evidence that normal aging is associated with reorganization of chemical network of the human brain.

Up-regulation of metabotropic glutamate receptor 3 mRNA expression in the cerebral cortex of monoarthritic rats

Metabotropic glutamate receptors (mGluR) have been shown to play a role in the modulation of acute and inflammatory pain. Additionally, we have recently detected time-dependent changes in the mRNA expression of several mGluR subtypes in thalamic nuclei of monoarthritic (MA) rats. In the present study, mGluR1, -3, -4, and -7 subtype mRNA expression was analyzed by in situ hybridization with radioactively labelled oligonucleotide probes in cerebral cortical regions of normal and MA rats at 2, 4, and 14 days of the disease. The mGluR1, -4, and -7 mRNAs were at background level in normal rats and did not change in MA animals. In contrast, mGluR3 mRNA expression was abundant in normal rats and was significantly increased in cortical areas of MA rats at all time points. Higher changes were detected bilaterally at 4 days, predominantly in layers IV/V, in the motor, primary, and secondary somatosensory cortices (average increases of 50-75%), but maximum rises occurred in the contralateral cingulate cortex (+138%). No changes were detected in the auditory cortex. The present data show an up-regulation of mGluR3 mRNA expression in the motor, somatosensory, and limbic cortices of MA rats. This possibly reflects the occurrence of central mechanisms counteracting the increased transmission of nociceptive input arising from the inflamed paw and the impaired motor behavior of these rats. Changes in the cingulate cortex may be related to the motivational-affective component of nociception.

Recovery of associative function following early amygdala lesions in rats

Adult rats with amygdala lesions made at either Postnatal Day (PND) 10 or PND40 were tested on a series of reversal tasks that tap the ability to form stimulus-reward associations. PND40 rats were significantly impaired relative to both controls and PND10 rats on learning rate of the original discrimination and subsequent reversals. Analyses of discrete learning phases revealed that the impairment was specific to the postchance phase. The PND10 group was not impaired relative to controls on any measure. These results confirm prior findings that amygdala lesions sustained in adulthood impair the formation of stimulus-reward associations. They also demonstrate that substantial sparing or recovery of function is possible when the lesion is made during early development. Furthermore, the findings support the view that behavioral recovery may be more likely if the lesion is sustained near the time of peak synaptogenesis.

Cooperative changes in GABA, glutamate and activity levels: the missing link in cortical plasticity

Different intracortical mechanisms have been reported to contribute to the substantial topographic reorganization of the mammalian primary visual cortex in response to matching lesions in the two retinas: an immediate expansion of receptive fields followed by a gradual shift of excitability into the deprived area and finally axonal sprouting of laterally projecting neurons months after the lesion. To gain insight into the molecular mechanisms of this adult plasticity, we used immunocytochemical and bioanalytical methods to measure the glutamate and GABA neurotransmitter levels in the visual cortex of adult cats with binocular central retinal lesions. Two to four weeks after the lesions, glutamate immunoreactivity was decreased in sensory-deprived cortex as confirmed by HPLC analysis of the glutamate concentration. Within three months normal glutamate immunoreactivity was restored. In addition, the edge of the unresponsive cortex was characterized by markedly increased glutamate immunoreactivity 2-12 weeks postlesion. This glutamate immunoreactivity peak moved into the deprived area over time. These glutamate changes corresponded to decreased spontaneous and visually driven activity in unresponsive cortex and to strikingly increased neuronal activity at the border of this cortical zone. Furthermore, the previously reported decrease in glutamic acid decarboxylase immunoreactivity was found to reflect decreased GABA levels in sensory-deprived cortex. Increased glutamate concentrations and neuronal activity, and decreased GABA concentrations, may be related to changes in synaptic efficiency and could represent a mechanism underlying the retinotopic reorganization that occurs well after the immediate receptive field expansion but long before the late axonal sprouting.

Tactile coactivation-induced changes in spatial discrimination performance

We studied coactivation-based cortical plasticity at a psychophysical level in humans. For induction of plasticity, we used a protocol of simultaneous pairing of tactile stimulation to follow as closely as possible the idea of Hebbian learning. We reported previously that a few hours of tactile coactivation resulted in selective and reversible reorganization of receptive fields and cortical maps of the hindpaw representation of the somatosensory cortex of adult rats (Godde et al., 1996). In the present study, simultaneous spatial two-point discrimination was tested on the tip of the right index finger in human subjects as a marker of plastic changes. After 2 hr of coactivation we found a significant improvement in discrimination performance that was reversible within 8 hr. Reduction of the duration of the coactivation protocol revealed that 30 min was not sufficient to drive plastic changes. Repeated application of coactivation over 3 consecutive days resulted in a delayed recovery indicating stabilization of the improvement over time. Perceptual changes were highly selective because no transfer of improved performance to fingers that were not stimulated was found. The results demonstrate the potential role of sensory input statistics (i.e., their probability of occurrence and spatiotemporal relationships) in the induction of cortical plasticity without involving cognitive factors such as attention or reinforcement.

Tactile coactivation-induced changes in spatial discrimination performance

We studied coactivation-based cortical plasticity at a psychophysical level in humans. For induction of plasticity, we used a protocol of simultaneous pairing of tactile stimulation to follow as closely as possible the idea of Hebbian learning. We reported previously that a few hours of tactile coactivation resulted in selective and reversible reorganization of receptive fields and cortical maps of the hindpaw representation of the somatosensory cortex of adult rats (Godde et al., 1996). In the present study, simultaneous spatial two-point discrimination was tested on the tip of the right index finger in human subjects as a marker of plastic changes. After 2 hr of coactivation we found a significant improvement in discrimination performance that was reversible within 8 hr. Reduction of the duration of the coactivation protocol revealed that 30 min was not sufficient to drive plastic changes. Repeated application of coactivation over 3 consecutive days resulted in a delayed recovery indicating stabilization of the improvement over time. Perceptual changes were highly selective because no transfer of improved performance to fingers that were not stimulated was found. The results demonstrate the potential role of sensory input statistics (i.e., their probability of occurrence and spatiotemporal relationships) in the induction of cortical plasticity without involving cognitive factors such as attention or reinforcement.