Mechanosensitivity and Neural Adaptation in Human Somatosensory System

Magnetoencephalography (MEG) was utilized to characterize the adaptation in the somatosensory cortical network due to repeated cutaneous tactile stimulation applied unilaterally on the face and hand using a custom-built pneumatic stimulator called the TAC-Cell. Face stimulation invoked neuromagnetic responses reflecting cortical activity in the contralateral primary somatosensory cortex (SI), while hand stimulation resulted in robust contralateral SI and posterior parietal cortex (PPC) activation. There was also activity observed in regions of the secondary somatosensory cortical areas (SII), although with a reduced amplitude and higher variability across subjects. There was a significant difference in adaptation rates between SI, and higher-order sensory cortices like the PPC for hand stimulation. Adaptation was also significantly dependent on the stimulus frequency and pulse index number within the stimulus train for both hand and face stimulation. The latency of the peak responses was significantly dependent on stimulus site and response component (SI, PPC). The difference in the latency of peak SI and PPC responses can be reflective of a hierarchical serial-processing network in the somatosensory cortex. Age- and sex-related changes of vibrotactile sensitivity in the orofacial and hand skin surfaces of healthy adults was demonstrated using an established psychophysical protocol. Vibrotactile threshold sensitivity increased as a function of age for finger stimulation, but remained unaltered for the face. Increase in the finger threshold sensitivity is due to age-related changes in the number and morphology of Pacinian corpuscles (absent in the face). Vibrotactile threshold sensitivity is significantly dependent on stimulation site, stimulus frequency, and sex of the participant. These differences are presumably due to dissimilarities in the type and density of mechanoreceptors present in the face and hand. A novel-method was developed to couple the use of fiber-optic displacement sensors with the pneumatic stimulator built in our laboratory called the TAC-Cell. This displacement sensor which is commonly used in industrial applications was successfully utilized to characterize the skin response to TAC-Cell stimulation. Skin displacement was significantly dependent on input stimulus amplitudes and varied as a function of the participants' sex. Power spectrum analysis and rise-fall time measurement of the skin-displacement showed that the TAC-Cell stimulus consists of a spectrally rich, high velocity signal that is capable of evoking a cortical response due to stimulation of the medial-lemniscus and trigeminal pathways

Characterization Of Sex-Based Differences In The Mechanical Properties Of Human Finger Glabrous Tissue Using A Fiberoptic Sensor

TAC-Cell is a custom-built somatosensory stimulator that delivers pneumatic cutaneous tactile inputs to virtually any skin target on the body and by virtue of its non-ferrous materials is compatible with functional magnetic resonance imaging (fMRI) and magnetoencephalography (MEG) brain scanners. In this study, we describe the method to measure apparent skin displacement induced by TAC-Cell stimulation of the glabrous surface of the distal phalanx of the index finger. Specifically, we studied the effect of four servo controller input voltages (0.4V to 1.0V) on resultant skin displacement among eighteen, neurotypical adult male and female participants. A fiberoptic displacement sensor, commonly used in industrial applications, was coupled to the TAC-Cell to measure the glabrous skin’s kinematic response to different stimulus amplitudes. Skin displacement was significantly dependent on stimulus amplitudes and sex (p\u3c 0.0001). Power spectrum and kinematic analysis of skin displacement showed that the pneumatic TAC-Cell stimulus consists of a spectrally rich, high velocity signal. In related work, we have shown that this dynamic pneumocutaneous stimulus is highly effective in evoking a cortical brain response for neurodiagnostic applications and somatosensory pathway analysis in health and disease

Frequency Modulation and Spatiotemporal Stability of the sCPG in Preterm Infants with RDS

The nonnutritive suck (NNS) is an observable and accessible motor behavior which is often used to make inference about brain development and pre-feeding skill in preterm and term infants. The purpose of this study was to model NNS burst compression pressure dynamics in the frequency and time domain among two groups of preterm infants, including those with respiratory distress syndrome (RDS, N = 15) and 17 healthy controls. Digitized samples of NNS compression pressure waveforms recorded at a 1-week interval were collected 15 minutes prior to a scheduled feed. Regression analysis and ANOVA revealed that healthy preterm infants produced longer NNS bursts and the mean burst initiation cycle frequencies were higher when compared to the RDS group. Moreover, the initial 5 cycles of the NNS burst manifest a frequency modulated (FM) segment which is a significant feature of the suck central pattern generator (sCPG), and differentially expressed in healthy and RDS infants. The NNS burst structure revealed significantly lower spatiotemporal index values for control versus RDS preterminfants during FM, and provides additional information on the microstructure of the sCPG which may be used to gauge the developmental status and progression of oromotor control systems among these fragile infants

TAC-Cell Inputs To Human Hand And Lip Induces Shortterm Adaptation Of The Primary Somatosensory Cortex

A new pneumatic tactile stimulator, called the TAC-Cell, was developed in our laboratory to noninvasively deliver patterned cutaneous stimulation to the face and hand in order to study the neuromagnetic response adaptation patterns within the primary somatosensory cortex (S1) in young adult humans. Individual TAC-Cells were positioned on the glabrous surface of the right hand, and midline of the upper and lower lip vermilion. A 151-channel magnetoencephalography (MEG) scanner was used to record the cortical response to a novel tactile stimulus which consisted of a repeating 6-pulse train delivered at three different frequencies through the active membrane surface of the TAC-Cell. The evoked activity in S1 (contralateral for hand stimulation, and bilateral for lip stimulation) was characterized from the best-fit dipoles of the earliest prominent response component. The S1 responses manifested significant modulation and adaptation as a function of the frequency of the punctate pneumatic stimulus trains and stimulus site (glabrous lip versus glabrous hand)

TAC-Cell Inputs To Human Hand And Lip Induces Shortterm Adaptation Of The Primary Somatosensory Cortex

A new pneumatic tactile stimulator, called the TAC-Cell, was developed in our laboratory to noninvasively deliver patterned cutaneous stimulation to the face and hand in order to study the neuromagnetic response adaptation patterns within the primary somatosensory cortex (S1) in young adult humans. Individual TAC-Cells were positioned on the glabrous surface of the right hand, and midline of the upper and lower lip vermilion. A 151-channel magnetoencephalography (MEG) scanner was used to record the cortical response to a novel tactile stimulus which consisted of a repeating 6-pulse train delivered at three different frequencies through the active membrane surface of the TAC-Cell. The evoked activity in S1 (contralateral for hand stimulation, and bilateral for lip stimulation) was characterized from the best-fit dipoles of the earliest prominent response component. The S1 responses manifested significant modulation and adaptation as a function of the frequency of the punctate pneumatic stimulus trains and stimulus site (glabrous lip versus glabrous hand)

Frequency Modulation and Spatiotemporal Stability of the sCPG in Preterm Infants with RDS

This is the published version, also available here: http://dx.doi.org/10.1155/2012/581538.The nonnutritive suck (NNS) is an observable and accessible motor behavior which is often used to make inference about brain development and pre-feeding skill in preterm and term infants. The purpose of this study was to model NNS burst compression pressure dynamics in the frequency and time domain among two groups of preterm infants, including those with respiratory distress syndrome (RDS, N=15) and 17 healthy controls. Digitized samples of NNS compression pressure waveforms recorded at a 1-week interval were collected 15 minutes prior to a scheduled feed. Regression analysis and ANOVA revealed that healthy preterm infants produced longer NNS bursts and the mean burst initiation cycle frequencies were higher when compared to the RDS group. Moreover, the initial 5 cycles of the NNS burst manifest a frequency modulated (FM) segment which is a significant feature of the suck central pattern generator (sCPG), and differentially expressed in healthy and RDS infants. The NNS burst structure revealed significantly lower spatiotemporal index values for control versus RDS preterm infants during FM, and provides additional information on the microstructure of the sCPG which may be used to gauge the developmental status and progression of oromotor control systems among these fragile infants

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

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

Epidural Electrical Stimulation for Stroke Rehabilitation: Results of the Prospective, Multicenter, Randomized, Single-Blinded Everest Trial.

BackgroundThis prospective, single-blinded, multicenter study assessed the safety and efficacy of electrical epidural motor cortex stimulation (EECS) in improving upper limb motor function of ischemic stroke patients with moderate to moderately severe hemiparesis.MethodsPatients ≥ 4 months poststroke were randomized 2:1 to an investigational (n = 104) or control (n = 60) group, respectively. Investigational patients were implanted (n = 94) with an epidural 6-contact lead perpendicular to the primary motor cortex and a pulse generator. Both groups underwent 6 weeks of rehabilitation, but EECS was delivered to investigational patients during rehabilitation. The primary efficacy endpoint (PE) was defined as attaining a minimum improvement of 4.5 points in the upper extremity Fugl-Meyer (UEFM) scale as well as 0.21 points in the Arm Motor Ability Test (AMAT) 4 weeks postrehabilitation. Follow-up assessments were performed 1, 4, 12, and 24 weeks postrehabilitation. Safety was evaluated by monitoring adverse events (AEs) that occurred between enrollment and the end of rehabilitation.ResultsPrimary intent-to-treat analysis showed no group differences at 4 weeks, with PE being met by 32% and 29% of investigational and control patients, respectively (P = .36). Repeated-measures secondary analyses revealed no significant treatment group differences in mean UEFM or AMAT scores. However, post hoc comparisons showed that a greater proportion of investigational (39%) than control (15%) patients maintained or achieved PE (P = .003) at 24 weeks postrehabilitation. Investigational group mean AMAT scores also improved significantly (P < .05) when compared to the control group at 24 weeks postrehabilitation. Post hoc analyses also showed that 69% (n = 9/13) of the investigational patients who elicited movement thresholds during stimulation testing met PE at 4 weeks, and mean UEFM and AMAT scores was also significantly higher (P < .05) in this subgroup at the 4-, 12-, and 24-week assessments when compared to the control group. Headache (19%), pain (13%), swelling (7%), and infection (7%) were the most commonly observed implant procedure-related AEs. Overall, there were 11 serious AEs in 9 investigational group patients (7 procedure related, 4 anesthesia related).ConclusionsThe primary analysis pertaining to efficacy of EECS during upper limb motor rehabilitation in chronic stroke patients was negative at 4 weeks postrehabilitation. A better treatment response was observed in a subset of patients eliciting stimulation induced upper limb movements during motor threshold assessments performed prior to each rehabilitation session. Post hoc comparisons indicated treatment effect differences at 24 weeks, with the control group showing significant decline in the combined primary outcome measure relative to the investigational group. These results have the potential to inform future chronic stroke rehabilitation trial design

Comparing Current Steering Technologies for Directional Deep Brain Stimulation Using a Computational Model That Incorporates Heterogeneous Tissue Properties

Objective A computational model that accounts for heterogeneous tissue properties was used to compare multiple independent current control (MICC), multi-stim set (MSS), and concurrent activation (co-activation) current steering technologies utilized in deep brain stimulation (DBS) on volume of tissue activated (VTA) and power consumption. Methods A computational model was implemented in Sim4Life v4.0 with the multimodal image-based detailed anatomical (MIDA) model, which accounts for heterogeneous tissue properties. A segmented DBS lead placed in the subthalamic nucleus (STN). Three milliamperes of current (with a 90 mu s pseudo-biphasic waveform) was distributed between two electrodes with various current splits. The laterality, directional accuracy, volume, and shape of the VTAs using MICC, MSS and co-activation, and their power consumption were computed and compared. Results MICC, MSS, and coactivation resulted in less laterality of steering than single-segment activation. Both MICC and MSS show directional inaccuracy (more pronounced with MSS) during radial current steering. Co-activation showed greater directional accuracy than MICC and MSS at centerline between the two activated electrodes. MSS VTA volume was smaller and more compact with less current spread outside the active electrode plane than MICC VTA. There was no consistent pattern of power drain between MSS and MICC, but electrode co-activation always used less power than either fractionating paradigm. Conclusion While current fractionalization technologies can achieve current steering between two segmented electrodes, this study shows that there are important limitations in accuracy and focus of tissue activation when tissue heterogeneity is accounted for