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Biomedical subjects

N Birbaumer

Publications and source records attributed to N Birbaumer.

At least 55 records · Page 3Linked to original sources

Phantom limb pain: a report of two cases.

The efficacy of pre-emptive analgesia for phantom limb pain is still unclear. It is generally accepted that pre hyphen;amputation pain increases the incidence of phantom and stump pain, even if pre-emptive analgesia is performed before and during surgery and in the postoperative period. Two cases of traumatic upper limb amputations are described here with no pre-existing pain. Both received similar antinociceptive treatment by continuous block of the brachial plexus through infusion of ropivacaine 0.375% at 5 ml/h for 10 days. Treatment of case 1 was initiated immediately after surgery; however, this amputee developed intensive phantom limb pain which persisted at 6 months. Early use of the prosthesis after surgery was not possible for this patient. The intensity of phantom limb pain in case 2 decreased significantly after 6 months, even though brachial plexus blockade was not started until 5 weeks post-trauma. This patient used a functional prosthesis intensively beginning early after amputation. Serial magnetoencephalographic recordings were performed in both patients. Only case 2 showed significant changes of cortical reorganization. In case 1 markedly less cortical plasticity was found. A combination of relevant risk factors such as a painful neuroma, behavioural and cognitive coping strategies and the early functional use of prostheses are discussed as important mechanisms contributing to the development of phantom pain and cortical reorganization.

Adult↗

Recognition of point-light biological motion displays by young children.

We tested the ability of children 3-5 years of age to recognise biological motion displays. Children and adults were presented with moving point-light configurations depicting a walking person, four-legged animals (dogs), and a bird. Participants were able to reliably recognise displays with biological motion, but failed in the identification of a static (four consecutive frames taken from each sequence) version. The results indicate that, irrespective of the highly reduced and unusual structural information available in point-light displays, biological motion is sufficient for reliable recognition of human and non-human forms at an age as early as 3 years. Moreover, 5-year-olds exhibit the ceiling level of recognition. The findings are discussed in the context of the neuropsychological and brain mechanisms involved in biological motion perception.

Adolescent↗

Multiple frequency steady-state evoked magnetic field mapping of digit representation in primary somatosensory cortex.

Magnetic source imaging of multiple frequency steady-state somatosensory evoked responses was examined using a 151-channel magnetoencephalography (MEG) system and a dual-channel electrical stimulator. Somatotopy of digit representation was studied in healthy subjects and effects of injury-related cortical plasticity in patients with unilateral transections of the median or the ulnar nerve. Dipole source locations exhibited somatotopic order with overlap between neighboring digits. In two of three nerve injury patients evidence for cortical reorganization was found. The location of sources related to digits neighboring deafferented digits was changed and their dipole moments were enlarged by comparsion with the sources related to contralateral homologue control digits. As a basis for magnetic source imaging, the recording of multiple frequency somatosensory steady-state evoked responses may be a viable and time saving alternative to the recording of transient evoked responses.

Adult↗

Dynamic organization of the somatosensory cortex induced by motor activity.

Intensive and long-lasting experience of altered sensory input induces permanent changes in the functional organization of the somatosensory cortex. In addition, an increasing body of evidence suggests the existence of dynamic, short-term and task-dependent adaptation of representational maps within somatosensory cortex. It is hypothesized that somatosensory maps can, not only, be acquired within a short period of time, but might also be set up during periods of training related to specific tasks and subsequently activated dynamically upon performance of that particular task. In order to test this hypothesis we studied the functional organization of somatosensory cortex for a heavily overlearned and frequently performed task for which no new acquisition of a sensory map had to be assumed. To this end, the functional organization of somatosensory cortex for handwriting was compared with the organization during rest in healthy humans. Functional organization of the somatosensory cortex was assessed using non-invasive, neuromagnetic source imaging based on tactile stimulation of the thumb (D1) and little finger (D5) during writing and rest. In different blocks, subjects wrote with their right, dominant and their left hand, respectively. During writing, D1 and D5 of the writing hand were stimulated. To test the reliability of our results all measurements were repeated after 1 week. It was found that amplitudes of somatosensory evoked magnetic fields with latencies of 45 ms were reduced during writing compared with rest. This finding is in accordance with the sensorimotor gating effect. Using source localization we could show that cortical representations of D1 and D5 are more distant during writing with either hand compared with rest. Our data suggest that somatosensory cortical maps undergo rapid modulation depending on task-specific involvement of sensory processing in daily-life overlearned movements. As it is unlikely that a new sensory map is always acquired when a frequently used task such as writing is performed, we suggest that somatosensory cortex switches between different, concurrently pre-existing maps depending on actual requirements. Task-dependent activation of pre-existing maps might be a powerful mechanism to optimize stimulus processing.

Adult↗

Phantom movements and pain. An fMRI study in upper limb amputees.

Using functional MRI, we investigated 14 upper limb amputees and seven healthy controls during the execution of hand and lip movements and imagined movements of the phantom limb or left hand. Only patients with phantom limb pain showed a shift of the lip representation into the deafferented primary motor and somatosensory hand areas during lip movements. Displacement of the lip representation in the primary motor and somatosensory cortex was positively correlated to the amount of phantom limb pain. Thalamic activation was only present during executed movements in the healthy controls. The cerebellum showed no evidence of reorganizational changes. In amputees, movement of the intact hand showed a level of activation similar to movement of the right dominant hand in the healthy controls. During imagination of moving the phantom hand, all patients showed significantly higher activation in the contralateral primary motor and somatosensory cortices compared with imagination of hand movements in the controls. In the patients with phantom limb pain but not the pain-free amputees, imagined movement of the phantom hand activated the neighbouring face area. These data suggest selective coactivation of the cortical hand and mouth areas in patients with phantom limb pain. This reorganizational change may be the neural correlate of phantom limb pain.

Adult↗

Simultaneous bilateral mismatch response to right- but not leftward sound lateralization.

Magnetoencephalography (MEG) was used to compare mismatch responses between hemispheres to changes in sound-source direction. Sixteen adults listened passively to two types of complex non-language sounds presented in separate blocks with midline standards and right- and left-lateralized deviants. Mismatch dipole amplitudes were larger contra- than ipsilaterally to the deviants. Both hemispheres processed right deviants simultaneously, whereas to left deviants, the left dipole peaked 20 ms later than the right dipole. A second experiment using the same standards but midline spectral deviants showed no interhemispheric differences. Here mismatch latencies were about 60 ms longer than in the location mismatch experiment. This suggested both fast, contralaterally dominant location mismatch responses and facilitated detection of auditory spatial deviance in the right hemifield.

Acoustic Stimulation↗

Activity patterns of human somatosensory cortex adapt dynamically to stimulus properties.

Long-term synchronous tactile stimulation of two sites of the body results in integrated, overlapping cortical representations whereas asynchronous stimulation leads to segregated representations. To investigate the cortical capacity to adapt dynamically to stimulation properties 22 subjects were stimulated at digits 1, 3 and 5 of both hands in either random or fixed order. Changes in the functional organization of the somatosensory cortex were inferred by neuromagnetic source analysis based on somatosensory evoked magnetic fields. Compared to the stimulation in random sequence, the stimulation in fixed order revealed a reduction in distance between the cortical representation of D1 and D3. We conclude that the pattern of activation in the somatosensory cortex adapts dynamically to the spatio-temporal characteristics of the stimuli.

Adult↗

The representation of articulation in the primary sensorimotor cortex.

Bilabial, alveolar and velar sounds are produced at different locations around the oral cavity. fMRI was used to localize cortical representation of articulation in seven healthy subjects during repetitive lip and vertical tongue movements as well as repetitive articulation of /pa/ (bilabial), /ta/ (alveolar), /ka/ (velar consonants) and a combination of all three in /pataka/. Centers of gravity (COG) analysis of fMRI activation in the primary motor (M1) and sensory cortex (S1) revealed /pa/- adjacent to lip representation and /ta/- articulation to tongue representation. The articulation of /pataka/ showed an activation pattern with a combination of the two M1/S1-components and additional activation in the supplementary motor area.

Adult↗

Right-hemisphere dominance for the processing of sound-source lateralization.

Cortical processing of change in direction of a perceived sound source was investigated in 12 human subjects using whole-head magnetoencephalography. The German word "da" was presented either with or without 0.7 msec interaural time delays to create the impression of right- or left-lateralized or midline sources, respectively. Midline stimuli served as standards, and lateralized stimuli served as deviants in a mismatch paradigm. Two symmetrically linked dipoles fitted to the mismatch fields showed stronger moments in the hemisphere contralateral to the side of the deviant. The right dipole displayed equal latencies to both left and right deviants, whereas left dipole latencies were longer for ipsilateral than contralateral deviants. Frequency analysis between 20-70 Hz and statistical probability mapping revealed increased induced gamma-band activity at 53+/-2.5 Hz to both types of deviants. Right deviants elicited spectral amplitude enhancements in this frequency range, peaking at latencies of 160 and 240 msec. These effects were localized bilaterally over the angular gyri and posterior temporal regions. Coherence analysis suggested the existence of two separate interhemispheric networks. For left-lateralized deviants, both spectral amplitude enhancements at 110 and 220 msec and coherence increases were restricted to the right hemisphere. In conclusion, both mismatch dipole latencies at the supratemporal plane and gamma-band activity in posterior parietotemporal areas suggested a right hemisphere engagement in the processing of bidirectional sound-source shifts. In contrast, left-hemisphere regions responded predominantly to contralateral events. These findings may help to elucidate phenomena such as unilateral auditory neglect.

Acoustic Stimulation↗

Statistical probability mapping reveals high-frequency magnetoencephalographic activity in supplementary motor area during self-paced finger movements.

Investigations of both haemodynamic and electroencephalographic measures of brain activity have demonstrated supplementary motor area (SMA) involvement in self-paced finger movements. In contrast, analysis of magnetoencephalographic (MEG) signals in the time domain has usually failed to detect SMA activity in healthy individuals. We investigated oscillatory MEG activity in 12 normal adults during (a) a self-paced, complex sequence of finger movements and (b) a simple finger opposition task paced externally by tactile stimuli presented to the contralateral thumb. Statistical probability mapping revealed enhanced non-phase-locked spectral amplitudes in the 22-28 Hz range over bilateral frontal cortex during self-paced as compared to externally cued finger movements. This activity may reflect recruitment of cell assemblies in SMA during self-paced, complex movements.

Adult↗

Differential activation in somatosensory cortex for different discrimination tasks.

Maps of the body surface in somatosensory cortex have been shown to be highly plastic, altering their configuration in response to changes in use of body parts. The current study investigated alterations in the functional organization of the human somatosensory cortex resulting from massed practice. Over a period of 4 weeks, subjects were given synchronous tactile stimulation of thumb (D1) and little finger (D5) for 1 hr/d. They had to identify the orientation of the stimuli. Neuroelectric source localization based on high-resolution EEG revealed that, when subjects received passive tactile stimulation of D1 or D5, the representations of the fingers in primary somatosensory cortex were closer together after training than before. There was also an apparently correlative tendency to anomalously mislocalize near-threshold tactile stimuli equally to the distant finger costimulated during training rather than preferentially to the finger nearest to the finger stimulated in a post-training test. However, when the stimulus discrimination had to be made, neuroelectric source imaging revealed that the digital representations of D1 and D5 were further apart after training than before. Thus, the same series of prolonged repetitive stimulations produced two different opposite effects on the spatial relationship of the cortical representations of the digits, suggesting that differential activation in the same region of somatosensory cortex is specific to different tasks.

Adult↗

Pavlovian aversive and appetitive odor conditioning in humans: subjective, peripheral, and electrocortical changes.

Differential Pavlovian conditioning of aversive and appetitive odors was examined in 30 male healthy subjects. The appetitive conditioning group (n=15) received a pleasant odor (vanilla), the aversive conditioning group (n=15) an unpleasant odor (fermented yeast) as unconditioned stimulus. Slides of two different neutral faces that were easy to discriminate served as conditioned stimuli (CS). An EEG was recorded from nine electrodes. Electromyographic activity was measured bilaterally from the m. corrugator supercilii and m. zygomaticus. The startle response was obtained from the m. orbicularis oculi. Finally, heart rate and skin conductance response were assessed. The subjective data and the skin conductance response revealed successful differential aversive conditioning. By contrast, the pleasant odor failed to produce appetitive odor conditioning. The conditioned and unconditioned response of the corrugator muscles confirm previous reports on the m. corrugator being strongly involved in the expression of negative affect. Contrary to previous findings, magnitude of the startle reflex was not found to be modulated depending on the valence of the CS. Central psychophysiological parameters showed little change during differential conditioning. The presence of subjective-evaluative conditioning and contingency awareness without significant changes in cortical and cardiovascular correlates might be due to extremely localized cortical processing of conditioned olfactory cues or primarily subcortical processing. The latter interpretation is strengthened by the presence of differential conditioning in non-voluntary responses such as the corrugator muscles.

Adolescent↗

Brain potentials in affective picture processing: covariation with autonomic arousal and affective report.

Emotionally arousing picture stimuli evoked scalp-recorded event-related potentials. A late, slow positive voltage change was observed, which was significantly larger for affective than neutral stimuli. This positive shift began 200-300 ms after picture onset, reached its maximum amplitude approximately 1 s after picture onset, and was sustained for most of a 6-s picture presentation period. The positive increase was not related to local probability of content type, but was accentuated for pictures that prompted increased autonomic responses and reports of greater affective arousal (e.g. erotic or violent content). These results suggest that the late positive wave indicates a selective processing of emotional stimuli, reflecting the activation of motivational systems in the brain.

Adolescent↗

Neuroimaging of chronic pain: phantom limb and musculoskeletal pain.

New developments in brain imaging lead to a better understanding of cortical and subcortical processes involved in pain perception and the establishment of chronic pain. For different forms of chronic pain long-term changes in cortical structures have been described. In patients with phantom limb pain and back pain alterations in the somatotopic organization of the primary somatosensory (SI) could be observed. The amount of this reorganization is correlated with the subjective pain rating. These changes, which are based on processes of neuronal plasticity, can partially be reversed by analgesic interventions. For the investigation of cortical processes concerning reorganization, EEG and MEG methods are most suitable because of their high temporal and spatial resolution. In conclusion, these findings open a new way for therapeutic interventions to prevent the development of chronic pain.

Back Pain↗

Distribution of mislocalizations of tactile stimuli on the fingers of the human hand.

Sensitivity of the fingers of the two hands to faint tactile stimuli were tested in eight healthy subjects with a von Frey hair in a forced choice point localization test. Frequencies of correct responses were higher on the left than on the right hand, consistent with a right hemispheric advantage for spatial processing. Within the hands, stimulations of the ring fingers resulted in the highest percentage of correct localizations and stimulations of the thumbs in the fewest correct responses. This superiority of the ring fingers is probably related to a higher point pressure sensitivity and does not reflect the relative size of the representational area of the different fingers in the somatosensory cortex. Mislocalizations, i.e., stimuli that were not correctly attributed to the stimulation site, were located in the vicinity of the stimulation site within the finger as well as across fingers. The distribution of mislocalization across fingers deviates from a distribution expected by chance, showing a higher frequency of mislocalizations to the neighboring fingers than to more distant fingers. This observation in humans matches well with electrophysiological evidence from animal studies that some primary somatosensory cortex neurons have receptive fields that are not restricted to a single digit, but rather cover neighboring digits.

Adult↗

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.

Journal Article↗

The thought translation device (TTD) for completely paralyzed patients.

The thought translation device trains locked-in patients to self-regulate slow cortical potentials (SCP's) of their electroencephalogram (EEG). After operant learning of SCP self-control, patients select letters, words or pictograms in a computerized language support program. Results of five respirated, locked-in-patients are described, demonstrating the usefulness of the thought translation device as an alternative communication channel in motivated totally paralyzed patients with amyotrophic lateral sclerosis.

Biofeedback, Psychology↗