Emotional modulation of pain: a clinical perspective.
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Cognition Disorders↗
Biomedical subjects
Sandra Kamping
Publications and source records attributed to Sandra Kamping.
Shifting of cortical somatosensory areas in a man with amelia.
The human brain represents the body in a homuncular fashion. Although these cortical representations are to some degree plastic, it is unclear how extensive this plasticity can be. Examinations of amputated or amelic subjects can contribute to answering this question. We examined a man who lacked both arms since birth and was free of phantom pain. Magnetic source imaging revealed that not only had the somatotopically adjacent representation of the lip moved into the cortical space usually representing the hand; but the representation of the foot had similarly moved towards the cortical hand area. These data illustrate a case of extensive cortical reorganization and suggest that the potential overlap of different body parts is much greater than previously anticipated.
Adult↗
Levodopa: faster and better word learning in normal humans.
Dopamine is a potent modulator of learning and has been implicated in the encoding of stimulus salience. Repetition, however, as required for the acquisition and reacquisition of sensorimotor or cognitive skills (e.g., in aphasia therapy), decreases salience. We here tested whether increasing brain levels of dopamine during repetitive training improves learning success. Forty healthy humans took 100mg of the dopamine precursor levodopa or placebo daily for 5 days in a randomized double-blind and parallel-group design. Ninety minutes later on each day, subjects were trained on an artificial vocabulary using a high-frequency repetitive approach. Levodopa significantly enhanced the speed, overall success, and long-term retention of novel word learning in a dose-dependent manner. These findings indicate new ways to potentiate learning in a variety of domains if conventional training alone fails.
Adult↗
D-amphetamine boosts language learning independent of its cardiovascular and motor arousing effects.
D-Amphetamine (AMPH) was effective in a number of studies on motor and language recovery after stroke, but given safety concerns, its general use after stroke is still debated. Most stroke patients are excluded from treatment because of a significant risk of cardiovascular dysregulation. AMPH acts on multiple transmitter systems, and mainly the noradrenergic actions are related to the cardiovascular effects. If AMPH's cardiovascular and arousal effects were correlated with its plasticity-enhancing effects in humans, this would imply that desired and undesired effects are inevitably tied. If not, improved cerebral reorganization may not be mediated by AMPH's arousing effects and could be achieved with substances lacking the undesired cardiovascular effects. As a model for language recovery after stroke, we used a prospective, randomized, double-blind, placebo-controlled design and taught 40 healthy male subjects an artificial vocabulary of 50 concrete nouns over the course of five consecutive training days (high-frequency training). The associative learning principle involved higher co-occurrences of 'correct' picture-pseudoword pairings as compared to 'incorrect' pairings. Subjects received either AMPH (0.25 mg/kg) or placebo 90 min prior to training on each day. Novel word learning was significantly faster and better in the AMPH as compared to the placebo group. Increased learning success was maintained 1 month post-training. No correlation was found between training success and drug-induced increases in blood pressure, heart rate, or a facilitation of simple motor reaction time. Our data show that AMPH's plasticity-enhancing effect in humans is not related to its cardiovascular arousal. This suggests that the beneficial effects in stroke patients could also be obtained by less cardiovascular active drugs.
Adult↗
Specific and nonspecific effects of transcranial magnetic stimulation on picture-word verification.
Repetitive transcranial magnetic stimulation (rTMS) can temporarily impair or improve performance, including language processing. It remains unclear, however, (i) which scalp sites are most appropriate to achieve the desired effects and (ii) which experimental setups produce facilitation or inhibition of language functions. We assessed the effects of TMS at different stimulation sites on picture-word verification in healthy volunteers. Twenty healthy volunteers with left language lateralization, as determined by functional transcranial Dopplersonography, performed picture-word verification prior to and after rTMS (1 Hz for 600 s at 110% of subjects' resting motor thresholds). Stimulation sites were the classical language areas (Broca's and Wernicke's), their homolog brain regions of the right hemisphere, and the occipital cortex. Additionally, sham stimulation over Broca's area was applied in a subsample of 11 subjects. As a control task, 10 volunteers performed a colour-tone matching task under the same experimental conditions. There was a general nonspecific arousal effect for both verum and sham TMS for both the picture-word verification and for the control task. However, superimposed there were opposite effects on picture-word verification for stimulation of Wernicke's area and Broca's area, namely a relative inhibition in the case of Wernicke's area and a relative facilitation in the case of Broca's area. These results demonstrate that low frequency rTMS has both general arousing effects and domain-specific effects.
Adult↗
Word learning can be achieved without feedback: implications for aphasia therapy.
PURPOSE: Children acquire new words through exposure, without the necessity for explicit feedback by caregivers. In aphasia therapy, feedback to the patient is considered an important asset even though the empirical base demonstrating superior learning with online feedback is lacking. The present study examined if healthy adults and patients with chronic aphasia can acquire a new lexicon by intense frequency of exposure alone. METHODS: We compared learning rates with "frequency of exposure alone" (no-feedback condition: n=19 healthy adults; two patients with chronic Broca's and Wernicke's aphasia, respectively) with a condition where subjects additionally received online feedback (feedback condition; n=19). The learning principle was higher statistical co-occurrences of "correct" picture-pseudoword pairings as compared to "incorrect" pairings. In the feedback condition, immediate online feedback on the correctness of respective choices was additionally provided. RESULTS: Both healthy groups successfully acquired the vocabulary. Feedback led to a slight initial acceleration of learning but did not improve latency to peak performance or long-term retention of lexical knowledge. These findings show that high frequency interactive exposure is a potent word learning mechanism in adults and that feedback is not crucial. This is further corroborated by our successful training of two patients with chronic aphasia without online feedback. CONCLUSIONS: Our findings demonstrate that word re-learning in aphasia could benefit from maximizing on the frequency of exposure and exploiting the therapeutic principle of "massed practice", which has been successful in physical rehabilitation after stroke. Additionally, economizing on feedback may prevent patients becoming discouraged by continuous confrontation with their deficits.
Adult↗
Learning of tactile frequency discrimination in humans.
Learning is based on the remodeling of neural connections in the brain. The purpose of the present study was to examine the extent to which training-induced improvements in tactile frequency discrimination in humans are correlated with an increase of cortical representations in the primary somatosensory cortex. Healthy male subjects (n = 16) were trained in a tactile frequency discrimination task of the left ring finger. During the first 15 days of training, there was a steep improvement in frequency discrimination, which generalized from the trained finger to its homologue on the opposite hand, and to a lesser extent, to the other fingers on both hands. During the following 15 days of training, there was only a minor improvement in tactile frequency discrimination. Retention of improved performance in frequency discrimination 30 days after training was demonstrated for all digits. Cortical finger representation in the primary somatosensory cortex, as measured by magnetic source imaging, did not change during training. Because of the generalized training effect and the lack of detectable increase in the cortical field evoked from the trained finger, we assume that skill improvement was mediated predominantly by regions outside the primary somatosensory cortex.
Adult↗