Do congruent lip movements facilitate speech processing in a dynamic audiovisual multi-talker scenario? An ERP study with older and younger adults.

In natural conversations, visible mouth and lip movements play an important role in speech comprehension. There is evidence that visual speech information improves speech comprehension, especially for older adults and under difficult listening conditions. However, the neurocognitive basis is still poorly understood. The present EEG experiment investigated the benefits of audiovisual speech in a dynamic cocktail-party scenario with 22 (aged 20-34 years) younger and 20 (aged 55-74 years) older participants. We presented three simultaneously talking faces with a varying amount of visual speech input (still faces, visually unspecific and audiovisually congruent). In a two-alternative forced-choice task, participants had to discriminate target words ("yes" or "no") among two distractors (one-digit number words). In half of the experimental blocks, the target was always presented from a central position, in the other half, occasional switches to a lateral position could occur. We investigated behavioral and electrophysiological modulations due to age, location switches and the content of visual information, analyzing response times and accuracy as well as the P1, N1, P2, N2 event-related potentials (ERPs) and the contingent negative variation (CNV) in the EEG. We found that audiovisually congruent speech information improved performance and modulated ERP amplitudes in both age groups, suggesting enhanced preparation and integration of the subsequent auditory input. In the older group, larger amplitude measures were found in early phases of processing (P1-N1). Here, amplitude measures were reduced in response to audiovisually congruent stimuli. In later processing phases (P2-N2) we found decreased amplitude measures in the older group, while an amplitude reduction for audiovisually congruent compared to visually unspecific stimuli was still observable. However, these benefits were only observed as long as no location switches occurred, leading to enhanced amplitude measures in later processing phases (P2-N2). To conclude, meaningful visual information in a multi-talker setting, when presented from the expected location, is shown to be beneficial for both younger and older adults.

Cortical reorganization following auditory deprivation predicts cochlear implant performance in postlingually deaf adults.

Long-term hearing loss in postlingually deaf (PD) adults may lead to brain structural changes that affect the outcomes of cochlear implantation. We studied 94 PD patients who underwent cochlear implantation and 37 patients who were MRI-scanned within 2 weeks after the onset of sudden hearing loss and expected with minimal brain structural changes in relation to deafness. Compared with those with sudden hearing loss, we found lower gray matter (GM) probabilities in bilateral thalami, superior, middle, inferior temporal cortices as well as the central cortical regions corresponding to the movement and sensation of the lips, tongue, and larynx in the PD group. Among these brain areas, the GM in the middle temporal cortex showed negative correlation with disease duration, whereas the other areas displayed positive correlations. Left superior, middle temporal cortical, and bilateral thalamic GMs were the most accurate predictors of post-cochlear implantation word recognition scores (mean absolute error [MAE] = 10.1, r = .82), which was superior to clinical variables used (MAE: 12.1, p < .05). Using the combined brain morphological and clinical features, we achieved the best prediction of the outcome (MAE: 8.51, r = .90). Our findings suggest that the cross-modal plasticity allowing the superior temporal cortex and thalamus to process other modal sensory inputs reverses the initially lower volume when deafness becomes persistent. The middle temporal cortex processing higher-level language comprehension shows persistent negative correlations with disease duration, suggesting this area's association with degraded speech comprehensions due to long-term deafness. Morphological features combined with clinical variables might play a key role in predicting outcomes of cochlear implantation.

The Effects of Modified Pursed Lips Breathing on Oxygenation Status in Children.

Respiratory disease in children can contribute to damaged alveoli, frailty of respiratory muscles, reduced lung function, impaired gas exchange, and gas retention in the airway. Such condition may lead to disruption of oxygen status. This study aimed to examine the effects of modified pursed lips breathing (PLB) by blowing into a water-filled bottle through a straw and a party whistle on the oxygenation status in children with oxygenation problems. This study used a quasi-experiment method with a pretest-posttest without a control group design approach. The sample consisted of 32 school-aged children and adolescents who were divided into two intervention groups. Group 1 underwent modified PLB by blowing into a water-filled bottle through a straw and Group 2 was provided with modified PLB by blowing a party whistle. The intervention was conducted one time in a day, in a rest time, for 10 min. The results showed that modified PLB by blowing into a water-filled bottle through a straw was more effective in reducing respiratory rate (RR) and improving oxygen saturation (SpO2) than modified PLB by blowing a party whistle. Modified PLB intervention by blowing into a water-filled bottle through a straw improved the oxygenation status of children affected by oxygenation problems. This intervention can be implemented as an independent nursing intervention to improve children's oxygenation status.

Lip closure training improves eating behaviors and prefrontal cortical hemodynamic activity and decreases daytime sleep in elderly persons.

Previous research suggests that aging-related deterioration of oral functions causes not only eating/swallowing disorders but also various conditions such as sleep disorders and higher-order brain dysfunction. The aim of the present study was to examine the effects of lip closure training on eating behavior, sleep, and brain function in elderly persons residing in an elder care facility. The 20 elderly subjects (mean age, 86.3 ± 1.0 years) were assigned to a control group or a lip closure training (LCT) group, in which an oral rehabilitation device was used for daily LCT sessions over a 4-week period. Before and after the 4-week intervention period, maximal lip closure force was measured, and prefrontal cortical hemodynamic activity (changes in oxygenated hemoglobin concentration) during lip closure movements was measured with (LCT group) or without (control group) use of the oral rehabilitation device. We also analyzed eating behavior and daytime sleep before and after the intervention period. Compared with the control group, the LCT group showed improved maximal lip closure force, shortened eating time, decreased food spill rates, and decreased daytime sleeping. Furthermore, compared with the control group, the LCT group showed a significant increase in prefrontal cortical activity during lip closure. In addition, the increase rate in the right dorsolateral prefrontal cortical activity after the intervention period was significantly correlated with the increase rate in the maximal lip closure force after the intervention period. These findings suggest that LCT is useful in elderly individuals with decreased eating/oral and cognitive functions without the risk of pulmonary aspiration during training.

Neural Mechanisms Underlying Cross-Modal Phonetic Encoding.

Audiovisual (AV) integration is essential for speech comprehension, especially in adverse listening situations. Divergent, but not mutually exclusive, theories have been proposed to explain the neural mechanisms underlying AV integration. One theory advocates that this process occurs via interactions between the auditory and visual cortices, as opposed to fusion of AV percepts in a multisensory integrator. Building upon this idea, we proposed that AV integration in spoken language reflects visually induced weighting of phonetic representations at the auditory cortex. EEG was recorded while male and female human subjects watched and listened to videos of a speaker uttering consonant vowel (CV) syllables /ba/ and /fa/, presented in Auditory-only, AV congruent or incongruent contexts. Subjects reported whether they heard /ba/ or /fa/. We hypothesized that vision alters phonetic encoding by dynamically weighting which phonetic representation in the auditory cortex is strengthened or weakened. That is, when subjects are presented with visual /fa/ and acoustic /ba/ and hear /fa/ (illusion-fa), the visual input strengthens the weighting of the phone /f/ representation. When subjects are presented with visual /ba/ and acoustic /fa/ and hear /ba/ (illusion-ba), the visual input weakens the weighting of the phone /f/ representation. Indeed, we found an enlarged N1 auditory evoked potential when subjects perceived illusion-ba, and a reduced N1 when they perceived illusion-fa, mirroring the N1 behavior for /ba/ and /fa/ in Auditory-only settings. These effects were especially pronounced in individuals with more robust illusory perception. These findings provide evidence that visual speech modifies phonetic encoding at the auditory cortex.SIGNIFICANCE STATEMENT The current study presents evidence that audiovisual integration in spoken language occurs when one modality (vision) acts on representations of a second modality (audition). Using the McGurk illusion, we show that visual context primes phonetic representations at the auditory cortex, altering the auditory percept, evidenced by changes in the N1 auditory evoked potential. This finding reinforces the theory that audiovisual integration occurs via visual networks influencing phonetic representations in the auditory cortex. We believe that this will lead to the generation of new hypotheses regarding cross-modal mapping, particularly whether it occurs via direct or indirect routes (e.g., via a multisensory mediator).

Compensations to auditory feedback perturbations in congenitally blind and sighted speakers: Acoustic and articulatory data.

This study investigated the effects of visual deprivation on the relationship between speech perception and production by examining compensatory responses to real-time perturbations in auditory feedback. Specifically, acoustic and articulatory data were recorded while sighted and congenitally blind French speakers produced several repetitions of the vowel /ø/. At the acoustic level, blind speakers produced larger compensatory responses to altered vowels than their sighted peers. At the articulatory level, blind speakers also produced larger displacements of the upper lip, the tongue tip, and the tongue dorsum in compensatory responses. These findings suggest that blind speakers tolerate less discrepancy between actual and expected auditory feedback than sighted speakers. The study also suggests that sighted speakers have acquired more constrained somatosensory goals through the influence of visual cues perceived in face-to-face conversation, leading them to tolerate less discrepancy between expected and altered articulatory positions compared to blind speakers and thus resulting in smaller observed compensatory responses.

Kinematic Analysis of Speech Sound Sequencing Errors Induced by Delayed Auditory Feedback.

Purpose: Delayed auditory feedback (DAF) causes speakers to become disfluent and make phonological errors. Methods for assessing the kinematics of speech errors are lacking, with most DAF studies relying on auditory perceptual analyses, which may be problematic, as errors judged to be categorical may actually represent blends of sounds or articulatory errors. Method: Eight typical speakers produced nonsense syllable sequences under normal and DAF (200 ms). Lip and tongue kinematics were captured with electromagnetic articulography. Time-locked acoustic recordings were transcribed, and the kinematics of utterances with and without perceived errors were analyzed with existing and novel quantitative methods. Results: New multivariate measures showed that for 5 participants, kinematic variability for productions perceived to be error free was significantly increased under delay; these results were validated by using the spatiotemporal index measure. Analysis of error trials revealed both typical productions of a nontarget syllable and productions with articulatory kinematics that incorporated aspects of both the target and the perceived utterance. Conclusions: This study is among the first to characterize articulatory changes under DAF and provides evidence for different classes of speech errors, which may not be perceptually salient. New methods were developed that may aid visualization and analysis of large kinematic data sets. Supplemental Material: https://doi.org/10.23641/asha.5103067.

The role of hearing ability and speech distortion in the facilitation of articulatory motor cortex.

Excitability of articulatory motor cortex is facilitated when listening to speech in challenging conditions. Beyond this, however, we have little knowledge of what listener-specific and speech-specific factors engage articulatory facilitation during speech perception. For example, it is unknown whether speech motor activity is independent or dependent on the form of distortion in the speech signal. It is also unknown if speech motor facilitation is moderated by hearing ability. We investigated these questions in two experiments. We applied transcranial magnetic stimulation (TMS) to the lip area of primary motor cortex (M1) in young, normally hearing participants to test if lip M1 is sensitive to the quality (Experiment 1) or quantity (Experiment 2) of distortion in the speech signal, and if lip M1 facilitation relates to the hearing ability of the listener. Experiment 1 found that lip motor evoked potentials (MEPs) were larger during perception of motor-distorted speech that had been produced using a tongue depressor, and during perception of speech presented in background noise, relative to natural speech in quiet. Experiment 2 did not find evidence of motor system facilitation when speech was presented in noise at signal-to-noise ratios where speech intelligibility was at 50% or 75%, which were significantly less severe noise levels than used in Experiment 1. However, there was a significant interaction between noise condition and hearing ability, which indicated that when speech stimuli were correctly classified at 50%, speech motor facilitation was observed in individuals with better hearing, whereas individuals with relatively worse but still normal hearing showed more activation during perception of clear speech. These findings indicate that the motor system may be sensitive to the quantity, but not quality, of degradation in the speech signal. Data support the notion that motor cortex complements auditory cortex during speech perception, and point to a role for the motor cortex in compensating for differences in hearing ability.

Lip movements entrain the observers' low-frequency brain oscillations to facilitate speech intelligibility.

During continuous speech, lip movements provide visual temporal signals that facilitate speech processing. Here, using MEG we directly investigated how these visual signals interact with rhythmic brain activity in participants listening to and seeing the speaker. First, we investigated coherence between oscillatory brain activity and speaker's lip movements and demonstrated significant entrainment in visual cortex. We then used partial coherence to remove contributions of the coherent auditory speech signal from the lip-brain coherence. Comparing this synchronization between different attention conditions revealed that attending visual speech enhances the coherence between activity in visual cortex and the speaker's lips. Further, we identified a significant partial coherence between left motor cortex and lip movements and this partial coherence directly predicted comprehension accuracy. Our results emphasize the importance of visually entrained and attention-modulated rhythmic brain activity for the enhancement of audiovisual speech processing.

Cortical involvement in the StartReact effect.

The rapid release of prepared movements by a loud acoustic stimulus capable of eliciting a startle response has been termed the StartReact effect (Valls-Solé et al., 1999), and premotor reaction times (PMTs) of <70 ms are often observed. Two explanations have been given for these short latency responses. The subcortical storage and triggering hypothesis suggests movements that can be prepared in advance of a "go" signal are stored and triggered from subcortical areas by a startling acoustic stimulus (SAS) without cortical involvement. Alternatively, it has been hypothesized that the SAS can trigger movements from cortical areas through a faster pathway ascending from subcortical structures. Two experiments were designed to examine the possible role of the primary motor cortex in the StartReact effect. In Experiment 1, we used suprathreshold transcranial magnetic stimulation (TMS) during the reaction time (RT) interval to induce a cortical silent period in the contralateral primary motor cortex (M1). Thirteen participants performed 20° wrist extension movements as fast as possible in response to either a control stimulus (82 dB) or SAS (124 dB). PMTs for startle trials were faster than for control trials, while TMS significantly delayed movement onset compared to No TMS or Sham TMS conditions. In Experiment 2, we examined the StartReact effect in a highly cortically represented action involving speech of a consonant-vowel (CV) syllable. Similar to previous work examining limb movements, a robust StartReact effect was found. Collectively, these experiments provide evidence for cortical (M1) involvement in the StartReact effect.

Influence of an external rhythm on oral motor control in children and adults.

BACKGROUND: Rhythm has been used in music therapy practice to facilitate speech output in children and adults; however, the underlying mechanism of speech entrainment is not yet understood. OBJECTIVE: The purpose of this study was to (a) determine the feasibility of using the limb motor response model for testing oral motor entrainment and (b) establish initial data on oral motor entrainment across ages. METHODS: Six healthy 7- to 10-year-olds, six 11- to 14-year-olds, and twelve 18-35-year-olds served as participants. The oral motor kinematics of the upper lip, lower lip, and jaw were examined while participants repeated a bilabial syllable, recorded under three conditions: preferred tempo with no stimulus, preferred tempo with a rhythmic auditory stimulus, and 10% faster with a rhythmic auditory stimulus. The Spatiotemporal Index (STI) was computed to determine movement variability in each condition and the Synchronization Error (SE) was calculated to determine deviations from the auditory stimulus. RESULTS: Successful completion of the protocol by most participants and initial evidence of entrainment supported feasibility. There was a statistically significant difference in the STI for condition and marker placement. There were no significant differences for age. CONCLUSION: Oral motor entrainment of isolated syllables may be measured using the motor response model. Although data indicated that children and adults could entrain oral motor movements to the external auditory stimulus, the perceived tempo or the cognitive demands of such tasks may increase oral motor variability.

[Clinical application of oral and lip acupuncture].

The origin, manipulations, including needling tools, postures of patients, selection of points, sterilization and specific manipulations, indications, instructions and contraindications of oral and lip acupuncture are sorted and summarized. It lays foundation to the national standard of oral acupuncture manipulations. It is also supposed to be adopted as clinical practice standard, and is going to be popularized in clinics.

Pilot study to assess the potential of oral myofunctional therapy for improving respiration during sleep.

PURPOSE: The present study was designed to assess the potential of oral myofunctional therapy (OMFT) for improving respiration parameters, Apnea-Hypopnea Index (AHI), and saturation of peripheral oxygen (SpO2) during sleep. METHODS: The Epworth Sleepiness Scale (ESS) was administered to 92 students in class time at the Nihon University School of Dentistry at Matsudo. The results showed that 15 students had a high ESS. Of the 15 students who had learnt about their excessive sleepiness, six students expressed their intention to receive treatment for their sleep condition. They volunteered as subjects for the study. The Lip Trainer Patakara(®) was used for labial closure force (LCF) training for 2 months. LCF, AHI and SPO2 during sleep were measured before training and after 2 months training. The paired t-test was applied for statistical analyses. RESULT: LCFs before and 2 months after training were 8.8 ± 1.6 and 12.9 ± 0.6N, respectively. LCF significantly increased after training compared to that before training. SpO2 before training and after training were 90.0 ± 2.9% and 96.8±0.8%, respectively. SpO2 after training was significantly increased compared to that before training. AHI before and after training were 15.1 ± 3.4 and 9.2 ± 1.5 events/h, respectively. AHI after training was significantly decreased compared to that before training. CONCLUSION: From this study, the following conclusions were made: (1) OMFT significantly increases LCF; and (2) the AHI and SpO2 during sleep are significantly improved after OMFT.

Independent component analysis of localized resting-state functional magnetic resonance imaging reveals specific motor subnetworks.

Recent studies have shown that blood oxygen level-dependent low-frequency (<0.1 Hz) fluctuations (LFFs) during a resting-state exhibit a high degree of correlation with other regions that share cognitive function. Initial studies of resting-state network mapping have focused primarily on major networks such as the default mode network, primary motor, somatosensory, visual, and auditory networks. However, more specific or subnetworks, including those associated with specific motor functions, have yet to be properly addressed. We performed independent component analysis (ICA) in a specific target region of the brain, a process we name, "localized ICA." We demonstrated that when ICA is applied to localized fMRI data, it can be used to distinguish resting-state LFFs associated with specific motor functions (e.g., finger tapping, foot movement, or bilateral lip pulsing) in the primary motor cortex. These ICA components generated from localized data can then be used as functional regions of interest to map whole-brain connectivity. In addition, this method can be used to visualize inter-regional connectivity by expanding the localized region and identifying components that show connectivity between the two regions.

Myofunctional and speech rehabilitation after orthodontic-surgical treatment of dento-maxillofacial dysgnathia.

OBJECTIVES: The lingual dysfunctions play a considerable role in the pathogenesis of dentoskeletal dysmorphisms. The treatment of dento-maxillofacial dysgnathia implies a functional rehabilitation to re-harmonize the stomatognathic system. This study aims to demonstrate the importance of a rehabilitation protocol of functional orofacial parameters at the end of a surgical-orthodontic treatment in order to achieve long-term success. MATERIALS AND METHODS: After orthognathic surgery, facial expression exercises and jaw exercises are prescribed to promote the recovery of neuromuscular function. At the end of treatment, a sample of 30 dysgnathic patients underwent a functional evaluation of the orofacial district to identify any lingual or articulatory dysfunctions. The information gathered led to an individual re-education program that consisted of an active myofunctional-logopedic approach integrated with appliances used as retention. RESULTS: 19 patients needed myofunctional therapy to re-educate deglutition and tongue posture. Articulatory disorders were found in 7 patients originally suffering from Class III and/or open-bite skeletal disharmony; 5 of these completed rehabilitation with speech therapy. After rehabilitation the functional parameters were completely normalized in 12 patients; in 5 cases, partial improvements were obtained, while in 2 cases the therapy was ineffective. CONCLUSIONS: In a patient undergoing post-surgical reconsolidation of his/her functional equilibrium even an uncontrolled speech defect may lead to an instable result. Only through an interdisciplinary approach it is possible to intercept and re-educate all the functions that are not compliant with the structural changes and to eliminate a tendency to relapse of the dysgnathia.

Reversal of soft-tissue anesthesia in asymptomatic endodontic patients: a preliminary, prospective, randomized, single-blind study.

INTRODUCTION: Phentolamine has been reported to be an effective local anesthetic reversal agent for soft tissue but has not been studied in endodontics. The purpose of this preliminary, prospective, randomized, single-blind study was to evaluate the reversal of soft-tissue anesthesia using phentolamine in asymptomatic endodontic patients. METHODS: Eighty-five adult subjects having a maxillary or mandibular asymptomatic tooth requiring endodontic therapy received either phentolamine or sham treatment(s) at the end of the endodontic treatment appointment. Soft-tissue anesthesia was monitored by subjects every 15 minutes for 5 hours. Subjects reported postoperative injection site pain and tooth pain using a Heft-Parker visual analog score every 30 minutes for the first 2 postoperative hours and every hour for 3 hours. RESULTS: There was a statistically significant difference in time to return-to-normal sensation for the maxillary lip/cheek and mandibular lip. Subjects who received phentolamine experienced an 88-minute decrease in time to return-to-normal maxillary lip/cheek sensation and a 47-minute decrease in time to return-to-normal mandibular lip sensation. The administration of phentolamine was not significantly more painful than administration of a sham treatment, and patients who received phentolamine did not experience significantly more postoperative pain at the injection site. Postoperative complications were minimal, and no clinically significant adverse reactions to the phentolamine were reported. CONCLUSIONS: Phentolamine would be beneficial for asymptomatic endodontic patients who would like to experience a faster return-to-normal soft-tissue function and sensation after the administration of local anesthesia.

The influence of auditory acuity on acoustic variability and the use of motor equivalence during adaptation to a perturbation.

PURPOSE: The aim of this study was to relate speakers' auditory acuity for the sibilant contrast, their use of motor equivalent trading relationships in producing the sibilant /∫/, and their produced acoustic distance between the sibilants /s/ and /∫/. Specifically, the study tested the hypotheses that during adaptation to a perturbation of vocal-tract shape, high-acuity speakers use motor equivalence strategies to a greater extent than do low-acuity speakers in order to reach their smaller phonemic goal regions, and that high-acuity speakers produce greater acoustic distance between 2 sibilant phonemes than do low-acuity speakers. METHOD: Articulographic data from 7 German speakers adapting to a perturbation were analyzed for the use of motor equivalence. The speakers' produced acoustic distance between /s/ and /∫/ was calculated. Auditory acuity was assessed for the same speakers. RESULTS: High-acuity speakers used motor equivalence to a greater extent when adapting to a perturbation than did low-acuity speakers. Additionally, high-acuity speakers produced greater acoustic contrasts than did low-acuity-speakers. It was observed that speech rate had an influence on the use of motor equivalence: Slow speakers used motor equivalence to a lesser degree than did fast speakers. CONCLUSION: These results provide support for the mutual interdependence of speech perception and production.

Rapid change in articulatory lip movement induced by preceding auditory feedback during production of bilabial plosives.

BACKGROUND: There has been plentiful evidence of kinesthetically induced rapid compensation for unanticipated perturbation in speech articulatory movements. However, the role of auditory information in stabilizing articulation has been little studied except for the control of voice fundamental frequency, voice amplitude and vowel formant frequencies. Although the influence of auditory information on the articulatory control process is evident in unintended speech errors caused by delayed auditory feedback, the direct and immediate effect of auditory alteration on the movements of articulators has not been clarified. METHODOLOGY/PRINCIPAL FINDINGS: This work examined whether temporal changes in the auditory feedback of bilabial plosives immediately affects the subsequent lip movement. We conducted experiments with an auditory feedback alteration system that enabled us to replace or block speech sounds in real time. Participants were asked to produce the syllable /pa/ repeatedly at a constant rate. During the repetition, normal auditory feedback was interrupted, and one of three pre-recorded syllables /pa/, /Φa/, or /pi/, spoken by the same participant, was presented once at a different timing from the anticipated production onset, while no feedback was presented for subsequent repetitions. Comparisons of the labial distance trajectories under altered and normal feedback conditions indicated that the movement quickened during the short period immediately after the alteration onset, when /pa/ was presented 50 ms before the expected timing. Such change was not significant under other feedback conditions we tested. CONCLUSIONS/SIGNIFICANCE: The earlier articulation rapidly induced by the progressive auditory input suggests that a compensatory mechanism helps to maintain a constant speech rate by detecting errors between the internally predicted and actually provided auditory information associated with self movement. The timing- and context-dependent effects of feedback alteration suggest that the sensory error detection works in a temporally asymmetric window where acoustic features of the syllable to be produced may be coded.

Functional results of electrical cortical stimulation of the lower sensory strip.

The aim of this paper is to provide functional results obtained from electrical cortical stimulation of the lower postcentral gyrus in patients who underwent either lesional or non-lesional epilepsy surgery. Group I (n=393) included those patients with gliosis or normal tissue and Group II (n=107) included patients with space-occupying lesions. For cortical stimulation, a unipolar voltage-controlled electrode was used. The tongue, lip, and hand/finger sequences over the lower postcentral gyrus lateromedially in both groups were in agreement with classic teaching. The presence of structural lesions, such as tumors and dysplasia, did not affect the vertical representation of the body parts on the lower sensory strip. Individual variations, which included mosaicism over the sensory strip, were frequent. Whether the functional variability and mosaicism within the sensory cortex result from a pathological condition or not remains to be elucidated in healthy humans using advanced non-invasive brain mapping techniques.