Activity in the pontine reticular nuclei scales with handgrip force in humans.

The neural pathways that contribute to force production in humans are currently poorly understood, as the relative roles of the corticospinal tract and brainstem pathways, such as the reticulospinal tract (RST), vary substantially across species. Using functional magnetic resonance imaging (fMRI), we aimed to measure activation in the pontine reticular nuclei (PRN) during different submaximal handgrip contractions to determine the potential role of the PRN in force modulation. Thirteen neurologically intact participants (age: 28 ± 6 yr) performed unilateral handgrip contractions at 25%, 50%, 75% of maximum voluntary contraction during brain scans. We quantified the magnitude of PRN activation from the contralateral and ipsilateral sides during each of the three contraction intensities. A repeated-measures ANOVA demonstrated a significant main effect of force (P = 0.012, [Formula: see text] = 0.307) for PRN activation, independent of side (i.e., activation increased with force for both contralateral and ipsilateral nuclei). Further analyses of these data involved calculating the linear slope between the magnitude of activation and handgrip force for each region of interest (ROI) at the individual-level. One-sample t tests on the slopes revealed significant group-level scaling for the PRN bilaterally, but only the ipsilateral PRN remained significant after correcting for multiple comparisons. We show evidence of task-dependent activation in the PRN that was positively related to handgrip force. These data build on a growing body of literature that highlights the RST as a functionally relevant motor pathway for force modulation in humans.NEW & NOTEWORTHY In this study, we used a task-based functional magnetic resonance imaging (fMRI) paradigm to show that activity in the pontine reticular nuclei scales linearly with increasing force during a handgrip task. These findings directly support recently proposed hypotheses that the reticulospinal tract may play an important role in modulating force production in humans.

The FAST VAN for Field Identification of Large Vessel Occlusion in Acute Stroke.

BACKGROUND: There is definitive evidence for effectiveness of thrombectomy for acute stroke with large vessel occlusion (LVO). A clinical tool to identify patients with LVO is therefore required for effective triage and prehospital decision making. We developed the FAST VAN tool, which follows from the Heart and Stroke Foundation FAST stroke screen, with the addition of cortical features of vision, aphasia, and neglect, to differentiate from lacunar syndromes. METHODS: Consecutive acute stroke alerts initiated by emergency medical services (EMS) were prospectively analyzed from April 2017 to Jan 2021. FAST VAN signs were recorded by first responders who had received online education about the tool. These findings were compared to the presence or absence of LVO on CT angiography. Analysis was also performed by appropriateness for comprehensive stroke centers (CSC) transfer if no LVO was present. EMS providers were surveyed regarding ease of use in terms of learning the tool and using in real-world practice. RESULTS: Data from 1080 consecutive acute strokes included 440 patients considered to have VAN signs by EMS. Fifty-four percent of VAN-positive patients showed LVO on CTA. Sensitivity, specificity, and accuracy were 86%, 75%, and 77%, respectively. In 204 false-positive cases, 143 (70%) were considered appropriate for evaluation at the CSC. EMS providers reported high satisfaction with learning and using the tool. DISCUSSION: The FAST VAN tool for identification of LVO meets desired characteristics of an effective screening tool in ease of use, efficiency, and accuracy. Aphasia remains the most challenging cortical feature to identify accurately.

Uncrossed corticospinal tracts presenting as transient tumor-related symptomatology.

Ipsilateral corticospinal innervation is rare. No prior cases have described ipsilateral tumor-associated symptoms as the presentation of an uncrossed corticospinal tract. Herein, we describe a case associated with a left frontal tumor, presenting with transient ipsilateral hemiparesis and aphasia. Due to the fluctuating symptomatology, we suspected a cerebrovascular cause and initially performed a workup for stroke. Ipsilateral motor innervation was discovered with intraoperative monitoring during the resection of the tumor, and confirmed with postoperative diffusion tensor imaging (DTI). Neurosurgeons should be aware of uncrossed motor system, and include it in the differential of ipsilateral deficit in patients with intracranial tumors.

An fMRI, DTI and Neurophysiological Examination of Atypical Organization of Motor Cortex in Ipsilesional Hemisphere Following Post-Stroke Recovery.

OBJECTIVES: We report a 61-year-old woman who developed left hemiparesis following a right frontal stroke. She underwent rehabilitation and regained function of the left side of her body. Three years after her first stroke, she developed a large left subdural hematoma and again presented with left hemiparesis. MATERIALS AND METHODS: Prior to the cranioplasty, an fMRI scan involving left and right hand movement, arm movement, and foot peddling were conducted in order to determine whether the patient showed ipsilateral activation for the motor tasks, thus explaining the left hemiparesis following the left subdural hematoma. Diffusion tensor imaging (DTI) tractography was also collected to visualize the motor and sensory tracts. RESULTS: The fMRI results revealed activation in the expected contralateral left primary motor cortex (M1) for the right-sided motor tasks, and bilateral M1 activation for the left-sided motor tasks. Intraoperative neurophysiology confirmed these findings, whereby electromyography revealed left-sided (i.e., ipsilateral) responses for four of the five electrode locations. The DTI results indicated that the corticospinal tracts and spinothalamic tracts were within normal limits and showed no displacement or disorganization. CONCLUSIONS: These results suggest that there may have been reorganization of the M1 following her initial stroke, and that the left hemisphere may have become involved in moving the left side of the body thereby leading to left hemiparesis following the left subdural hematoma. The findings suggest that cortical reorganization may occur in stroke patients recovering from hemiparesis, and specifically, that components of motor processing subserved by M1 may be taken over by ipsilateral regions.

Language lateralization differences between left and right temporal lobe epilepsy as measured by overt word reading fMRI activation and DTI structural connectivity.

In cases of brain disease such as temporal lobe epilepsy (TLE), damage may lead to functional reorganization and a shift in language dominance to homolog regions in the other hemisphere. If the effects of TLE on language dominance are hemisphere-focused, then brain regions and connections involved in word reading should be less left-lateralized in left temporal lobe epilepsy (lTLE) than right temporal lobe epilepsy (rTLE) or healthy controls, and the opposite effect should be observed in patients with rTLE. In our study, functional magnetic resonance imaging (fMRI) showed that patients with rTLE had more strongly lateralized left hemisphere (LH) activation than patients with lTLE and healthy controls in language-related brain regions (pars opercularis and fusiform gyrus (FuG)). Corresponding with this difference, diffusion tensor imaging (DTI) found differences in connectivity indicative of patients with lTLE having greater tract integrity than patients with rTLE in the right hemisphere (RH) uncinate fasciculus (UF), inferior longitudinal fasciculus (ILF), and inferior fronto-occipital fasciculus (IFOF) using the network-based statistic analysis method. The UF, ILF, and IFOF tract integrity have previously been associated with lexical (whole-word) processing abilities. Multivariate distance matrix regression provided converging evidence for regions of the IFOF having different connectivity patterns between groups with lTLE and rTLE. This research demonstrates language lateralization differences between patient groups with lTLE and rTLE, and corresponding differences in the connectivity strength of the ILF, IFOF, and UF. This research provides a novel approach to measuring lateralization of language in general, and the fMRI and DTI findings were integral for guiding the neurosurgeons performing the TLE resections. This approach should inform future studies of language lateralization and language reorganization in patients such as those with TLE.

Reorganized neural activation in motor cortex following subdural fluid collection: an fMRI and DTI study.

We report a patient with a cavernous malformation involving the right lentiform nucleus. Pre-surgical planning included fMRI localization of language, motor, and sensory processing, and DTI of white matter tracts. fMRI results revealed no activation near the planned resection zone. However, post-surgery the patient developed a subdural fluid collection, which applied pressure to the primary motor cortex (M1). Follow-up scans revealed that motor activation had shifted due to pressure, and then shifted to a new location after the fluid collection subsided. This case report suggests that long-term neural reorganization can occur in response to short term compression in the cortex.

Attentional Network Differences Between Migraineurs and Non-migraine Controls: fMRI Evidence.

Migraine is a headache disorder characterized by sensitivity to light and sound. Recent research has revealed abnormal visual-spatial attention in migraineurs in between headache attacks. Here, we ask whether these attentional abnormalities can be attributed to specific regions of the known attentional network to help characterize the abnormalities in migraine. Specifically, the ventral frontoparietal network of attention is involved with assessing the behavioural relevance of unattended stimuli. Given the decreased suppression of unattended stimuli reported in migraineurs, we hypothesized that migraineurs would have abnormal processing in the ventral portion of the frontoparietal network of attention. To address this, we used functional magnetic resonance imaging to assess the attentional control networks during visual spatial-orienting tasks in migraineurs (N = 16) as compared to non-migraine controls (N = 16). We employed two visual orienting paradigms with target discrimination tasks: (1) voluntary orienting to central arrow cues, and (2) reflexive orienting to peripheral flash cues. While both groups showed activation in the key areas of attentional processing networks, migraineurs showed less activation than non-migraine controls in a key area of the ventral frontoparietal network of attention, the right temporal parietal junction (rTPJ), during both voluntary and reflexive visual spatial orienting. Given the role of rTPJ is to assess the visual environment for behaviorally relevant sensory stimuli outside the focus of attention and signal other attentional areas to reorient attention to behaviorally salient stimuli, our findings fit with previous research showing that migraineurs lack suppression of unattended events and have heightened orienting to sudden onset stimuli in peripheral locations.

Inclusion of attentional networks in the pre-surgical neuroimaging assessment of a large deep hemispheric cavernous malformation: an FMRI case report.

BACKGROUND AND IMPORTANCE: Functional magnetic resonance imaging (fMRI) is a noninvasive and reliable tool for mapping eloquent cortex in patients prior to brain surgery. Ensuring intact perceptual and cognitive processing is a key goal for neurosurgeons, and recent research has indicated the value of including attentional network processing in pre-surgical fMRI in order to help preserve such abilities, including reading, after surgery. CLINICAL PRESENTATION: We report a 42-year-old patient with a large cavernous malformation, near the left basal ganglia. The lesion measured 3.8 × 1.7 × 1.8 cm. In consultation with the patient and the multidisciplinary cerebrovascular team, the decision was made to offer the patient surgical resection. The surgical resection involved planned access via the left superior parietal lobule using stereotactic location. The patient declined an awake craniotomy; therefore, direct electrocortical stimulation (ECS) could not be used for intraoperative language localization in this case. Pre-surgical planning included fMRI localization of language, motor, sensory, and attentional processing. The key finding was that both reading and attention-processing tasks revealed consistent activation of the left superior parietal lobule, part of the attentional control network, and the site of the planned surgical access. Given this information, surgical access was adjusted to avoid interference with the attentional control network. The lesion was removed via the left inferior parietal lobule. The patient had no new neurologic deficits postoperatively but did develop mild neuropathic pain in the left hand. CONCLUSION: This case report supports recent research that indicates the value of including fMRI maps of attentional tasks along with traditional language-processing tasks in preoperative planning in patients undergoing neurosurgery procedures.

Harmful and Harmless Soil-Dwelling Fungi Indicate Microhabitat Suitability for Off-Host Ixodid Ticks.

Following blood meals or questing bouts, hard ticks (Ixodidae) must locate moist off-host microhabitats as refuge. Soil-dwelling fungi, including entomopathogenic Beauveria bassiana (Bb), thrive in moist microhabitats. Working with six species of ixodid ticks in olfactometer bioassays, we tested the hypothesis that ticks avoid Bb. Contrary to our prediction, nearly all ticks sought, rather than avoided, Bb-inoculated substrates. In further bioassays with female black-legged ticks, Ixodes scapularis, ticks oriented towards both harmful Bb and harmless soil-dwelling fungi, implying that fungi-regardless of their pathogenicity-signal habitat suitability to ticks. Only accessible Bb-inoculated substrate appealed to ticks, indicating that they sense Bb or its metabolites by contact chemoreception. Bb-inoculated substrate required ≥24 h of incubation before it appealed to ticks, suggesting that they respond to Bb metabolites rather than to Bb itself. Similarly, ticks responded to Bb-inoculated and incubated cellulose but not to sterile cellulose, indicating that Bb detection by ticks hinges on the Bb metabolism of cellulose. 2-Methylisoborneol-a common fungal metabolite with elevated presence in disturbed soils-strongly deterred ticks. Off-host ticks that avoid disturbed soil may lower their risk of physical injury. Synthetic 2-methylisoborneol could become a commercial tick repellent, provided its repellency extends to ticks in diverse taxa.

Unique, Shared, and Dominant Brain Activation in Visual Word Form Area and Lateral Occipital Complex during Reading and Picture Naming.

Identifying printed words and pictures concurrently is ubiquitous in daily tasks, and so it is important to consider the extent to which reading words and naming pictures may share a cognitive-neurophysiological functional architecture. Two functional magnetic resonance imaging (fMRI) experiments examined whether reading along the left ventral occipitotemporal region (vOT; often referred to as a visual word form area, VWFA) has activation that is overlapping with referent pictures (i.e., both conditions significant and shared, or with one significantly more dominant) or unique (i.e., one condition significant, the other not), and whether picture naming along the right lateral occipital complex (LOC) has overlapping or unique activation relative to referent words. Experiment 1 used familiar regular and exception words (to force lexical reading) and their corresponding pictures in separate naming blocks, and showed dominant activation for pictures in the LOC, and shared activation in the VWFA for exception words and their corresponding pictures (regular words did not elicit significant VWFA activation). Experiment 2 controlled for visual complexity by superimposing the words and pictures and instructing participants to either name the word or the picture, and showed primarily shared activation in the VWFA and LOC regions for both word reading and picture naming, with some dominant activation for pictures in the LOC. Overall, these results highlight the importance of including exception words to force lexical reading when comparing to picture naming, and the significant shared activation in VWFA and LOC serves to challenge specialized models of reading or picture naming.

Ipsilesional Motor Cortex Activation with High-force Unimanual Handgrip Contractions of the Less-affected Limb in Participants with Stroke.

Stroke is a leading cause of severe disability that often presents with unilateral motor impairment. Conventional rehabilitation approaches focus on motor practice of the affected limb and aim to suppress brain activity in the contralesional hemisphere. Conversely, exercise of the less-affected limb promotes contralesional brain activity which is typically viewed as contraindicated in stroke recovery due to the interhemispheric inhibitory influence onto the ipsilesional hemisphere. Yet, high-force unimanual handgrip contractions are known to increase ipsilateral brain activation in control participants, and it remains to be determined if high-force contractions with the less-affected limb would promote ipsilateral brain activation in participants with stroke (i.e., the ipsilesional hemisphere). Therefore, this study aimed to determine how parametric increases in handgrip force during repeated contractions with the less-affected limb impacts brain activity bilaterally in participants with stroke and in a cohort of neurologically intact controls. Participants performed repeated submaximal contractions at 25%, 50%, and 75% of their maximum voluntary contraction during separate functional magnetic resonance imaging brain scans. Brain activation during the tasks was quantified as the percent change from resting levels. In this study, higher force contractions were found to increase brain activation in the ipsilesional (stroke)/ipsilateral (controls) hemisphere in both groups (p = .002), but no between group differences were observed. These data suggest that high-force exercise with the less-affected limb may promote ipsilesional cortical plasticity to promote motor recovery of the affected-limb in participants with stroke.

High Force Unimanual Handgrip Contractions Increase Ipsilateral Sensorimotor Activation and Functional Connectivity.

Imaging and brain stimulation studies seem to correct the classical understanding of how brain networks, rather than contralateral focal areas, control the generation of unimanual voluntary force. However, the scaling and hemispheric-specificity of network activation remain less understood. Using fMRI, we examined the effects of parametrically increasing right-handgrip force on activation and functional connectivity among the sensorimotor network bilaterally with 25%, 50%, and 75% maximal voluntary contractions (MVC). High force (75% MVC) unimanual handgrip contractions resulted in greater ipsilateral motor activation and functional connectivity with the contralateral hemisphere compared to a low force 25% MVC condition. The ipsilateral motor cortex activation and network strength correlated with relative handgrip force (% MVC). Increases in unimanual handgrip force resulted in greater ipsilateral sensorimotor activation and greater functional connectivity between hemispheres within the sensorimotor network.

Atypical language localization in right temporal lobe epilepsy: An fMRI case report.

We report a 41- year-old, left-handed patient with drug-resistant right temporal lobe epilepsy (TLE). Presurgical fMRI was conducted to examine whether the patient had language functioning in the right hemisphere given that left-handedness is associated with a higher prevalence of right hemisphere dominance for language. The fMRI results revealed bilateral activation in Broca's and Wernicke's areas and activation of eloquent cortex near the region of planned resection in the right temporal lobe. Due to right temporal language-related activation, the patient underwent an awake right-sided temporal lobectomy with intraoperative language mapping. Intraoperative direct cortical stimulation (DCS) was conducted in the regions corresponding to the fMRI activation, and the patient showed language abnormalities, such as paraphasic errors, and speech arrest. The decision was made to abort the planned anterior temporal lobe procedure, and the patient instead underwent a selective amygdalohippocampectomy via the Sylvian fissure at a later date. Post-operatively the patient was seizure-free with no neurological deficits. Taken together, the results support previous findings of right hemisphere language activation in left-handed individuals, and should be considered in cases in which presurgical localization is conducted for left-hand dominant patients undergoing neurosurgical procedures.

Where words and space collide: The overlapping neural activation of lexical and sublexical reading with voluntary and reflexive spatial attention.

Recent research has shown a relationship between reading and attention, however the neuroanatomical overlap of these two processes has remained relatively unexplored. Therefore, we sought to investigate the overlapping neural mechanisms of spatial attention and reading using functional magnetic resonance imaging. Participants performed two attentional orienting tasks (reflexive and voluntary), and two overt word-reading tasks (lexical and sublexical). We hypothesized that there would be greater unique activation overlap of reflexive attention with lexical reading, and of voluntary attention with sublexical reading. Results indicated that lexical reading had greater overlapping activation in reflexive orienting areas compared to sublexical reading, suggesting that lexical reading may employ more automatic attentional mechanisms. In contrast, sublexical reading had greater overlapping activation with voluntary attention areas compared to lexical reading, suggesting that phonetic decoding may rely more heavily on voluntary attention. This research broadens our understanding of the neural overlap that underlies the relationship between reading and spatial attention.

Contralateral effects of unilateral training: sparing of muscle strength and size after immobilization.

The contralateral effects of unilateral strength training, known as cross-education of strength, date back well over a century. In the last decade, a limited number of studies have emerged demonstrating the preservation or "sparing" effects of cross-education during immobilization. Recently published evidence reveals that the sparing effects of cross-education show muscle site specificity and involve preservation of muscle cross-sectional area. The new research also demonstrates utility of training with eccentric contractions as a potent stimulus to preserve immobilized limb strength across multiple modes of contraction. The cumulative data in nonclinical settings suggest that cross-education can completely abolish expected declines in strength and muscle size in the range of ∼13% and ∼4%, respectively, after 3-4 weeks of immobilization of a healthy arm. The evidence hints towards the possibility that unique mechanisms may be involved in preservation effects of cross-education, as compared with those that lead to functional improvements under normal conditions. Cross-education effects after strength training appear to be larger in clinical settings, but there is still only 1 randomized clinical trial demonstrating the potential utility of cross-education in addition to standard treatment. More work is necessary in both controlled and clinical settings to understand the potential interaction of neural and muscle adaptations involved in the observed sparing effects, but there is growing evidence to advocate for the clinical utility of cross-education.

The Effect of Tumor Neovasculature on Functional Magnetic Resonance Imaging Blood Oxygen Level-Dependent Activation.

BACKGROUND: We report the case of a 40-year-old patient with a large, World Health Organization grade III oligodendroglioma in the left parietal lobe. CASE DESCRIPTION: Presurgical planning included functional magnetic resonance imaging (fMRI) localization of language, motor, and somatosensory processing. fMRI results for motor and somatosensory tasks revealed activation in perilesional regions near the surgical resection as well as deactivation in the tumor for the sensory task, suggesting decreased autoregulation in the region owing to the glioma. fMRI results showed left-hemisphere dominance for language and activation in perilesional regions for all 3 speech tasks (i.e., word reading, picture naming, and semantic questions). In addition, the results demonstrated that the high vascularity of the lesion altered the blood oxygen level-dependent function, resulting in false-positive and false-negative activation in the semantic questions and leg/foot rubbing task, respectively. Intraoperative direct cortical stimulation was conducted in the regions corresponding to fMRI activation while the patient performed motor, sensory, and language tasks and showed no loss of function. Follow-up fMRI revealed that there was no longer activation in the tumor or in perilesional regions, presumably owing to the resection of the vascularized tumor. CONCLUSIONS: This case highlights the importance of presurgical fMRI to inform the neurosurgical approach and emphasizes the need for careful interpretation of fMRI data, especially in cases of malignant glioma, which can decrease autoregulation in surrounding regions, affecting fMRI blood oxygen level-dependent signal.

More than a feeling: The bidirectional convergence of semantic visual object and somatosensory processing.

Prevalent theories of semantic processing assert that the sensorimotor system plays a functional role in the semantic processing of manipulable objects. While motor execution has been shown to impact object processing, involvement of the somatosensory system has remained relatively unexplored. Therefore, we developed two novel priming paradigms. In Experiment 1, participants received a vibratory hand prime (on half the trials) prior to viewing a picture of either an object interacted primarily with the hand (e.g., a cup) or the foot (e.g., a soccer ball) and reported how they would interact with it. In Experiment 2, the same objects became the prime and participants were required to identify whether the vibratory stimulation occurred to their hand or foot. In both experiments, somatosensory priming effects arose for the hand objects, while foot objects showed no priming benefits. These results suggest that object semantic knowledge bidirectionally converges with the somatosensory system.

Disentangling Genuine Semantic Stroop Effects in Reading from Contingency Effects: On the Need for Two Neutral Baselines.

The automaticity of reading is often explored through the Stroop effect, whereby color-naming is affected by color words. Color associates (e.g., "sky") also produce a Stroop effect, suggesting that automatic reading occurs through to the level of semantics, even when reading sub-lexically (e.g., the pseudohomophone "skigh"). However, several previous experiments have confounded congruency with contingency learning, whereby faster responding occurs for more frequent stimuli. Contingency effects reflect a higher frequency-pairing of the word with a font color in the congruent condition than in the incongruent condition due to the limited set of congruent pairings. To determine the extent to which the Stroop effect can be attributed to contingency learning of font colors paired with lexical (word-level) and sub-lexical (phonetically decoded) letter strings, as well as assess facilitation and interference relative to contingency effects, we developed two neutral baselines: each one matched on pair-frequency for congruent and incongruent color words. In Experiments 1 and 3, color words (e.g., "blue") and their pseudohomophones (e.g., "bloo") produced significant facilitation and interference relative to neutral baselines, regardless of whether the onset (i.e., first phoneme) was matched to the color words. Color associates (e.g., "ocean") and their pseudohomophones (e.g., "oshin"), however, showed no significant facilitation or interference relative to onset matched neutral baselines (Experiment 2). When onsets were unmatched, color associate words produced consistent facilitation on RT (e.g., "ocean" vs. "dozen"), but pseudohomophones (e.g., "oshin" vs. "duhzen") failed to produce facilitation or interference. Our findings suggest that the Stroop effects for color and associated stimuli are sensitive to the type of neutral baseline used, as well as stimulus type (word vs. pseudohomophone). In general, contingency learning plays a large role when repeating congruent items more than incongruent items, but appropriate pair-frequency matched neutral baselines allow for the assessment of genuine facilitation and interference. Using such baselines, we found reading processes proceed to a semantic level for familiar words, but not pseudohomophones (i.e., phonetic decoding). Such assessment is critical for separating the effects of genuine congruency from contingency during automatic word reading in the Stroop task, and when used with color associates, isolates the semantic contribution.