Re-wiring the brain: increased functional connectivity within primary somatosensory cortex following synchronous co-activation.

The primary somatosensory cortex shows precise topographical organisation, but can be quickly modified by alterations to sensory inputs. Temporally correlated sensory inputs to the digits can result in the merging of digit representations on the cortical surface. Underlying mechanisms driving these changes are unclear but the strengthening of intra-cortical synaptic connections via Hebbian mechanisms has been suggested. We use fMRI measures of temporal coherence to infer alterations in the relative strength of neuronal connections between digit regions 2 and 4 following 3 hours of synchronous and asynchronous co-activation. Following synchronous co-activation we find a 20% increase in temporal coherence of the fMRI signal (p=0.0004). No significant change is seen following asynchronous co-activation suggesting that temporal coincidence between the two digit inputs during co-activation is driving this coherence change. In line with previous work we also find a trend towards reduced separation of the digit representations following synchronous co-activation and significantly increased separation for the asynchronous case. Increased coherence is significantly correlated with reduced digit separation for the synchronous case. This study shows that passive synchronous stimulation to the digits strengthens the underlying cortical connections between the digit regions in only a few hours, and that this mechanism may be related to topographical re-organisation.

Effects of the N-methyl-D-Aspartate receptor antagonist dextromethorphan on vibrotactile adaptation.

BACKGROUND: Previous reports have demonstrated that short durations of vibrotactile stimuli (less than or equal to 2 sec) effectively and consistently modify both the perceptual response in humans as well as the neurophysiological response in somatosensory cortex. The change in cortical response with adaptation has been well established by a number of studies, and other reports have extended those findings in determining that both GABA- and NMDAR-mediated neurotransmission play a significant role in the dynamic response of somatosensory cortical neurons. In this study, we evaluated the impact that dextromethorphan (DXM), an NMDAR antagonist, had on two distinct vibrotactile adaptation tasks. RESULTS: All subjects, both those that ingested 60 mg DXM and those that ingested placebo, were evaluated for their amplitude discriminative capacity between two simultaneously delivered vibrotactile stimuli both with and without 3 conditions of pre-exposure to adapting stimulation. The results demonstrated that the perceptual metrics of subjects who ingested 60 mg DXM were significantly altered from that of controls when the amplitude discrimination task followed one of the conditions of adapting stimulation. Without the condition of pre-exposure to an adapting stimulus (or stimuli), there was little difference between the observations obtained from the subjects that ingested DXM and controls. Peak impact on subject response occurred at 60 min post-ingestion, whereas the scores of controls who ingested placebo were not impacted. CONCLUSION: The results - that DXM blocks vibrotactile adaptation - is consistent with the suggestion that NMDAR-mediated neurotransmission plays a significant role in the perceptual adaptive response. This finding is also consistent with neurophysiological findings that report observations of the effects of NMDAR block on the SI cortical response to repetitive vibrotactile stimulation.

Changes in EEG during graded exercise on a recumbent cycle ergometer.

Previous studies have shown changes in brain activity as a result of exercise; however, few studies have examined changes during exercise. The purpose of this study was to examine brain activity during a graded exercise test. Twenty male participants performed a graded exercise test on a recumbent cycle ergometer. Exercise intensity was set initially at 50W and was increased by 50W every 2 minutes until volitional fatigue was reached. Electroencephalography (EEG) was measured prior to the onset of exercise, during the last minute of each stage of exercise, immediately post-exercise, and 10 minutes into recovery. EEG was recorded from 8 scalp sites leading to analysis of alpha 1, alpha 2, beta 1, beta 2, and theta activities. Expired air was collected and analyzed for ventilation rate (VE), VO2, % of peak VO2, and Respiratory Exchange Ratio (RER). No differences were seen in EEG between the hemispheres of the brain. There was, however, a significant increase in brain activity across the spectrum occurring at 200 W through immediately post-exercise. Brain activity returned to pre- exercise levels by 10 minutes post. VO2, % of peak VO2 and RER increased linearly with exercise intensity. VE increased linearly through 200 W; however, a disproportionate increase was seen in VE from 200 W to peak exercise. The results of this investigation demonstrate that brain activity may be related to exercise intensity. Future research will want to examine how these changes in brain activity influence affective, perceptual and cognitive changes often associated with exercise. Efforts will also need to be made to determine if changes in brain activity during exercise are mediated by central (within the brain) or peripheral mechanisms. Key pointsEEG can be recorded during exercise.Brain EEG activity increases during exercise and may be related to exercise intensity.Brain EEG activity returns to resting levels quickly after the cessation of exercise.

A neuroscientific approach to the examination of concussions in student-athletes.

Concussions are occurring at alarming rates in the United States and have become a serious public health concern. The CDC estimates that 1.6 to 3.8 million concussions occur in sports and recreational activities annually. Concussion as defined by the 2013 Concussion Consensus Statement "may be caused either by a direct blow to the head, face, neck or elsewhere on the body with an 'impulsive' force transmitted to the head." Concussions leave the individual with both short- and long-term effects. The short-term effects of sport related concussions may include changes in playing ability, confusion, memory disturbance, the loss of consciousness, slowing of reaction time, loss of coordination, headaches, dizziness, vomiting, changes in sleep patterns and mood changes. These symptoms typically resolve in a matter of days. However, while some individuals recover from a single concussion rather quickly, many experience lingering effects that can last for weeks or months. The factors related to concussion susceptibility and the subsequent recovery times are not well known or understood at this time. Several factors have been suggested and they include the individual's concussion history, the severity of the initial injury, history of migraines, history of learning disabilities, history of psychiatric comorbidities, and possibly, genetic factors. Many studies have individually investigated certain factors both the short-term and long-term effects of concussions, recovery time course, susceptibility and recovery. What has not been clearly established is an effective multifaceted approach to concussion evaluation that would yield valuable information related to the etiology, functional changes, and recovery. The purpose of this manuscript is to show one such multifaceted approached which examines concussions using computerized neurocognitive testing, event related potentials, somatosensory perceptual responses, balance assessment, gait assessment and genetic testing.

Tests and measures used by specialist physical therapists when examining patients with stroke.

BACKGROUND AND PURPOSE: Examination procedures preferred by physical therapists have not been documented either specifically or comprehensively. The purpose of this study was to determine which tests and measures are used most frequently by specialists in the examination of adults with stroke. SUBJECTS: Physical therapy specialists were identified as having geriatric or neurologic certification through the American Board of Physical Therapy Specialties. A request to participate in a Web-based survey was sent to 471 individuals in the American Physical Therapy Association's Directory of Certified Specialists. METHODS: A comprehensive list of tests and measures was first derived from the Interactive Guide to Physical Therapist Practice. The list was finalized based on several exclusion criteria and the results of a pilot study. Subjects rated the frequency of use of 294 tests and measures with patients post-stroke on a Likert scale. RESULTS: The survey response rate was 31.7% (n = 128). The 50 most frequently used tests and measures were identified. DISCUSSION AND CONCLUSION: The results of this study do not identify the tests and measures that clinicians should use, only those that the specialists use. Nevertheless, clinicians may want to consider tests and measurements frequently used by specialists when examining adults with stroke.