Electrotactile BCI for Top-Down Somatosensory Training: Clinical Feasibility Trial of Online BCI Control in Subacute Stroke Patients.

This study investigates the feasibility of a novel brain-computer interface (BCI) device designed for sensory training following stroke. The BCI system administers electrotactile stimuli to the user's forearm, mirroring classical sensory training interventions. Concurrently, selective attention tasks are employed to modulate electrophysiological brain responses (somatosensory event-related potentials-sERPs), reflecting cortical excitability in related sensorimotor areas. The BCI identifies attention-induced changes in the brain's reactions to stimulation in an online manner. The study protocol assesses the feasibility of online binary classification of selective attention focus in ten subacute stroke patients. Each experimental session includes a BCI training phase for data collection and classifier training, followed by a BCI test phase to evaluate online classification of selective tactile attention based on sERP. During online classification tests, patients complete 20 repetitions of selective attention tasks with feedback on attention focus recognition. Using a single electroencephalographic channel, attention classification accuracy ranges from 70% to 100% across all patients. The significance of this novel BCI paradigm lies in its ability to quantitatively measure selective tactile attention resources throughout the therapy session, introducing a top-down approach to classical sensory training interventions based on repeated neuromuscular electrical stimulation.

Cortical Coding of Gustatory and Thermal Signals in Active Licking Mice.

Eating behaviors are influenced by the integration of gustatory, olfactory, and somatosensory signals, which all contribute to the perception of flavor. Although extensive research has explored the neural correlates of taste in the gustatory cortex (GC), less is known about its role in encoding thermal information. This study investigates the encoding of oral thermal and chemosensory signals by GC neurons compared to the oral somatosensory cortex. In this study, we recorded the spiking activity of more than 900 GC neurons and 500 neurons from the oral somatosensory cortex in mice allowed to freely lick small drops of gustatory stimuli or deionized water at varying non-nociceptive temperatures. We then developed and used a Bayesian-based analysis technique to assess neural classification scores based on spike rate and phase timing within the lick cycle. Our results indicate that GC neurons rely predominantly on rate information, although phase information is needed to achieve maximum accuracy, to effectively encode both chemosensory and thermosensory signals. GC neurons can effectively differentiate between thermal stimuli, excelling in distinguishing both large contrasts (14°C vs. 36°C) and, although less effectively, more subtle temperature differences. Finally, a direct comparison of the decoding accuracy of thermosensory signals between the two cortices reveals that while the somatosensory cortex showed higher overall accuracy, the GC still encodes significant thermosensory information. These findings highlight the GC's dual role in processing taste and temperature, emphasizing the importance of considering temperature in future studies of taste processing.

Evaluating somatosensory evoked potentials in predicting treatment outcomes for thoracolumbar spinal compression fractures using closed reduction and over-extension techniques.

OBJECTIVE: To evaluate the predictive value of somatosensory evoked potentials (SEPs) for the efficacy of closed reduction combined with over-extension reduction technique (PVP) in managing thoracolumbar spinal compression fractures. METHODS: Data were collected from 125 patients who underwent closed reduction with PVP and SEP monitoring from February 2021 to July 2023. We evaluated surgery success rates, incidence of bone cement leakage, and patient recovery outcomes including vertebral anterior height, Oswestry Disability Index (ODI), and Cobb angle restoration. SEP results were analyzed to categorize patients into effective and ineffective treatment groups. Differences in SEP waveforms between these groups were examined, and ROC analysis was used to assess the predictive value of these differences. Multivariate logistic regression was employed to identify risk factors affecting treatment efficacy. RESULTS: Post-treatment assessments showed significant improvements in vertebral anterior height, ODI, and Cobb angle. SEP monitoring correlated well with intraoperative findings and physical examinations. During reduction, changes in SEP latency and amplitude were noted in 37 patients, with 7 patients meeting SEP amplitude alarm criteria, which normalized after adjustments. During PVP, 28 patients exhibited SEP amplitude fluctuations and 5 experienced a 30% reduction in amplitude following initial cement injection, with no significant latency changes. Treatment was deemed effective in 93 patients and ineffective in 32. SEP amplitudes during vertebral compression and PVP were significantly lower in the effective group (P<0.05). The AUC for predicting treatment efficacy was 0.819 and 0.859, respectively. Multivariate analysis revealed low preoperative vertebral compression ratio, number of fractures, and abnormal SEP amplitudes as independent risk factors for treatment outcomes. CONCLUSION: SEP monitoring provides an accurate reflection of spinal cord function during closed reduction with PVP, aiding in predicting treatment safety and efficacy. The use of SEP monitoring is thus recommended for clinical application in this context.

Effectiveness of bimodal stimulation of the auditory-somatosensory system in the treatment of tonal tinnitus.

BACKGROUND AND OBJECTIVES: The dorsal cochlear nucleus (DCN) is the interaction site of auditory and somatosensory system inputs. According to the stochastic resonance theory, hearing loss increases the neural activity of the somatosensory system in the DCN and causes tinnitus. it is possible to modulate this neural hyperactivity by applying random noise through the auditory and somatosensory systems (bimodal stimulation). Therefore, this study aimed to investigate the effectiveness of the bimodal intervention based on the theory of stochastic resonance. METHODS: The study divided 34 participants into unimodal and bimodal groups with 17 subjects in each. The bimodal group received customized acoustic stimulation along with transcutaneous auricular vagus nerve stimulation (tAVNS) and the unimodal group received customized acoustic stimulation along with tAVNS as a sham. The treatment sessions in both groups were 6 sessions and each session lasted for 20 min. The participants were evaluated before, immediately after, and one month after the completion of the intervention sessions, using the Tinnitus Handicap Inventory (THI) questionnaire and the mismatch negativity (MMN) test. RESULTS: After the intervention sessions, the results indicated a statistically significant decrease in THI scores and a significant increase in the MMN amplitude in the bimodal group compared to the unimodal group. No significant changes in MMN latency were observed between the two groups. These changes were stable in the one-month follow-up visit. CONCLUSIONS: Our study showed that bimodal stimulation is a better intervention option compared to unimodal stimulation. Bimodal stimulation may be an effective intervention method for some subjects with tinnitus, especially people with hearing loss who have tonal tinnitus.

Mechanical and cold polymodality coexist in tactile peripheral afferents, and it's not mediated by TRPM8.

In the mammalian somatosensory system, polymodality is defined as the competence of some neurons to respond to multiple forms of energy (e.g., mechanical and thermal). This ability is thought to be an exclusive property of nociceptive neurons (polymodal C-fiber nociceptors) and one of the pillars of nociceptive peripheral plasticity. The current study uncovered a completely different neuronal sub-population with polymodal capabilities on the opposite mechanical modality spectrum (tactile). We have observed that several tactile afferents (1/5) can respond to cold in non-nociceptive ranges. These cells' mechanical thresholds and electrical properties are similar to any low-threshold mechano-receptors (LT), conducting in a broad range of velocities (Aδ to Aß), lacking CGRP and TRPM8 receptors. Due to its density, cold-response range, speed, and response to injury (or lack thereof), we speculate on its role in controlling reflexive behaviors (wound liking and rubbing) and modulation of nociceptive spinal cord integration. Further studies are required to understand the mechanisms behind this neuron's polymodality, central architecture, and impact on pain perception.

Role of proprioception in corrective visually-guided movements: larger movement errors in both arms of a deafferented individual compared to control participants.

Proprioception plays an important role in both feedforward and feedback processes underlying movement control. This has been shown with individuals who suffered a profound proprioceptive loss and use vision to partially compensate for the sensory loss. The purpose of this study was to specifically examine the role of proprioception in feedback motor responses to visual perturbations by examining voluntary arm movements in an individual with a rare case of selective peripheral deafferentation (GL). We compared her left and right hand movements with those of age-matched female control participants (70.0 years ± 0.2 SEM) during a reaching task. Participants were asked to move their unseen hand, represented by a cursor on the screen, quickly and accurately to reach a visual target. A visual perturbation could be pseudorandomly applied, at movement onset, to either the target position (target jump) or the cursor position (cursor jump). Results showed that despite the continuous visual feedback that was provided, GL produced larger errors in final position accuracy compared to control participants, with her left nondominant hand being more erroneous after a cursor jump. We also found that the proprioceptively-deafferented individual produced less spatially efficient movements than the control group. Overall, these results provide evidence of a heavier reliance on proprioceptive feedback for movements of the nondominant hand relative to the dominant hand, supporting the view of a lateralization of the feedback processes underlying motor control.

Usefulness of somatosensory evoked potentials for monitoring the clinical course of patients with chronic inflammatory demyelinating polyradiculoneuropathy.

INTRODUCTION/AIMS: Somatosensory evoked potentials (SSEPs) are described as a supportive tool to diagnose chronic inflammatory demyelinating polyradiculoneuropathy (CIDP); however, there is a lack of studies determining the effectiveness of SSEPs in monitoring the clinical course of individuals with this condition. The aims of this study are to evaluate the utility of SSEPs in monitoring patients with CIDP and to assess their association with clinical outcomes following immunomodulatory therapy. METHODS: This was a single-center retrospective observational study that included patients who met European Federation of Neurological Societies and Peripheral Nerve Society criteria for CIDP between 2018 and 2023. SSEPs were performed at diagnosis and during follow-up after the start of immunomodulatory treatment. Fisher's exact test was employed to assess the association between clinical improvement and SSEP improvement. RESULTS: Eighteen patients were included in the study. Ten patients had a typical CIDP pattern and 11 were male. In 17, SSEPs were abnormal prior to the start of immunomodulatory treatment. In patients who showed clinical improvement with immunomodulatory therapy, we observed that 15/17 had partial or complete improvement in SSEPs. Patients who showed no clinical improvement with first-line treatment exhibited worsening SSEPs. There was a significant association between clinical and SSEPs improvement (p = 0.009). DISCUSSION: We observed a positive association between improvement in SSEPs and clinical improvement in patients with CIDP. Our data suggest that SSEPs may be useful for monitoring the clinical course of patients with CIDP, but additional, larger studies are needed.

Goal-directed learning is multidimensional and accompanied by diverse and widespread changes in neocortical signaling.

New tasks are often learned in stages with each stage reflecting a different learning challenge. Accordingly, each learning stage is likely mediated by distinct neuronal processes. And yet, most rodent studies of the neuronal correlates of goal-directed learning focus on individual outcome measures and individual brain regions. Here, we longitudinally studied mice from naïve to expert performance in a head-fixed, operant conditioning whisker discrimination task. In addition to tracking the primary behavioral outcome of stimulus discrimination, we tracked and compared an array of object-based and temporal-based behavioral measures. These behavioral analyses identify multiple, partially overlapping learning stages in this task, consistent with initial response implementation, early stimulus-response generalization, and late response inhibition. To begin to understand the neuronal foundations of these learning processes, we performed widefield Ca2+ imaging of dorsal neocortex throughout learning and correlated behavioral measures with neuronal activity. We found distinct and widespread correlations between neocortical activation patterns and various behavioral measures. For example, improvements in sensory discrimination correlated with target stimulus evoked activations of response-related cortices along with distractor stimulus evoked global cortical suppression. Our study reveals multidimensional learning for a simple goal-directed learning task and generates hypotheses for the neuronal modulations underlying these various learning processes.

Somatosensory processing in long COVID fatigue and its relations with physiological and psychological factors.

Fatigue is prevalent amongst people with long COVID, but is poorly understood. The sensory attenuation framework proposes that impairments in sensory processing lead to heightened perception of effort, driving fatigue. This study aims to investigate the role of somatosensory processing impairments in long COVID fatigue and quantify how sensory processing relates to other prominent symptoms of long COVID including autonomic dysfunction, mood and illness beliefs in driving the experience of fatigue. We will recruit 44 individuals with long COVID fatigue and 44 individuals with neither long COVID nor fatigue (controls). Our primary objective is to compare baseline somatosensory processing between individuals with long COVID fatigue and controls. Additionally, we will explore the associations between somatosensory processing, fatigability and the level of fatigue induced by cognitive and physical exertion. Due to the complex nature of fatigue, we will also investigate how long COVID, state fatigue, perceived effort, mood, illness beliefs, autonomic symptoms and autonomic nervous system function interact to predict trait fatigue. This comprehensive investigation aims to elucidate how sensory processing and other prominent symptoms interact to impact the experience of fatigue.

Volume electron microscopy analysis of synapses in primary regions of the human cerebral cortex.

Functional and structural studies investigating macroscopic connectivity in the human cerebral cortex suggest that high-order associative regions exhibit greater connectivity compared to primary ones. However, the synaptic organization of these brain regions remains unexplored. In the present work, we conducted volume electron microscopy to investigate the synaptic organization of the human brain obtained at autopsy. Specifically, we examined layer III of Brodmann areas 17, 3b, and 4, as representative areas of primary visual, somatosensorial, and motor cortex. Additionally, we conducted comparative analyses with our previous datasets of layer III from temporopolar and anterior cingulate associative cortical regions (Brodmann areas 24, 38, and 21). 9,690 synaptic junctions were 3D reconstructed, showing that certain synaptic characteristics are specific to particular regions. The number of synapses per volume, the proportion of the postsynaptic targets, and the synaptic size may distinguish one region from another, regardless of whether they are associative or primary cortex. By contrast, other synaptic characteristics were common to all analyzed regions, such as the proportion of excitatory and inhibitory synapses, their shapes, their spatial distribution, and a higher proportion of synapses located on dendritic spines. The present results provide further insights into the synaptic organization of the human cerebral cortex.

Transformation of neural coding for vibrotactile stimuli along the ascending somatosensory pathway.

In mammals, action potentials fired by rapidly adapting mechanosensitive afferents are known to reliably time lock to the cycles of a vibration. How and where along the ascending neuraxis is the peripheral afferent temporal code transformed into a rate code are currently not clear. Here, we probed the encoding of vibrotactile stimuli with electrophysiological recordings along major stages of the ascending somatosensory pathway in mice. We discovered the main transformation step was identified at the level of the thalamus, and parvalbumin-positive interneurons in thalamic reticular nucleus participate in sharpening frequency selectivity and in disrupting the precise spike timing. When frequency-specific microstimulation was applied within the brainstem, it generated frequency selectivity reminiscent of real vibration responses in the somatosensory cortex and could provide informative and robust signals for learning in behaving mice. Taken together, these findings could guide biomimetic stimulus strategies to activate specific nuclei along the ascending somatosensory pathway for neural prostheses.

Altered somatosensory processing in adult attention deficit hyperactivity disorder.

BACKGROUND: Tactile sensitivity and sensory overload in ADHD are well-documented in clinical-, self-, and parent- reports, but empirical evidence is scarce and ambiguous and focuses primarily on children. Here, we compare both empirical and self-report tactile sensitivity and ADHD symptomatology in adults with ADHD and neurotypical controls. We evaluate whether tactile sensitivity and integration is more prevalent in ADHD and whether it is related to ADHD symptom severity. METHODS: Somatosensory evoked potential (SEP) amplitudes were measured in 27 adults with ADHD and 24 controls during four conditions (rest, stroking of the own arm, stroking of the arm by a researcher, and stroking of an object). Participants also filled out questionnaires on tactile sensitivity and ADHD symptoms and performed a Qb-test as an objective measure of ADHD symptom severity. RESULTS: Participants with ADHD self-reported greater tactile sensitivity and ADHD symptom severity than controls and received higher scores on the Qb-test. These values correlated with one another. ADHD participants showed lower tolerable threshold for electrical radial nerve stimulus, and greater reduction in cortical SEP amplitudes during additional tactile stimuli which was correlated with ADHD symptoms. CONCLUSIONS: We find that ADHD symptomatology and touch sensitivity are directly linked, using both self-reports and experimental measures. We also find evidence of tactile sensory overload in ADHD, and an indication that this is linked to inattention specifically. Tactile sensitivity and sensory overload impact the functioning and life quality of many people with ADHD, and clinicians should consider this when treating their patients.

CutFEM-based MEG forward modeling improves source separability and sensitivity to quasi-radial sources: A somatosensory group study.

Source analysis of magnetoencephalography (MEG) data requires the computation of the magnetic fields induced by current sources in the brain. This so-called MEG forward problem includes an accurate estimation of the volume conduction effects in the human head. Here, we introduce the Cut finite element method (CutFEM) for the MEG forward problem. CutFEM's meshing process imposes fewer restrictions on tissue anatomy than tetrahedral meshes while being able to mesh curved geometries contrary to hexahedral meshing. To evaluate the new approach, we compare CutFEM with a boundary element method (BEM) that distinguishes three tissue compartments and a 6-compartment hexahedral FEM in an n = 19 group study of somatosensory evoked fields (SEF). The neural generators of the 20 ms post-stimulus SEF components (M20) are reconstructed using both an unregularized and a regularized inversion approach. Changing the forward model resulted in reconstruction differences of about 1 centimeter in location and considerable differences in orientation. The tested 6-compartment FEM approaches significantly increase the goodness of fit to the measured data compared with the 3-compartment BEM. They also demonstrate higher quasi-radial contributions for sources below the gyral crowns. Furthermore, CutFEM improves source separability compared with both other approaches. We conclude that head models with 6 compartments rather than 3 and the new CutFEM approach are valuable additions to MEG source reconstruction, in particular for sources that are predominantly radial.

Spatial sensorimotor mismatch between the motor command and somatosensory feedback decreases motor cortical excitability. A transcranial magnetic stimulation-virtual reality study.

Effective control of movement predominantly depends on the exchange and integration between sensory feedback received by our body and motor command. However, the precise mechanisms governing the adaptation of the motor system's response to altered somatosensory signals (i.e., discrepancies between an action performed and feedback received) following movement execution remain largely unclear. In order to address these questions, we developed a unique paradigm using virtual reality (VR) technology. This paradigm can induce spatial incongruence between the motor commands executed by a body district (i.e., moving the right hand) and the resulting somatosensory feedback received (i.e., feeling touch on the left ankle). We measured functional sensorimotor plasticity in 17 participants by assessing the effector's motor cortical excitability (right hand) before and after a 10-min VR task. The results revealed a decrease in motor cortical excitability of the movement effector following exposure to a 10-min conflict between the motor output and the somatosensory input, in comparison to the control condition where spatial congruence between the moved body part and the area of the body that received the feedback was maintained. This finding provides valuable insights into the functional plasticity resulting from spatial sensorimotor conflict arising from the discrepancy between the anticipated and received somatosensory feedback following movement execution. The cortical reorganization observed can be attributed to functional plasticity mechanisms within the sensorimotor cortex that are related to establishing a new connection between somatosensory input and motor output, guided by temporal binding and the Hebbian plasticity rule.

Visual effects on tactile stimulation and its perception: A pilot study using near-infrared spectroscopy.

In rubber hand illusion, visual information affects tactile information, whereas in the mirror box illusion, visual information has the opposite effect. However, its underlying mechanisms are not fully understood. As one of the reasons, non-invasive neuroimaging techniques, such as functional magnetic resonance, positron emission tomography, and electroencephalography, often fail to detect complex and fragile responses in the sensory-motor cortex. Using near-infrared spectroscopy (NIRS), we examined neural activity during tactile tracing on a sine-shaped acrylic board to investigate the effects of (1) visual information and (2) the spatial frequency of the sine shape on brain activity. We used spatial frequencies of 2-3 and 20-30 Hz as low- and high-tactile stimuli, respectively. Two types of experiments, with and without an acrylic board, were conducted. Participants performed the tracing tasks with their index finger at 1 Hz of temporal frequency of a 200 mm length of the acrylic board as main tasks and only space moving without touching as a control task. We show effect of visual information on neural activation, including not only activation intensity but also activation patterns.•Testing of mutual effects of vision and haptics.•Testing of sensory-motor paradox using NIRS.•A high NIRS sensitivity to stimulus-induced hemodynamic change.

The safety and utility of the semi-sitting position for clipping of posterior circulation aneurysms.

BACKGROUND: The semi-sitting position offers advantages for surgeries in the posterior cranial fossa. However, data on its safety and effectiveness for clipping aneurysms in the posterior cerebral circulation are limited. This retrospective cohort study evaluates the safety and effectiveness of using the semi-sitting position for these surgeries. METHODS: We conducted a retrospective study of 17 patients with posterior cerebral circulation aneurysms who underwent surgical clipping in the semi-sitting position in the Department of Neurosurgery at Hannover Medical School over a 10-year period. RESULTS: The mean age at surgery was 62 years (range, 31 to 75). Fourteen patients were admitted with subarachnoid hemorrhage and 3 patients had incidental aneurysmas. Fifteen patients had PICA aneurysms, and two had aneurysms of the vertebral artery and the superior cerebellar artery, respectively. The median diameter of the aneurysms was 5 mm (range 3-17 mm). Intraoperative venous air embolism (VAE) occurred in 4 patients, without affecting the surgical or clinical course. VAE was associated with a mild decrease of EtCO2 levels in 3 patients and in 2 patients a decrease of blood pressure occurred which was managed effectively. Surgical procedures proceeded as planned in all instances. There were no complications secondary to VAE. Two patients died secondary to respiratory problems (not related to VAE), and one patient was lost to follow-up. Eleven of fourteen patients were partially or completely independent (Barthel index between 60 and 100) at a median follow-up duration of 13.5 months (range, 3-103 months). CONCLUSION: The semi-sitting position is a safe and effective technique for the surgical clipping of aneurysms in the posterior cerebral circulation. The incidence of VAE is comparable to that seen in tumor surgery. However, it is crucial for the surgical and anesthesiological team to be familiar with potential complications and to react immediately in case of an occurrence of VAE.

Amelioration of behavioral and histological impairments in somatosensory cortex injury rats by limbal mesenchymal stem cell transplantation.

Introduction: Cortical lesions can cause major sensory and motor impairments, representing a significant challenge in neuroscience and clinical medicine. Limbal mesenchymal stem cells (LMSCs), renowned for their remarkable ability to proliferate and distinct characteristics within the corneal epithelium, offer a promising opportunity for regenerative treatments. This study aimed to assess whether the transplantation of LMSCs could improve tactile ability in rats with lesions of the barrel cortex. Methods: In this experimental study, we divided 21 rats into three groups: a control group, a lesion group with cortical cold lesion induction but no stem cell treatment, and a group receiving LMSC transplantation following cold lesion induction. We conducted 3-week sensory assessments using a texture discrimination test and an open-field test. We also performed Nissl staining to assess changes on the cellular level. Results: Rats in the LMSC transplantation group demonstrated significant improvements in their ability to discrimination textures during the second and third weeks compared to those in the lesion group. The open-field test results showed an increased exploratory behavior of rats in the LMSC transplantation group by the third week compared to the lesion group. Additionally, Nissl staining revealed cellular alterations in the damaged cortex, with a significant distinction observed between rats in the LMSCs and lesion group. Conclusion: The findings suggest that LMSC transplantation enhances sensory recovery in rats with cortical lesions, particularly their ability to discriminate textures. LMSC transplantation benefits brain tissue reparation after a cold lesion on the somatosensory cortex.

Performance of the ERC/ESICM-recommendations for neuroprognostication after cardiac arrest: Insights from a prospective multicenter cohort.

AIM: To investigate the performance of the 2021 ERC/ESICM-recommended algorithm for predicting poor outcome after cardiac arrest (CA) and potential tools for predicting neurological recovery in patients with indeterminate outcome. METHODS: Prospective, multicenter study on out-of-hospital CA survivors from 28 ICUs of the AfterROSC network. In patients comatose with a Glasgow Coma Scale motor score ≤3 at ≥72 h after resuscitation, we measured: (1) the accuracy of neurological examination, biomarkers (neuron-specific enolase, NSE), electrophysiology (EEG and SSEP) and neuroimaging (brain CT and MRI) for predicting poor outcome (modified Rankin scale score ≥4 at 90 days), and (2) the ability of low or decreasing NSE levels and benign EEG to predict good outcome in patients whose prognosis remained indeterminate. RESULTS: Among 337 included patients, the ERC-ESICM algorithm predicted poor neurological outcome in 175 patients, and the positive predictive value for an unfavourable outcome was 100% [98-100]%. The specificity of individual predictors ranged from 90% for EEG to 100% for clinical examination and SSEP. Among the remaining 162 patients with indeterminate outcome, a combination of 2 favourable signs predicted good outcome with 99[96-100]% specificity and 23[11-38]% sensitivity. CONCLUSION: All comatose resuscitated patients who fulfilled the ERC-ESICM criteria for poor outcome after CA had poor outcome at three months, even if a self-fulfilling prophecy cannot be completely excluded. In patients with indeterminate outcome (half of the population), favourable signs predicted neurological recovery, reducing prognostic uncertainty.

Modulation of cortical representations of sensory and contextual information underlies aversive associative learning.

Cortical neurons encode both sensory and contextual information, yet it remains unclear how experiences modulate these cortical representations. Here, we demonstrate that trace eyeblink conditioning (TEC), an aversive associative-learning paradigm linking conditioned (CS) with unconditioned stimuli (US), finely tunes cortical coding at both population and single-neuron levels. Initially, we show that the primary somatosensory cortex (S1) is necessary for TEC acquisition, as evidenced by local muscimol administration. At the population level, TEC enhances activity in a small subset (∼20%) of CS- or US-responsive primary neurons (rPNs) while diminishing activity in non-rPNs, including locomotion-tuned or unresponsive PNs. Crucially, TEC learning modulates the encoding of sensory versus contextual information in single rPNs: CS-responsive neurons become less responsive, while US-responsive neurons gain responses to CS. Moreover, we find that the cholinergic pathway, via nicotinic receptors, underlies TEC-induced modulations. These findings suggest that experiences dynamically tune cortical representations through cholinergic pathways.

Cervicogenic Somatic Tinnitus: A Narrative Review Exploring Non-otologic Causes.

Cervicogenic somatic tinnitus (CST) is a subgroup of somatosensory tinnitus that arises from altered sensory input from the cervical spine due to changes in anatomical and physiological functions. Unlike primary tinnitus, usually caused by auditory system issues, CST is due to somatosensory disruptions from the cervical region. Conditions such as degenerative disc disease, cervical spondylosis, whiplash injuries, and neck muscle stress or spasms are commonly associated with CST. The pathophysiology of CST involves complex interactions between the cervical spine's somatosensory inputs and central auditory pathways, particularly affecting the dorsal cochlear nucleus (DCN) in the brainstem, leading to enhanced excitability and synaptic reorganization, giving rise to tinnitus. Accurate diagnosis and management of CST require a comprehensive approach, including patient history, physical examination, audiological assessments, and imaging studies. Treatment strategies encompass physical therapy, medications, interventional procedures, and complementary therapies, aiming to reduce tinnitus perception, alleviate neck dysfunction, and improve overall quality of life. Emerging therapies, such as neuromodulation and regenerative medicine, show promise in further improving CST management. This multidisciplinary approach highlights the importance of addressing both musculoskeletal and auditory health in the effective treatment of CST.