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Functional brain activity during motor control and pain processing in chronic jaw pain
Roy, Arnaba; Wang, Wei-en; Ho, Rachel L.M.; Ribeiro-Dasilva, Margarete C.; Fillingim, Roger B; Coombes, Stephen A.
Changes in brain function in chronic pain have been studied using paradigms that deliver acute pain-eliciting stimuli or assess the brain at rest. Although motor disability accompanies many chronic pain conditions, few studies have directly assessed brain activity during motor function in individuals with chronic pain. Using chronic jaw pain as a model, we assessed brain activity during a precisely controlled grip force task and during a precisely controlled pain-eliciting stimulus on the forearm. We used multivariate analyses to identify regions across the brain whose activity together best separated the groups. We report 2 novel findings. First, although the parameters of grip force production were similar between the groups, the functional activity in regions including the prefrontal cortex, insula, and thalamus best separated the groups. Second, although stimulus intensity and pain perception were similar between the groups, functional activity in brain regions including the dorsal lateral prefrontal cortex, rostral ventral premotor cortex, and inferior parietal lobule best separated the groups. Our observations suggest that chronic jaw pain is associated with changes in how the brain processes motor and pain-related information even when the effector producing the force or experiencing the pain-eliciting stimulus is distant from the jaw. We also demonstrate that motor tasks and multivariate analyses offer alternative approaches for studying brain function in chronic jaw pain.
Biomarkers Perspective Published in Science Translational Medicine
We investigated the effect of acute levodopa administration on movement-related cortical oscillations and movement velocity in Parkinson’s disease (PD). Patients with PD on and off medication and age- and sex-matched healthy controls performed a ballistic upper limb flexion movement as fast and accurately as possible while cortical oscillations were recorded with high-density electroencephalography. Patients off medication were also studied using task-based functional magnetic resonance imaging (fMRI) using a force control paradigm. Percent signal change of functional activity during the force control task was calculated for the putamen and subthalamic nucleus (STN) contralateral to the hand tested. We found that Patients with PD off medication had an exaggerated movement-related beta-band (13–30 Hz) desynchronization in the supplementary motor area (SMA) compared to controls. In PD, spectral power in the beta-band was correlated with movement velocity. Following an acute dose of levodopa, we observed that the beta-band desynchronization in the SMA was reduced in PD, and was associated with increased movement velocity and increased voltage of agonist muscle activity. Further, using fMRI we found that the functional activity in the putamen and STN in the off medication state, was related to how responsive that cortical oscillations in the SMA of PD were to levodopa. Collectively, these findings provide the first direct evaluation of how movement-related cortical oscillations relate to movement velocity during the ballistic phase of movement in PD and demonstrate that functional brain activity in the basal ganglia pathways relate to the effects of dopaminergic medication on cortical neuronal oscillations during movement.
We are actively recruiting PhD students for the Fall 2018 semester. We use a range of systems neuroscience techniques that include functional magnetic resonance imaging (fMRI), structural MRI, diffusion imaging (DTI), electromyography (EMG), high-density electroencephalography (EEG), and pain stimulation procedures. Incoming students will work on neuroimaging studies of motor and sensory function. Projects related to human and rodent imaging are ongoing. Tuition waiver and stipend support is available through fellowships and teaching assistantships in the department of Applied Physiology and Kinesiology and T32 Training Grant in Movement Disorders and Neurorestoration. Please send vita or inquiries to either David Vaillancourt at firstname.lastname@example.org or Steve Coombes at email@example.com.
Information about our Ph.D. Program can be found here: http://hhp.ufl.edu/about/academics/phd/apk-phd-/
Progression markers of Parkinson’s disease are crucial for successful therapeutic development. Recently, a diffusion magnetic resonance imaging analysis technique using a bitensor model was introduced allowing the estimation of the fractional volume of free water within a voxel, which is expected to increase in neurodegenerative disorders such as Parkinson’s disease. Prior work demonstrated that free water in the posterior substantia nigra was elevated in Parkinson’s disease compared to controls across single- and multi-site cohorts, and increased over 1 year in Parkinson’s disease but not in controls at a single site. Here, the goal was to validate free water in the posterior substantia nigra as a progression marker in Parkinson’s disease, and describe the pattern of progression of free water in patients with a 4-year follow-up tested in a multicentre international longitudinal study of de novo Parkinson’s disease (http://www.ppmi-info.org/). The analyses examined: (i) 1-year changes in free water in 103 de novo patients with Parkinson’s disease and 49 controls; (ii) 2- and 4-year changes in free water in a subset of 46 patients with Parkinson’s disease imaged at baseline, 12, 24, and 48 months; (iii) whether 1- and 2-year changes in free water predict 4-year changes in the Hoehn and Yahr scale; and (iv) the relationship between 4-year changes in free water and striatal binding ratio in a subgroup of Parkinson’s disease who had undergone both diffusion and dopamine transporter imaging. Results demonstrated that: (i) free water level in the posterior substantia nigra increased over 1 year in de novo Parkinson’s disease but not in controls; (ii) free water kept increasing over 4 years in Parkinson’s disease; (iii) sex and baseline free water predicted 4-year changes in free water; (iv) free water increases over 1 and 2 years were related to worsening on the Hoehn and Yahr scale over 4 years; and (v) the 4-year increase in free water was associated with the 4-year decrease in striatal binding ratio in the putamen. Importantly, all longitudinal results were consistent across sites. In summary, this study demonstrates an increase over 1 year in free water in the posterior substantia nigra in a large cohort of de novo patients with Parkinson’s disease from a multi-site cohort study and no change in healthy controls, and further demonstrates an increase of free water in Parkinson’s disease over the course of 4 years. A key finding was that results are consistent across sites and the 1-year and 2-year increase in free water in the posterior substantia nigra predicts subsequent long-term progression on the Hoehn and Yahr staging system. Collectively, these findings demonstrate that free water in the posterior substantia nigra is a valid, progression imaging marker of Parkinson’s disease, which may be used in clinical trials of disease-modifying therapies.
Burciu et al. (2017)
Cervical dystonia (CD) is the most common type of focal dystonia, causing abnormal movements of the neck and head. In this study, we used noninvasive imaging to investigate the motor system of patients with CD and uncover the neural correlates of dystonic symptoms. Furthermore, we examined whether a commonly prescribed anticholinergic medication in CD has an effect on the dystonia-related brain abnormalities. Participants included 16 patients with CD and 16 healthy age-matched controls. We collected functional MRI scans during a force task previously shown to extensively engage the motor system, and diffusion and T1-weighted MRI scans from which we calculated free-water and brain tissue densities. The dystonia group was also scanned ca. 2 h after a 2-mg dose of trihexyphenidyl. Severity of dystonia was assessed pre- and post-drug using the Burke-Fahn-Marsden Dystonia Rating Scale. Motor-related activity in CD was altered relative to controls in the primary somatosensory cortex, cerebellum, dorsal premotor and posterior parietal cortices, and occipital cortex. Most importantly, a regression model showed that increased severity of symptoms was associated with decreased functional activity of the somatosensory cortex and increased activity of the cerebellum. Structural imaging measures did not differ between CD and controls. The single dose of trihexyphenidyl altered the fMRI signal in the somatosensory cortex but not in the cerebellum. Symptom severity was not significantly reduced post-treatment. Findings show widespread changes in functional brain activity in CD and most importantly that dystonic symptoms relate to disrupted activity in the somatosensory cortex and cerebellum.
Cereb Cortex. 2017 Mar 14:1-15. doi: 10.1093/cercor/bhx066. [Epub ahead of print]
A Template and Probabilistic Atlas of the Human Sensorimotor Tracts using Diffusion MRI.
Archer DB, Vaillancourt DE, Coombes SA.
The purpose of this study was to develop a high-resolution sensorimotor area tract template (SMATT) which segments corticofugal tracts based on 6 cortical regions in primary motor cortex, dorsal premotor cortex, ventral premotor cortex, supplementary motor area (SMA), pre-supplementary motor area (preSMA), and primary somatosensory cortex using diffusion tensor imaging. Individual probabilistic tractography analyses were conducted in 100 subjects using the highest resolution data currently available. Tractography results were refined using a novel algorithm to objectively determine slice level thresholds that best minimized overlap between tracts while preserving tract volume. Consistent with tracing studies in monkey and rodent, our observations show that cortical topography is generally preserved through the internal capsule, with the preSMA tract remaining most anterior and the primary somatosensory tract remaining most posterior. We combine our results into a freely available white matter template named the SMATT. We also provide a probabilistic SMATT that quantifies the extent of overlap between tracts. Finally, we assess how the SMATT operates at the individual subject level in another independent data set, and in an individual after stroke. The SMATT and probabilistic SMATT provide new tools that segment and label sensorimotor tracts at a spatial resolution not previously available.
J Neurophysiol. 2016 Nov 30:jn.00650.2016. doi: 10.1152/jn.00650.2016. [Epub ahead of print]
Automated Classification of Pain Perception using High Density Electroencephalography Data.
Misra G, Wang WE, Archer DB, Roy A, Coombes SA1.
Translating brief millisecond-long pain-eliciting stimuli to the subjective perception of pain is associated with changes in theta, alpha, beta, and gamma oscillations over sensorimotor cortex. However, when a pain-eliciting stimulus continues for minutes, regions beyond the sensorimotor cortex such as the prefrontal cortex are also engaged. Abnormalities in prefrontal cortex have been associated with chronic pain states, but conventional millisecond-long EEG paradigms do not engage prefrontal regions. In the current study we collected high-density EEG data during an experimental paradigm in which subjects experienced a 4 second low or high intensity pain-eliciting stimulus. EEG data were analyzed using independent component analyses, EEG source localization analyses, and measure projection analyses. We report three novel findings. First, an increase in pain perception was associated with an increase in gamma and theta power in a cortical region that included medial prefrontal cortex. Second, a decrease in lower beta power was associated with an increase in pain perception in a cortical region that included the contralateral sensorimotor cortex. Third, we employed machine learning for automated classification of EEG data into low and high pain classes. Theta and gamma power in the medial prefrontal region and lower beta power in the contralateral sensorimotor region served as features for classification. We found a leave-one-out cross-validation accuracy of 89.58%. Developing biological markers for pain states continues to gain traction in the literature, and our findings provide new information that advances this body of work.
Accurate motor performance may depend on the scaling of distinct oscillatory activity within the motor cortex and effective neural communication between the motor cortex and other brain areas. Oscillatory activity within the beta-band (13-30Hz) has been suggested to provide distinct functional roles for attention and sensorimotor control, yet it remains unclear how beta-band and other oscillatory activity within and between cortical regions is coordinated to enhance motor performance. We explore this open issue by simultaneously measuring high-density cortical activity and elbow flexor and extensor neuromuscular activity during ballistic movements, and manipulating error using high and low visual gain across three target distances. Compared with low visual gain, high visual gain decreased movement errors at each distance. Group analyses in 3D source-space revealed increased theta-, alpha-, and beta-band desynchronization of the contralateral motor cortex and medial parietal cortex in high visual gain conditions and this corresponded to reduced movement error. Dynamic causal modeling was used to compute connectivity between motor cortex and parietal cortex. Analyses revealed that gain affected the directionally-specific connectivity across broadband frequencies from parietal to sensorimotor cortex but not from sensorimotor cortex to parietal cortex. These new findings provide support for the interpretation that broad-band oscillations in theta, alpha, and beta frequency bands within sensorimotor and parietal cortex coordinate to facilitate accurate upper limb movement.