Olaf Steinsträter

High-Precision Neuromagnetic Study of the Functional Organization of the Human Auditory Cortex

Previous studies have proven that a dipole source analysis of the auditory evoked field is capable of providing evidence of the tonotopic organization of the human auditory cortex. To explore the nature of the estimated dipoles in greater detail, a single subject was extensively studied, and the estimated sources were registered in a three-dimensional reconstruction of the cortical surface derived from magnetic resonance images. The stimuli were 500-ms tone bursts with frequencies of 250, 500, 1,000, and 2,000 Hz (mean intensity of 60 dB SL). The total number of stimuli presented per condition was about 3,600 (36 independent experiments spread over 4 days). Using special postprocessing techniques, the relative localization accuracy could be enhanced to such an extent that differences in the dipole locations of 1 mm could be clearly distinguished. The results suggest that peak N1m (latency around 100 ms) arises from the planum temporale, whereas peak P2m (latency around 170 ms) appears to correspond to a center of activity in (or close to) Heschl’s gyrus. The tonotopic organization found for the generator of N1m was consistent with earlier studies (‘the higher the frequency the deeper the source’). However, additional findings (time dependence of the estimated sources; slightly different tonotopy obtained for field change; dependence of the estimated sources on the estimation technique) indicate that multiple areas are involved in the generation of N1m. Evidence of a frequency-dependent source location was found also for P2m.

Dehydration confounds the assessment of brain atrophy

Computerized brain volumetry has potential value for diagnosis and the follow-up evaluation of degenerative disorders. A potential pitfall of this method is the extent of physiologic variations in brain volume. The authors show that dehydration and rehydration can significantly change brain volume: lack of fluid intake for 16 hours decreased brain volume by 0.55% (SD, ±0.69), and after rehydration total cerebral volume increased by 0.72% (SD, ±0.21).

Tactile thermal oral stimulation increases the cortical representation of swallowing

BackgroundDysphagia is a leading complication in stroke patients causing aspiration pneumonia, malnutrition and increased mortality. Current strategies of swallowing therapy involve on the one hand modification of eating behaviour or swallowing technique and on the other hand facilitation of swallowing with the use of pharyngeal sensory stimulation. Thermal tactile oral stimulation (TTOS) is an established method to treat patients with neurogenic dysphagia especially if caused by sensory deficits. Little is known about the possible mechanisms by which this interventional therapy may work. We employed whole-head MEG to study changes in cortical activation during self-paced volitional swallowing in fifteen healthy subjects with and without TTOS. Data were analyzed by means of synthetic aperture magnetometry (SAM) and the group analysis of individual SAM data was performed using a permutation test.ResultsCompared to the normal swallowing task a significantly increased bilateral cortical activation was seen after oropharyngeal stimulation. Analysis of the chronological changes during swallowing suggests facilitation of both the oral and the pharyngeal phase of deglutition.ConclusionIn the present study functional cortical changes elicited by oral sensory stimulation could be demonstrated. We suggest that these results reflect short-term cortical plasticity of sensory swallowing areas. These findings facilitate our understanding of the role of cortical reorganization in dysphagia treatment and recovery.

Cortical swallowing processing in early subacute stroke

BackgroundDysphagia is a major complication in hemispheric as well as brainstem stroke patients causing aspiration pneumonia and increased mortality. Little is known about the recovery from dysphagia after stroke. The aim of the present study was to determine the different patterns of cortical swallowing processing in patients with hemispheric and brainstem stroke with and without dysphagia in the early subacute phase.MethodsWe measured brain activity by mean of whole-head MEG in 37 patients with different stroke localisation 8.2 +/- 4.8 days after stroke to study changes in cortical activation during self-paced swallowing. An age matched group of healthy subjects served as controls. Data were analyzed by means of synthetic aperture magnetometry and group analyses were performed using a permutation test.ResultsOur results demonstrate strong bilateral reduction of cortical swallowing activation in dysphagic patients with hemispheric stroke. In hemispheric stroke without dysphagia, bilateral activation was found. In the small group of patients with brainstem stroke we observed a reduction of cortical activation and a right hemispheric lateralization.ConclusionBulbar central pattern generators coordinate the pharyngeal swallowing phase. The observed right hemispheric lateralization in brainstem stroke can therefore be interpreted as acute cortical compensation of subcortically caused dysphagia. The reduction of activation in brainstem stroke patients and dysphagic patients with cortical stroke could be explained in terms of diaschisis.

Neuromagnetic source analysis using magnetic resonance images for the construction of source and volume conductor model

SummarySources of the somatosensory evoked fields (SEF) for one subject were estimated using constraints from the magnetic resonance images (MRI) of the same subject. A realistic volume conductor model was shaped corresponding to the inside of the skull. Sources were restricted to a dipole patch riding on the surface of the cortex, reconstructed from the individual MRI. Such a patch can be considered as a uniformly activated cortical area giving rise to distributed currents which flow perpendicular to the cortical surface. Source locations obtained for the SEF in response to separate stimulations of lower lip, first and fifth digit, and collarbone followed the course of the contralateral central sulcus. The order of the estimated source locations was in agreement with the somatosensory homunculus of Penfield and Rasmussen. Similar results were obtained with the simple model of a current dipole in a homogeneous sphere. In contrast, combining a current dipole model with a realistic volume conductor model was rather problematic as it overestimates the radial dipole component by an order of magnitude.

Sensitivity of Beamformer Source Analysis to Deficiencies in Forward Modeling

Beamforming approaches have recently been developed for the field of electroencephalography (EEG) and magnetoencephalography (MEG) source analysis and opened up new applications within various fields of neuroscience. While the number of beamformer applications thus increases fast‐paced, fundamental methodological considerations, especially the dependence of beamformer performance on leadfield accuracy, is still quite unclear. In this article, we present a systematic study on the influence of improper volume conductor modeling on the source reconstruction performance of an EEG‐data based synthetic aperture magnetometry (SAM) beamforming approach. A finite element model of a human head is derived from multimodal MR images and serves as a realistic volume conductor model. By means of a theoretical analysis followed by a series of computer simulations insight is gained into beamformer performance with respect to reconstruction errors in peak location, peak amplitude, and peak width resulting from geometry and anisotropy volume conductor misspecifications, sensor noise, and insufficient sensor coverage. We conclude that depending on source position, sensor coverage, and accuracy of the volume conductor model, localization errors up to several centimeters must be expected. As we could show that the beamformer tries to find the best fitting leadfield (least squares) with respect to its scanning space, this result can be generalized to other localization methods. More specific, amplitude, and width of the beamformer peaks significantly depend on the interaction between noise and accuracy of the volume conductor model. The beamformer can strongly profit from a high signal‐to‐noise ratio, but this requires a sufficiently realistic volume conductor model. Hum Brain Mapp, 2010.

Scalp position and efficacy of transcranial magnetic stimulation.

OBJECTIVE To assess the impact of the scalp site on the biological effects of TMS. METHODS We performed high-resolution, three-dimensional whole head magnetic resonance imaging (MRI) in a healthy subject, systematically measured the scalp-to-cortex distance across the head and calculated the resulting electric field in the superficial cortex. RESULTS The variability in scalp-to-cortex distance led to differences in calculated cortical electric field strengths of a factor of two. A major portion of this variability was explained by a lateral to medial gradient with scalp-to-cortex distances being greatest close to the midline and smallest towards the temporal coordinates. CONCLUSIONS Because of the medio-lateral gradient in scalp-to-cortex distance interventions tailored on the basis of effects of TMS in the motor system will systematically induce stronger than expected electric currents when performed laterally to the motor spot. SIGNIFICANCE The biological effects of TMS outside the motor spot may be markedly different from those observed in the motor system and this should be taken into account to optimize TMS for the evaluation or treatment of neuropsychiatric disorders.

Transcranial magnetic stimulation—a sandwich coil design for a better sham

OBJECTIVE To improve the quality of TMS studies by developing a new sham condition. METHODS We describe a novel and easily arranged TMS set-up of two standard TMS coils and a magnetic shield, stacked like a sandwich. In a first step we compare the magnetic field in the sham and verum conditions. In a second step we ask six subjects to rate the stimulation intensity. RESULTS The magnetic field in the sham mode is reduced to about one eighth of that during verum stimulation. The attenuation of the magnetic field is not limited to the actual stimulation site but also effective at neighbouring brain areas, avoiding direct and indirect stimulation via connected neural pathways. This also minimizes stimulation of the skin, but as a consequence allows subjects to distinguish between verum and sham conditions when these are contrasted directly. The position of the coil system and the acoustic sensations are indistinguishable between sham and verum condition. Subjects are not able to discriminate TMS position and condition by external cues. CONCLUSIONS The proposed TMS setup is simple and allows verum and sham TMS without interaction of the researcher. If used with the magnetic shield, the magnetic field in the brain is attenuated most. SIGNIFICANCE With the sandwich TMS coil system it is possible to improve the quality of TMS studies.

Rhythmic and melodic deviations in musical sequences recruit different cortical areas for mismatch detection.

The mismatch negativity (MMN), an event-related potential (ERP) representing the violation of an acoustic regularity, is considered as a pre-attentive change detection mechanism at the sensory level on the one hand and as a prediction error signal on the other hand, suggesting that bottom-up as well as top-down processes are involved in its generation. Rhythmic and melodic deviations within a musical sequence elicit a MMN in musically trained subjects, indicating that acquired musical expertise leads to better discrimination accuracy of musical material and better predictions about upcoming musical events. Expectation violations to musical material could therefore recruit neural generators that reflect top-down processes that are based on musical knowledge. We describe the neural generators of the musical MMN for rhythmic and melodic material after a short-term sensorimotor-auditory (SA) training. We compare the localization of musical MMN data from two previous MEG studies by applying beamformer analysis. One study focused on the melodic harmonic progression whereas the other study focused on rhythmic progression. The MMN to melodic deviations revealed significant right hemispheric neural activation in the superior temporal gyrus (STG), inferior frontal cortex (IFC), and the superior frontal (SFG) and orbitofrontal (OFG) gyri. IFC and SFG activation was also observed in the left hemisphere. In contrast, beamformer analysis of the data from the rhythm study revealed bilateral activation within the vicinity of auditory cortices and in the inferior parietal lobule (IPL), an area that has recently been implied in temporal processing. We conclude that different cortical networks are activated in the analysis of the temporal and the melodic content of musical material, and discuss these networks in the context of the dual-pathway model of auditory processing.

Cortical Processing of Swallowing in ALS Patients with Progressive Dysphagia – A Magnetoencephalographic Study

Amyotrophic lateral sclerosis (ALS) is a rare disease causing degeneration of the upper and lower motor neuron. Involvement of the bulbar motor neurons often results in fast progressive dysphagia. While cortical compensation of dysphagia has been previously shown in stroke patients, this topic has not been addressed in patients suffering from ALS. In the present study, we investigated cortical activation during deglutition in two groups of ALS patients with either moderate or severe dysphagia. Whole-head MEG was employed on fourteen patients with sporadic ALS using a self-paced swallowing paradigm. Data were analyzed by means of time-frequency analysis and synthetic aperture magnetometry (SAM). Group analysis of individual SAM data was performed using a permutation test. We found a reduction of cortical swallowing related activation in ALS patients compared to healthy controls. Additionally a disease-related shift of hemispheric lateralization was observed. While healthy subjects showed bilateral cortical activation, the right sensorimotor cortex was predominantly involved in ALS patients. Both effects were even stronger in the group of patients with severe dysphagia. Our results suggest that bilateral degeneration of the upper motor neuron in the primary motor areas also impairs further adjusted motor areas, which leads to a strong reduction of ‘swallowing related’ cortical activation. While both hemispheres are affected by the degeneration a relatively stronger activation is seen in the right hemisphere. This right hemispheric lateralization of volitional swallowing observed in this study may be the only sign of cortical plasticity in dysphagic ALS patients. It may demonstrate compensational mechanisms in the right hemisphere which is known to predominantly coordinate the pharyngeal phase of deglutition. These results add new aspects to our understanding of the pathophysiology of dysphagia in ALS patients and beyond. The compensational mechanisms observed could be relevant for future research in swallowing therapies.