Microcontroller based fibre-optic visual presentation system for multisensory neuroimaging

Presenting visual stimuli in physical 3D space during fMRI experiments carries significant technical challenges. Certain types of multisensory visuotactile experiments and visuomotor tasks require presentation of visual stimuli in peripersonal space, which cannot be accommodated by ordinary projection screens or binocular goggles. However, light points produced by a group of LEDs can be transmitted through fibre-optic cables and positioned anywhere inside the MRI scanner. Here we describe the design and implementation of a microcontroller-based programmable digital device for controlling fibre-optically transmitted LED lights from a PC. The main feature of this device is the ability to independently control the colour, brightness, and timing of each LED. Moreover, the device was designed in a modular and extensible way, which enables easy adaptation for various experimental paradigms. The device was tested and validated in three fMRI experiments involving basic visual perception, a simple colour discrimination task, and a blocked multisensory visuo-tactile task. The results revealed significant lateralized activation in occipital cortex of all participants, a reliable response in ventral occipital areas to colour stimuli elicited by the device, and strong activations in multisensory brain regions in the multisensory task. Overall, these findings confirm the suitability of this device for presenting complex fibre-optic visual and cross-modal stimuli inside the scanner.     

Seeing touch in the somatosensory cortex: a TMS study of the visual perception of touch

Recent studies suggest the existence of a visuo-tactile mirror system, comprising the primary (SI) and secondary (SII) somatosensory cortices, which matches observed touch with felt touch. Here, repetitive transcranial magnetic stimulation (rTMS) was used to determine whether SI or SII play a functional role in the visual processing of tactile events. Healthy participants performed a visual discrimination task with tactile stimuli (a finger touching a hand) and a control task (a finger moving without touching). During both tasks, rTMS was applied over either SI or SII, and to the occipital cortex. rTMS over SI selectively reduced subject performance for interpreting whether a contralateral visual tactile stimulus contains a tactile event, whereas SII stimulation impaired visual processing regardless of the tactile component. These findings provide evidence for a multimodal sensory-motor system with mirror properties, where somatic and visual properties of action converge. SI, a cortical area traditionally viewed as modality-specific, is selectively implicated in the visual processing of touch. These results are in line with the existence of a sensory mirror system mediating the embodied simulation concept.     

Somatosensory cortical activations are suppressed in patients with tactile extinction: a PET study

OBJECTIVE: To investigate whether tactile extinction alters the cortical somatosensory activations induced by hand vibration. BACKGROUND: Tactile extinction occurs mainly after right-brain lesions and consists of the inability to perceive a contralesional cutaneous stimulation when a similar stimulus is applied to the mirror region of the ipsilesional hemibody. The pathophysiology of tactile extinction is poorly understood, but it is considered to be a deficit of selective attention of somatosensory stimuli. Although other theories have been proposed, our understanding of the pathophysiology of tactile extinction may benefit from functional imaging studies. METHODS: We selected three patients with pure tactile extinction and a mainly subcortical right-brain lesion that spared the primary sensorimotor cortex (SM1). We used PET to investigate the responses to unilateral and bilateral hand vibration in SM1 and the secondary somatosensory cortical area (SII). RESULTS: During bilateral hand vibration, activation was normal in the left SM1, suppressed in the right SM1, and markedly decreased in both SII, which was consistent with the extinction of the left-hand stimulus. During unilateral left-hand vibration, the activation of the right SM1 was still markedly impaired, but the activation of both SII was normal. CONCLUSIONS: We found marked changes in the activation of cortical somatosensory areas induced by hand vibration in patients with tactile extinction. The role of selective attention in cortical activation is also examined.     

An ERP investigation on visuotactile interactions in peripersonal and extrapersonal space: evidence for the spatial rule

The spatial rule of multisensory integration holds that cross-modal stimuli presented from the same spatial location result in enhanced multisensory integration. The present study investigated whether processing within the somatosensory cortex reflects the strength of cross-modal visuotactile interactions depending on the spatial relationship between visual and tactile stimuli. Visual stimuli were task-irrelevant and were presented simultaneously with touch in peripersonal and extrapersonal space, in the same or opposite hemispace with respect to the tactile stimuli. Participants directed their attention to one of their hands to detect infrequent tactile target stimuli at that hand while ignoring tactile targets at the unattended hand, all tactile nontarget stimuli, and any visual stimuli. Enhancement of ERPs recorded over and close to the somatosensory cortex was present as early as 100 msec after onset of stimuli (i.e., overlapping with the P100 component) when visual stimuli were presented next to the site of tactile stimulation (i.e., perihand space) compared to when these were presented at different locations in peripersonal or extrapersonal space. Therefore, this study provides electrophysiological support for the spatial rule of visual-tactile interaction in human participants. Importantly, these early cross-modal spatial effects occurred regardless of the locus of attention. In addition, and in line with previous research, we found attentional modulations of somatosensory processing only to be present in the time range of the N140 component and for longer latencies with an enhanced negativity for tactile stimuli at attended compared to unattended locations. Taken together, the pattern of the results from this study suggests that visuotactile spatial effects on somatosensory processing occur prior and independent of tactile-spatial attention.     

ALE meta‐analysis reveals dissociable networks for affective and discriminative aspects of touch

Emotionally‐laden tactile stimulation—such as a caress on the skin or the feel of velvet—may represent a functionally distinct domain of touch, underpinned by specific cortical pathways. In order to determine whether, and to what extent, cortical functional neuroanatomy supports a distinction between affective and discriminative touch, an activation likelihood estimate (ALE) meta‐analysis was performed. This meta‐analysis statistically mapped reported functional magnetic resonance imaging (fMRI) activations from 17 published affective touch studies in which tactile stimulation was associated with positive subjective evaluation (n = 291, 34 experimental contrasts). A separate ALE meta‐analysis mapped regions most likely to be activated by tactile stimulation during detection and discrimination tasks (n = 1,075, 91 experimental contrasts). These meta‐analyses revealed dissociable regions for affective and discriminative touch, with posterior insula (PI) more likely to be activated for affective touch, and primary somatosensory cortices (SI) more likely to be activated for discriminative touch. Secondary somatosensory cortex had a high likelihood of engagement by both affective and discriminative touch. Further, meta‐analytic connectivity (MCAM) analyses investigated network‐level co‐activation likelihoods independent of task or stimulus, across a range of domains and paradigms. Affective‐related PI and discriminative‐related SI regions co‐activated with different networks, implicated in dissociable functions, but sharing somatosensory co‐activations. Taken together, these meta‐analytic findings suggest that affective and discriminative touch are dissociable both on the regional and network levels. However, their degree of shared activation likelihood in somatosensory cortices indicates that this dissociation reflects functional biases within tactile processing networks, rather than functionally and anatomically distinct pathways. Hum Brain Mapp 37:1308‐1320, 2016. © 2016 Wiley Periodicals, Inc.     

Working memory for vibrotactile frequencies: Comparison of cortical activity in blind and sighted individuals

In blind, occipital cortex showed robust activation to nonvisual stimuli in many prior functional neuroimaging studies. The cognitive processes represented by these activations are not fully determined, although a verbal recognition memory role has been demonstrated. In congenitally blind and sighted (10 per group), we contrasted responses to a vibrotactile one‐back frequency retention task with 5‐s delays and a vibrotactile amplitude‐change task; both tasks involved the same vibration parameters. The one‐back paradigm required continuous updating for working memory (WM). Findings in both groups confirmed roles in WM for right hemisphere dorsolateral prefrontal (DLPFC) and dorsal/ventral attention components of posterior parietal cortex. Negative findings in bilateral ventrolateral prefrontal cortex suggested task performance without subvocalization. In bilateral occipital cortex, blind showed comparable positive responses to both tasks, whereas WM evoked large negative responses in sighted. Greater utilization of attention resources in blind were suggested as causing larger responses in dorsal and ventral attention systems, right DLPFC, and persistent responses across delays between trials in somatosensory and premotor cortex. In sighted, responses in somatosensory and premotor areas showed iterated peaks matched to stimulation trial intervals. The findings in occipital cortex of blind suggest that tactile activations do not represent cognitive operations for nonverbal WM task. However, these data suggest a role in sensory processing for tactile information in blind that parallels a similar contribution for visual stimuli in occipital cortex of sighted. Hum Brain Mapp, 2010. © 2010 Wiley‐Liss, Inc.     

Functional integration within the human pain system as revealed by Granger causality

Pain is a complex experience subserved by an extended network of brain areas. However, the functional integration among these brain areas, i.e., how they interact and communicate to generate a coherent pain percept and an adequate behavioral response is largely unknown. Here, we used magnetoencephalography to investigate functional integration among pain‐related cortical activations in terms of Granger causality and compared it with tactile‐related activations. The results show causal influences of primary somatosensory cortex on secondary somatosensory cortex for tactile‐related but not for pain‐related activations, which supports the proposition of a partially parallel organization of pain processing in the human brain. Furthermore, during a simple reaction time task, the strength of causal influences between somatosensory areas but not the latencies between activations correlated significantly with the speed of reaction times. These findings show how the analysis of functional integration complements traditional analyses of electrophysiological data and provides novel and behaviorally relevant information about the organization of the human pain system. Hum Brain Mapp, 2009. © 2009 Wiley‐Liss, Inc.     

How does brain activation differ in children with unilateral cerebral palsy compared to typically developing children,during active and passive movements,and tactile stimulation? An fMRI study

The aim of the functional magnetic resonance imaging (fMRI) study was to investigate brain activation associated with active and passive movements, and tactile stimulation in 17 children with right-sided unilateral cerebral palsy (CP), compared to 19 typically developing children (TD). The active movements consisted of repetitive opening and closing of the hand. For passive movements, an MRI-compatible robot moved the finger up and down. Tactile stimulation was provided by manually stroking the dorsal surface of the hand with a sponge cotton cloth. In both groups, contralateral primary sensorimotor cortex activation (SM1) was seen for all tasks, as well as additional contralateral primary somatosensory cortex (S1) activation for passive movements. Ipsilateral cerebellar activity was observed in TD children during all tasks, but only during active movements in CP children. Of interest was additional ipsilateral SM1 recruitment in CP during active movements as well as ipsilateral S1 activation during passive movements and tactile stimulation. Another interesting new finding was the contralateral cerebellum activation in both groups during different tasks, also in cerebellar areas not primarily linked to the sensorimotor network. Active movements elicited significantly more brain activation in CP compared to TD children. In both groups, active movements displayed significantly more brain activation compared to passive movements and tactile stimulation.     

How does brain activation differ in children with unilateral cerebral palsy compared to typically developing children, during active and passive movements, and tactile stimulation? An fMRI study

The aim of the functional magnetic resonance imaging (fMRI) study was to investigate brain activation associated with active and passive movements, and tactile stimulation in 17 children with right-sided unilateral cerebral palsy (CP), compared to 19 typically developing children (TD). The active movements consisted of repetitive opening and closing of the hand. For passive movements, an MRI-compatible robot moved the finger up and down. Tactile stimulation was provided by manually stroking the dorsal surface of the hand with a sponge cotton cloth. In both groups, contralateral primary sensorimotor cortex activation (SM1) was seen for all tasks, as well as additional contralateral primary somatosensory cortex (S1) activation for passive movements. Ipsilateral cerebellar activity was observed in TD children during all tasks, but only during active movements in CP children. Of interest was additional ipsilateral SM1 recruitment in CP during active movements as well as ipsilateral S1 activation during passive movements and tactile stimulation. Another interesting new finding was the contralateral cerebellum activation in both groups during different tasks, also in cerebellar areas not primarily linked to the sensorimotor network. Active movements elicited significantly more brain activation in CP compared to TD children. In both groups, active movements displayed significantly more brain activation compared to passive movements and tactile stimulation.     

The representation of space near the body through touch and vision

This review discusses how visual and the tactile signals are combined in the brain to ensure appropriate interactions with the space around the body. Visual and tactile signals converge in many regions of the brain (e.g. parietal and premotor cortices) where multisensory input can interact on the basis of specific spatial constraints. Crossmodal interactions can modulate also unisensory visual and somatosensory cortices, possibly via feed-back projections from fronto-parietal areas. These processes enable attentional selection of relevant locations in near body space, as demonstrated by studies of spatial attention in healthy volunteers and in neuropsychological patients with crossmodal extinction. These crossmodal spatial effects can be flexibly updated taking into account the position of the eyes and the limbs, thus reflecting the spatial alignment of visuo-tactile stimuli in external space. Further, studies that manipulated vision of body parts (alien, real or fake limbs) have demonstrated that passive viewing of the body can influence the perception of somatosensory stimuli, again involving areas in the premotor and parietal cortices. Finally, we discuss how tool-use can expand the region of visuo-tactile integration in near body space, emphasizing the flexibility of this system at the single-neuron level in the monkey's parietal cortex, with corresponding multisensory effects in normals and neuropsychological patients. We conclude that visuo-tactile crossmodal links dominate the representation of near body space and that this is implemented functionally in parietal and premotor brain regions. These integration processes mediate the orienting of spatial attention and generate an efficient and flexible representation the space around the body.     

Functional connectivity between somatosensory and visual cortex in early blind humans

Crossmodal plasticity occurs when loss of input in one sensory modality leads to reorganization in brain representations of other sensory modalities. In congenital blindness the visual cortex becomes responsive to somatosensory input such as occurs during Braille reading. The route by which somatosensory information reaches the visual cortex is not known. Here, we used repetitive transcranial magnetic stimulation (rTMS) to probe the connection between primary somatosensory cortex (S1) and early visual cortex (V1 and neighboring areas), combining rTMS with positron emission tomography (PET). We applied stimulation over S1 in sighted, early blind and late blind individuals. Baseline regional cerebral blood flow in occipital cortex was highest in early blind and lowest in late blind individuals. Only the early blind group showed significant activation of early visual areas when rTMS was delivered over S1. This activation was significantly higher in early than in late blind, but not relative to sighted controls. These results are consistent with the hypothesis that tactile information may reach early visual areas in early blind humans through cortico-cortical pathways, possibly supporting enhanced tactile information processing.     

Neural substrates of tactile object recognition: an fMRI study

A functional magnetic resonance imaging (fMRI) study was conducted during which seven subjects carried out naturalistic tactile object recognition (TOR) of real objects. Activation maps, conjunctions across subjects, were compared between tasks involving TOR of common real objects, palpation of "nonsense" objects, and rest. The tactile tasks involved similar motor and sensory stimulation, allowing higher tactile recognition processes to be isolated. Compared to nonsense object palpation, the most prominent activation evoked by TOR was in secondary somatosensory areas in the parietal operculum (SII) and insula, confirming a modality-specific path for TOR. Prominent activation was also present in medial and lateral secondary motor cortices, but not in primary motor areas, supporting the high level of sensory and motor integration characteristic of object recognition in the tactile modality. Activation in a lateral occipitotemporal area associated previously with visual object recognition may support cross-modal collateral activation. Finally, activation in medial temporal and prefrontal areas may reflect a common final pathway of modality-independent object recognition. This study suggests that TOR involves a complex network including parietal and insular somatosensory association cortices, as well as occipitotemporal visual areas, prefrontal, and medial temporal supramodal areas, and medial and lateral secondary motor cortices. It confirms the involvement of somatosensory association areas in the recognition component of TOR, and the existence of a ventrolateral somatosensory pathway for TOR in intact subjects. It challenges the results of previous studies that emphasize the role of visual cortex rather than somatosensory association cortices in higher-level somatosensory cognition.     

Altered somatosensory processing in trigeminal neuralgia

Trigeminal neuralgia (TN) is a pain state characterized by intermittent unilateral pain attacks in one or several facial areas innervated by the trigeminal nerve. The somatosensory cortex is heavily involved in the perception of sensory features of pain, but it is also the primary target for thalamic input of nonpainful somatosensory information. Thus, pain and somatosensory processing are accomplished in overlapping cortical structures raising the question whether pain states are associated with alteration of somatosensory function itself. To test this hypothesis, we used functional magnetic resonance imaging to assess activation of primary (SI) and secondary (SII) somatosensory cortices upon nonpainful tactile stimulation of lips and fingers in 18 patients with TN and 10 patients with TN relieved from pain after successful neurosurgical intervention in comparison with 13 healthy subjects. We found that SI and SII activations in patients did neither depend on the affected side of TN nor differ between operated and nonoperated patients. However, SI and SII activations, but not thalamic activations, were significantly reduced in patients as compared to controls. These differences were most prominent for finger stimulation, an area not associated with TN. For lip stimulation SI and SII activations were reduced in patients with TN on the contra‐ but not on the ipsilateral side to the stimulus. These findings suggest a general reduction of SI and SII processing in patients with TN, indicating a long‐term modulation of somatosensory function and pointing to an attempt of cortical adaptation to potentially painful stimuli. Hum Brain Mapp, 2009. © 2009 Wiley‐Liss, Inc.     

Dorsal penile nerve stimulation elicits left-hemisphere dominant activation in the second somatosensory cortex

Activation of peripheral mixed and cutaneous nerves activates a distributed cortical network including the second somatosensory cortex (SII) in the parietal operculum. SII activation has not been previously reported in the stimulation of the dorsal penile nerve (DPN). We recorded somatosensory evoked fields (SEFs) to DPN stimulation from 7 healthy adults with a 122-channel whole-scalp neuromagnetometer. Electrical pulses were applied once every 0.5 or 1.5 sec to the left and right DPN. For comparison, left and right median and tibial nerves were stimulated alternatingly at 1.5-sec intervals. DPN stimuli elicited weak, early responses in the vicinity of responses to tibial nerve stimulation in the primary somatosensory cortex. Strong later responses, peaking at 107-126 msec were evoked in the SII cortices of both hemispheres, with left-hemisphere dominance. In addition to tactile processing, SII could also contribute to mediating emotional effects of DPN stimuli.     

Viewing the body prepares the brain for touch: effects of TMS over somatosensory cortex

Viewing the body can improve tactile perception. We investigated whether this could be due to a remodeling of somatosensory cortical areas during vision of the body. Single-pulse transcranial magnetic stimulation (TMS) was delivered over the primary and secondary somatosensory areas of subjects who showed clear visual-tactile enhancement while they performed a tactile grating discrimination task. Before the tactile stimulus, subjects viewed either their right index finger through a semisilvered mirror or an object reflected by the mirror and positioned to appear in the same location as the finger. In a first experiment we observed that TMS over primary somatosensory cortex significantly reduced subjects' accuracy whilst viewing the hand. No such reduction was found when subjects viewed a neutral object. In a second experiment, we disrupted the activity of primary and secondary somatosensory areas in different sessions. When stimulating the primary somatosensory cortex, a reduction in accuracy was again found while viewing the hand, but not a neutral object. TMS over secondary somatosensory cortex had no effect in any condition. Our results show that vision of the body may act at an early stage in stimulus elaboration and perception, allowing an anticipatory tuning of the neural circuits in primary somatosensory cortex that underlie tactile acuity.     

Changes in brain activation in stroke patients after mental practice and physical exercise： a functional MRI study

Mental practice is a new rehabilitation method that reters to the mental rehearsal ot motor imagery content with the goal of improving motor performance. However, the relationship between activated regions and motor recovery after mental practice training is not well understood. In this study, 15 patients who suffered a firstever subcortical stroke with neurological deficits affecting the right hand, but no significant cognitive impairment were recruited. 10 patients underwent mental practice combined with physical practice training, and 5 patients only underwent physical practice training. We observed brain activation regions after 4 weeks of training, and explored the correlation of activation changes with functional recovery of the affected hands. The results showed that, after 4 weeks of mental practice combined with physical training, the Fugl-Meyer assessment score for the affected right hand was significantly increased than that after 4 weeks of practice training alone. Functional MRI showed enhanced activation in the left primary somatosensory cortex, attenuated activation intensity in the right primary motor cortex, and enhanced right cerebellar activation observed during the motor imagery task using the affected right hand after mental practice training. The changes in brain cortical activity were related to functional recovery of the hand. Experimental findings indicate that cortical and cerebellar functional reorganization following mental practice contributed to the improvement of hand function.     

Neuromagnetic imaging of cortical oscillations accompanying tactile stimulation

We applied a new method of imaging frequency-specific changes in brain activity in humans during a finger brushing task in order to measure changes in cortical rhythms during tactile stimulation. Neuromagnetic recordings were conducted in five subjects using a whole-head MEG system during tactile stimulation of the right index finger, with or without visual feedback, and while viewing another individual's index finger being stimulated. Volumetric images of changes in source power relative to pre-stimulus baseline levels were computed with 2 mm resolution over the entire brain using a minimum-variance beamforming algorithm (synthetic aperture magnetometry). Onset of tactile stimulation produced a brief (200-300 ms) suppression of mu band (8-15 Hz) and beta band (15-30 Hz) cortical activity in the primary somatosensory and primary motor cortex, respectively, followed by a bilateral increase in beta band activity ('beta rebound') in motor cortex. This pattern of suppression/rebound was absent when subjects observed finger brushing or brushing motions without receiving stimulation. In contrast, these conditions resulted in bilateral increases in beta band activity in sensorimotor areas and decreased power in the alpha (8-12 Hz) band in primary visual areas. These results show that spatially filtered MEG provides a useful method for directly imaging the temporal sequence of changes in cortical rhythms during transient tactile stimulation, and provide evidence that observation of tactile input to another individual's hand, or object motion itself, can influence independent rhythmic activity in visual and sensorimotor cortex.     

Stability of tactile- and pain-related fMRI brain activations: an examination of threshold-dependent and threshold-independent methods

Functional MRI can be used to assess brain plasticity over time. To confidently attribute changes in activation patterns to cortical plasticity, it is important to establish the stability of cortical activation patterns. Because little is known concerning the stability of somatosensory-evoked brain responses, we assessed the reproducibility of within-subject responses in key somatosensory regions [thalamus, primary and secondary cortex (S1, S2)] to tactile and painful stimuli using threshold-dependent and threshold-independent analyses. Six subjects underwent four biweekly scanning sessions during which tactile and painful stimuli were applied to the hand. Standard thresholding and voxel counting techniques were compared with a novel threshold-independent method utilizing percent signal change within the regions of interest. Contralateral S1 and S2 were qualitatively reproducible during tactile stimulation, with overlapping activations >85% of the time. S2 was also highly reproducible during painful stimulation (88%), whereas S1 was less reproducible (44%). However, activation in the thalamus to both tactile and painful stimulation was highly variable. Ipsilateral activation was consistent within S2 but sparse within S1 and thalamus. Deactivations within ipsilateral S1 occurred 48% of the time with tactile stimuli, and 90% of the time with painful stimuli. Within contralaterally activated regions intraclass correlations (ICCs) were very high using the unthresholded method regardless of the type of stimulation, whereas much lower ICCs arose from the thresholded analyses. These data indicate that a threshold-independent analysis can produce more reproducible outcomes than a standard threshold-dependent analysis.     

Crossmodal influences in somatosensory cortex: Interaction of vision and touch

Previous research has shown that information from one sensory modality has the potential to influence activity in a different modality, and these crossmodal interactions can occur early in the cortical sensory processing stream within sensory‐specific cortex. In addition, it has been shown that when sensory information is relevant to the performance of a task, there is an upregulation of sensory cortex. This study sought to investigate the effects of simultaneous bimodal (visual and vibrotactile) stimulation on the modulation of primary somatosensory cortex (SI), in the context of a delayed sensory‐to‐motor task when both stimuli are task‐relevant. It was hypothesized that the requirement to combine visual and vibrotactile stimuli would be associated with an increase in SI activity compared to vibrotactile stimuli alone. Functional magnetic resonance imaging (fMRI) was performed on healthy subjects using a 3T scanner. During the scanning session, subjects performed a sensory‐guided motor task while receiving visual, vibrotactile, or both types of stimuli. An event‐related design was used to examine cortical activity related to the stimulus onset and the motor response. A region of interest (ROI) analysis was performed on right SI and revealed an increase in percent blood oxygenation level dependent signal change in the bimodal (visual + tactile) task compared to the unimodal tasks. Results of the whole‐brain analysis revealed a common fronto‐parietal network that was active across both the bimodal and unimodal task conditions, suggesting that these regions are sensitive to the attentional and motor‐planning aspects of the task rather than the unimodal or bimodal nature of the stimuli. Hum Brain Mapp, 2010. © 2009 Wiley‐Liss, Inc.     

Primary somatosensory cortex activation is not altered in patients with ventroposterior thalamic lesions: a PET study

BACKGROUND AND PURPOSE: We know remarkably little about the mechanisms underlying cortical activation. Such mechanisms might be better understood by studying the effect of well-localized lesions on the cortical activations in simple paradigms. METHODS: We used H(2)(15)O and positron emission tomography to measure regional cerebral blood flow (rCBF) at rest and during hand vibration in 7 patients with unilateral thalamic lesion involving the ventroposterior (VP) somatosensory thalamic relay nuclei. We compared the results with those obtained in 6 patients with thalamic lesions sparing the VP nuclei and 6 healthy controls. RESULTS: The patients with VP lesions had a selective hypoperfusion at rest in the ipsilesional primary sensorimotor cortex (SM1). This hypoperfusion was significantly correlated with the degree of contralateral somatosensory deficit. This abnormality may reflect the deafferentation of SM1 from its somatosensory thalamic input. Despite this deafferentation, the ipsilesional SM1 was normally activated by the vibration of the hypoesthetic hand. CONCLUSIONS: The fact that a lesion of the somatosensory thalamic relay nuclei alters the rCBF at rest in SM1 but not its activation by hand vibration indicates that the mechanism of cortical activation is complex, even in the case of simple sensory stimulation. In addition, a dissociation may occur between obvious neurological deficits and apparently normal activation patterns, which suggests that activation studies should be interpreted cautiously in patients with focal brain lesions.