Previous research has established that observing another in pain activates both affective and sensorimotor cortical activity that is also present during the first-hand experience of pain. Some researchers have taken this “mirroring” response as indicative of empathic processing. However, very little work has explored the downstream behavioral effects of empathic pain observation. The aim of this dissertation is to begin to fill this gap in the literature by exploring the relationship between empathic pain observation, overt motor behaviours, and sensorimotor activity. In chapters 2-4, I provide robust evidence that observing pain inflicted on another person leads to faster reaction time responses. This effect is shown to be temporally extended (by at least 500ms after pain observation), effector-general (affecting both finger and foot responses), influenced by top-down (i.e., instructions to explicitly empathize) but not bottom-up (i.e., the perceived level of pain) factors, and is not influenced by adaptive (approach/withdraw) behaviours. In chapter 5, I show that sensorimotor activity, measured via TMS-induced Motor Evoked Potentials, increases while observing another in pain regardless whether the observer is preparing to make an action vs. passively observing the stimuli. These results run counter to the literature, and I provide several explanations for why these results were found. Lastly, in chapter 6, I show that sensorimotor activity, measured via Mu and Beta suppression, also increases while observing another in pain regardless whether the observer is preparing to make an action vs. passively observing the stimuli. Interestingly, I do not find significant correlations between sensorimotor activity during pain observation and faster reaction times after pain observation. I embed these findings in relation to the wider social neuroscience of empathy literature and discuss several limitations and challenges in empirically measuring “empathy” as a psychological construct. Overall, this dissertation furthers our understanding of empathy for pain by highlighting the behavioural consequences of pain observation and its connection (or rather, lack thereof) to sensorimotor activity during pain observation. / Thesis / Doctor of Philosophy (PhD) / Past research suggests that overlapping brain activity during the first-hand experience of pain and pain observation may be indicative of empathy. However, very little work has been done to explore how pain observation influences overt behaviours. This thesis investigates this issue by having participants complete a reaction time task while watching videos of needles stabbing a person’s hand. The findings reported in this thesis suggests that observing another in pain facilitates motor behaviours (i.e., faster reaction times); this facilitation extends 500ms after pain observation, affects both the hand and feet, is accentuated by instructing participants to explicitly empathize, and is not influenced by approach vs. withdraw movements. Brain activity in the motor system was also found to increase during pain observation. Overall, this thesis begins the discussion of how empathic pain observation influences explicit motor behaviours, and how such behaviours may be related to brain activity.

No / The right temporoparietal cortex plays a critical role in body representation. Here, we applied repetitive transcranial magnetic stimulation (rTMS) over right extrastriate body area (EBA) and temporoparietal junction (TPJ) to investigate their causative roles in perceptual representations of one's own and others' body. Healthy women adjusted size-distorted pictures of their own body or of the body of another person according to how they perceived the body (subjective task) or how others perceived it (intersubjective task). In keeping with previous reports, at baseline, we found an overall underestimation of body size. Crucially, EBA-rTMS increased the underestimation bias when participants adjusted the images according to how others perceived their own or the other woman's body, suggesting a specific role of EBA in allocentric body representations. Conversely, TPJ-rTMS increased the underestimation bias when participants adjusted the body of another person, either a familiar other or a close friend, in both subjective and intersubjective tasks, suggesting an involvement of TPJ in representing others' bodies. These effects were body-specific, since no TMS-induced modulation was observed when participants judged a familiar object. The results suggest that right EBA and TPJ play active and complementary roles in the complex interaction between the perceptions of one's own and other people's body.

Post-traumatic stress disorder (PTSD) is a highly debilitating mental illness that is incited by various types of trauma and causes core symptoms of re-experiencing, hyperarousal, avoidance of trauma-related stimuli, and negative cognition and mood. It is accompanied by functional, social, and occupational impairment, as well as higher risks of medical comorbidities and mortality. Estimates indicate that PTSD affects 3.9% of the global population, and 7-9% of the US population, with only 50% of those with persistent PTSD treatment-seeking. The gold standard of PTSD treatment is prolonged exposure therapy and cognitive processing theory, with the addition of antidepressants; however, dropout rates are high likely due to the adverse effects of worsening re-experiencing of trauma and exacerbating behaviors of avoidance. As a result, alternative therapies such as transcranial magnetic stimulation (TMS) represent more tolerable treatment options. Historically, literature on TMS is promising for its low risk of side effects and efficacy, but there is no general consensus on treatment-specific targets, frequency of treatment delivery, or long-term efficacy. This proposed study will evaluate the use of neuroimaging guided intermittent theta burst stimulation, a form of TMS, for core PTSD symptom reduction and its efficacy up to one year in duration to potentially reduce the morbidity and mortality sequelae of PTSD.

No / In this report, we evaluate the role of visual areas responsive to motion in the human brain in the perception of stimulus speed. We first identified and localized V1, V3A, and V5/MT+ in individual participants on the basis of blood oxygenation level-dependent responses obtained in retinotopic mapping experiments and responses to moving gratings. Repetitive transcranial magnetic stimulation (rTMS) was then used to disrupt the normal functioning of the previously localized visual areas in each participant. During the rTMS application, participants were required to perform delayed discrimination of the speed of drifting or spatial frequency of static gratings. The application of rTMS to areas V5/MT and V3A induced a subjective slowing of visual stimuli and ( often) caused increases in speed discrimination thresholds. Deficits in spatial frequency discrimination were not observed for applications of rTMS to V3A or V5/MT+. The induced deficits in speed perception were also specific to the cortical site of TMS delivery. The application of TMS to regions of the cortex adjacent to V5/MT and V3A, as well as to area V1, produced no deficits in speed perception. These results suggest that, in addition to area V5/MT+, V3A plays an important role in a cortical network that underpins the perception of stimulus speed in the human brain. / BBSRC

付記する学位プログラム名: 京都大学卓越大学院プログラム「メディカルイノベーション大学院プログラム」 / 京都大学 / 新制・課程博士 / 博士(人間健康科学) / 甲第25541号 / 人健博第125号 / 新制||人健||9(附属図書館) / 京都大学大学院医学研究科人間健康科学系専攻 / (主査)教授 緑川 光春, 教授 市橋 則明, 教授 荒川 芳輝 / 学位規則第4条第1項該当 / Doctor of Human Health Sciences / Kyoto University / DFAM

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This thesis describes a series of experiments in human observers using neurophysiological and behavioural approaches to investigate the effects of varying haptic stimuli, attentional demand and age on motor control and perception during haptic sensing (i.e., using the hand to seek sensory information by touch). In Experiments I-IV, transcranial magnetic stimulation (TMS) was used to explore changes in corticomotor excitability when participants were actively engaged in haptic sensing tasks. These studies showed that corticospinal excitability, as reflected in motor evoked potential (MEP) amplitude, was greatly enhanced when participants were engaged in different forms of haptic sensing. Interestingly, this extra corticomotor facilitation was absent when participants performed finger movements without haptic sensing or when attention was diverted away from haptic input by a concurrent cognitive task (Exp I). This provided strong evidence that the observed corticomotor facilitation was likely central in origin and related to haptic attention. Neuroimaging has shown activation of the parieto-frontal network likely subserves this aspect of haptic perception. Further, this haptic-specific corticomotor facilitation was finely modulated depending on whether participants focused attention on identifying material (texture) as opposed to geometric properties of scanned surfaces (Exp II). With regards to aging effects, haptic-related corticomotor facilitation was associated with higher recognition accuracy in seniors (Exp III). In line with this, seniors exhibited similar levels of haptic-related corticomotor facilitation to young adults when task demands were adjusted for age (Exp IV). Interestingly, both young and senior adults also showed substantial corticomotor facilitation in the ‘resting’ hand when the ipsilateral hand was engaged in haptic sensing (Exp IV). Simply touching the stimulus without being required to identify its properties (no attentional task demands) produced no extra corticomotor facilitation in either hand or age group, attesting again to the specificity of the effects with regards to haptic attention. In Experiments V-VI, the ability to recognise 2-D letters by touch was investigated using kinematic and psychophysical measures. In Experiment V, we characterized how age affected contact forces deployed at the fingertip. This investigation showed that older adults exhibited lower normal force and increased letter-to-letter variability in normal force when compared to young adults. This difference in contact force likely contributed to longer contact times and lower recognition accuracy in older adults, suggesting a central contribution to age-related declines in haptic perception. Consistent with this interpretation, Experiment VI showed that haptic letter recognition in older adults was characterized not only by lower recognition accuracy but also by substantial increases in response times and specific patterns of confusion between letters. All in all, these investigations highlight the critical interaction of central factors such as attentional demand with aging effects on motor and perceptual aspects of haptic sensing. Of particular significance is the clear demonstration that corticomotor excitability is greatly enhanced when a haptic sensing component (i.e., attending to specific haptic features) is added to simple finger movements performed at minimal voluntary effort levels (typically <15 % of the maximal effort). These observations underline the therapeutic potential of active sensory training strategies based on haptic sensing tasks for the re-education of motor and perceptual deficits in hand function (e.g., subsequent to a stroke). The importance of adjusting attentional demands and stimuli is highlighted, particularly with regards to special considerations in the aging population.

No description available.

Résumé : INTRODUCTION : Le rappel de douleurs passées est souvent inexact. Ce phénomène, connu sous le nom de biais mnémonique, pourrait être lié au développement de certaines douleurs chroniques. Dans une étude précédente, notre laboratoire a montré, grâce à l’électroencéphalographie, que l’activité du gyrus temporal supérieur (GTS) était positivement corrélée à l’exagération des rappels douloureux. L’objectif de cette étude était de confirmer si l’activité cérébrale du GTS est impliquée causalement dans le phénomène du biais mnémonique. MÉTHODES : Dans cette étude randomisée à double insu, la stimulation magnétique transcrânienne (TMS) fut utilisée pour perturber temporairement l’activité du GTS (paradigme de lésion virtuelle). Les participants étaient assignés aléatoirement au groupe contrôle (TMS simulée, n = 21) ou au groupe expérimental (TMS réelle, n = 21). L’intensité et l’aspect désagréable de la douleur ont été évalués grâce à des échelles visuelles analogues (ÉVA; 0 à 10) immédiatement après l’événement douloureux (stimulations électriques du nerf sural droit) et au rappel, 2 mois plus tard. L’exactitude du rappel douloureux fut calculée en soustrayant l’ÉVA au rappel de l’ÉVA initiale. RÉSULTATS : Le biais mnémonique de l’intensité de la douleur était similaire dans les deux groupes (contrôle = -0,3, expérimental = 0,0; p = 0,83) alors que le biais mnémonique de l’aspect désagréable de la douleur était significativement inférieur dans le groupe expérimental (contrôle = 1.0, expérimental = -0,4; p < 0,05). CONCLUSION : Nos résultats suggèrent que le GTS affecte spécifiquement nos souvenirs liés à l’aspect motivo-affectif de la douleur. Étant donné le lien entre l’exagération des souvenirs douloureux et la persistance de la douleur, l’inhibition du GTS pourrait être une avenue intéressante pour prévenir le développement de douleur chronique. / Abstract : INTRODUCTION: Pain memories are often inaccurate. This phenomenon, known as the mnemonic pain bias, could be related to the development of chronic pain. In a past study, our research team showed, using electroencephalography, that the activity of the superior temporal gyrus (STG) was positively correlated to the exaggeration of pain recall. The aim of this study was to confirm that the STG is causally involved in the pain mnemonic bias. METHODS: In this randomised double-blind study, single-pulse transcranial magnetic stimulation (TMS) was used to transiently disrupt (virtual lesion paradigm) the activity of the STG. Participants were either assigned to the control (sham TMS, n = 21) or experimental (real TMS, n = 21) group. Pain intensity and unpleasantness were assessed using visual analog scales (VAS; 0-10) immediately after the painful event (electric stimulations of the right sural nerve) and at recall, 2 months later. The accuracy of the pain recall was determined by calculating the difference between the VAS at recall and the initial VAS. RESULTS: The mnemonic pain intensity bias was similar in both groups (control = -0.3, experimental = 0.0; p = 0.83). However, the mnemonic pain unpleasantness bias was significantly lower in the experimental group (control = 1.0, experimental = -0.4; p < 0.05). CONCLUSION: Our results suggest that the STG affects specifically our memories of the affective component of pain. Given the link between exaggerated pain memories and the development of persistent pain, this study suggests that the inhibition of the STG could be a promising avenue for individuals at risk of developing chronic pain.

Introdução e objetivos: A estimulação magnética transcraniana (EMT) é um método exclusivo para estimulação cerebral não-invasiva. A diferença fundamental entre EMT e as outras técnicas disponíveis de mapeamento por imagem do cérebro é que se estabelece haver uma relação de causa e efeito entre a resposta fisiológica evocada e o estímulo magnético. A relação entre estrutura e função como a principal característica, constitui uma modalidade de mapeamento cerebral ainda não estabelecido. Os recentes avanços no processamento de imagem permitiram refinar EMT através de sua combinação com a ressonância magnética utilizando-se do sistema de neuronavegação para orientar o posicionamento da bobina em relação ao córtex. Assim a posição da bobina sobre o couro cabeludo pode ser mantida constante conforme verificado pela orientação de navegação em tempo real com registro visual. O objetivo deste estudo foi avaliar a utilidade da EMT no mapeamento cortical motor em comparação com o mapeamento cirúrgico com estimulação cortical direta. Métodos: O estudo foi conduzido com 30 mapeamentos consecutivos em pacientes com programação de cirurgia para tumores adjacentes ao córtex motor. O mapeamento pré-operatório foi realizado com o sistema de estimulação magnética transcraniana navegada. Esta estimulação gera um pulso magnético através de uma bobina. Este método permite estimulação diretamente no córtex cerebral. Eletródios de superfície foram anexados ao abdutor curto do polegar. Em seguida, o limiar motor em repouso (LM) foi determinado através da aplicação de estimulação para região cortical da mão presumida. Mapeamento peritumoral foi realizado na intensidade de 120% do LM. O mapeamento foi realizando com definição de coordenadas vetoriais. Estas coordenadas foram ponderadas previamente por potencial evocado motor. O mapeamento intra-operatório foi realizado pelo cirurgião antes da ressecção do tumor também com neuronavegação. Os locais de estimulação intraoperatória foram selecionados de forma independente dos resultados da EMT. Resultados: Os pontos obtidos na ECD foram comparados ao mapa da EMT segundo coordenadas vetoriais dos centros geométricos da nuvem de pontos obtidos. Verificamos que a distância dos pontos vetoriais médios (centro geométrico) dos pontos obtidos nos dois métodos de mapeamentos diferiu em 4,85 +/- 1,89 mm. A análise de correlação intraclasse revelou uma correlação de 0,901 com p<0,001. As distâncias dos pontos obtidos para o tumor, identificamos uma alta correlação entre estas variáveis com r=0,87, p=0,001. O Limiar motor na EMT é maior no córtex motor do adjacente ao tumor, comparado ao córtex normal. Não há correlação entre os limiares motores de repouso na EMT e na estimulação elétrica. A exatidão do mapeamento com EMT é mantida em pacientes com déficits motores. A condição clínica dos pacientes melhorou significativamente em 3 meses após a cirurgia. Conclusões: A estimulação magnética transcraniana navegada é uma ferramenta confiável e precisa com congruência de pontos obtidos comparados com o mapeamento intraoperatório. EMT navegada é um método promissor para o mapeamento funcional pré-operatória em cirurgia de tumor adjacente ao motor córtex / Introduction and aims: Transcranial magnetic stimulation (TMS) is a unique method for non-invasive brain stimulation. The fundamental difference between TMS and other available non-invasive brain imaging techniques is that when a physiological response is evoked by stimulation of a cortical area, that specific cortical area is causally related to the response. The relationship between structure and function as the major feature constituting a brain mapping modality can therefore not be established. Recent advances in image processing allowed us to refine TMS by combining magnetic resonance imaging modalities with TMS using a neuronavigation system to measure the position of the stimulating coil and map this position onto a MRI data set. This technique has several advantages over recent TMS mapping strategies. The position of the coil on the scalp can be held constant as verified by real time visual guidance. The aim of this study was to evaluate the usefulness of navigayed TMS for cortical mapping compared with surgical mapping with direct cirtical stimulation. Methods: The study was performed with 30 neurosurgeries for tumors in or near precentral gyrus. Preoperative mapping was performed with the navigated transcranial brain stimulation system. The TMS system calculates the strength, location, and direction of the stimulating electric field in cortical tissue. It allows online targeting of stimulation directly to peritumoral córtex. The coordinates of TMS mapping were weighted by motor evoked potential. Surface electromyography electrodes were attached to abductor pollicis brevis. Next, the resting motor threshold was determined. The motor threshold was then defined traditionally as the lowest stimulation intensity capable of eliciting motor evoked potentials in at least 5 of 10 trials. The motor threshold was reported both as the percentage of the maximum stimulator intensity. Peritumoral mapping was performed at 120% motor threshold. The intraoperative mapping was performed by the surgeon performing the tumor resection. The Intraoperative direct cortical stimulation locations were chosen independently of the TMS results. The direct electric cortical stimulation points were compared with TMS responses according to original distances of vectorial modules. Results: There is a similarity of the points performed in two mapping methods. We found the distances between geometric centers of TMS and DCS 4,85 +/- 1,89. We identified a strong correlation between these vectorial points (r = 0.901 and p < 0.001). The motor threshold in TMS is the largest in the motor cortex near to the tumor compared to normal cortex (p<0,001). Patients with deficits presented excellent accuracy in two methods. The clinical performance of the patient improved significantly 3 months after surgery. Conclusion: TMS allowed for reliable, precise application in brain mapping and the peritumoral somatotopy corresponded well between the 2 modalities. Navigated TMS is a promising method for preoperative functional mapping in motor cortex tumor surgery