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Processing in prefrontal cortex underlies tactile direction discrimination: An fMRI study of a patient with a traumatic spinal cord lesion.

Journal article
Authors Linda Lundblad
Håkan Olausson
Clas Malmeström
Helena Backlund Wasling
Published in Neuroscience letters
Volume 483
Issue 3
Pages 197-200
ISSN 1872-7972
Publication year 2010
Published at Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation
Pages 197-200
Language en
Keywords Brain Mapping, methods, Discrimination (Psychology), physiology, Humans, Image Processing, Computer-Assisted, methods, Magnetic Resonance Imaging, Male, Middle Aged, Orientation, physiology, Oxygen, blood, Physical Stimulation, methods, Prefrontal Cortex, blood supply, physiopathology, Spinal Cord Injuries, pathology, physiopathology, Touch, physiology
Subject categories Clinical neurophysiology, Experimental brain research


We have investigated cortical processing of tactile direction discrimination (TDD) in a patient with unilateral tactile disturbance due to spinal cord lesion. The patient R.A. (male, 45 years old), suffers from a traumatic dorsal column lesion at the level of Th XI-XII on the right side. He was instructed to report the direction of 2mm long skin pull stimulations applied in a proximal or distal direction on his right or left lower legs during functional magnetic resonance imaging (fMRI). Although R.A. considered himself to have nearly normal tactile sensibility, testing showed severely disturbed TDD on his right leg whereas results were within the range of healthy subjects on his left leg. For both legs TDD activated an extensive cortical network that included opercular parietal area 1 (OP1) of the second somatosensory cortex (S2), as has previously been observed in healthy subjects. However, dorsolateral prefrontal cortex (DLPFC) and anterior insular cortex (AIC) were only activated for the unaffected (left) leg where TDD was normal. A revisit of previously published data showed that healthy subjects consistently had TDD-related activations in DLPFC and AIC. However, in several healthy subjects AIC, but not DLPFC, was also activated for skin pull stimulations per se without the TDD task. Thus, the patient's data, in conjunction with the previous results from healthy subjects, suggest that DLPFC processing is important for tactile decision making based on proper tactile input.

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