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Cognitive performance in Major Depressive Disorder (MDD) is frequently impaired and related to functional outcomes. Repetitive Transcranial Magnetic Stimulation (rTMS) may exert its effects on MDD acting both on depressive symptoms and neurocognition. Furthermore, cognitive status could predict the therapeutic response of depressive symptoms to rTMS. However, cognitive performances as a predictor of rTMS response in MDD has not been thoroughly investigated. This review aims to evaluate the role of pre-treatment cognitive performance as a predictor of clinical response to rTMS, and the effects of rTMS on neurocognition in MDD.A systematic review of studies evaluating neurocognition in MDD as an outcome and/or predictor of response to rTMS was conducted using PubMed/Medline and Embase.Fifty-eight articles were identified: 25 studies included neurocognition as a predictor of response to rTMS; 56 used cognitive evaluation as an outcome of rTMS. Baseline cognitive performance and cognitive improvements after rTMS predicted clinical response to rTMS. Moreover, rTMS improved cognition in MDD.Cognitive assessment could predict improvement of depression in MDD patients undergoing rTMS and help selecting patients that could have beneficial effects from rTMS. A routine cognitive assessment might stratify MDD patients and track rTMS related cognitive improvement.

Background The Action Observation Therapy (AOT) is a well-established post-stroke rehabilitation treatment based on the theoretical framework of the Mirror Neuron System (MNS) activation. However, AOT protocols are still heterogeneous in terms of video contents of observed actions. Objective The aim of this study was to analyze electroencephalographic (EEG) recordings in stroke patients during the observation of different videos of task-specific upper limb movements, and to define which category of actions can elicit a stronger cortical activation in the observer’s brain. Methods Signals were analyzed from 19 chronic stroke subjects observing customized videos that represented 3 different categories of upper limb actions: Finalized Actions, Non-Finalized Actions, and Control Videos. The Event-Related Desynchronization in the µ and β bands was chosen to identify the involvement of the cerebral cortex: the area of the normalized power spectral density was calculated for each category and, deepening, for the reaching and completion sub-phases of Finalized Actions. For descriptive purposes, the time course of averaged signal power was described. The Kruskal–Wallis test ( P Results The analysis showed a greater desynchronization when subjects observed Finalized Actions with respect to Non-Finalized in all recorded areas; Control videos provoked a synchronization in the same areas and frequency bands. The reaching phase of feeding and self-care actions evoked a greater suppression both in µ and β bands. Conclusions The observation of finalized arm movements seems to elicit the strongest activation of the MNS in chronic stroke patients. This finding may help the clinicians to design future AOT-based stroke rehabilitation protocols. Clinical Trial Registration: Clinical Trial Registration—URL: http://www.clinicaltrials.gov . Unique identifier: NCT04047134.

In autism spectrum disorder (ASD), socio-communicative impairments and stereotypical behaviours are paralleled by sensorimotor deficits. Individuals with ASD show an altered selection of motor parameters, resulting in clumsy and fragmented actions. Here, we investigated inter-joint coordination and motor synergies as a potential substrate of motor control problems in ASD. Synergies enable co-controlling redundant motor degrees of freedom (DoF, e.g. joint angles, muscles) by mapping behavioural goals into a flexible and low-dimensional set of variables. This mechanism simplifies motor control and helps to find unambiguous solutions for motor tasks. In a reaching-grasping paradigm, children with ASD showed reduced coupling between DoF, which correlated with socio-communicative symptoms severity. Impaired synergies may help to frame well-established motor problems in ASD, including impaired motor sequencing and abnormal trial-to-trial motor variability. On the other hand, synergies also provide an effective and compact coding system of observed actions. Impaired synergies may thus jeopardize motor interaction by initiating bottom-up cascade effects, leading to pervasive impairments of social behaviour. Finally, we trained an automatic classification algorithm to distinguish between ASD and typically developing (TD) participants based on reaching-grasping kinematics. Classification accuracy reached up to 0.947. This result corroborates and expands previous accounts claiming that motor-based early recognition is feasible and effective in ASD.

Recent technological advances show the feasibility of offline decoding speech from neuronal signals, paving the way to the development of chronically implanted speech brain computer interfaces (sBCI). Two key steps that still need to be addressed for the online deployment of sBCI are, on the one hand, the definition of relevant design parameters of the recording arrays, on the other hand, the identification of robust physiological markers of the patient’s intention to speak, which can be used to online trigger the decoding process. To address these issues, we acutely recorded speech-related signals from the frontal cortex of two human patients undergoing awake neurosurgery for brain tumors using three different micro-electrocorticographic ([Formula: see text]ECoG) devices. First, we observed that, at the smallest investigated pitch (600[Formula: see text][Formula: see text]m), neighboring channels are highly correlated, suggesting that more closely spaced electrodes would provide some redundant information. Second, we trained a classifier to recognize speech-related motor preparation from high-gamma oscillations (70–150[Formula: see text]Hz), demonstrating that these neuronal signals can be used to reliably predict speech onset. Notably, our model generalized both across subjects and recording devices showing the robustness of its performance. These findings provide crucial information for the design of future online sBCI.

Implantable neural interfaces advance the possibilities for neuroscientists to study the brain. They are also promising for use in a multitude of bioelectronic therapies. Electrode technology plays a central role in these developments, as the electrode surfaces form the physical interfaces between technology and the biological targets. Despite this, a common understanding of how electrodes should best be evaluated and compared with respect to their efficiency in recording and stimulation is currently lacking. Without broadly accepted performance tests, it is difficult to rank the many suggestions for electrode materials available in the literature, or to identify where efforts should be focused to advance the field most efficiently. This tutorial critically discusses the most relevant performance tests for characterization of neural interface electrodes and explains their implementation, interpretation and respective limitations. We propose a unified standard to facilitate transparent reporting on electrode performance, promote efficient scientific process and ultimately accelerate translation into clinical practice. This tutorial describes a set of essential performance tests for characterization of neural interface electrodes. The authors provide guidelines for standardized implementation and reporting on electrode performances.

Movements overtly sample sensory information, making sensory analysis an active-sensing process. In this study, we show that visual information sampling is not just locked to the (overt) movement dynamics but to the internal (covert) dynamics of cortico-motor control. We asked human participants to perform continuous isometric contraction while detecting unrelated and unpredictable near-threshold visual stimuli. The motor output (force) shows zero-lag coherence with brain activity (recorded via electroencephalography) in the beta-band, as previously reported. In contrast, cortical rhythms in the alpha-band systematically forerun the motor output by 200 milliseconds. Importantly, visual detection is facilitated when cortico-motor alpha (not beta) synchronization is enhanced immediately before stimulus onset, namely, at the optimal phase relationship for sensorimotor communication. These findings demonstrate an ongoing coupling between visual sampling and motor control, suggesting the operation of an internal and alpha-cycling visuomotor loop., The motor rhythm of perception. Movements overtly sample sensory information, making sensory analysis an active-sensing process. This study shows that visual information sampling is not just synchronized to the (overt) movement dynamics, but to the internal (covert) dynamics of cortico-motor control.

Visual processing of other’s actions is supported by sensorimotor brain activations. Access to sensorimotor representations may, in principle, provide the top-down signal required to bias search and selection of critical visual features. For this to happen, it is necessary that a stable one-to-one mapping exists between observed kinematics and underlying motor commands. However, due to the inherent redundancy of the human musculoskeletal system, this is hardly the case for multijoint actions where everyone has his own moving style (individual motor signature—IMS). Here, we investigated the influence of subject’s IMS on subjects’ motor excitability during the observation of an actor achieving the same goal by adopting two different IMSs. Despite a clear dissociation in kinematic and electromyographic patterns between the two actions, we found no group-level modulation of corticospinal excitability (CSE) in observers. Rather, we found a negative relationship between CSE and actor-observer IMS distance, already at the single-subject level. Thus, sensorimotor activity during action observation does not slavishly replicate the motor plan implemented by the actor, but rather reflects the distance between what is canonical according to one’s own motor template and the observed movements performed by other individuals.

Significance Estimation of intentions from the observation of other people’s actions has been proposed to rely on the same motor chain organization supporting the execution of intentional actions. However, the nature of the mechanism by which a specific neuronal chain is selected among possible alternatives during action observation remains obscure. Our study shows that in absence of discriminative contextual cues, subtle changes in the kinematics of the observed action inform mapping to the most probable chain. These results shed light on the importance of kinematics for the attribution of intentions to actions., The ability to understand intentions based on another’s movements is crucial for human interaction. This ability has been ascribed to the so-called motor chaining mechanism: anytime a motor chain is activated (e.g., grasp-to-drink), the observer attributes to the agent the corresponding intention (i.e., to drink) from the first motor act (i.e., the grasp). However, the mechanisms by which a specific chain is selected in the observer remain poorly understood. In the current study, we investigate the possibility that in the absence of discriminative contextual cues, slight kinematic variations in the observed grasp inform mapping to the most probable chain. Chaining of motor acts predicts that, in a sequential grasping task (e.g., grasp-to-drink), electromyographic (EMG) components that are required for the final act [e.g., the mouth-opening mylohyoid (MH) muscle] show anticipatory activation. To test this prediction, we used MH EMG, transcranial magnetic stimulation (TMS; MH motor-evoked potentials), and predictive models of movement kinematics to measure the level and timing of MH activation during the execution (Experiment 1) and the observation (Experiment 2) of reach-to-grasp actions. We found that MH-related corticobulbar excitability during grasping observation varied as a function of the goal (to drink or to pour) and the kinematics of the observed grasp. These results show that subtle changes in movement kinematics drive the selection of the most probable motor chain, allowing the observer to link an observed act to the agent’s intention.

There is a current claim that humans are able to effortlessly detect others' hidden mental state by simply observing their movements and transforming the visual input into motor knowledge to predict behaviour. Using a classical paradigm quantifying motor predictions, we tested the role of vision feedback during a reach and load-lifting task performed either alone or with the help of a partner. Wrist flexor and extensor muscle activities were recorded on the supporting hand. Early muscle changes preventing limb instabilities when participants performed the task by themselves revealed the contribution of the visual input in postural anticipation. When the partner performed the unloading, a condition mimicking a split-brain situation, motor prediction followed a pattern evolving along the task course and changing with the integration of successive somatosensory feedback. Our findings demonstrate that during social behaviour, in addition to self-motor representations, individuals cooperate by continuously integrating sensory signals from various sources.

International audience; During a conversation, neural processing of speech production and speech perception in both speakers temporally overlap and is continuously modulated in real time, based on conversation dynamics, context, expectations, and quality of the interaction. Recently, a growing interest in the neural dynamics underlying interactive tasks, in particular in the language domain, has mainly tackled the temporal aspects of turn-taking in dialogues. Beside temporal coordination, an under-investigated phenomenon is the neural correlate of implicit convergence towards a shared phonetic space. Here, we used dual electroencephalography (dual-EEG) to record brain signals from subjects involved in a relatively constrained interactive task where they were asked to take turns in chaining words according to a phonetic rhyming rule. We quantified participants' initial phonetic fingerprints and tracked their convergence during the interaction via a robust and automatic speaker verification technique. Results show that phonetic convergence is characterized by a left anterior alpha/low-beta desynchronization in the speech motor preparation phase and by high beta suppression before and during listening to speech in right central and left frontal sectors, respectively. With this work, we provide evidence that during turn-taking verbal interaction, alpha and beta oscillatory dynamics are linked to the coordination of the " how " rather than the " when " interaction takes place. We suggest therefore that speech-based interaction, besides affecting the temporal pattern of turn-taking, leads to a critical change in speech phonetic targets. These changes in how we generate the speech output, are reflected in specific preparatory neural markers demonstrating that during a conversation, speech perception and production are highly interdependent and co-constructed by participants.

Transcranial magnetic stimulation was used to investigate corticospinal output changes in 10 professional piano players during motor imagery of triad chords in C major to be “mentally” performed with three fingers of the right hand (thumb, index, and little finger). Five triads were employed in the task; each composed by a stable 3rd interval (C4-E4) and a varying third note that could generate a 5th (G4), a 6th (A4), a 7th (B4), a 9th (D5), or a 10th (E5) interval. The 10th interval chord was thought to be impossible in actual execution for biomechanical reasons, as long as the thumb and the index finger remained fixed on the 3rd interval. Chords could be listened from loudspeakers, read on a staff, or listened and read at the same time while performing the imagery task. The corticospinal output progressively increased along with task demands in terms of mental representation of hand extension. The effects of audio, visual, or audiovisual musical stimuli were generally similar, unless motor imagery of kinetically impossible triads was required. A specific three-effector motor synergy was detected, governing the representation of the progressive mental extension of the hand. Results demonstrate that corticospinal facilitation in professional piano players can be modulated according to the motor plan, even if simply “dispatched” without actual execution. Moreover, specific muscle synergies, usually encoded in the motor cortex, emerge along the cross-modal elaboration of musical stimuli and in motor imagery of musical performances.

International audience; The planning of any motor action requires a complex multisensory processing by the brain. Gravity - immutable on Earth - has been shown to be a key input to these mechanisms. Seminal fMRI studies performed during visual perception of falling objects and self-motion demonstrated that humans represent the action of gravity in parts of the cortical vestibular system; in particular, the insular cortex and the cerebellum. However, little is known as to whether a specific neural network is engaged when processing non-visual signals relevant to gravity. We asked participants to perform vertical and horizontal hand movements without visual control, while lying in a 3T-MRI scanner. We highlighted brain regions activated in the processing of vertical movements, for which the effects of gravity changed during execution. Precisely, the left insula was activated in vertical movements and not in horizontal movements. Moreover, the network identified by contrasting vertical and horizontal movements overlapped with neural correlates previously associated to the processing of simulated self-motion and visual perception of the vertical direction. Interestingly, we found that the insular cortex activity is direction-dependent which suggests that this brain region processes the effects of gravity on the moving limbs through non-visual signals.

Localized drug delivery represents one of the most challenging uses of systems based on conductive polymer films. Typically, anionic drugs are incorporated within conductive polymers through electrostatic interaction with the positively charged polymer. Following this approach, the synthetic glucocorticoid dexamethasone phosphate is often delivered from neural probes to reduce the inflammation of the surrounding tissue. In light of the recent literature on the neuroprotective and anti-inflammatory properties of tauroursodeoxycholic acid (TUDCA), for the first time, this natural bile acid was incorporated within poly(3,4-ethylenedioxythiophene) (PEDOT). The new material, PEDOT-TUDCA, efficiently promoted an electrochemically controlled delivery of the drug, while preserving optimal electrochemical properties. Moreover, the low cytotoxicity observed with viability assays, makes PEDOT-TUDCA a good candidate for prolonging the time span of chronic neural recording brain implants.

Errors while performing an action are fundamental for learning. During interaction others’ errors must be monitored and taken into account to allow joint action coordination and imitation learning. This monitoring relies on an action observation network (AON) mainly based on parietofrontal recurrent circuits. Although different studies suggest that inappropriate actions may rapidly be inhibited during execution, little is known about the modulation of the AON when an action misstep is shown. Here we used single and paired pulse transcranial magnetic stimulation to assess corticospinal excitability, intracortical facilitation and intracortical inhibition at different time intervals (120, 180, 240 ms) after the visual presentation of a motor execution error. Results show a specific and early (120 ms) decrease of intracortical inhibition likely because of a significant mismatch between the observed erroneous action and observer’s expectations. Indeed, as proposed by the top-down predictive framework, the motor system may be involved in the generation of these error signals and our data show that this mechanism could rely on the early decrease of intracortical inhibition within the corticomotor system.

Observing others' actions desynchronizes electroencephalographic (EEG) rhythms and modulates corticospinal excitability as assessed by transcranial magnetic stimulation (TMS). However, it remains unclear if these measures reflect similar neurofunctional mechanisms at the individual level. In the present study, a within-subject experiment was designed to assess these two neurophysiological indexes and to quantify their mutual correlation. Participants observed reach-to-grasp actions directed towards a small (precision grip) or a large object (power grip). We focused on two specific time points for both EEG and TMS. The first time point (t1) coincided with the maximum hand aperture, i.e. the moment at which a significant modulation of corticospinal excitability is expected. The second (t2), coincided with the EEG resynchronization occurring at the end of the action, i.e. the moment at which a hypothetic minimum for action observation effect is expected. Results showed a Mu rhythm bilateral desynchronization at t1 with differential resynchronization at t2 in the two hemispheres. Beta rhythm was more desynchronized in the left hemisphere at both time points. These EEG differences, however, were not influenced by grip type. Conversely, motor potentials evoked by TMS in an intrinsic hand muscle revealed an interaction effect of grip and time. No significant correlations between Mu/Beta rhythms and motor evoked potentials were found. These findings are discussed considering the spatial and temporal resolution of the two investigated techniques and argue over two alternative explanations: i. each technique provides different measures of the same process or ii. they describe complementary features of the action observation network in humans.

At present, functional magnetic resonance imaging (fMRI) is one of the most useful methods of studying cognitive processes in the human brain in vivo, both for basic science and clinical goals. Although neuroscience studies often rely on group analysis, clinical applications must investigate single subjects (patients) only. Particularly for the latter, issues regarding the reliability of fMRI readings remain to be resolved. To determine the ability of intra-run variability ( IRV ) weighting to consistently detect active voxels, we first acquired fMRI data from a sample of healthy subjects, each of whom performed 4 runs (4 blocks each) of self-paced finger-tapping. Each subject's data was analyzed using single-run general linear model (GLM), and each block was then analyzed separately to calculate the IRV weighting. Results show that integrating IRV information into standard single-subject GLM activation maps significantly improved the reliability ( p = 0.007) of the single-subject fMRI data. This suggests that taking IRV into account can help identify the most constant and relevant neuronal activity at the single-subject level.

Background. Given the technical difficulties, a limited number of works have been published on insular gliomas surgery and risk factors for tumor recurrence (TR) are poorly documented.Objective. The aim of the study was to determine TR in adult patients with initial diagnosis of insular Low-Grade Gliomas (LGGs) that subsequently underwent second surgery.Methods. A consecutive series of 53 patients with insular LGGs was retrospectively reviewed; 23 patients had two operations for TR.Results. At the time of second surgery, almost half of the patients had experienced progression into high-grade gliomas (HGGs). Univariate analysis showed that TR is influenced by the following: extent of resection (EOR) (P<0.002), ΔVT2T1value (P<0.001), histological diagnosis of oligodendroglioma (P=0.017), and mutation of IDH1 (P=0.022). The multivariate analysis showed that EOR at first surgery was the independent predictor for TR (P<0.001).Conclusions. In patients with insular LGG the EOR at first surgery represents the major predictive factor for TR. At time of TR, more than 50% of cases had progressed in HGG, raising the question of the oncological management after the first surgery.

Action observation, similarly to action execution, facilitates the observer's motor system and Transcranial Magnetic Stimulation (TMS) has been instrumental in exploring the nature of these motor activities. However, contradictory findings question some of the fundamental assumptions regarding the neural computations run by the Action Observation Network (AON). To better understand this issue, we delivered TMS over the observers' motor cortex at two timings of two reaching-grasping actions (precision vs power grip) and we recorded Motor-Evoked Potentials (4 hand/arm muscles; MEPs). At the same time, we also recorded whole-hand TMS Evoked Kinematics (8 hand elevation angles; MEKs) that capture the global functional motor output, as opposed to the limited view offered by recording few muscles. By repeating the same protocol twice, and a third time after continuous theta burst stimulation (cTBS) over the motor cortex, we observe significant time-dependent grip-specific MEPs and MEKs modulations, that disappeared after cTBS. MEKs, differently from MEPs, exhibit a consistent significant modulation across pre-cTBS sessions. Beside clear methodological implications, the multidimensionality of MEKs opens a window on muscle synergies needed to overcome system redundancy. By providing better access to the AON computations, our results strengthen the idea that action observation shares key organizational similarities with action execution.

In this study, we recorded the pressure exerted onto an object by the index finger and the thumb of the preferred hand of 18 human subjects and either hand of two macaque monkeys during a precision grasping task. The to-be-grasped object was a custom-made device composed by two plates which could be variably oriented by a motorized system while keeping constant the size and thus grip dimension. The to-be-grasped plates were covered by an array of capacitive sensors to measure specific features of finger adaptation, namely pressure intensity and centroid location and displacement. Kinematic measurements demonstrated that for human subjects and for monkeys, different plate configurations did not affect wrist velocity and grip aperture during the reaching phase. Consistently, at the instant of fingers-plates contact, pressure centroids were clustered around the same point for all handle configurations. However, small pressure centroid displacements were specifically adopted for each configuration, indicating that both humans and monkeys can display finger adaptation during precision grip. Moreover, humans applied stronger thumb pressure intensity, performed less centroid displacement and required reduced adjustment time, as compared to monkeys. These pressure patterns remain similar when different load forces were required to pull the handle, as ascertained by additional measurements in humans. The present findings indicate that, although humans and monkeys share common features in motor control of grasping, they differ in the adjustment of fingertip pressure, probably because of skill and/or morphology divergences. Such a precision grip device may form the groundwork for future studies on prehension mechanisms.

High-density surface microelectrodes for electrocorticography (ECoG) have become more common in recent years for recording electrical signals from the cortex. With an acceptable invasiveness/signal fidelity trade-off and high spatial resolution, micro-ECoG is a promising tool to resolve fine task-related spatial-temporal dynamics. However, volume conduction — not a negligible phenomenon — is likely to frustrate efforts to obtain reliable and resolved signals from a sub-millimeter electrode array. To address this issue, we performed an independent component analysis (ICA) on micro-ECoG recordings of somatosensory-evoked potentials (SEPs) elicited by median nerve stimulation in three human patients undergoing brain surgery for tumor resection. Using well-described cortical responses in SEPs, we were able to validate our results showing that the array could segregate different functional units possessing unique, highly localized spatial distributions. The representation of signals through the root-mean-square (rms) maps and the signal-to-noise ratio (SNR) analysis emphasizes the advantages of adopting a source analysis approach on micro-ECoG recordings in order to obtain a clear picture of cortical activity. The implications are twofold: while on one side ICA may be used as a spatial-temporal filter extracting micro-signal components relevant to tasks for brain–computer interface (BCI) applications, it could also be adopted to accurately identify the sites of nonfunctional regions for clinical purposes.

Audiovisual speech perception is likely based on the association between auditory and visual informa- tion into stable audiovisual maps. Conflicting audiovisual inputs generate perceptual illusions such as the McGurk effect. Audiovisual mismatch effects could be either driven by the detection of violations in the standard audiovisual statistics or via the sensorimotor reconstruction of the distal articulatory event that generated the audiovisual ambiguity. In order to disambiguate between the two hypotheses we exploit the fact that the tongue is hidden to vision. For this reason, tongue movement encoding can solely be learned via speech production but not via others' speech perception alone. Here we asked participants to identify speech sounds while matching or mismatching visual representations of tongue movements which were shown. Vision of congruent tongue movements facilitated auditory speech identification with respect to incongruent trials. This result suggests that direct visual experience of an articulator movement is not necessary for the generation of audiovisual mismatch effects. Furthermore, we suggest that audiovisual integration in speech may benefit from speech production learning.

Action perception and recognition are core abilities fundamental for human social interaction. A parieto-frontal network (the mirror neuron system) matches visually presented biological motion information onto observers' motor representations. This process of matching the actions of others onto our own sensorimotor repertoire is thought to be important for action recognition, providing a non-mediated "motor perception" based on a bidirectional flow of information along the mirror parieto-frontal circuits. State-of-the-art machine learning strategies for hand action identification have shown better performances when sensorimotor data, as opposed to visual information only, are available during learning. As speech is a particular type of action (with acoustic targets), it is expected to activate a mirror neuron mechanism. Indeed, in speech perception, motor centers have been shown to be causally involved in the discrimination of speech sounds. In this paper, we review recent neurophysiological and machine learning-based studies showing (a) the specific contribution of the motor system to speech perception and (b) that automatic phone recognition is significantly improved when motor data are used during training of classifiers (as opposed to learning from purely auditory data).

International audience; Limb immobilization and nonuse are well-known causes of corticomotor depression. While physical training can drive the recovery from nonuse-dependent corticomotor effects, it remains unclear if it is possible to gain access to motor cortex in alternative ways, such as through motor imagery (MI) or action observation (AO). Transcranial magnetic stimulation was used to study the excitability of the hand left motor cortex in normal subjects immediately before and after 10 h of right arm immobilization. During immobilization, subjects were requested either to imagine to act with their constrained limb or to observe hand actions performed by other individuals. A third group of control subjects watched a nature documentary presented on a computer screen. Hand corticomotor maps and recruitment curves reliably showed that AO, but not MI, prevented the corticomotor depression induced by immobilization. Our results demonstrate the existence of a visuomotor mechanism in humans that links AO and execution which is able to effect cortical plasticity in a beneficial way. This facilitation was not related to the action simulation, because it was not induced by explicit MI.

This paper investigates a biologically motivated model of peripersonal space through its implementation on a humanoid robot. Guided by the present understanding of the neurophysiology of the fronto-parietal system, we developed a computational model inspired by the receptive fields of polymodal neurons identified, for example, in brain areas F4 and VIP. The experiments on the iCub humanoid robot show that the peripersonal space representation i) can be learned efficiently and in real-time via a simple interaction with the robot, ii) can lead to the generation of behaviors like avoidance and reaching, and iii) can contribute to the understanding the biological principle of motor equivalence. More specifically, with respect to i) the present model contributes to hypothesizing a learning mechanisms for peripersonal space. In relation to point ii) we show how a relatively simple controller can exploit the learned receptive fields to generate either avoidance or reaching of an incoming stimulus and for iii) we show how the robot can select arbitrary body parts as the controlled end-point of an avoidance or reaching movement.

This article presents results from a multidisciplinary research project on the integration and transfer of language knowledge into robots as an empirical paradigm for the study of language development in both humans and humanoid robots. Within the framework of human linguistic and cognitive development, we focus on how three central types of learning interact and co-develop: individual learning about one's own embodiment and the environment, social learning (learning from others), and learning of linguistic capability. Our primary concern is how these capabilities can scaffold each other's development in a continuous feedback cycle as their interactions yield increasingly sophisticated competencies in the agent's capacity to interact with others and manipulate its world. Experimental results are summarized in relation to milestones in human linguistic and cognitive development and show that the mutual scaffolding of social learning, individual learning, and linguistic capabilities creates the context, conditions, and requisites for learning in each domain. Challenges and insights identified as a result of this research program are discussed with regard to possible and actual contributions to cognitive science and language ontogeny. In conclusion, directions for future work are suggested that continue to develop this approach toward an integrated framework for understanding these mutually scaffolding processes as a basis for language development in humans and robots.

Because Broca's area is known to be involved in many cognitive functions, including language, music, and action processing, several attempts have been made to propose a unifying theory of its role that emphasizes a possible contribution to syntactic processing. Recently, we have postulated that Broca's area might be involved in higher-order chunk processing during implicit learning of a motor sequence. Chunking is an information-processing mechanism that consists of grouping consecutive items in a sequence and is likely to be involved in all of the aforementioned cognitive processes. Demonstrating a contribution of Broca's area to chunking during the learning of a nonmotor sequence that does not involve language could shed new light on its function. To address this issue, we used offline MRI-guided TMS in healthy volunteers to disrupt the activity of either the posterior part of Broca's area (left Brodmann's area [BA] 44) or a control site just before participants learned a perceptual sequence structured in distinct hierarchical levels. We found that disruption of the left BA 44 increased the processing time of stimuli representing the boundaries of higher-order chunks and modified the chunking strategy. The current results highlight the possible role of the left BA 44 in building up effector-independent representations of higher-order events in structured sequences. This might clarify the contribution of Broca's area in processing hierarchical structures, a key mechanism in many cognitive functions, such as language and composite actions.

Music ensembles are an ideal test-bed for quantitative analysis of social interaction. Music is an inherently social activity, and music ensembles offer a broad variety of scenarios which are particularly suitable for investigation. Small ensembles, such as string quartets, are deemed a significant example of self-managed teams, where all musicians contribute equally to a task. In bigger ensembles, such as orchestras, the relationship between a leader (the conductor) and a group of followers (the musicians) clearly emerges. This paper presents an overview of recent research on social interaction in music ensembles with a particular focus on (i) studies from cognitive neuroscience; and (ii) studies adopting a computational approach for carrying out automatic quantitative analysis of ensemble music performances.

Despite intraoperative technical improvements, the insula remains a challenging area for surgery because of its critical relationships with vascular and neurophysiological functional structures.To retrospectively investigate the morbidity profile in insular nonenhancing gliomas, with special emphasis on volumetric analysis of tumoral resection.From 2000 to 2010, 66 patients underwent surgery. All surgical procedures were conducted under cortical-subcortical stimulation and neurophysiological monitoring. Volumetric scan analysis was applied on T2-weighted magnetic resonance images (MRIs) to establish preoperative and postoperative tumoral volume.The median preoperative tumor volume was 108 cm. The median extent of resection was 80%. The median follow-up was 4.3 years. An immediate postoperative worsening was detected in 33.4% of cases; a definitive worsening resulted in 6% of cases. Patients with extent of resection of90% had an estimated 5-year overall survival rate of 92%, whereas those with extent of resection between 70% and 90% had a 5-year overall survival rate of 82% (P.001). The difference between preoperative tumoral volumes on T2-weighted MRI and on postcontrast T1-weighted MRI ([T2 - T1] MRI volume) was computed to evaluate the role of the diffusive tumoral growing pattern on overall survival. Patients with preoperative volumetric difference30 cm demonstrated a 5-year overall survival rate of 92%, whereas those with a difference of30 cm had a 5-year overall survival rate of 57% (P = .02).With intraoperative cortico-subcortical mapping and neurophysiological monitoring, a major resection is possible with an acceptable risk and a significant result in the follow-up.

Purpose To investigate whether repeated sessions of motor imagery and action observation modulate corticospinal excitability (CE) over time, whether these processes are susceptible of any training effect and if such effect might be different for the dominant and non dominant hemisphere. Methods 11 subjects underwent three sessions, spaced 5-7 days, of single-pulse Transcranial Magnetic Stimulation (TMS) of right and left primary motor cortex. Subjects were asked to imagine or observe pinch-grip actions with either hand. Motor evoked potentials (MEPs) were recorded bilaterally from the First Dorsal Interosseus muscle (FDI), acting as main agonist during precision grip. Results Motor imagery consistently enhanced CE with respect to action observation, regardless of hemispheric lateralization and of separate testing sessions. However, motor imagery increased CE only when measured over the non-dominant hemisphere, during the third session with respect to the first one. The increase of CE induced by action observation in the first session was not further modified throughout the remaining two sessions, in either hemisphere. Conclusions Results suggest that motor imagery is sustained by a cortical network susceptible to training effects only for the non-dominant hemisphere. Such an effect was lacking for action observation, likely because of the innateness of these mechanisms. Results might have implications for rehabilitative purposes.

Action and perception are functionally linked in the brain, but a hotly debated question is whether perception and comprehension of stimuli depend on motor circuits. Brain language mechanisms are ideal for addressing this question. Neuroimaging investigations have found specific motor activations when subjects understand speech sounds, word meanings and sentence structures. Moreover, studies involving transcranial magnetic stimulation and patients with lesions affecting inferior frontal regions of the brain have shown contributions of motor circuits to the comprehension of phonemes, semantic categories and grammar. These data show that language comprehension benefits from frontocentral action systems, indicating that action and perception circuits are interdependent.

Several transcranial magnetic stimulation (TMS) studies have reported facilitation of the primary motor cortex (M1) during the mere observation of actions. This facilitation was shown to be highly congruent, in terms of somatotopy, with the observed action, even at the level of single muscles. With the present study, we investigated whether this muscle-specific facilitation of the observer’s motor system reflects the degree of muscular force that is exerted in an observed action. Two separate TMS experiments are reported in which corticospinal excitability was measured in the hand area of M1 while subjects observed the lifting of objects of different weights. The type of action ‘grasping-and-lifting-the-object’ was always identical, but the grip force varied according to the object’s weight. In accordance to previous findings, excitability of M1 was shown to modulate in a muscle-specific way, such that only the cortical representation areas in M1 that control the specific muscles used in the observed lifting action became increasingly facilitated. Moreover, muscle-specific M1 facilitation was shown to modulate to the force requirements of the observed actions, such that M1 excitability was considerably higher when observing heavy object lifting compared with light object lifting. Overall, these results indicate that different levels of observed grip force are mirrored onto the observer’s motor system in a highly muscle-specific manner. The measured force-dependent modulations of corticospinal excitability in M1 are hypothesized to be functionally relevant for scaling the observed grip force in the observer’s own motor system. In turn, this mechanism may contribute, at least partly, to the observer’s ability to infer the weight of the lifted object. ispartof: European Journal of Neuroscience vol:31 issue:6 pages:1144-1153 ispartof: location:France status: published

Broca's area is classically associated with speech production. Recently, Broca's area has also been implicated in speech perception and non-linguistic information processing. With respect to the latter function, Broca's area is considered to be a central area in a network constituting the human mirror system, which maps observed or heard actions onto motor programs to execute analogous actions. These mechanisms share some similarities with Liberman's motor theory, where objects of speech perception correspond to listener's intended articulatory gestures. The aim of the current series of behavioral, TMS and fMRI studies was to test if Broca's area is indeed implicated in such audio-motor transformations. More specifically, using a classical phonological rhyme priming paradigm, we investigated whether the role of Broca's area could be purely phonological or rather, is lexical in nature. In the behavioral baseline study, we found a large priming effect in word prime/target pairs (W-W) and no effect for pseudo-words (PW-PW). Online TMS interference of Broca's area canceled the priming difference between W-W and PW-PW by enhancing the effects for PW-PW. Finally, the fMRI study showed activation of Broca's area for W-W pairs, but not for PW-PW pairs. Our data show that Broca's area plays a significant role in speech perception strongly linked to the lexicality of a stimulus.

The exact contribution of Broca's area to motor cognition is still controversial. Here we used repetitive transcranial magnetic stimulation (5 Hz, five pulses) to interfere transiently with the function of left BA44 in 13 healthy individuals; the task consisted of reordering human actions or nonbiological events based on three pictures presented on a computer screen and extracted from a video showing the entire sequence beforehand. We found that a virtual lesion of left BA44 impairs individual performance only for biological actions, and more specifically for object-oriented syntactic actions. Our finding provides evidence that Broca's area plays a crucial role in encoding complex human movements, a process which may be crucial for understanding and/or programming actions.

Recent advances in the field of cognitive neuroscience have revealed that direct gaze modulates activity in cortical and subcortical key regions of the ‘social brain network’, including the inferior frontal gyrus (IFG) and the anterior rostral medial prefrontal cortex (arMPFC). However, very little is known about how direct gaze is processed during live interaction with a real partner. Here, for the first time we used an experimental setup allowing the participant inside an MRI scanner to interact face-to-face with a partner located in the scanner room. Depending on condition, the participant and the partner were instructed either to look at each other in the eyes or to direct their gaze away from the other. As control conditions, participants gazed at their own eyes, reflected in a mirror, or gazed at a picture of the partner's eyes. Results revealed that direct gaze by the partner was associated with activity in areas involved in production and comprehension of language and action, including the IFG, the premotor cortex (PM), and the supplementary motor area (SMA). Activations in these areas were observed regardless of the participant's gaze behavior. In contrast, increased activity in arMPFC, an area involved in inference of other mental states during social interaction and communication, was only observed when the participant reciprocated the partner's direct gaze so as to establish mutual gaze. Psychophysiological interaction (PPI) analysis revealed effective connectivity between the IFG and the arMPFC during mutual gaze. This suggests that, within a larger network concerned with the processing of social gaze, mutual gaze with a real partner is established by an increased coupling between areas involved in the detection of communicative intentions, language, and social interaction.

Sentences, musical phrases and goal-directed actions are composed of elements that are linked by specific rules to form meaningful outcomes. In goal-directed actions including a non-canonical element or scrambling the order of the elements alters the action’s content and structure, respectively. In the present study we investigated event-related potentials of the electroencephalographic (EEG) activity recorded during observation of both alterations of the action content (obtained by violating the semantic components of an action, e.g. making coffee with cola) and alterations of the action structure (obtained by inverting the order of two temporally adjacent pictures of sequences depicting daily life actions) interfering with the normal flow of the motor acts that compose an action. Action content alterations elicited a bilateral posterior distributed EEG negativity, peaking at around 400 ms after stimulus onset similar to the ERPs evoked by semantic violations in language studies. Alteration of the action structure elicited an early left anterior negativity followed by a late left anterior positivity, which closely resembles the ERP pattern found in language syntax violation studies. Our results suggest a functional dissociation between the processing of action content and structure, reminiscent of a similar dissociation found in the language or music domains. Importantly, this study provides further support to the hypothesis that some basic mechanisms, such as the rule-based structuring of sequential events, are shared between different cognitive domains.

One of the most difficult tasks for the surgeon during the removal of low-grade gliomas is to identify as precisely as possible the borders between functional and non-functional brain tissue with the aim of obtaining the maximal possible resection which allows to the patient the longer survival. For this purpose, systems for acute extracellular recordings of single neuron and multi-unit activity are considered promising. Here we describe a system to be used with 16 microelectrodes arrays that consists of an autoclavable headstage, a built-in inserter for precise electrode positioning and a system that measures and controls the pressure exerted by the headstage on the brain with a twofold purpose: to increase recording stability and to avoid disturbance of local perfusion which would cause a degradation of the quality of the recording and, eventually, local ischemia. With respect to devices where only electrodes are autoclavable, our design permits the reduction of noise arising from long cable connections preserving at the same time the flexibility and avoiding long-lasting gas sterilization procedures. Finally, size is much smaller and set up time much shorter compared to commercial systems currently in use in surgery rooms, making it easy to consider our system very useful for intra-operatory mapping operations.

We investigated changes in the corticospinal pattern of activity in healthy volunteers during sustained noxious and non-noxious mechanical stimulation of the first hand digit, resulting from active (self-stimulation) or passive (externally-induced) pressing against a sharp or blunted tip. The results indicate that, in order to press a finger onto a noxious stimulus with the same force generated to press onto a non-noxious one, the motor cortex adopts a peculiar strategy in terms of recruitment of motor units. This is reflected by an increase of corticospinal excitability (as revealed by motor potentials evoked by transcranial magnetic stimulation of the contralateral primary motor cortex) and EMG activity of agonist muscles, possibly related to an increase of motor unit synchronization.

We investigate the use of phonetic motor invariants (MIs), that is, recurring kinematic patterns of the human phonetic articulators, to improve automatic phoneme discrimination. Using a multi-subject database of synchronized speech and lips/tongue trajectories, we first identify MIs commonly associated with bilabial and dental consonants, and use them to simultaneously segment speech and motor signals. We then build a simple neural network-based regression schema (called Audio-Motor Map, AMM) mapping audio features of these segments to the corresponding MIs. Extensive experimental results show that (a) a small set of features extracted from the MIs, as originally gathered from articulatory sensors, are dramatically more effective than a large, state-of-the-art set of audio features, in automatically discriminating bilabials from dentals; (b) the same features, extracted from AMM-reconstructed MIs, are as effective as or better than the audio features, when testing across speakers and coarticulating phonemes; and dramatically better as noise is added to the speech signal. These results seem to support some of the claims of the motor theory of speech perception and add experimental evidence of the actual usefulness of MIs in the more general framework of automated speech recognition.

OBJECTIVE: To investigate long-latency motor evoked potentials (MEPs) elicited by transcranial magnetic stimulation in congenital hemiplegia (CH) and to seek for correlation with paretic hand movement deficits. METHODS: MEPs were recorded from the first dorsal interosseous of both hands in 12 CH patients and 12 age-matched controls; dexterity and upper limb function were quantitatively assessed in both groups. RESULTS: In CH patients, long-latency MEPs, occurring much later than the commonly reported MEPs, were frequently observed in the paretic and non-paretic hands. Four distinct groups of long-latency MEPs were found, each cluster being identified by its mean latency, namely 35, 85, 160 and 225 ms. The residual dexterity of the paretic hand was correlated with the presence of contralateral MEPs with a 20 and 225 ms latency and was negatively correlated with ipsilateral MEPs, irrespective of their latency. In controls, only few MEPs with a latency of 225 ms were found in 4 out of 12 subjects. CONCLUSIONS: The pattern of MEPs found in CH patients differs dramatically from that reported in adult stroke patients, suggesting that long-latency MEPs are a rather distinctive consequence of early corticospinal lesions. The hypothesis that a given cluster of long-latency MEPs is mediated by a particular pathway appears very unlikely. Rather, we suggest that an exacerbation of cortical and/or spinal excitability is at the origin of these long-latency MEPs.

The activation of listener's motor system during speech processing was first demonstrated by the enhancement of electromyographic tongue potentials as evoked by single-pulse transcranial magnetic stimulation (TMS) over tongue motor cortex. This technique is, however, technically challenging and enables only a rather coarse measurement of this motor mirroring. Here, we applied TMS to listeners’ tongue motor area in association with ultrasound tissue Doppler imaging to describe fine-grained tongue kinematic synergies evoked by passive listening to speech. Subjects listened to syllables requiring different patterns of dorso-ventral and antero-posterior movements (/ki/, /ko/, /ti/, /to/). Results show that passive listening to speech sounds evokes a pattern of motor synergies mirroring those occurring during speech production. Moreover, mirror motor synergies were more evident in those subjects showing good performances in discriminating speech in noise demonstrating a role of the speech-related mirror system in feed-forward processing the speaker's ongoing motor plan.

Non-verbal group dynamics are often opaque to a formal quantitative analysis of communication flow. In this context, ensemble musicians can be a reliable model of expert group coordination. In fact, bodily motion is a critical component of inter-musician coordination and thus could be used as a valuable index of sensorimotor communication. Here we measured head movement kinematics of an expert quartet of musicians and, by applying Granger Causality analysis, we numerically described the causality patterns between participants. We found a clear positive relationship between the amount of communication and complexity of the score segment. Furthermore, we also applied temporal and dynamical changes to the musical score, known by the first violin only. The perturbations were devised in order to force unidirectional communication between the leader of the quartet and the other participants. Results show that in these situations, unidirectional influence from the leader decreased, thus implying that effective leadership may require prior sharing of information between participants. In conclusion, we could measure the amount of information flow and sensorimotor group dynamics suggesting that the fabric of leadership is not built upon exclusive information knowledge but rather on sharing it.

International audience; Gaveau J, Berret B, Demougeot L, Fadiga L, Pozzo T, Papaxanthis C. Energy-related optimal control accounts for gravitational load: comparing shoulder, elbow, and wrist rotations. J Neurophysiol 111: 4-16, 2014. First published October 16, 2013; doi: 10.1152/jn.01029.2012.-We permanently deal with gravity force. Experimental evidences revealed that moving against gravity strongly differs from moving along the gravity vector. This directional asymmetry has been attributed to an optimal planning process that optimizes gravity force effects to minimize energy. Yet, only few studies have considered the case of vertical movements in the context of optimal control. What kind of cost is better suited to explain kinematic patterns in the vertical plane? Here, we aimed to understand further how the central nervous system (CNS) plans and controls vertical arm movements. Our reasoning was the following: if the CNS optimizes gravity mechanical effects on the moving limbs, kinematic patterns should change according to the direction and the magnitude of the gravity torque being encountered in the motion. Ten subjects carried out single-joint movements, i.e., rotation around the shoulder (whole arm), elbow (forearm), and wrist (hand) joints, in the vertical plane. Joint kinematics were analyzed and compared with various theoretical optimal model predictions (minimum absolute work-jerk, jerk, torque change, and variance). We found both direction-dependent and joint-dependent variations in several kinematic parameters. Notably, directional asymmetries decreased according to a proximodistal gradient. Numerical simulations revealed that our experimental findings could be attributed to an optimal motor planning (minimum absolute work-jerk) that integrates the direction and the magnitude of gravity torque and minimizes the absolute work of forces (energy-related cost) around each joint. Present results support the general idea that the CNS implements optimal solutions according to the dynamic context of the action.

Transcranial magnetic stimulation (TMS) was used to investigate whether the excitability of the corticospinal system is selectively affected by motor imagery. To this purpose, we performed two experiments. In the first one we recorded motor evoked potentials from right hand and arm muscles during mental simulation of flexion/extension movements of both distal and proximal joints. In the second experiment we applied magnetic stimulation to the right and the left motor cortex of subjects while they were imagining opening or closing their right or their left hand. Motor evoked potentials (MEPs) were recorded from a hand muscle contralateral to the stimulated cortex. The results demonstrated that the excitability pattern during motor imagery dynamically mimics that occurring during movement execution. In addition, while magnetic stimulation of the left motor cortex revealed increased corticospinal excitability when subjects imagined ipsilateral as well as contralateral hand movements, the stimulation of the right motor cortex revealed a facilitatory effect induced by imagery of contralateral hand movements only. In conclusion, motor imagery is a high level process, which, however, manifests itself in the activation of those same cortical circuits that are normally involved in movement execution.

Listening speech sounds activates motor and premotor areas in addition to temporal and parietal brain regions. These activations are somatotopically localized according to the effectors recruited in the production of particular phonemes. Previous work demonstrated that transcranial magnetic stimulation (TMS) of speech motor centers somatotopically altered speech perception, suggesting a role for the motor system. However, these effects seemed to occur only under adverse listening conditions, suggesting that degraded speech may stimulate listeners to adopt unnatural neural strategies relying on motor centers. Here, we investigated whether naturally occurring interspeaker variability, which did not affect task difficulty, made a speech discrimination task sensitive to TMS interference. In this paradigm, TMS over tongue and lips motor representations somatotopically altered the discrimination time of speech. Furthermore, the TMS-induced effect correlated with listeners' similarity judgments between listeners' and speakers' speech productions. Thus, the degree of motor recruitment depends on the perceived distance between listener and speaker. This result supports the claim that discriminating others' speech pattern requires the contribution of the listener's own motor repertoire. We conclude that motor recruitment in speech perception can be a natural product of discriminating speech in a normally variable and unpredictable environment, not merely related to task difficulty.

The representation of actions within the action-observation network is thought to rely on a distributed functional organization. Furthermore, recent findings indicate that the action-observation network encodes not merely the observed motor act, but rather a representation that is independent from a specific sensory modality or sensory experience. In the present study, we wished to determine to what extent this distributed and 'more abstract' representation of action is truly supramodal, i.e. shares a common coding across sensory modalities. To this aim, a pattern recognition approach was employed to analyze neural responses in sighted and congenitally blind subjects during visual and/or auditory presentation of hand-made actions. Multivoxel pattern analyses-based classifiers discriminated action from non-action stimuli across sensory conditions (visual and auditory) and experimental groups (blind and sighted). Moreover, these classifiers labeled as 'action' the pattern of neural responses evoked during actual motor execution. Interestingly, discriminative information for the action/non action classification was located in a bilateral, but left-prevalent, network that strongly overlaps with brain regions known to form the action-observation network and the human mirror system. The ability to identify action features with a multivoxel pattern analyses-based classifier in both sighted and blind individuals and independently from the sensory modality conveying the stimuli clearly supports the hypothesis of a supramodal, distributed functional representation of actions, mainly within the action-observation network.

The ongoing interest in densely packed miniaturized electrode arrays for high-resolution epicortical recordings has induced many researchers to explore the use of nanomaterial coatings to reduce electrode impedance while increasing signal-to-noise ratio and charge injection capability. Although these materials are very effective, their use in clinical practice is strongly inhibited by concerns about the potential risks derived from the use of nanomaterials in direct contact with the human brain. In this work we propose a novel approach to safely couple nanocoated electrodes to the brain surface by encapsulating them with a biocompatible hydrogel. We prove that fibrin hydrogel coating over nanocoated high-density arrays of epicortical microelectrodes is electrically transparent and allows avoiding direct exposure of the brain tissue to the nanocoatings while maintaining all the advantages derived from the nanostructured electrode surface. This method may make available acute and sub-acute neural recordings with nanocoated high-resolution arrays for clinical applications.

We examined the hypothesis that predictive gaze during observation of other people's actions depends on the activation of corresponding action plans in the observer. Using transcranial magnetic stimulation and eye-tracking technology we found that stimulation of the motor hand area, but not of the leg area, slowed gaze predictive behavior (compared to no TMS). This result shows that predictive eye movements to others' action goals depend on a somatotopical recruitment of the observer's motor system. The study provides direct support for the view that a direct matching process implemented in the mirror-neuron system plays a functional role for real-time goal prediction.

Non-verbal communication enables efficient transfer of information among people. In this context, classic orchestras are a remarkable instance of interaction and communication aimed at a common aesthetic goal: musicians train for years in order to acquire and share a non-linguistic framework for sensorimotor communication. To this end, we recorded violinists' and conductors' movement kinematics during execution of Mozart pieces, searching for causal relationships among musicians by using the Granger Causality method (GC). We show that the increase of conductor-to-musicians influence, together with the reduction of musician-to-musician coordination (an index of successful leadership) goes in parallel with quality of execution, as assessed by musical experts' judgments. Rigorous quantification of sensorimotor communication efficacy has always been complicated and affected by rather vague qualitative methodologies. Here we propose that the analysis of motor behavior provides a potentially interesting tool to approach the rather intangible concept of aesthetic quality of music and visual communication efficacy.

Object A growing number of published studies have recently demonstrated the role of resection in overall survival (OS) for patients with gliomas. In this retrospective study, the authors objectively investigated the role of the extent of resection (EOR) in OS in patients with low-grade gliomas (LGGs). Methods Between 1998 and 2011, 190 patients underwent surgery for LGGs. All surgical procedures were conducted under corticosubcortical stimulation. The EOR was established by analyzing the pre- and postoperative volumes of the gliomas on T2-weighted MRI studies. The difference between the preoperative tumor volumes was also investigated by measuring the volumetric difference between the T2- and T1-weighted MRI images (ΔVT2T1) to evaluate how the diffusive tumor-growing pattern affected the EOR achieved. Results The median preoperative tumor volume was 55 cm3, and in almost half of the patients the EOR was greater than 90%. In this study, patients with an EOR of 90% or greater had an estimated 5-year OS rate of 93%, those with EOR between 70% and 89% had a 5-year OS rate of 84%, and those with EOR less than 70% had a 5-year OS rate of 41% (p < 0.001). New postoperative deficits were noted in 43.7% of cases, while permanent deficits occurred in 3.16% of cases. There were 41 deaths (21.6%), and the median follow-up was 4.7 years. A further volumetric analysis was also conducted to compare 2 different intraoperative protocols (Series 1 [intraoperative electrical stimulation alone] vs Series 2 [intraoperative stimulation plus overlap of functional MRI/fiber tracking diffusion tensor imaging data on a neuronavigation system]). Patients in Series 1 had a median EOR of 77%, while those in Series 2 had a median EOR of 90% (p = 0.0001). Multivariate analysis showed that OS is influenced not only by EOR (p = 0.001) but also by age (p = 0.003), histological subtype (p = 0.005), and the ΔVT2T1 value (p < 0.0001). Progression-free survival is similarly influenced by histological subtype (fibrillary astrocytoma, p = 0.003), EOR (p < 0.0001), and ΔVT2T1 value (p < 0.0001), as is malignant progression–free survival (p = 0.003, p < 0.0001, and p < 0.0001, respectively). Finally, the study shows that the higher the ΔVT2T1 value, the less extensive the currently possible resection, highlighting an apparent correlation between the ΔVT2T1 value itself and EOR (p < 0.0001). Conclusions The EOR and the ΔVT2T1 values are the strongest independent predictors in improving OS as well as in delaying tumor progression and malignant transformation. Furthermore, the ΔVT2T1 value may be useful as a predictive index for EOR. Finally, due to intraoperative corticosubcortical mapping and the overlap of functional data on the neuronavigation system, major resection is possible with an acceptable risk and a significant increase in expected OS.