Cortical connectivity and spectral perturbations underlying TENS stimulation of hand nerves: a case study

The major challenge in upper limbs neuroprosthetic improvement is the implementation of effective sensory feedback. Transcutaneous electrical nerve stimulation (TENS) of the median and ulnar nerves confirmed, with electroencephalographic (EEG) recordings, the presence of appropriate responses in relevant cortical areas with induced sensation successfully located in the innervation regions of each nerve. The characterization of these elicited responses could be used to recreate precise somatotopic feedback from hand protheses. Using TENS and EEG, the purpose of this study was to detect distinctions in time-frequency cortical dynamics and connectivity occurring after stimulation of hand nerves. Region of interest (ROI) were selected according to topographical distributions and Somatosensory Evoked Potentials (SEP) localization and were named Contralateral Parietal (Cont P), Central Frontal (Cent F) and Superior Parietal (Sup P). The analysis of cortical oscillations showed spectral inflections in theta [4-7 Hz] and alpha [7.5-12.5 Hz] band which occurred at 60 ms in Cont P and 300 ms in Sup P and prominent for the ulnar condition over the median one. The beta band decrease [16-30 Hz] which occurred in the same ROIs was especially significant after ulnar stimulation too. Effective connectivity measures did not differ significantly across conditions but exhibited some slight difference in the alpha-band causal flow coming from Cent F in direction to Cont P and Sup P. Although pending completion of multiple-subjects study, these results already suggest magnitude differences in somatosensory spectral fluctuations and sensorimotor interactions flows.