Conventional functional imaging paradigms use periods of repetitive task performance to generate sustained functional signal changes. We have developed a technique of imaging the small, transient signal changes that occur after single cognitive events. The technique uses echo-planar imaging at 3 T to generate functional images of the whole brain with a temporal resolution of 3 seconds. It uses a signal averaging technique to create time sweeps of functional activity. After a single cognitive event, widely distributed patterns of brain activation can be detected and their time course measured. This technique enables the individual cognitive tasks that constitute a paradigm to be analyzed separately and compared. We describe the application of this new technique to separate the cognitive elements in a simple "go/no-go" motor paradigm. Comparison of activation patterns during "go" and "no-go" responses reveals hierarchical subdivision of the medial premotor cortex into an anterior region (presupplementary motor area) involved in movement decision making and a posterior region (supplementary motor area proper) directly involved in motor execution.

Previous functional magnetic resonance imaging (fMRI) studies have demonstrated digit somatotopy in primary somatosensory cortex (SI), and even shown that at high spatial resolution it is possible to resolve within-digit somatotopy. However, fMRI studies have failed to resolve the spatial organisation of digit representations in secondary somatosensory cortex (SII). One of the major limitations of high spatial resolution fMRI studies of the somatosensory system has been the long acquisition time needed to acquire slices spanning both SI and SII. Here, we exploit the increased blood oxygenation level dependent contrast of ultra-high-field (7 Tesla) fMRI and the use of multiband imaging to study the topographic organisation in SI and SII with high spatial resolution at the individual subject level. A total of n = 6 subjects underwent vibrotactile stimulation of their face, hand digits and foot (body imaging) and their individual hand digits (digit mapping) for each left and right sides of the body. In addition, n = 2 subjects participated only in the body imaging experiment on both their left and right sides. We show an orderly representation of the face, hand digits and foot in contralateral primary cortex in each individual subject. In SII, there is clear separation of the body areas of the face, hand and foot but the spatial organisation varies across individual subjects. However, separate representation of the individual digits of the hand in SII could not be resolved, even at the spatial resolution of 1.5 mm due to largely overlapping representations.

Botulinum toxin (BoNT) injections are an effective treatment for cervical dystonia. Approximately 20% of patients eventually stop BoNT treatment, mostly because of treatment failure. These recommendations review the different therapeutic interventions for optimising the treatment in secondary poor responder patients. Immunoresistance has become less common over the years, but the diagnosis has to be addressed with a frontalis test or an Extensor Digitorum Brevis test. In case of immunoresistance to BoNT-A, we discuss the place the different therapeutic options (BoNT-A holidays, BoNT-B injections, alternative BoNT-A injections, deep brain stimulation). When poor responders are not immunoresistant, they benefit from reviewing (1) injections technique with electromyography or ultrasound guidance, (2) muscles selection and (3) dose of BoNT. In addition, in both scenarios, a holistic approach including drug treatment, retraining and psychological support is valuable in the management of these complex and severe cervical dystonia.