Frontiers in Human Neuroscience

Many pathological conditions, including chronic pain (CP), can impair cognitive functions. These functions are essential for adapting and evolving in concordance with the environment, which are key processes for coping with CP. However, in CP centers, cognitive assessment is rarely included in CP patient follow-up due to a lack of time, appropriate tools, or trained health professionals. To fill this gap, our team developed EasyCog, a digital tool that enables rapid self-assessment of cognitive functions. It enables cognitive evaluation without an experimenter's help, thanks to speech recognition powered by an artificial neural network. In the initial validation steps, we established normative values for 7 cognitive functions on a cohort of 76 healthy subjects. Because EasyCog includes tests comparable to the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE), we assessed its reliability against available normative values. To assess its specificity, we compared data from healthy subjects with 15 subjects with mild cognitive impairment (MCI) and 15 age-matched CP patients selected from a medical center. Finally, we tested EasyCog's test-retest reliability by repeating sessions at different time intervals. EasyCog showed excellent sensitivity to age-related decline, similar to MoCA normative values. Several cognitive functions were significantly and differentially impaired in MCI subjects and CP patients compared to normative values in healthy subjects, confirming good specificity. Finally, test-retest analysis showed no effect at a 4-month interval. In conclusion, EasyCog appears to be a convenient and reliable numeric tool for rapidly assessing and monitoring cognitive functions in patients.

Visual wayfinding is essential for safe navigation but remains poorly characterized in people with ultra-low vision (ULV). Because assessing complex environments in the real world carries safety risks, this study utilized a calibrated virtual reality (VR) platform to safely quantify navigation. Participants with ULV, normal vision (NV), and simulated ULV (sULV) completed tasks across three environments (street crossing, cafeteria, and metro station) of increasing complexity to determine which metrics best capture task difficulty. Navigation metrics included motion onset latency, walking speed, path efficiency, and turn deviation derived from head position data. Participants with ULV showed longer onset latency, slower walking speed, reduced path efficiency, and greater turn deviation compared with NV, while sULV showed intermediate performance. These metrics successfully reflected increasing task difficulty across environments, with the metro station posing the greatest challenge. Path efficiency consistently detected differences between environments across groups, whereas turn deviation provided insight into complex tasks. Findings indicate that diverse virtual environments capture distinct aspects of navigation that cannot be safely studied in the real world, and trajectory-based metrics capture navigation behavior more effectively than conventional measures. VR-based assessment offers a useful approach for evaluating functional navigation and guiding rehabilitation strategies in profound vision loss.

Neuromarketing mainly seeks to enhance the prediction of marketing stimuli success, such as commercials and movie trailers, by integrating neurophysiological measures with traditional behavioral measures. In the current study, the authors tested whether neural activity could predict consumer valuation and how preferences change after watching commercials, both immediately and over time. Participants (n=161) watched images of products followed by commercials advertising those products while their neural activity was recorded using electroencephalograph (EEG). They watched the product images again a week later without EEG recordings. Immediately after each stimulus exposure, participants stated their willingness to pay (WTP) for the product and how much they liked the commercial. Standard EEG measures showed weak and inconsistent relationships with behavior and yielded near-chance predictions. In contrast, deep learning models applied to the raw neural data achieved substantially higher predictive accuracy, successfully predicting both immediate and delayed WTP and ad liking. Importantly, the authors were able to successfully predict preferences for new participants and/or new products the models were not trained on. However, accuracy declined as generalization demands increased. Moreover, prediction performance declined as value differences narrow. Together, these findings show that neural responses carry reliable and temporally persistent information about consumer valuation and its evolution over time.

Purpose: Fibromyalgia involves chronic widespread pain and heightened movement evoked pain (MEP), which can limit access to resistance training's functional and psychological benefits by hindering exercise participation and adherence. This study aimed to determine whether transcutaneous electrical nerve stimulation (TENS) applied during resistance exercise reduces MEP in women with fibromyalgia. Materials and methods: 21 women with fibromyalgia performed 2 sets of 10 leg press repetitions at 60% predicted 1 RM while receiving randomized active TENS (100 Hz) or sham TENS. Pain intensity and unpleasantness (0 to 10 numerical rating scales) were assessed at baseline, immediately post exercise, 15 min post-exercise, end-of-day, and 24h later. Results: Active TENS led to a greater reduction in post-exercise pain than sham, with 90% of participants experiencing at least a 15% decrease in whole body pain 15 minutes post-exercise, compared to none in the sham group. No group differences were observed at the end of the day or 24h after the exercise session. Conclusion: These results suggest that a single session of high frequency TENS during resistance exercise can produce short term reductions in MEP in women with fibromyalgia. While effects did not persist at 24h, these short-term effects may help mitigate acute exercise related pain and support early training adherence.

Immersive technologies, encompassed within the x reality (XR) framework spanning the reality virtuality continuum, are emerging as tools to facilitate behavioral adaptation through interaction with controlled environments. Yet, how XR features shape users behavior remains poorly understood, particularly when a coordination between cognitive and motor demands is required. Among these features, body visualization (i.e., how the user body is rendered within the environment), is especially relevant to XR usages in rehabilitation and skill training, since body related feedback is known to strongly influence movement adaptation under cognitive motor interference. Still, whether and how different body visualization scenarios shape movement adaptation and what are the underlying neural processes, remains unclear. To address these questions, thirty healthy young adults performed a stepping task concurrently with an updating n back task under three body visualization scenarios (real body, no body, and a knee position cue) and four levels of dual tasks while we recorded high density mobile electroencephalography. The absence of body visualization impaired motor performance, reducing stepping accuracy and increasing omissions. Remarkably, a knee position cue alone restored performance to real body levels, without improving embodiment. This behavioral benefit co occurred with neural modulations reflecting enhanced conflict monitoring and adjusted motor preparation, evidenced by changes in the frontocentral N450 component and sensorimotor alpha and beta activity, respectively. These findings indicate that minimal body related visual cues, rather than full visualization, can support cognitive motor performance in XR, without altering embodiment. They position cueing as a practical design strategy for movement related XR usages and motivate further investigations of other forms of body related feedback to optimize cognitive motor behavior.

Background: Although typically considered an auditory experience, music listening engages multiple sensory systems, including somatosensory and motor pathways, making it an inherently multisensory phenomenon. However, research has predominantly examined the influence of music on other sensory systems, while the reciprocal question - how the existing state of a sensory system modulates the music listening experience- has received considerably less attention. To address this gap, we examined neural activity during music listening in two somatosensory states: one preceded by vibroacoustic stimulation (VAS) and one preceded by rest alone. Methods: Forty participants completed two MEG sessions in a within-subject crossover design. In one session, they received 20 minutes of 40 Hz VAS before listening to 10 minutes of self-selected relaxing music (VAS_ML); in the other, they lay on the same mattress without stimulation (NoVAS_ML). Oscillatory and aperiodic activity were estimated using DICS beamforming and FOOOF decomposition for the whole music period and for early and late listening segments. Results: Across the full listening period, the VAS condition was associated with reduced alpha power in the posterior temporal lobe and increased low-gamma power in the medial somatosensory and motor cortices compared to the NoVAS condition, suggesting enhanced cortical excitability and stronger auditory-motor engagement. Over time, both music listening conditions showed increases in alpha and beta power, consistent with habituation to the musical stimulus, though the spatial distribution differed qualitatively: changes were widespread across temporal and occipital regions in the NoVAS condition but remained localized to temporal areas after VAS. Additionally, VAS uniquely increased temporal-lobe theta power over time, whereas the NoVAS condition showed a decrease in the aperiodic exponent. Subjectively, participants reported stronger emotional intensity during music listening after VAS. Conclusion: These findings suggest that preceding VAS induces a more engaged neural state and qualitatively alters the temporal dynamics of music processing.

Communication is inherently interactive, yet most neuroimaging studies examine individuals in isolation. Here, we used functional near-infrared spectroscopy (fNIRS) hyperscanning to investigate interbrain synchrony (IBS) during naturalistic communication. In Study 1, 13 healthy familiar dyads completed Joint Singing, Joint Reading, and Picture Guessing tasks. IBS was quantified using wavelet transform coherence across bilateral frontal and temporoparietal regions. Joint Singing produced higher IBS than the other tasks in several regions, including the dorsolateral prefrontal cortex and temporoparietal junction, and selected effects were greater in true than pseudo-dyads. In Study 2, we applied the same paradigm to five individuals with chronic post-stroke aphasia interacting with trained speech-language pathologists. IBS could be estimated in all dyads after lesion-informed channel exclusion, although regional coverage varied with lesion location. These findings demonstrate that fNIRS hyperscanning can capture task-dependent interpersonal neural coupling during spoken interaction and can be extended to communication involving individuals with aphasia. This approach provides a foundation for studying how neural coordination between communication partners relates to functional communication and partner-supported interaction.

Purpose: Electrical stimulation of the occipital cortex evokes visual percepts known as phosphenes. To date, most human studies have examined phosphenes elicited by large surface or depth electrodes. These differ considerably from the small penetrating intracortical microelectrodes capable of stimulating highly localized cortical populations that are the basis of current next-generation devices. Here, we provide a detailed characterization of phosphenes evoked by such intracortical microelectrodes. Methods: As part of the CORTIVIS clinical trial, a Utah Electrode Array with 100 penetrating electrodes was implanted in the early visual cortex of four blind volunteers. Participants completed drawing and description tasks in response to single-electrode stimulation. Two participants also performed forced-choice tasks to determine whether phosphenes elicited by different electrodes could be reliably discriminated. Results: Single-electrode stimulation reliably evoked phosphenes in all participants. Most percepts appeared in the contralateral visual field, although two participants reported near-midline ipsilateral percepts. Phosphenes ranged from simple dots to elongated, textured, circular, or otherwise idiosyncratic forms. One participant reported distinguishable phosphene colors, which depended on electrode and amplitude structure and varied across sessions. The two participants tested on forced-choice discrimination could successfully identify electrode-specific phosphenes across multiple sessions. Conclusions: Intracortical microstimulation of the human visual cortex produces phosphenes with diverse, electrode-specific appearances that are recognizable across repeated trials. These findings indicate that penetrating microelectrodes often evoke more structured percepts than simple points or blobs, providing foundational evidence that electrode-specific encoding strategies will be necessary in future visual prosthetic devices.

Background: Chronic pain affects hundreds of millions worldwide and remains a major clinical challenge, despite numerous available treatments. Advances in brain imaging offer a promising path toward identifying neural signatures of chronic pain, potentially enhancing diagnosis and guiding treatment. However, while a core set of brain regions, including the insula, cingulate, and somatosensory cortices, has been repeatedly implicated, findings regarding other regions and connectivity patterns involved remain inconsistent, with limited robust replication. Objective: To address these gaps, the present work characterizes resting-state functional connectivity and gray matter volume differences between chronic pain patients and pain-free controls. Methods: In this secondary analysis of publicly available data, anatomical and resting-state functional MRI were analyzed from 56 patients with chronic knee pain due to osteoarthritis and 20 pain-free controls. Group comparisons used Network-Based Statistic (NBS) and Bayesian multivariate regression models, controlling for demographic covariates. Results: In the pain group, about 75% of parcellated brain regions exhibited increased functional connectivity compared to controls. The 30 highest degree centrality regions in the NBS network were concentrated in regions consistent with prior pain neuroimaging findings. Additionally, chronic pain patients exhibited reduced gray matter volume (-3.98%; SD 1.2%) across 33% of parcellated brain regions, including key regions implicated in pain processing. Conclusions: These findings demonstrate widespread functional and anatomical neural alterations in chronic pain, revealing a global pattern of reorganization extending beyond previously reported network-pair effects. Characterizing such alterations may contribute to ongoing efforts to identify neuroimaging markers of chronic pain, with potential translational relevance.

PurposeSpeech perception is a fundamental part of everyday communication that relies on more than simple identification of words and sentences. Attention and listening engagement both contribute to speech perception, while representing distinct aspects of the listening experience. Attention is typically associated with cognitive focus, whereas listening engagement additionally involves cognitive and affective immersion in sound. Despite their importance, these states remain difficult to disentangle, behaviorally and physiologically. Both have been linked to interpersonal synchronization (the synchronization of biobehavioral signals across individuals), raising questions about what this synchronization actually reflects. MethodIn this study, we disentangled attention and listening engagement by independently manipulating both factors within a single experiment. Thirty participants listened to two simultaneously presented streams of meaningful speech and were instructed to focus on only one. Both attended and unattended stimuli were designed to be either engaging or non-engaging. Neural activity was recorded using EEG, while physiological responses were measured using heart rate and electrodermal activity. ResultsInterpersonal synchronization was computed from neural and bodily signals, alongside a self- report measure of listening engagement and auditory attention decoding (AAD), a neural measure of selective attention. Interpersonal synchronization of all three modalities significantly predicted listening engagement, whereas neural interpersonal synchronization was the only measure that significantly predicted attention. These findings suggest that attention is primarily driven by cognitive processes represented in the brain, while listening engagement additionally involves affective processes that are more strongly reflected in bodily responses. ConclusionsOverall, this study demonstrates that different forms of interpersonal synchronization reflect distinct dimensions of the listening experience and supports interpersonal synchronization as a potential objective marker of listening engagement.

Objective: Perceived injustice is a psychosocial risk factor associated with delayed recovery and poor occupational outcomes among workers with pain conditions. We examined a theory-informed pathway linking occupational stressors, perceived injustice, pain interference, depressive symptoms, and insomnia, while evaluating selected measurement properties of the Japanese Injustice Experience Questionnaire-Short Form (IEQ-SF-J). Methods: This cross-sectional online survey included 600 Japanese workers (300 with headache and 300 with low back pain). Structural validity of the IEQ-SF-J was evaluated using exploratory and confirmatory factor analyses (CFA) and item response theory. Construct validity was examined using Spearman correlations. Structural equation modelling (SEM) estimated indirect associations between job demands or low job control and pain interference, depressive symptoms, and insomnia, with perceived injustice specified as a latent intervening construct. Results: CFA supported a unidimensional structure (comparative fit index = 0.993; root mean square error of approximation = 0.080). Internal consistency was acceptable (Cronbach's ; = 0.82; McDonald's {omega}; = 0.90), and test-retest reliability was moderate (intraclass correlation coefficient = 0.60). IEQ-SF-J scores correlated significantly with pain interference, insomnia, and depressive symptoms. Job demands and low job control showed significant indirect associations with all three outcomes involving perceived injustice. Conclusions: The IEQ-SF-J showed supportive evidence for several measurement properties and occupied a theoretically coherent position in associations linking occupational stressors with pain interference, depressive symptoms, and insomnia among workers with headache or low back pain.

The primary goal of a brain-computer interface (BCI) is to enable interactions with the environment by generating control signals directly from brain activity, independent of physical movement including gaze shifts. Attentional selection of peripheral objects has been used to control a BCI but requires sufficient visual acuity to reliably recognize the target stimulus. Here, we systematically investigated the effect of different stages of visual impairment on event-related potentials (ERPs) and BCI performance while healthy participants directed covert attention to peripheral visual stimuli. We hypothesized that the effect of visual impairments such as blurred or monocular vision might alter attention-related visual ERPs, but has only minor or no impact at all on BCI performance when color is the target feature. Early attention sensitive visual components were altered in monocular vision compared to binocular vision. Simulated vision degradation resulted in reduction of ERPs in the P300 range. The differences in ERPs across vision conditions did not affect the decoding accuracy of the BCI. The study not only revealed differences of visual ERPs in different viewing conditions but primarily demonstrated that a BCI can be reliably controlled by focusing attention on a visual stimulus whose distinguishing features such as color, can be recognized even with visual impairments. This provides a promising approach to enable paralyzed persons to communicate using a non-invasive, gaze-independent BCI.

Irritable bowel syndrome (IBS) is a common disorder of brain-gut interaction characterized by recurrent abdominal pain and altered bowel habits. Although music-based interventions (MBIs) have shown benefits on pain and stress, the mechanisms associated with MBI-related changes in IBS pain remain poorly understood, and the feasibility of capturing these responses using multimodal wearable monitoring in everyday settings has not been established. This protocol describes a single-arm pilot mechanistic trial examining clinical and multimodal mechanistic responses to an MBI in adults with IBS and the feasibility of extending physiological monitoring from the laboratory to home settings. Thirty-six adults aged 18-50 years with provider-confirmed IBS will be enrolled, with approximately 30 expected to complete the post-intervention laboratory visit. Participants will receive board-certified music therapist-guided laboratory sessions and complete four weeks of self-administered home practice using a standardized 20-minute MBI protocol at least five days per week. Guided by a brain-gut mechanistic framework, assessments will include patient-reported pain, stress, and IBS symptoms; quantitative sensory testing; gut microbiome profiling using 16S rRNA gene sequencing; and multimodal physiological recordings of neural, autonomic, and muscular activity. Analyses will characterize within-session and longitudinal changes in clinical and mechanistic measures and assess recruitment, retention, MBI adherence, wearable data completeness, and participant acceptability. Findings will inform the selection of candidate mechanisms and wearable monitoring approaches for evaluation in a future adequately powered randomized controlled trial.

Background Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and post-COVID condition are complex, debilitating illnesses characterized by persistent fatigue and post-exertional malaise. Recovery is uncommon without targeted intervention; however, emerging clinical reports suggest that a subset of patients experience full resolution of symptoms after engaging in mind-body approaches. Patient perspectives on these interventions are divided, and qualitative evidence exploring successful recovery pathways is rare. This protocol outlines a study to investigate the contextual factors and patient-constructed explanations surrounding full recovery from ME/CFS or post-COVID condition using mind-body approaches. Methods and analysis We will employ a qualitative descriptive design rooted in a constructivist paradigm. Purposive and snowball sampling will be used to recruit approximately 20 adults from established infection-associated fatigue networks who self-report full recovery (lasting three months or more) from ME/CFS or post-COVID condition following a mind-body approach. Data will be collected through semi-structured interviews conducted via Zoom, and investigator reflexivity will be reported. Demographic information, including comorbidities, will be documented to contextualize the sample. Data will be analyzed inductively using reflexive thematic analysis. To ensure research rigor and reporting transparency, the study will adhere to the 15-point checklist of criteria for good thematic analysis proposed by Braun and Clarke. Dissemination We will publish our findings in a peer-reviewed, open-access journal and present at relevant academic conferences. A lay summary of the results will also be shared directly with participating patient recovery networks.

The validation of objective neurophysiological monitoring of concussion from diagnosis to return to play has the potential to improve the clinical care of athletes. Extracted from event-related potentials (ERP), brain vital signs offer a non-invasive objective neurophysiological measure of three well established ERP responses that complement existing clinical assessments: 1) the N100 response related to auditory sensation; 2) the P300 response related to basic attention; and 3) the N400 response related to cognitive processing. The N400, in particular, has increasingly been demonstrated to be sensitive to head impact related cognitive impairment. Accordingly, brain vital sign measures were collected in n =165 rugby league players from two Australian professional National Rugby League clubs (NRL), with concussed players (n =26) being subsequently assessed over a total of five separate time points (Baseline, Day 2, Day 5, Day 10, and Day 42). This timeline aligned with acute (Day 2), NRL mandatory minimum return-to-play (RTP) guidelines (Day 10), and an extended post RTP period. Relative to baseline, the results revealed significant N400 cognitive processing latency delays at Day 2 post-concussion (p =0.002). The N400 latency delays persisted past day 5, significantly returning to baseline values at Day 10, consistent with the RTP mandatory minimum requirement. The findings indicated that neurophysiological recovery occurred in this cohort within an approximate 10-day time frame. Future studies monitoring brain vital sign changes across the trajectory of injury to recovery are needed in sports related concussion management.

Significance: Misophonia is characterized by decreased tolerance to specific sounds ("triggers") that evoke negative emotional, physiological, and behavioral responses. To understand the neural mechanisms underlying misophonia, functional neuroimaging has been proposed such as functional magnetic resonance imaging (fMRI). However, the fMRI environment introduces substantial noise that increases anxiety, which is one of the comorbidities of misophonia, confounds auditory stimuli, and is costly. We therefore propose an alternative, functional near-infrared spectroscopy (fNIRS) to detect misophonia-related responses. Aim: We evaluated the feasibility of fNIRS to detect misophonia-related sound-evoked responses. Approach: We measured fNIRS, electrodermal activity (EDA), and photoplethysmography (PPG) data from ten adults with minimal to mild misophonia symptoms while they listened to trigger, unpleasant, and neutral sounds. Participants rated their annoyance and antisociality after each sound. Results: Compared with neutral sounds, trigger and unpleasant sounds received higher subjective ratings and evoked greater neural response in the orofacial area. Neural responses tended to increase with annoyance ratings. Significantly lower heart rate (HR) was observed during unpleasant sounds than during neutral and trigger sounds, with no significant difference in EDA features. Conclusions: fNIRS can measure misophonia responses in a quiet setting. Both brain and physiological responses have the same trend observed in prior fMRI studies, verifying its feasibility.

Flow is a subjective state where tasks feel effortless and rewarding. It has been linked to distinct neural signatures, yet dynamics of these signals remain poorly understood. Here, we investigated spectral dynamics of brain activity in flow. We recorded electroencephalogram (EEG) data at positions AF7, AF8, TP9, and TP10 using a lightweight wearable device worn by ten adult participants while they completed a go-signal task and two stop-signal tasks. Task difficulty was continuously adjusted to induce either a sense of flow or frustration. Time-resolved spectral power and interregional coherence were extracted with continuous wavelet and wavelet coherence transforms; subjective flow was assessed after each block with the short-form Flow-State Scale. Subjective ratings confirmed that the flow and frustration conditions diverged in perception of flow. In the flow block, errors on stop trials coincided with pre-stimulus reductions in right temporoparietal gamma power and frontal beta and gamma power, alongside diminished frontotemporal gamma coherence. Comparison of flow and frustration revealed higher temporal beta power during frustration, consistent with greater cognitive load. Flow may involve finely balanced beta and gamma dynamics, and brief collapses of these rhythms may predict task errors. Spectral dynamics are actionable features for closed-loop engagement monitoring applications.

Mobile EEG can link neuroimaging to natural behavior, but effects recorded during movement, and sport in particular, are difficult to interpret because neural activity overlaps with signals from movement, muscle activity, and cable movement artifacts. We analyzed the OpenNeuro Real World Table Tennis dataset to test whether peri-hit spectral activity could be analyzed and how it differed between human-opponent and ball-machine play. Data from 25 participants comprising EEG, noise-layers, EMG and motion recordings was analyzed with pre-hit, impact, and post-hit windows. EEG power bands were residualized using trial-level root mean square from noise-layer, EMG, and motion/miscellaneous channels. Spectral parameterization modeled spectra as an aperiodic component plus periodic peaks. The principal short-window model was resolution-aware; sensitivity analyses reduced model complexity, used a 2.0-s peri-hit subwindow (-1.0 to +1.0 s), or disabled periodic fitting. Results showed residualized alpha and beta power was lower during ball-machine play, including pre-hit posterior alpha power. The clearest context difference was a higher ball-machine aperiodic exponent over posterior and parietal sensors, corresponding to a steeper broadband spectral slope. Posterior post-hit means were 0.451 and 0.606 for human-opponent and ball-machine play, respectively. A focal parietal effect persisted across specifications. The results support artifact-informed, resolution-aware spectral analysis as an effective approach for detecting robust spectral differences between naturalistic visuomotor contexts and suggest that EEG may provide useful information about the processes engaged by different practice environments, without establishing a single cognitive or physiological mechanism or demonstrating a training outcome.

Chronic spatial neglect after right-hemisphere stroke reflects network dysfunction, with recovery influenced by structural connectivity. Music recruits coordinated bi-hemispheric activity and may promote interhemispheric communication after stroke. Following our pilot study in post-stroke aphasia, we asked whether classical music modulates connectivity and behavior in chronic neglect. Three patients completed a crossover protocol comparing two weeks of daily audiovisual classical music with an audiobook control, with neglect, mood, quality-of-life, diffusion MRI, and resting-state high-density EEG measures. All showed right superior longitudinal fasciculus II disconnection with preserved callosal pathways. In N2, line bisection shifted leftward across all five lines after music, together with increased posterior interhemispheric theta-band weighted symbolic mutual information (wSMI), then deteriorated into the pathological range after the audiobook, without mood improvement. N1 showed mixed behavioral effects, with mood and quality of life improving after music. N3 showed no significant spatial improvement and worsened mood after music. These heterogeneous responses motivate larger studies of connectional predictors. The findings support the feasibility of classical music as an adjunct to neglect rehabilitation and suggest that cognitive changes may occur independently of mood, while the audiobook cannot be considered an inert control.

ObjectivesStroke commonly impairs proprioception and motor function, yet the cortical sensory processes underlying these impairments remain poorly understood. Prior electrophysiological studies have primarily focused on the average magnitude of unilateral cortical sensory responses to vibration, potentially overlooking distributed and trial-to-trial features of sensory processing that may be functionally relevant to proprioceptive processing and motor performance. We therefore aimed to characterize bilateral cortical sensory responses to determine their relationships with proprioceptive and motor function. MethodsEEG was recorded from forty-six individuals with chronic stroke during a rapid, passive, vibrotactile stimulation paradigm applied to the left and right fingertips. Somatosensory evoked potentials (SEPs) and event-related desynchronization (ERD) were quantified. Finger proprioceptive performance was assessed using a passive, robotic, finger crossing identification task, while motor function was evaluated using the Box and Block Test, Fugl-Meyer Assessment, and Nine Hole Peg Test. Associations with function were assessed using (i) unilateral sensory response magnitude at the contralateral parietal cortex and (ii) somatosensory decoder performance, defined as the accuracy with which a decoder identified the location of the stimulated hand (i.e. paretic vs. non-paretic) from combined bihemispheric response patterns. The association between these responses and proprioceptive ability and motor function was assessed. These associations were further evaluated jointly across multiple motor function measures using an exploratory analysis leveraging nonlinear dimensionality reduction and clustering. ResultsVibrotactile stimulation of the paretic hand elicited ipsilesional SEP and ERD that were reduced in magnitude compared to stimulation of the non-paretic hand. Both decreased SEP magnitude and reduced sensory decoder performance were associated with greater finger proprioceptive error. Unlike unilateral responses, the somatosensory decoders performance was also strongly associated with motor function, explaining approximately 22.5% of the variance in motor performance. Dimensionality reduction and clustering across multiple motor assessment scores showed distinct subgroups, that showed significant differences in sensory decoding. ConclusionsThe hemispheric distribution and discriminability of cortical sensory responses are functionally relevant markers of sensorimotor integrity after stroke. Assessing relative lateralization of somatosensory responses for each hand, rather than the magnitude of dominant contralateral responses alone, may better capture the reliability of sensory processing after stroke, as well as the distributed cortical reorganization supporting sensorimotor function. These findings support the potential value of a novel decoding-based neurophysiological measure for sensory-driven rehabilitation, biomarker development, and patient stratification.