Fibers connecting the primary motor and sensory areas play a role in grasp stability of the hand

The goal of this study was to evaluate the function of fibers that connect the hand area of the primary motor and sensory cortices. A 63-year-old male with a metastatic brain tumor located in the left primary motor area underwent awake surgery. During removal of the tumor, the posterior end of the primary motor cortex, including the fibers between the motor and sensory cortex, was resected, as confirmed by 3D reconstruction of fMRI and diffusion tensor imaging (DTI). Preoperative fMRI with right hand clenching revealed activation in the area around the tumor in the primary motor area. Postoperative fMRI with right hand clenching showed posterior shift of the activation to the sensory area. In contrast, 3D reconstruction of fMRI and DTI with left hand clenching showed activation of cortex corresponding to the motor and sensory hand area. Postoperative neurological examination revealed no change in right hand strength, but the patient complained of decrease right hand grasp stability when he concentrated on using his left hand. These findings suggest that the fibers connecting the primary hand motor and sensory areas play a role in the hand grasp stability.

[1]  P. Basser,et al.  Diffusion tensor MR imaging of the human brain. , 1996, Radiology.

[2]  R. Johansson,et al.  Evidence for the involvement of the posterior parietal cortex in coordination of fingertip forces for grasp stability in manipulation. , 2003, Journal of neurophysiology.

[3]  M. Solaiyappan,et al.  In vivo three‐dimensional reconstruction of rat brain axonal projections by diffusion tensor imaging , 1999, Magnetic resonance in medicine.

[4]  Mitchel S. Berger,et al.  Brain Mapping Techniques to Maximize Resection, Safety, and Seizure Control in Children with Brain Tumors , 1989 .

[5]  A. Alexander,et al.  White matter tractography using diffusion tensor deflection , 2003, Human brain mapping.

[6]  J. Byrne,et al.  Neural analogue of long-term sensitization training produces long-term (24 and 48 h) facilitation of the sensory-to-motor neuron connection in Aplysia. , 1994, Journal of neurophysiology.

[7]  R. Cox,et al.  Functional MR activation correlated with intraoperative cortical mapping. , 1997, AJNR. American journal of neuroradiology.

[8]  V. Wedeen,et al.  Reduction of eddy‐current‐induced distortion in diffusion MRI using a twice‐refocused spin echo , 2003, Magnetic resonance in medicine.

[9]  S. Ronner,et al.  Cortical mapping for defining the limits of tumor resection. , 1987, Neurosurgery.

[10]  G. Joshi,et al.  Use of the laryngeal mask airway during awake craniotomy for tumor resection. , 2000, Journal of clinical anesthesia.

[11]  H. Asanuma,et al.  Functional role of the sensory cortex in learning motor skills in cats , 1989, Brain Research.

[12]  H. Asanuma,et al.  Projection from the sensory to the motor cortex is important in learning motor skills in the monkey. , 1993, Journal of neurophysiology.

[13]  Geoff J. M. Parker,et al.  Characterizing function–structure relationships in the human visual system with functional MRI and diffusion tensor imaging , 2004, NeuroImage.

[14]  T A Yousry,et al.  Topography of the cortical motor hand area: prospective study with functional MR imaging and direct motor mapping at surgery. , 1995, Radiology.

[15]  P. Basser,et al.  MR diffusion tensor spectroscopy and imaging. , 1994, Biophysical journal.

[16]  P Jenmalm,et al.  Visual and Somatosensory Information about Object Shape Control Manipulative Fingertip Forces , 1997, The Journal of Neuroscience.

[17]  M. Raichle,et al.  Tracking neuronal fiber pathways in the living human brain. , 1999, Proceedings of the National Academy of Sciences of the United States of America.

[18]  Karl J. Friston,et al.  Comparing Functional (PET) Images: The Assessment of Significant Change , 1991, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[19]  R. Johansson,et al.  Reactive control of precision grip does not depend on fast transcortical reflex pathways in X‐linked Kallmann subjects , 2000, The Journal of physiology.

[20]  Pratik Mukherjee,et al.  Subcortical pathways serving cortical language sites: initial experience with diffusion tensor imaging fiber tracking combined with intraoperative language mapping , 2004, NeuroImage.

[21]  Gordon L. Kindlmann,et al.  Tensorlines: advection-diffusion based propagation through diffusion tensor fields , 1999, Proceedings Visualization '99 (Cat. No.99CB37067).

[22]  John S. Duncan,et al.  Combined functional MRI and tractography to demonstrate the connectivity of the human primary motor cortex in vivo , 2003, NeuroImage.

[23]  G. Ojemann,et al.  Cortical language localization in left, dominant hemisphere. An electrical stimulation mapping investigation in 117 patients. , 1989, Journal of neurosurgery.