Whole-hand sensorimotor area: cortical stimulation localization and correlation with functional magnetic resonance imaging.

OBJECT The pli de passage moyen (PPM) is an omega-shaped cortical landmark bulging into the central sulcus. There has been considerable interest in the PPM given that hand motor and sensory tasks have been found on functional magnetic resonance (fMR) imaging to activate the structure. Note, however, that the cortical function subserved by the PPM is not completely understood. Finger and thumb function are somatotopically organized over the central area and encompass a larger cortical surface than the anatomical PPM. Therefore, a sensory or motor hand area within the PPM would be redundant with the somatotopically organized digit function in the primary sensorimotor cortex. In this study the authors aimed to clarify the function subserved by the PPM and further evaluate hand area function in the primary sensorimotor cortex. METHODS To further elucidate the function subserved by the PPM, patients underwent cortical stimulation in the region of the PPM as well as fMR imaging-demonstrated activation of the hand area. Two separate analytical methods were used to correlate hand area functional imaging with whole-hand sensory and motor responses induced by cortical stimulation. RESULTS A relationship of the anatomical PPM with cortical stimulation responses as well as hand fMR imaging activation was observed. CONCLUSIONS A strong relationship was identified between the PPM, whole-hand sensory and motor stimulation responses, and fMR imaging hand activation. Whole-hand motor and whole-hand sensory cortical regions were identified in the primary sensorimotor cortex. It was localized to the PPM and exists in addition to the somatotopically organized finger and thumb sensory and motor areas.

[1]  E Wyllie,et al.  Functional anatomy of the human supplementary sensorimotor area: results of extraoperative electrical stimulation. , 1994, Electroencephalography and clinical neurophysiology.

[2]  M. Hallett,et al.  Finger Somatotopy in Human Primary Somatosensory Cortex: A PET Study , 1998, NeuroImage.

[3]  Jean-Christophe Sol,et al.  Quantification of True In Vivo (Application) Accuracy in Cranial Image-guided Surgery: Influence of Mode of Patient Registration , 2006, Neurosurgery.

[4]  D. Ferrier.  The Functions of the Brain , 1887, Edinburgh Medical Journal.

[5]  O. Foerster,et al.  THE MOTOR CORTEX IN MAN IN THE LIGHT OF HUGHLINGS JACKSON'S DOCTRINES , 1936 .

[6]  W. Penfield,et al.  SOMATIC MOTOR AND SENSORY REPRESENTATION IN THE CEREBRAL CORTEX OF MAN AS STUDIED BY ELECTRICAL STIMULATION , 1937 .

[7]  Mountcastle Vb,et al.  Central nervous mechanisms subserving position sense and kinesthesis. , 1959 .

[8]  O. Hikosaka,et al.  Vertical neuronal arrays in the postcentral gyrus signaling active touch: a receptive field study in the conscious monkey , 2004, Experimental Brain Research.

[9]  T. Allison,et al.  Functional magnetic resonance imaging of sensory and motor cortex: comparison with electrophysiological localization. , 1995, Journal of neurosurgery.

[10]  P M Rossini,et al.  Functional localization of the sensory hand area with respect to the motor central gyrus knob. , 1999, Neuroreport.

[11]  A. Grinvald,et al.  The Cortical Representation of the Hand in Macaque and Human Area S-I: High Resolution Optical Imaging , 2001, The Journal of Neuroscience.

[12]  R. Bittar,et al.  Localization of hand motor activation in Broca's pli de passage moyen. , 1999, Journal of neurosurgery.

[13]  E. A. Schafer,et al.  A Record of Experiments upon the Functions of the Cerebral Cortex , 1887 .

[14]  R. LaMotte,et al.  Fine-scale organization of SI (area 3b) in the squirrel monkey revealed with intrinsic optical imaging. , 2001, Journal of neurophysiology.

[15]  W. Penfield.  The Cerebral Cortex of Man , 1950 .

[16]  R. Frackowiak,et al.  Somatotopy of Vibrotactile Stimulation in S1: An fMRI Study. , 1998, NeuroImage.

[17]  Abbas F. Sadikot,et al.  Localization of somatosensory function by using positron emission tomography scanning: a comparison with intraoperative cortical stimulation. , 1999, Journal of neurosurgery.

[18]  D. V. van Essen,et al.  A tension-based theory of morphogenesis and compact wiring in the central nervous system. , 1997, Nature.

[19]  M. Diamond,et al.  Evidence for a mosaic representation of the body surface in area 3b of the somatic cortex of cat. , 1987, Proceedings of the National Academy of Sciences of the United States of America.

[20]  T P POWELL,et al.  Central nervous mechanisms subserving position sense and kinesthesis. , 1959, Bulletin of the Johns Hopkins Hospital.

[21]  David C Reutens,et al.  Functional topography of the low postcentral area. , 2002, Journal of neurosurgery.

[22]  A. Perneczky,et al.  Brain Lab VectorVision Neuronavigation System: Technology and Clinical Experiences in 131 Cases , 1999 .

[23]  V. Mountcastle,et al.  Some aspects of the functional organization of the cortex of the postcentral gyrus of the monkey: a correlation of findings obtained in a single unit analysis with cytoarchitecture. , 1959, Bulletin of the Johns Hopkins Hospital.

[24]  D. Thomas,et al.  Accuracy of true frameless stereotaxy: in vivo measurement and laboratory phantom studies. Technical note. , 1999, Journal of neurosurgery.

[25]  S. Small,et al.  Somatotopy in human primary motor and somatosensory hand representations revisited. , 2001, Cerebral cortex.

[26]  W. Boling,et al.  Localization of hand sensory function to the pli de passage moyen of Broca. , 2004, Journal of neurosurgery.

[27]  C. Lumenta,et al.  BrainLab VectorVision Neuronavigation System: technology and clinical experiences in 131 cases. , 1999, Neurosurgery.

[28]  Alexander Muacevic,et al.  Accuracy and clinical applicability of a passive marker based frameless neuronavigation system , 2000, Journal of Clinical Neuroscience.

[29]  A Olivier,et al.  Sensory cortical tongue representation in man. , 1983, Journal of neurosurgery.

[30]  J. Talairach,et al.  Referentially oriented cerebral MRI anatomy : an atlas of stereotaxic anatomical correlations for gray and white matter , 1993 .

[31]  V. Mountcastle.  The columnar organization of the neocortex. , 1997, Brain : a journal of neurology.

[32]  E C Wong,et al.  Processing strategies for time‐course data sets in functional mri of the human brain , 1993, Magnetic resonance in medicine.

[33]  C Henri,et al.  Use of the callosal grid system for the preoperative identification of the central sulcus. , 1992, Stereotactic and functional neurosurgery.

[34]  R W Cox,et al.  AFNI: software for analysis and visualization of functional magnetic resonance neuroimages. , 1996, Computers and biomedical research, an international journal.

[35]  N Nakasato,et al.  Primary thumb sensory cortex located at the lateral shoulder of the inverted omega-shape on the axial images of the central sulcus. , 2000, Neurologia medico-chirurgica.

[36]  M. Sur,et al.  Representations of the body surface in postcentral parietal cortex of Macaca fascicularis , 1980, The Journal of comparative neurology.

[37]  Philip Servos,et al.  Distributed digit somatotopy in primary somatosensory cortex , 2004, NeuroImage.

[38]  B. Bergamasco,et al.  Pseudo-ulnar sensory loss in a patient from a small cortical infarct of the postcentral knob , 2005, Neurology.

[39]  B L Whitsel,et al.  Minicolumnar activation patterns in cat and monkey SI cortex. , 1993, Cerebral cortex.

[40]  G. Glover,et al.  Spiral‐in/out BOLD fMRI for increased SNR and reduced susceptibility artifacts , 2001, Magnetic resonance in medicine.

[41]  A Villringer,et al.  fMRI assessment of somatotopy in human Brodmann area 3b by electrical finger stimulation , 1998, Neuroreport.

[42]  V. Mountcastle.  Modality and topographic properties of single neurons of cat's somatic sensory cortex. , 1957, Journal of neurophysiology.

[43]  M. Diamond,et al.  Demonstration of discrete place‐defined columns—segregates—in the cat SI , 1990, The Journal of comparative neurology.

[44]  B L Whitsel,et al.  Response of anterior parietal cortex to different modes of same-site skin stimulation. , 1998, Journal of neurophysiology.

[45]  H. Alkadhi,et al.  Localization of the motor hand area to a knob on the precentral gyrus. A new landmark. , 1997, Brain : a journal of neurology.