Stereotactic recordings of median nerve somatosensory‐evoked potentials in the human pre‐supplementary motor area

Median nerve somatosensory‐evoked potentials (SEPs) have been recorded using intracortical electrodes stereotactically implanted in the frontal lobe of eight epileptic patients in order to assess the waveforms, latencies and surface‐to‐depth distributions of somatosensory responses generated in the anterior subdivision of supplementary motor areas (SMAs), the so‐called pre‐SMA. Intracortical responses were analysed in two latency ranges: 0–50 ms and 50–150 ms after stimulus. In all patients, we recorded in the first 50 ms after stimulus two positive P14 and P20 potentials followed by a N30 negativity. In the hemisphere contralateral to stimulation, the P20–N30 potentials showed a clear amplitude decrease from the outer to the inner aspect of the frontal lobe with minimal amplitudes in the pre‐SMA. In the hemisphere ipsilateral to stimulus, P20 and N30 amplitudes were decreasing from mesial to lateral frontal cortex. In the 50–150 ms latency range, contacts implanted in the pre‐SMA recorded a negative potential in the 60–70 ms latency range which, in five patients, was followed by a positive response peaking 80–110 ms after stimulus. These potentials were not picked up by more superficial contacts. We conclude that no early SEP is generated in pre‐SMA in the first 50 ms after stimulation, while some potentials peaking in the 60–100 ms after stimulus are likely to originate from this cortical area. The latency of the pre‐SMA responses recorded in our patients supports the hypothesis that the pre‐SMA does not receive short‐latency somatosensory inputs via direct thalamocortical projections. More probably the pre‐SMA receives somatosensory inputs mediated by a polysynaptic transcortical transmission through functionally secondary motor and somatosensory areas.

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