A probabilistic map of the human ventral sensorimotor cortex using electrical stimulation
A probabilistic map of the human ventral sensorimotor cortex using electrical stimulation
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DOI：
10.3171/2014.11.jns14889
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发表时间：
2015-08-01
影响因子：
4.1
通讯作者：
Chang, Edward F.
中科院分区：
文献类型：
--
作者：
Breshears, Jonathan D.;Molinaro, Annette M.;Chang, Edward F.
对象人类腹侧感觉运动皮层（vSMC）参与面部表情、咀嚼和吞咽，以及人类言语产生的动态和高度协调的运动。然而，vSMC 组织仍然知之甚少，之前发表的人口驱动的体细胞图并不能以定量、概率的方式准确反映个体之间的变异性。本研究的目的是描述 vSMC 对电刺激的反应，生成 vSMC 功能的概率图，并量化个体之间的变异性。 方法 收集 33 名接受清醒开颅手术的患者术中 vSMC 电刺激的照片、视频和立体定向 MRI 数据。刺激部位被转换为基于解剖标志的二维坐标系。对运动、感觉和言语刺激反应进行了审查和分类。生成了刺激反应的概率图，并对空间方差进行了量化。 结果 在 33 名患者中，作者确定了 194 名运动反应、212 名感觉反应、61 名言语停滞和 27 名混合反应。反应是复杂的、刻板的，并且大多是非生理性的运动，涉及手、口面部和喉部的肌肉组织。在个体中，口头运动表征的存在各不相同。然而，背腹顺序始终保留。最强烈的运动反应是下巴（概率 0.85）、舌头（0.64）、嘴唇（0.58）和喉咙（0.52）。 6 名患者 (0.18) 出现发声，多发于靠近嘴唇和背喉区域的背部。感觉反应在空间上是分散的；然而，患者的主观报告在口腔内的定位非常精确。最强烈的反应包括舌头（0.82）和嘴唇（0.42）。言语停止的概率为 0.85，最高位置为中央沟前 15-20 毫米、侧裂背侧、中央前回或盖部。 结论 作者报告了基于术中皮质电刺激的人类 vSMC 功能的概率图。这些结果定义了单个个体 vSMC 中映射结果的预期范围，并揭示了支持言语运动控制和非言语功能的 vSMC 的功能组织。
OBJECT The human ventral sensorimotor cortex (vSMC) is involved in facial expression, mastication, and swallowing, as well as the dynamic and highly coordinated movements of human speech production. However, vSMC organization remains poorly understood, and previously published population-driven maps of its somatotopy do not accurately reflect the variability across individuals in a quantitative, probabilistic fashion. The goal of this study was to describe the responses to electrical stimulation of the vSMC, generate probabilistic maps of function in the vSMC, and quantify the variability across individuals.METHODS Photographic, video, and stereotactic MRI data of intraoperative electrical stimulation of the vSMC were collected for 33 patients undergoing awake craniotomy. Stimulation sites were converted to a 2D coordinate system based on anatomical landmarks. Motor, sensory, and speech stimulation responses were reviewed and classified. Probabilistic maps of stimulation responses were generated, and spatial variance was quantified.RESULTS In 33 patients, the authors identified 194 motor, 212 sensory, 61 speech-arrest, and 27 mixed responses. Responses were complex, stereotyped, and mostly nonphysiological movements, involving hand, orofacial, and laryngeal musculature. Within individuals, the presence of oral movement representations varied; however, the dorsal-ventral order was always preserved. The most robust motor responses were jaw (probability 0.85), tongue (0.64), lips (0.58), and throat (0.52). Vocalizations were seen in 6 patients (0.18), more dorsally near lip and dorsal throat areas. Sensory responses were spatially dispersed; however, patients' subjective reports were highly precise in localization within the mouth. The most robust responses included tongue (0.82) and lips (0.42). The probability of speech arrest was 0.85, highest 15-20 mm anterior to the central sulcus and just dorsal to the sylvian fissure, in the anterior precentral gyrus or pars opercularis.CONCLUSIONS The authors report probabilistic maps of function in the human vSMC based on intraoperative cortical electrical stimulation. These results define the expected range of mapping outcomes in the vSMC of a single individual and shed light on the functional organization of the vSMC supporting speech motor control and nonspeech functions.