Unusual cortical stimulation findings: Connectivity between primary motor and supplementary motor areas
Unusual cortical stimulation findings: Connectivity between primary motor and supplementary motor areas
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DOI：
10.1016/j.yebeh.2010.09.006
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发表时间：
2010-12-01
影响因子：
2.6
通讯作者：
Diehl, Beate
中科院分区：
文献类型：
--
作者：
Kovac, Stjepana;Scott, Catherine;Diehl, Beate
我们描述了一个42岁的右手感觉运动性癫痫患者，他接受了左侧初级运动皮层（M1）的术中皮层刺激标测（CSM）。预期主要运动皮层区域的皮层刺激仅诱发复杂的运动反应，近端右臂和近端左腿不对称强直运动，这通常在刺激辅助运动区（SMA）时观察到。在解剖学M1表示的术中或术中皮层刺激期间，无法隔离右手功能。发作期和发作间期的活动包含在异常运动反应的区域内，发作间期活动的MEG显示从左侧内侧额叶皮层到外侧额叶皮层的棘波传播。这种传播途径可能促进了M1与SMA的连接，因此解释了刺激M1后的异常运动反应。这个病例强调了发作间期活动对运动皮层可塑性的潜在影响。(C)2010年爱思唯尔公司All rights reserved.
We describe a 42-year old patient with right hand sensorimotor seizures who underwent extraoperative cortical stimulation mapping (CSM) of the left primary motor cortex (M1). Cortical stimulation of the region where primary motor cortex was expected evoked exclusively complex motor responses with proximal right arm and proximal left leg asymmetric tonic movements that are usually observed on stimulation of the supplementary motor area (SMA). Right hand function could not be isolated during either extraoperative or intraoperative cortical stimulation of the anatomical M1 representation. Ictal and interictal activity was contained within the region with the abnormal motor response, and MEG of interictal activity showed spike propagation from the left mesial to lateral frontal cortex. This propagation pathway may have facilitated M1-to-SMA connectivity and therefore explain the unusual motor response after stimulation of M1. This case highlights the potential impact of interictal activity on plasticity of the motor cortex. (C) 2010 Elsevier Inc. All rights reserved.