Localization of the motor hand area using transcranial magnetic stimulation and functional magnetic resonance imaging
Localization of the motor hand area using transcranial magnetic stimulation and functional magnetic resonance imaging
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DOI：
10.1016/s1388-2457(98)00027-3
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发表时间：
1999-04-01
影响因子：
4.7
通讯作者：
Töpper, R
中科院分区：
文献类型：
--
作者：
Boroojerdi, B;Foltys, H;Töpper, R
目的：利用功能磁共振成像（fMRI）技术研究手部运动区的解剖定位。手内在肌肉的运动皮层代表由一个旋钮状结构组成。这在轴向平面中是Ω形或ε形的，在矢状平面中是钩形的。由于这个旋钮位于大脑表面，因此可以通过经颅磁刺激（TMS）进行非侵入性刺激。这是我们研究的目的，以确定使用功能磁共振成像的手旋钮，并揭示如果解剖手旋钮对应的运动皮层的手区，确定由TMS，通过一个无框架的MRI为基础的neuronavigationsystem.Methods：超阈值经颅磁刺激施加在4名健康志愿者的头皮左侧的网格。记录健侧小手肌的运动诱发电位（MEP），并计算MEP的重心（CoG）。网格上每个点的精确解剖定位使用无框架MRI神经导航系统确定。在每一个主题中，运动皮层的手区域可视化使用功能磁共振成像在感觉运动激活过程中实现握紧右手。结果：在所有4个科目，在功能磁共振成像和CoG的MEP的所有调查肌肉的激活中央前部位位于预测的解剖区域内，所谓的手旋钮。结论：经颅磁刺激是一种可靠的运动皮层定位方法。从运动输出图计算的CoG可以用作运动皮层中所表示的肌肉的位置的准确估计。(C)1999爱思唯尔科学爱尔兰有限公司保留所有权利。
Objective: The anatomical location of the motor area of the hand may be revealed using functional magnetic resonance imaging (fMRI). The motor cortex representation of the intrinsic hand muscles consists of a knob-like structure. This is omega- or epsilon-shaped in the axial plane and hook-shaped in the sagittal plane. As this knob lies on the surface of the brain, it can be stimulated non-invasively by transcranial magnetic stimulation (TMS). It was the aim of our study to identify the hand knob using fMRI and to reveal if the anatomical hand knob corresponds to the hand area of the motor cortex, as identified by TMS, by means of a frameless MRI-based neuronavigation system.Methods: Suprathreshold transcranial magnetic stimuli were applied over a grid on the left side of the scalp of 4 healthy volunteers. The motor evoked potentials (MEPs) were recorded from the contralateral small hand muscles, and the centers of gravity (CoG) of the MEPs were calculated. The exact anatomical localization of each point on the grid was determined using a frameless MRI-based neuronavigation system. In each subject, the hand area of the motor cortex was visualized using fMRI during sensorimotor activation achieved by clenching the right hand.Results: In all 4 subjects, the activated precentral site in the fMRI and the CoG of the MEP of all investigated muscles lay within the predicted anatomical area, the so-called hand knob. This knob had the form of an omega in two subjects and an epsilon in the other two subjects.Conclusions: TMS is a reliable method for mapping the motor cortex. The CoG calculated from the motor output maps may be used as an accurate estimation of the location of the represented muscle in the motor cortex. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.