Towle Vernon L, Khorasani Leila, Uftring Stephen, Pelizzari Charles, Erickson Robert K, Spire Jean-Paul, Hoffmann Kenneth, Chu David, Scherg Michael
Department of Neurology, University of Chicago, Chicago, IL, USA.
Neuroimage. 2003 Jul;19(3):684-97. doi: 10.1016/s1053-8119(03)00147-2.
The locations of the human primary hand cortical somatosensory and motor areas were estimated using structural and functional MRI, scalp-recorded somatosensory-evoked potential dipole localization, expert judgments based on cortical anatomy, and direct cortical stimulation and recording studies. The within-subject reliability of localization (across 3 separate days) was studied for eight normal subjects. Intraoperative validation was obtained from five neurosurgical patients. The mean discrepancy between the different noninvasive functional imaging methods ranged from 6 to 26 mm. Quantitative comparison of the noninvasive methods with direct intraoperative stimulation and recording studies did not reveal a significant mean difference in accuracy. However, the expert judgments of the location of the sensory hand areas were significantly more variable (maximum error, 39 mm) than the dipole or functional MRI techniques. It is concluded that because expert judgments are less reliable for identifying the cortical hand area, consideration of the findings of noninvasive functional MRI and dipole localization studies is desirable for preoperative surgical planning.
利用结构和功能磁共振成像、头皮记录的体感诱发电位偶极子定位、基于皮质解剖学的专家判断以及直接皮质刺激和记录研究，对人类手部初级皮质体感区和运动区的位置进行了估计。对8名正常受试者研究了定位的受试者内可靠性（在3个不同日期）。从5名神经外科患者获得了术中验证。不同非侵入性功能成像方法之间的平均差异范围为6至26毫米。非侵入性方法与术中直接刺激和记录研究的定量比较未显示出准确性方面的显著平均差异。然而，与偶极子或功能磁共振成像技术相比，专家对手部感觉区位置的判断差异明显更大（最大误差为39毫米）。得出的结论是，由于专家判断在识别皮质手部区域方面可靠性较低，因此在术前手术规划中考虑非侵入性功能磁共振成像和偶极子定位研究的结果是可取的。
