Terada Kiyohito, Usui Naotaka, Umeoka Shuichi, Baba Koichi, Mihara Tadahiro, Matsuda Kazumi, Tottori Takayasu, Agari Takashi, Nakamura Fumihiro, Inoue Yushi
Department of Neurology, Shizuoka Institute of Epilepsy and Neurological Disorders, 886 Urushiyama, Aoi-ku, Shizuoka 420-8688, Japan.
J Clin Neurophysiol. 2008 Dec;25(6):351-6. doi: 10.1097/WNP.0b013e31818f4fec.
We attempted to clarify functional interhemispheric connections of motor cortex (MC) by investigating cortico-cortical evoked potentials from human brains in vivo. Three patients with intractable epilepsy who underwent invasive EEG monitoring with subdural electrodes as presurgical evaluation were studied. Electric pulse stimuli were delivered in a bipolar fashion to two adjacent electrodes on and around MC. Cortico-cortical evoked potentials were recorded by averaging electrocorticograms from the contralateral hemisphere. An initial positive triphasic or an initial negative biphasic wave was recorded when the contralateral MCs were stimulated. When the non-MC electrodes were stimulated, no response was recorded. The latencies ranged from 9.2 to 23.8 ms for the initial positive peak, and 25.4 to 39.4 ms for the initial or the second negative peak. The cortico-cortical evoked potentials responses were maximal around the homonymous electrodes with the stimulated electrodes. Our results directly demonstrate the presence of the functional interhemispheric connections originating in MC. The interhemispheric transit time is indicated. The homotopic distribution of the responses indicates that motor coordination of the bilateral bodies is, at least partially, controlled within MC.
我们试图通过研究人类大脑在体的皮质-皮质诱发电位来阐明运动皮质(MC)的半球间功能连接。研究了3例难治性癫痫患者,这些患者在术前评估时接受了硬膜下电极侵入性脑电图监测。电脉冲刺激以双极方式施加于MC及其周围的两个相邻电极。通过对来自对侧半球的皮质电图进行平均来记录皮质-皮质诱发电位。刺激对侧MC时,记录到一个初始正三相波或一个初始负双相波。刺激非MC电极时,未记录到反应。初始正峰的潜伏期为9.2至23.8毫秒,初始或第二个负峰的潜伏期为25.4至39.4毫秒。皮质-皮质诱发电位反应在与刺激电极同名的电极周围最大。我们的结果直接证明了起源于MC的半球间功能连接的存在。显示了半球间传导时间。反应的同位分布表明,双侧身体的运动协调至少部分是在MC内控制的。