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埃德温·博尔德雷和怀尔德·潘菲尔德的小人:坎特尔夫人赋予的生命(在现实主义内外)。

Edwin Boldrey and Wilder Penfield's Homunculus: A Life Given by Mrs. Cantlie (In and Out of Realism).

机构信息

Department of Surgery, University of Missouri Kansas City, Marion Bloch Neuroscience Institute, Saint Luke's Hospital of Kansas City, Kansas, Missouri, USA.

The Loyal and Edith Davis Neurosurgical Research Laboratory, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.

出版信息

World Neurosurg. 2019 Dec;132:377-388. doi: 10.1016/j.wneu.2019.08.116. Epub 2019 Aug 27.

Abstract

For nearly 90 years, notions of the brain have been inextricably associated with a homunculus that has become embedded within medical education as the precise representation of rolandic cortical function. We sought to define the history, evolution, accuracy, and impact of this pictorial means of showing cortical representation. We mathematically defined the evolutionary accuracy of appropriate homunculi using image analysis techniques for all points defined by Penfield, Boldrey, Rasmussen, Jasper, and Erickson, calculating perpendicular distances and defining areas and distributions of rolandic and sylvian regions labeled for sensory and motor activity with comparison with all homunculi. Prerolandic sensory representation composed 13%-47% of total sensory area (mean, 29%); postrolandic motor representation composed 15%-65% of total motor area (mean, 31%). Discrepancy between cortical perpendicular length attributed to a particular function on 1937 diagrams was greater than that attributed on the 1950 homunculus (motor: mean, 74%; range, 63%-96%; sensory: mean, 66%; range, 17%-92%) (P < 0.05). The homunculus, if truly drawn according to cortical mapping evidence, could never have been recognized as near humanoid, yet it has attained epic educational and practical longevity.

摘要

近 90 年来,大脑的概念一直与一个小人紧密相关,这个小人已经嵌入医学教育中,成为 Rolandic 皮质功能的精确代表。我们试图定义这种展示皮质代表的图形手段的历史、演变、准确性和影响。我们使用图像分析技术,为 Penfield、Boldrey、Rasmussen、Jasper 和 Erickson 定义的所有点,定义了适当的小人的进化准确性,计算了垂直距离,并定义了 Rolandic 和 Sylvian 区域的面积和分布,这些区域被标记为感觉和运动活动,与所有小人进行了比较。前 Rolandic 感觉代表构成了总感觉区域的 13%-47%(平均值,29%);后 Rolandic 运动代表构成了总运动区域的 15%-65%(平均值,31%)。1937 年图表上归因于特定功能的皮质垂直长度差异大于 1950 年小人图上的差异(运动:平均值,74%;范围,63%-96%;感觉:平均值,66%;范围,17%-92%)(P<0.05)。如果根据皮质映射证据真正绘制小人,它绝不可能被认为是类人型的,但它已经获得了史诗般的教育和实用寿命。

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