Department of Neurosurgery, Sapporo Medical University, South 1, West 16, Chuo-ku, 060-8543 Sapporo, Japan.
Department of Neurosurgery, Sapporo Medical University, South 1, West 16, Chuo-ku, 060-8543 Sapporo, Japan.
Rev Neurol (Paris). 2020 Sep;176(7-8):592-600. doi: 10.1016/j.neurol.2019.12.005. Epub 2020 Mar 5.
This study investigated the networks of Negative motor areas (NMAs) using electric cortical stimulation and diffusion tensor imaging (DTI).
Twelve patients with intractable focal epilepsy, in which NMAs were identified by electrical cortical stimulation, were enrolled in this study. Electric stimulation at 50Hz was applied to the electrodes during motor tasks to identify the NMAs. DTI was used to identify the subcortical fibers originating from the NMAs found by electrical stimulation.
NMAs were found in lateral frontal areas (premotor area (PM) and precentral gyrus) in all 12 patients, in pre-supplementary motor areas (pre-SMAs) in four patients, and in posterior parietal cortices (PPCs) in four. DTI detected fibers connecting to the ipsilateral PMs, PPCs and temporal regions via U-fibers, superior longitudinal fasciculus (SLF), and arcuate fasciculus (AF) from the lateral frontal NMAs. Pre-SMA-NMAs had connections with ipsilateral PMs and contralateral pre-SMAs via the frontal aslant tract and transcallosal commissural fibers, and PPC-NMAs with ipsilateral PMs via SLF and AF.
This study found the characteristic cortical network of each NMA, and especially revealed new insight of pre-SMA-NMA and PPC NMA. These NMAs might be associated with different mechanism of negative motor response.
本研究通过电皮质刺激和弥散张量成像(DTI)研究了负运动区(NMAs)的网络。
本研究纳入了 12 例因难治性局灶性癫痫而接受电皮质刺激定位 NMAs 的患者。在运动任务中,通过刺激电极以 50Hz 的频率施加电刺激,以确定 NMAs 的位置。通过 DTI 识别源自电刺激确定的 NMAs 的皮质下纤维。
所有 12 例患者均在前外侧额区(运动前区(PM)和中央前回)发现 NMAs,4 例患者在前补充运动区(pre-SMAs)发现 NMAs,4 例患者在后顶叶皮质(PPCs)发现 NMAs。DTI 检测到通过 U 纤维、上纵束(SLF)和弓状束(AF)从外侧额 NMAs 连接同侧 PM、PPC 和颞叶的纤维。前 SMA-NMAs 通过额斜束和胼胝体连合纤维与同侧 PM 和对侧前 SMA 相连,PPC-NMAs 通过 SLF 和 AF 与同侧 PM 相连。
本研究发现了每个 NMA 的特征性皮质网络,特别是揭示了新的 SMA-NMA 和 PPC-NMA 的见解。这些 NMAs 可能与负运动反应的不同机制有关。