Department of Rehabilitation Medicine, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China.
Department of Rehabilitation Medicine, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China.
Brain Stimul. 2020 May-Jun;13(3):891-899. doi: 10.1016/j.brs.2020.02.031. Epub 2020 Mar 4.
Brain mapping is fundamental to understanding brain organization and function. However, a major drawback to the traditional Brodmann parcellation technique is the reliance on the use of postmortem specimens. It has therefore historically been difficult to make any comparison regarding functional data from different regions or hemispheres within the same individual. Moreover, this method has been significant limited by subjective boundaries and classification criteria and therefore suffer from reproducibility issues. The development of transcranial magnetic stimulation (TMS) offers an alternative approach to brain mapping, specifically the motor cortical regions by eliciting quantifiable functional reactions.
To precisely describe the motor cortical topographic representation of pharyngeal constrictor musculature using TMS and to further map the brain for use as a tool to study brain plasticity.
51 healthy subjects (20 male/31 female, 19-26 years old) were tested using single-pulse TMS combined with intraluminal catheter-guided high-resolution manometry and a standardized grid cap. We investigated various parameters of the motor-evoked potential (MEP) that include the motor map area, amplitude, latency, center of gravity (CoG) and asymmetry index.
Cortically evoked response latencies were similar for the left and right hemispheres at 6.79 ± 0.22 and 7.24 ± 0.27 ms, respectively. The average scalp positions (relative to the vertex) of the pharyngeal motor cortical representation were 10.40 ± 0.19 (SE) cm medio-lateral and 3.20 ± 0.20 (SE) cm antero-posterior in the left hemisphere and 9.65 ± 0.24 (SE) cm medio-lateral and 3.18 ± 0.23 (SE) cm antero-posterior in the right hemisphere. The mean motor map area of the pharynx in the left and right hemispheres were 9.22 ± 0.85(SE) cmand 10.12 ± 1.24(SE) cm, respectively. The amplitudes of the MEPs were 35.94 ± 1.81(SE)uV in the left hemisphere and 34.49 ± 1.95(SE)uV in the right hemisphere. By comparison, subtle but consistent differences in the degree of the bilateral hemispheric representation were also apparent both between and within individuals.
The swallowing musculature has a bilateral motor cortical representation across individuals, but is largely asymmetric within single subjects. These results suggest that TMS mapping using a guided intra-pharyngeal EMG catheter combined with a standardized gridded cap might be a useful tool to localize brain function/dysfunction by linking brain activation to the corresponding physical reaction.
脑图谱对于理解大脑的组织和功能至关重要。然而，传统的布罗德曼分区技术的一个主要缺点是依赖于使用死后标本。因此，很难对来自同一个体不同区域或半球的功能数据进行任何比较。此外，这种方法受到主观边界和分类标准的显著限制，因此存在可重复性问题。经颅磁刺激（TMS）的发展为脑图谱提供了一种替代方法，特别是通过诱发出可量化的功能反应来定位运动皮质区域。
使用 TMS 精确描述咽缩肌的运动皮质表面代表，并进一步绘制大脑图谱，作为研究大脑可塑性的工具。
51 名健康受试者（20 名男性/31 名女性，19-26 岁）接受单脉冲 TMS 结合经腔内导管引导的高分辨率测压和标准化网格帽的测试。我们研究了运动诱发电位（MEP）的各种参数，包括运动图面积、振幅、潜伏期、重心（CoG）和不对称指数。
左右半球皮质诱发反应潜伏期分别为 6.79±0.22ms 和 7.24±0.27ms，相似。左侧咽运动皮质代表的平均头皮位置（相对于顶点）为 10.40±0.19（SE）cm 中线侧和 3.20±0.20（SE）cm 前-后，右侧为 9.65±0.24（SE）cm 中线侧和 3.18±0.23（SE）cm 前-后。左侧和右侧咽的平均运动图面积分别为 9.22±0.85（SE）cm 和 10.12±1.24（SE）cm。左侧 MEP 的振幅为 35.94±1.81（SE）uV，右侧为 34.49±1.95（SE）uV。相比之下，个体间和个体内双侧半球代表程度的差异也很明显。
吞咽肌肉在个体间具有双侧运动皮质代表，但在单个个体中则主要是不对称的。这些结果表明，使用经腔内 EMG 导管引导的 TMS 映射结合标准化网格帽可能是一种有用的工具，通过将大脑激活与相应的物理反应联系起来，来定位大脑功能/障碍。
