Nii Y, Uematsu S, Lesser R P, Gordon B
Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD 21287-7247, USA.
Neurology. 1996 Feb;46(2):360-7. doi: 10.1212/wnl.46.2.360.
To clarify the exact anatomic relationship of electrically identified hand areas to the central sulcus, we constructed cortical surface renderings of magnetic resonance images (MRI) to locate the central sulcus accurately and measured the distances of stimulated points from the central sulcus and the Sylvian fissure. We obtained hand responses in 33 patients who underwent implantation of subdural grid electrodes for evaluation and surgical treatment of intractable epilepsy and analyzed these responses according to the presence of motor, sensory, mixed motor and sensory, and arrest responses. Hand motor responses occurred not only in the precentral gyrus but also in the postcentral gyrus, with great variability in superior-to-inferior distribution. Sensory responses also occurred in both the precentral and postcentral gyri with a distribution more ventral than that of motor responses. Mixed motor and sensory responses tended to be limited to the middle part of the central sulcus. Sites where electrical stimulation arrested simple hand repetitive voluntary movements occurred widely throughout the premotor and primary sensorimotor cortices. These data indicate a marked variability in the location of the human cortical hand area, and suggest that motor and sensory hand cortices overlap and are not divided in a simple manner by the central sulcus.
为了阐明电刺激识别的手部区域与中央沟的确切解剖关系，我们构建了磁共振成像（MRI）的皮质表面渲染图以精确确定中央沟的位置，并测量了刺激点与中央沟和外侧裂的距离。我们对33例因难治性癫痫接受硬膜下网格电极植入以进行评估和手术治疗的患者进行了手部反应检测，并根据运动、感觉、混合运动和感觉以及阻滞反应的情况对这些反应进行了分析。手部运动反应不仅出现在中央前回，也出现在中央后回，在上下分布上有很大差异。感觉反应也出现在中央前回和中央后回，其分布比运动反应更靠腹侧。混合运动和感觉反应往往局限于中央沟中部。电刺激使简单手部重复性自主运动停止的部位广泛分布于运动前区和初级感觉运动皮层。这些数据表明人类皮质手部区域的位置存在显著差异，并提示手部运动和感觉皮层相互重叠，并非由中央沟简单划分。
