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Magnetoencephalographic study of hand and foot sensorimotor organization in 325 consecutive patients evaluated for tumor or epilepsy surgery.

Willemse RB, Hillebrand A, Ronner HE, Vandertop WP, Stam CJ - Neuroimage Clin (2015)

Bottom Line: The success rate for motor and sensory localization for the feet was significantly lower than for the hands (motor_hand 94.6% versus motor_feet 81.8%, p < 0.001; sensory_hand 95.3% versus sensory_feet 76.0%, p < 0.001).The ipsilateral motor responses were found in 43 (14%) out of 308 patients with motor recordings (range: 8.3-50%, depending on the underlying pathology), and had a higher occurrence in the foot than in the hand (motor_foot 44.8% versus motor_hand 29.6%, p = 0.031).MEG localization of sensorimotor cortex activation was more successful for the hand compared to the foot.

View Article: PubMed Central - PubMed

Affiliation: Neurosurgical Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.

ABSTRACT

Objectives: The presence of intracranial lesions or epilepsy may lead to functional reorganization and hemispheric lateralization. We applied a clinical magnetoencephalography (MEG) protocol for the localization of the contralateral and ipsilateral S1 and M1 of the foot and hand in patients with non-lesional epilepsy, stroke, developmental brain injury, traumatic brain injury and brain tumors. We investigated whether differences in activation patterns could be related to underlying pathology.

Methods: Using dipole fitting, we localized the sources underlying sensory and motor evoked magnetic fields (SEFs and MEFs) of both hands and feet following unilateral stimulation of the median nerve (MN) and posterior tibial nerve (PTN) in 325 consecutive patients. The primary motor cortex was localized using beamforming following a self-paced repetitive motor task for each hand and foot.

Results: The success rate for motor and sensory localization for the feet was significantly lower than for the hands (motor_hand 94.6% versus motor_feet 81.8%, p < 0.001; sensory_hand 95.3% versus sensory_feet 76.0%, p < 0.001). MN and PTN stimulation activated 86.6% in the contralateral S1, with ipsilateral activation < 0.5%. Motor cortex activation localized contralaterally in 76.1% (5.2% ipsilateral, 7.6% bilateral and 11.1% failures) of all motor MEG recordings. The ipsilateral motor responses were found in 43 (14%) out of 308 patients with motor recordings (range: 8.3-50%, depending on the underlying pathology), and had a higher occurrence in the foot than in the hand (motor_foot 44.8% versus motor_hand 29.6%, p = 0.031). Ipsilateral motor responses tended to be more frequent in patients with a history of stroke, traumatic brain injury (TBI) or developmental brain lesions (p = 0.063).

Conclusions: MEG localization of sensorimotor cortex activation was more successful for the hand compared to the foot. In patients with neural lesions, there were signs of brain reorganization as measured by more frequent ipsilateral motor cortical activation of the foot in addition to the traditional sensory and motor activation patterns in the contralateral hemisphere. The presence of ipsilateral neural reorganization, especially around the foot motor area, suggests that careful mapping of the hand and foot in both contralateral and ipsilateral hemispheres prior to surgery might minimize postoperative deficits.

No MeSH data available.


Related in: MedlinePlus

Axial (left) and coronal (right) MR images showing two examples of task-related power decreases in the beta band, demonstrating ipsilateral motor responses in Cases 2 and 3 during hand or foot movements. Case 2: 9-year-old female with intractable and non-lesional epilepsy showing pronounced ipsilateral cortical responses for both hands with localization in the hand area. Foot movements, despite good performance, show no cortical response (not shown). Case 3: 36-year-old female with focal cortical dysplasia in the depth of the central sulcus of the left hemisphere shows a contralateral response of both hands and the left foot. Right foot movements show an ipsilateral response at the medial wall of the primary motor cortex. L: left; R: right; A: anterior; P: posterior.
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f0010: Axial (left) and coronal (right) MR images showing two examples of task-related power decreases in the beta band, demonstrating ipsilateral motor responses in Cases 2 and 3 during hand or foot movements. Case 2: 9-year-old female with intractable and non-lesional epilepsy showing pronounced ipsilateral cortical responses for both hands with localization in the hand area. Foot movements, despite good performance, show no cortical response (not shown). Case 3: 36-year-old female with focal cortical dysplasia in the depth of the central sulcus of the left hemisphere shows a contralateral response of both hands and the left foot. Right foot movements show an ipsilateral response at the medial wall of the primary motor cortex. L: left; R: right; A: anterior; P: posterior.

Mentions: Motor tasks of the foot showed significantly (p = 0.031) more ipsilateral responses than for the hand. Ipsilateral responses of the hand were equally distributed between left- and right hand motor tasks. Left foot movement resulted in significantly more ipsilateral responses (9.6%) versus right foot movement (6.5%, p = 0.046). Examples of ipsilateral hand and foot responses are shown in Fig. 2.


Magnetoencephalographic study of hand and foot sensorimotor organization in 325 consecutive patients evaluated for tumor or epilepsy surgery.

Willemse RB, Hillebrand A, Ronner HE, Vandertop WP, Stam CJ - Neuroimage Clin (2015)

Axial (left) and coronal (right) MR images showing two examples of task-related power decreases in the beta band, demonstrating ipsilateral motor responses in Cases 2 and 3 during hand or foot movements. Case 2: 9-year-old female with intractable and non-lesional epilepsy showing pronounced ipsilateral cortical responses for both hands with localization in the hand area. Foot movements, despite good performance, show no cortical response (not shown). Case 3: 36-year-old female with focal cortical dysplasia in the depth of the central sulcus of the left hemisphere shows a contralateral response of both hands and the left foot. Right foot movements show an ipsilateral response at the medial wall of the primary motor cortex. L: left; R: right; A: anterior; P: posterior.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4660376&req=5

f0010: Axial (left) and coronal (right) MR images showing two examples of task-related power decreases in the beta band, demonstrating ipsilateral motor responses in Cases 2 and 3 during hand or foot movements. Case 2: 9-year-old female with intractable and non-lesional epilepsy showing pronounced ipsilateral cortical responses for both hands with localization in the hand area. Foot movements, despite good performance, show no cortical response (not shown). Case 3: 36-year-old female with focal cortical dysplasia in the depth of the central sulcus of the left hemisphere shows a contralateral response of both hands and the left foot. Right foot movements show an ipsilateral response at the medial wall of the primary motor cortex. L: left; R: right; A: anterior; P: posterior.
Mentions: Motor tasks of the foot showed significantly (p = 0.031) more ipsilateral responses than for the hand. Ipsilateral responses of the hand were equally distributed between left- and right hand motor tasks. Left foot movement resulted in significantly more ipsilateral responses (9.6%) versus right foot movement (6.5%, p = 0.046). Examples of ipsilateral hand and foot responses are shown in Fig. 2.

Bottom Line: The success rate for motor and sensory localization for the feet was significantly lower than for the hands (motor_hand 94.6% versus motor_feet 81.8%, p < 0.001; sensory_hand 95.3% versus sensory_feet 76.0%, p < 0.001).The ipsilateral motor responses were found in 43 (14%) out of 308 patients with motor recordings (range: 8.3-50%, depending on the underlying pathology), and had a higher occurrence in the foot than in the hand (motor_foot 44.8% versus motor_hand 29.6%, p = 0.031).MEG localization of sensorimotor cortex activation was more successful for the hand compared to the foot.

View Article: PubMed Central - PubMed

Affiliation: Neurosurgical Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.

ABSTRACT

Objectives: The presence of intracranial lesions or epilepsy may lead to functional reorganization and hemispheric lateralization. We applied a clinical magnetoencephalography (MEG) protocol for the localization of the contralateral and ipsilateral S1 and M1 of the foot and hand in patients with non-lesional epilepsy, stroke, developmental brain injury, traumatic brain injury and brain tumors. We investigated whether differences in activation patterns could be related to underlying pathology.

Methods: Using dipole fitting, we localized the sources underlying sensory and motor evoked magnetic fields (SEFs and MEFs) of both hands and feet following unilateral stimulation of the median nerve (MN) and posterior tibial nerve (PTN) in 325 consecutive patients. The primary motor cortex was localized using beamforming following a self-paced repetitive motor task for each hand and foot.

Results: The success rate for motor and sensory localization for the feet was significantly lower than for the hands (motor_hand 94.6% versus motor_feet 81.8%, p < 0.001; sensory_hand 95.3% versus sensory_feet 76.0%, p < 0.001). MN and PTN stimulation activated 86.6% in the contralateral S1, with ipsilateral activation < 0.5%. Motor cortex activation localized contralaterally in 76.1% (5.2% ipsilateral, 7.6% bilateral and 11.1% failures) of all motor MEG recordings. The ipsilateral motor responses were found in 43 (14%) out of 308 patients with motor recordings (range: 8.3-50%, depending on the underlying pathology), and had a higher occurrence in the foot than in the hand (motor_foot 44.8% versus motor_hand 29.6%, p = 0.031). Ipsilateral motor responses tended to be more frequent in patients with a history of stroke, traumatic brain injury (TBI) or developmental brain lesions (p = 0.063).

Conclusions: MEG localization of sensorimotor cortex activation was more successful for the hand compared to the foot. In patients with neural lesions, there were signs of brain reorganization as measured by more frequent ipsilateral motor cortical activation of the foot in addition to the traditional sensory and motor activation patterns in the contralateral hemisphere. The presence of ipsilateral neural reorganization, especially around the foot motor area, suggests that careful mapping of the hand and foot in both contralateral and ipsilateral hemispheres prior to surgery might minimize postoperative deficits.

No MeSH data available.


Related in: MedlinePlus