gms | German Medical Science

65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

Article

Send article

Primary motor areas of the frontal cortex in patients with motor eloquent brain lesions

Meeting Abstract

Search Medline for

  • Lucia Bulubasova - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, München, Deutschland
  • Jamil Sabih - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, München, Deutschland
  • Noriko Tanigawa - Faculty of Linguistics, Philology, & Phonetics, University of Oxford, Oxford, United Kingdom
  • Florian Ringel - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, München, Deutschland
  • Bernhard Meyer - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, München, Deutschland
  • Sandro M. Krieg - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, München, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocMI.06.05

doi: 10.3205/14dgnc310, urn:nbn:de:0183-14dgnc3106

Published: May 13, 2014

© 2014 Bulubasova et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective: Although the majority of primary motor function of the brain is located in the precentral gyrus, studies showed the importance of motor areas located frontal and dorsal of the precentral gyrus. This phenomenon was also supposed to be even more present in patients with brain lesions when plastic reshaping impairs functional anatomy. Navigated transcranial magnetic stimulation (nTMS) is a modern technology which enables a precise location of those motor functions non-invasively. This study therefore examines the distribution of the primary motor areas throughout the cortex in a considerably large cohort of patients with brain lesions in or adjacent to the rolandic cortex.

Method: 100 patients with motor eloquent brain lesions were examined by nTMS motor mapping. Examined muscles were abductor policis brevis (APB), abductor digiti minimi (ADM), flexor carpi radialis (FCR) and the biceps muscle (BCS), for the lower limb tibialis anterior (TA) and gastrocnemius (GCN). The patients were divided into five groups according to lesion localization (prerolandic, rolandic, postcentral, temporodorsal, and parietal tumor). The distribution of motor areas among these groups and in general among all patients was on the one hand shown graphically by using SPM8 for normalization and fusion, on the other hand statistically determined by analyzing the latencies of muscular evoked potentials (MEP).

Results: The motor areas in the medial and superior frontal gyrus show longer latencies than those in the precentral gyrus in general. The mean value of the measured latencies in all patients for the ADM muscle was 23.55 ± 2.77 ms in the precentral gyrus, 23.94 ± 3.04 ms in the superior frontal and 24.00 ± 2.37 ms in the medial frontal gyrus (p=0.0055).

Conclusions: The study indicates that there are more primary motor areas frontal to the precentral gyrus as proved by short (monosynaptic) MEP.