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Precentral Knob Corresponds to the Primary Motor and Premotor Area

Published online by Cambridge University Press:  02 December 2014

N. Shinoura*
Affiliation:
Department of Neurosurgery, Komagome Metropolitan Hospital, Hon-Komagome, Bunkyo-ku
Y. Suzuki
Affiliation:
Department of Radiologic Technology, Tokyo Metropolitan University of Health Sciences, Higashiogu, Arakawa-ku, Tokyo, Japan
R. Yamada
Affiliation:
Department of Neurosurgery, Komagome Metropolitan Hospital, Hon-Komagome, Bunkyo-ku
Y. Tabei
Affiliation:
Department of Neurosurgery, Komagome Metropolitan Hospital, Hon-Komagome, Bunkyo-ku
K. Saito
Affiliation:
Department of Neurosurgery, Komagome Metropolitan Hospital, Hon-Komagome, Bunkyo-ku
K. Yagi
Affiliation:
Department of Radiologic Technology, Tokyo Metropolitan University of Health Sciences, Higashiogu, Arakawa-ku, Tokyo, Japan
*
Department of Neurosurgery, Komagome Metropolitan Hospital, 3-18-22 Hon-Komagome, Bunkyo-ku, Tokyo 113-8677, Japan
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Abstract

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Purpose:

Cortical mapping during awake surgery assesses intraoperative neurological change in response to electrical stimulation to provide direct information regarding the anatomical localization of the primary motor area (M1). The goal of the present study was to analyze the reliability of the identification of the precentral knob in the axial image of magnetic resonance imaging or functional MRI (fMRI) for the detection of M1.

Materials and Methods:

Among patients with brain tumors within or near M1 in whom awake surgery was employed from April 2004 through March 2007, 14 cases were analyzed in which either the M1 or premotor area (PMA) was successfully detected by mapping during awake surgery.

Results:

The precentral knob was localized to the PMA in 4 cases and to M1 in 10 cases. By contrast, the gyrus activated by hand clenching in fMRI on the affected side at least partially corresponded to M1 in all cases, while those on the unaffected side corresponded to M1 in 12 of 12 cases.

Conclusion:

These results indicate that the precentral knob corresponds to PMA as well as to M1, whereas the gyrus activated in fMRI corresponds to M1 on the affected and unaffected side.

Type
Original Article
Copyright
Copyright © The Canadian Journal of Neurological 2009

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