The hand motor hotspot is not always located in the hand knob

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dc.contributor.author Ahdab, Rechdi
dc.contributor.author Ayache, Samar S.
dc.contributor.author Brugieres, Pierre
dc.contributor.author Farhat, Wassim H.
dc.contributor.author Lechauffeur, Jean-Pascal
dc.date.accessioned 2019-04-10T11:36:05Z
dc.date.available 2019-04-10T11:36:05Z
dc.date.copyright 2016 en_US
dc.date.issued 2019-04-10
dc.identifier.issn 1573-6792 en_US
dc.identifier.uri http://hdl.handle.net/10725/10401
dc.description.abstract The hand motor hot spot (hMHS) is one of the most salient parameters in transcranial magnetic stimulation (TMS) practice, notably used for targeting. It is commonly accepted that the hMHS corresponds to the hand representation within the primary motor cortex (M1). Anatomical and imaging studies locate this representation in a region of the central sulcus called the “hand knob”. The aim of this study was to determine if the hMHS location corresponds to its expected location at the hand knob. Twelve healthy volunteers and eleven patients with chronic neuropathic pain of various origins, but not related to a brain lesion, were enrolled. Morphological magnetic resonance imaging of the brain was normal in all participants. Both hemispheres were studied in all participants except four (two patients and two healthy subjects). Cortical mapping of the hand motor area was conducted using a TMS-dedicated navigation system and recording motor evoked potentials (MEPs) in the contralateral first dorsal interosseous (FDI) muscle. We then determined the anatomical position of the hMHS, defined as the stimulation site providing the largest FDI-MEPs. In 45 % of hemispheres of normal subjects and 25 % of hemispheres of pain patients, the hMHS was located over the central sulcus, most frequently at the level of the hand knob. However, in the other cases, the hMHS was located outside M1, most frequently anteriorly over the precentral or middle frontal gyrus. This study shows that the hMHS does not always correspond to the hand knob and M1 location in healthy subjects or patients. Therefore, image-guided navigation is needed to improve the anatomical accuracy of TMS targeting, even for M1. en_US
dc.language.iso en en_US
dc.title The hand motor hotspot is not always located in the hand knob en_US
dc.type Article en_US
dc.description.version Published en_US
dc.title.subtitle a neuronavigated transcranial magnetic stimulation study en_US
dc.author.school SOM en_US
dc.author.idnumber 201100314 en_US
dc.author.department N/A en_US
dc.description.embargo N/A en_US
dc.relation.journal Brain Topography en_US
dc.journal.volume 29 en_US
dc.journal.issue 4 en_US
dc.article.pages 590-597 en_US
dc.keywords Motor cortex en_US
dc.keywords Motor hotspot en_US
dc.keywords Navigation en_US
dc.keywords Sulcal anatomy en_US
dc.keywords Transcranial magnetic stimulation en_US
dc.identifier.doi http://dx.doi.org/10.1007/s10548-016-0486-2 en_US
dc.identifier.ctation Ahdab, R., Ayache, S. S., Brugières, P., Farhat, W. H., & Lefaucheur, J. P. (2016). The hand motor hotspot is not always located in the hand knob: a neuronavigated transcranial magnetic stimulation study. Brain topography, 29(4), 590-597. en_US
dc.author.email rechdi.ahdab@lau.edu.lb en_US
dc.identifier.tou http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php en_US
dc.identifier.url https://link.springer.com/article/10.1007/s10548-016-0486-2 en_US
dc.author.affiliation Lebanese American University en_US

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