Motor cortex stimulation in the treatment of deafferentation pain. I. Localization of the motor cortex.
MRI and electrophysiological techniques to localize the primary motor cortex (MC) were performed on patients considered for MC stimulation for the treatment of deafferentation pain. The representation and trajectory of the rolandic fissure (RF) were accurately localized by external cranial landmarks and radiopaque fiducials superimposed on oblique MRI sections. In addition, the scalp distribution of the corticocortical responses elicited by acute epidural stimulation [motor cortex (MC) in frontal and sensory cortex (SC) in parietal scalp regions], and analgesic responses at the topographical representation of the painful periphery elicited by subacute epidural stimulation were found to be simple and reliable procedures to localize MC, SC and RF.
Velasco
Marcos
M
Department of Stereotactic and Functional Neurosurgery, General Hospital of Mexico, National Medical Center, Mexico City, Mexico. velascof@salud.gob.mx
Velasco
Francisco
F
Brito
Francisco
F
Velasco
Ana Luisa
AL
Nguyen
Jean Paul
JP
Marquez
Irma
I
Boleaga
Bernardo
B
Keravel
Yves
Y
D002422:Causalgia / Q000175:diagnosis / Q000601:surgery* / Q000628:therapy*; D003399:Craniotomy; D004558:Electric Stimulation; D004599:Electric Stimulation Therapy / Q000379:methods*; D005073:Evoked Potentials, Somatosensory; D006801:Humans; D008279:Magnetic Resonance Imaging; D008475:Median Nerve / Q000502:physiology; D009044:Motor Cortex / Q000502:physiology*; D009046:Motor Neurons / Q000502:physiology; D009475:Neurons, Afferent / Q000502:physiology; D019635:Neurosurgical Procedures