title: New morphologic variants of the hand motor cortex as seen with MR imaging in a large study population.
abstract: OBJECTIVE
  The hand motor cortex (HMC) has been classically described as having an omega or epsilon shape in axial-plane images obtained with CT and MR imaging. The aim of this study was to use MR imaging and Talairach normalization in a large sample population that was homogeneous for age and handedness to evaluate in a sex model a new classification with 5 morphologic variants of the HMC in the axial plane (omega, medially asymmetric epsilon, epsilon, laterally asymmetric epsilon, and null).
  
  
  METHODS
  Structural brain MR images were obtained from 257 right-handed healthy subjects (143 men and 114 women; mean age, 23.1 +/- 1.1 years) via a Talairach space transformed 3D magnetization-prepared rapid acquisition of gradient echo sequence. The frequencies of the different HMC variants were reported for hemisphere and sex.
  
  
  RESULTS
  The new variants of the HMC (medially asymmetric epsilon, laterally asymmetric epsilon, and null) were observed in 2.9%, 7.0%, and 1.8% of the hemispheres, respectively. Statistically significant sex differences were observed: The epsilon variant was twice as frequent in men, and an interhemispheric concordance for morphologic variants was observed only for women.
  
  
  CONCLUSIONS
  The large study population permitted the description of a new morphologic classification that included 3 new variants of the HMC. This new morphologic classification should facilitate the identification of the precentral gyrus in subsequent studies and in everyday practice.
authors.affiliation: Institute Advanced Biomedical Technologies of the Department of Clinical Sciences and Bioimaging, University G. d'Annunzio, Chieti, Italy. massimo.caulo@itab.unich.it
authors.forename: M
authors.initials: M
authors.lastname: Caulo
authors.forename: C
authors.initials: C
authors.lastname: Briganti
authors.forename: P A
authors.initials: PA
authors.lastname: Mattei
authors.forename: B
authors.initials: B
authors.lastname: Perfetti
authors.forename: A
authors.initials: A
authors.lastname: Ferretti
authors.forename: G L
authors.initials: GL
authors.lastname: Romani
authors.forename: A
authors.initials: A
authors.lastname: Tartaro
authors.forename: C
authors.initials: C
authors.lastname: Colosimo
mesh_terms: D000328:Adult; D005260:Female; D006225:Hand / Q000502:physiology*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D009044:Motor Cortex / Q000033:anatomy & histology* / Q000502:physiology*; D015588:Observer Variation; D012016:Reference Values; D015203:Reproducibility of Results; D012727:Sex Characteristics; D016037:Single-Blind Method