Real world demonstration of hand motor mapping using the structural connectivity atlas

Area of Science:

• Neuroscience
• Neurosurgery
• Medical Imaging

Background:

• Accurate localization of the hand-motor-cortex (HMC) is critical for neurosurgery.
• Existing HMC localization methods have limitations.
• Precise presurgical planning requires efficient and accurate cortical region identification.

Purpose of the Study:

• To evaluate the Structural Connectivity Atlas (SCA) for locating the HMC.
• To assess SCA's efficacy in a small cohort study.

Main Methods:

• Used MRI and DTI from 11 adult subjects to create personalized brain maps with SCA and Brainnetome regions.
• Administered single-pulse Transcranial Magnetic Stimulation (TMS) over the SCA-identified HMC using neuronavigation.
• Compared SCA-identified HMC with visually determined HMC (Omega fold on Precentral Gyrus) by a neuroanatomist.

Main Results:

• The SCA successfully located the HMC in 90% of subjects.
• The SCA-identified HMC elicited motor responses in 61% of subjects.
• The SCA demonstrated capability in both healthy and anatomically distorted brains.

Conclusions:

• The SCA is a viable tool for HMC localization, even in complex brain anatomies.
• SCA shows potential for integration into presurgical planning workflows.
• Further research with larger cohorts and diverse cortical targets is recommended.