Peripheral afferents with common function cluster in the median nerve and somatotopically innervate the human palm

Concentric needle electrodes with a central core diameter of 20-30 microm were used to explore median nerve fascicles in man. Such electrodes can simultaneously monitor subtle electrophysiological and topographical features even within parts of a fascicle. Single-unit recordings from myelinated fibres were more easily obtained at some intrafascicular sites than others. Typically, groups of identified myelinated fibres in these regions, possibly corresponding to a cluster of Ranvier nodes, tended to be fibres responding to stimuli of the same modality. These afferents innervated the glabrous skin of the human hand and fingers in a somatotopic manner. In particular, the somatotopy even seemed to be present at the receptor level in the skin. This novel aspect of peripheral nerve organisation is probably of fundamental importance for the interplay between peripheral and central processes involved in somatosensation both under normal conditions and in disease. Some clinical implications of the findings are discussed.