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

• Published in: Clinical neurology and neurosurgery Vol. 228; p. 107679
• Main Authors: Osipowicz, Karol, Profyris, Christos, Mackenzie, Alana, Nicholas, Peter, Rudder, Peter, Taylor, Hugh M., Young, Isabella M., Joyce, Angus W., Dobbin, Lewis, Tanglay, Onur, Thompson, Lerroy, Mashilwane, Tshimollo, Sughrue, Michael E., Doyen, Stephane
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01-05-2023; Elsevier Limited
• Subjects: Accuracy; Adult; Anatomy; Brain; Brain architecture; Brain mapping; Brain Mapping - methods; Cohort Studies; Cortex (motor); Evoked Potentials, Motor - physiology; Hand - physiology; Humans; Localization; Machine learning; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Methods; Motor hotspot; Motor mapping; Neural networks; Neurology; Precentral gyrus; Tau protein; TMS; Transcranial magnetic stimulation; Transcranial Magnetic Stimulation - methods; Sydney New South Wales Australia; Australia; Motor mapping; TMS; Motor hotspot; Machine learning
• ISSN: 0303-8467; 1872-6968
• DOI: 10.1016/j.clineuro.2023.107679

Locating the hand-motor-cortex (HMC) is an essential component within many neurosurgeries. Despite advancements in these localization methods there are still downfalls for each. Additionally, the importance of presurgical planning calls for increasingly accurate and efficient methods of locating specific cortical regions.
In this study we aimed to test the ability of the Structural Connectivity Atlas (SCA), a machine-learning based method to parcellate the human cortex, to locate the HMC in a small cohort study.
Using MRI and DTI images obtained from adult subjects (n = 11), personalized brain maps were created for each individual based on a SCA paired with the Brainnetome region for the HMC. Subjects received single pulse TMS, over the HMC region through the use of a neuronavigation system. If they responded with motor movement, this was recorded. The SCA identified HMC region was compared to the visual-determined HMC through identifying the Omega fold on the Precentral Gyrus, which was completed by a trained neuroanatomist. A Kendall’s Tau B correlation was conducted between anatomical match and visual movement.
This study concluded that the SCA was capable of locating the HMC in healthy and distorted brains. Overall, the SCA defined the anatomical area of the HMC in 90 % of subjects and triggered a motor response in 61 %.
The SCA could be suitable for incorporation into presurgical planning practices due to its ability to map anatomically abnormal brains. Further studies on larger cohorts and targeting different areas of cortex could be beneficial.
•Locating the hand-motor-cortex (HMC) is essential in neurosurgery.•We tested the ability of a machine learning method to locate the HMC based on tractography.•Our method located the HMC in 90 % of subjects, in both healthy and distorted brains.•A motor response was triggered in 61 % of subjects using TMS.