Abstract:
The primary motor cortex and supplementary motor area (SMA) are
purportedly involved in the generation of the P22 and N30 components of
somatosensory evoked potentials (SEPs) evoked by electrical stimulation
of the median nerve at the wrist. We used regional cerebral blood flow
(rCBF) measurements and PET in 10 normal subjects to study the cerebral
areas activated by median nerve electrical stimulation. PET scans were
performed with the subjects at rest and during stimulation of the right
median nerve at frequencies of up to 20 Hz. Stimulation evoked a single
focus of activation in the primary somatosensory area (SI). An increase
of rCBF in this area was linearly correlated with stimulus frequencies
of up to 4 Hz and then reached a plateau. The SMA was not significantly
activated by stimulation at any of the frequencies tested. In contrast
to the SI, the SMA showed no trend toward a correlation between the rCBF
changes and the stimulus repetition rate. In order to achieve maximal
resolution in the sensorimotor cortex, regions of interest were placed
in individual co-registered MRI-PET images on both sides of the central
sulcus. There was no significant increase of rCBF in the crown of the
precentral gyrus. These results suggest that a contribution of the
primary motor cortex and the SMA to the generation of the P22 and N30
components of SEPs is unlikely. Consequently, functional clinical
interpretations derived from P22 or N30 abnormalities must be
reconsidered