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目的运用导航经颅磁刺激探索国人右利手汉字图示书写功能区的皮层定位,并分析研究该技术下与手运动中枢的皮层位置关系。方法对10例健康受试者完成汉字示图书写的任务,在进行书写的同时予以导航下经颅磁刺激,根据出现书写障碍的阳性位点,测绘书写功能区的区域和面积;通过导航经颅磁刺激刺激右手运动功能区出现运动诱发电位,记录右手肌肉肌电数据和阳性刺激坐标,计算右手运动功能区面积,进行书写功能区与右手运动功能区大小和距离的对比。结果 10例健康汉语母语受试者均可以在导航经颅磁刺激下定位书写中枢。书写功能区的皮层定位较为固定,阳性位点主要位于额中回后部(86%,55/64)。书写功能区面积小于右手运动功能区的面积,差异具有统计学意义(161.03 mm~2±62.58 mm~2 vs.589.50 mm~2±227.34 mm~2,t=-4.050,P<0.001)。书写功能区的位置与手运动区的皮层定位存在一定距离(d=12.58 mm±2.71 mm),并没有功能区的重合。结论导航经颅磁刺激技术可以辅助定位示图书写功能区位置,并且书写功能区与手运动功能区没有重合。
Objective To explore the cortical localization of right-handed Chinese character pictorial function area by navigating transcranial magnetic stimulation and to analyze the relationship between the cortical position of this center and the hand movement center. Methods Totally 10 Chinese healthy subjects completed the tasks of writing Chinese characters, navigated transcranial magnetic stimulation while writing, and plotted the areas and areas of functional areas based on the positive sites of writing disorder. Magnetic stimulation of the right hand motor function area of motor evoked potentials, recording right muscle EMG data and positive stimulus coordinates, right motor function area calculation area, the writing function area and right hand movement function area size and distance contrast. Results All 10 healthy Chinese native speakers were able to locate the writing center under navigable transcranial magnetic stimulation. The cortical location of the writing area was relatively fixed, with the positive sites mainly located in the back of the frontal gyrus (86%, 55/64). The area of the writing ribbon was smaller than that of the right hand movement. The difference was statistically significant (161.03 mm ~ 2 ± 62.58 mm ~ 2 vs.589.50 mm ~ 2 ± 227.34 mm ~ 2, t = -4.050, P <0.001). The location of the writing ribbon is somewhat distanced from the cortical location of the hand movement zone (d = 12.58 mm ± 2.71 mm) and there is no coincidence of ribbons. Conclusion The navigation technique of transcranial magnetic stimulation can help locate the position of the drawing and writing function area, and there is no coincidence of the writing and hand movement function areas.