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BRAIN

New Morphologic Variants of the Hand Motor Cortex as Seen with MR Imaging in a Large Study Population

M. Cauloa, C. Brigantia, P.A. Matteia, B. Perfettia, A. Ferrettia, G.L. Romania, A. Tartaroa and C. Colosimob

a From the Institute Advanced Biomedical Technologies of the Department of Clinical Sciences and Bioimaging, University "G. d’Annunzio," Chieti, Italy
b Department of Radiology, Catholic University of Rome, Italy

Please address correspondence to Massimo Caulo, MD, PhD, ITAB–Institute for Advanced Biomedical Technologies, University "G. d’Annunzio" of Chieti-Pescara, Via dei Vestini, n. 33, 66100 Chieti, Italy; e-mail: massimo.caulo{at}itab.unich.it

BACKGROUND AND PURPOSE: The hand motor cortex (HMC) has been classically described as having an omega or epsilon shape in axial-plane images obtained with CT and MR imaging. The aim of this study was to use MR imaging and Talairach normalization in a large sample population that was homogeneous for age and handedness to evaluate in a sex model a new classification with 5 morphologic variants of the HMC in the axial plane (omega, medially asymmetric epsilon, epsilon, laterally asymmetric epsilon, and null).

MATERIALS AND METHODS: Structural brain MR images were obtained from 257 right-handed healthy subjects (143 men and 114 women; mean age, 23.1 ± 1.1 years) via a Talairach space transformed 3D magnetization-prepared rapid acquisition of gradient echo sequence. The frequencies of the different HMC variants were reported for hemisphere and sex.

RESULTS: The new variants of the HMC (medially asymmetric epsilon, laterally asymmetric epsilon, and null) were observed in 2.9%, 7.0%, and 1.8% of the hemispheres, respectively. Statistically significant sex differences were observed: The epsilon variant was twice as frequent in men, and an interhemispheric concordance for morphologic variants was observed only for women.

CONCLUSION: The large study population permitted the description of a new morphologic classification that included 3 new variants of the HMC. This new morphologic classification should facilitate the identification of the precentral gyrus in subsequent studies and in everyday practice.