Intraoperative electrical stimulation of the human dorsal spinal cord reveals a map of arm and hand muscle responses
James R. McIntosh, Evan F. Joiner, Jacob L. Goldberg, Lynda M. Murray, Bushra Yasin, Anil Mendiratta, Steven Karceski, Earl Thuet, Oleg Modik, Evgeny Shelkov, Joseph M. Lombardi, Zeeshan M. Sardar, Ronald A. Lehman, Christopher E. Mandigo, K. Daniel Riew, Noam Y. Harel, Michael S. Virk, Jason B. Carmel
Abstract
A map of muscle responses to cervical epidural stimulation during clinically indicated surgery revealed strongest activation when stimulating laterally compared to midline and revealed differences to be weaker than expected across different segments. In contrast, waveform shapes and latencies were most similar when stimulating midline and laterally, indicating activation of overlapping circuitry. Thus, a map of the cervical spinal cord reveals organization and may help guide stimulation to activate arm and hand muscles strongly and selectively.