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Research ArticleBrain

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

M. Caulo, C. Briganti, P.A. Mattei, B. Perfetti, A. Ferretti, G.L. Romani, A. Tartaro and C. Colosimo
American Journal of Neuroradiology September 2007, 28 (8) 1480-1485; DOI: https://doi.org/10.3174/ajnr.A0597
M. Caulo
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C. Briganti
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P.A. Mattei
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B. Perfetti
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A. Ferretti
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G.L. Romani
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A. Tartaro
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C. Colosimo
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    Fig 1.

    Schematic representation of the criteria used for morphologic classification and corresponding MR image of a typical example. The position of the third fissure, which segments the knob, modifying its appearance from an omega to an epsilon in the lateral, central, or medial part of the hand knob indicates a medially asymmetric epsilon, epsilon, and laterally asymmetric epsilon, respectively. To distinguish an omega from a null, the height of the knob must be greater than the thickness of the precentral gyrus measured at the base of the knob. If the height is smaller than the thickness, the HMC is classified as null. Multiplanar reformatted MR imaging axial sections were obtained from left hemispheres 50 ± 2 mm above the Talairach ACPC plane. The red area in the MR images highlights the morphologic variant.

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    Fig 2.

    Multiplanar reformatted axial sections obtained 50 ± 2 mm above the Talairach anterior AC-PC plane. Images are shown using the right-left radiologic convention. The following are representative examples of the different combinations of HMC morphologic variants (red highlight) in the 2 hemispheres: A, Omega-omega. B, Epsilon-epsilon. C, Medially asymmetric epsilon-medially asymmetric epsilon. D, Laterally asymmetric epsilon-laterally asymmetric epsilon. E, Null-null. F, Epsilon-omega. G, Omega-laterally asymmetric epsilon. H, Omega-epsilon. I, Omega-medially asymmetric epsilon. J, Medially asymmetric epsilon-omega. The first 5 indicate concordant combinations, and the latter 5, the most common disconcordant combinations.

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    Table 1:

    HMC morphologic variants by gender

    OmegaMedially Asymmetric EpsilonEpsilonLaterally Asymmetric EpsilonNullTotal
    No. (%)No. (%)No. (%)No. (%)No. (%)No.
    Overall
        Left hemisphere201 (78.2)7 (2.7)31 (12.1)14 (5.4)4 (1.6)257
        Right hemisphere201 (78.2)8 (3.1)21 (8.2)22 (8.6)5 (1.9)257
        Total402 (78.2)15 (2.9)52 (10.1)36 (7.0)9 (1.8)514
    Men
        Left hemisphere105 (73.4)4 (2.8)23 (16.1)10 (7.0)1 (0.7)143
        Right hemisphere114 (79.7)2 (1.4)16 (11.2)10 (7.0)1 (0.7)143
        Total*219 (76.6)6 (2.1)39 (13.6)20 (7.0)2 (0.7)286
    Women
        Left hemisphere96 (84.2)3 (2.6)8 (7.0)4 (3.5)3 (2.6)114
        Right hemisphere87 (76.3)6 (5.3)5 (4.4)12 (10.5)4 (3.5)114
        Total†183 (80.3)9 (3.9)13 (5.7)16 (7.0)7 (3.1)228
    • * χ2 = 13.675 with 4 df; P = .008.

    • † χ2 = 7.933 with 1 df; P = .005.

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    Table 2:

    Correlation of morphologic variants of the HMC for hemispheres in men and women

    LeftRightTotal
    OmegaMedially Asymmetric EpsilonEpsilonLaterally Asymmetric EpsilonNull
    Men*
        Omega88 (61.5)4 (2.8)18 (12.6)3 (2.1)1 (0.7)114 (79.7)
        Medially asymmetric epsilon2 (1.4)0 (0.0)0 (0.0)0 (0.0)0 (0.0)2 (1.4)
        Epsilon8 (5.6)0 (0.0)4 (2.8)4 (2.8)0 (0.0)16 (11.2)
        Laterally asymmetric epsilon7 (4.9)0 (0.0)1 (0.7)2 (1.4)0 (0.0)10 (7.0)
        Null0 (0.0)0 (0.0)0 (0.0)1 (0.7)0 (0.0)1 (0.7)
        Total105 (73.4)4 (2.8)23 (16.1)10 (7.0)1 (0.7)143
    Women†
        Omega76 (66.7)1 (0.9)6 (5.3)2 (1.8)2 (1.8)87 (76.5)
        Medially asymmetric epsilon5 (4.4)1 (0.9)0 (0.0)0 (0.0)0 (0.0)6 (5.3)
        Epsilon3 (2.6)0 (0.0)1 (0.9)1 (0.9)0 (0.0)5 (4.4)
        Laterally asymmetric epsilon9 (7.6)1 (0.9)1 (0.9)1 (0.9)0 (0.0)12 (10.3)
        Null3 (2.6)0 (0.0)0 (0.0)0 (0.0)1 (0.9)4 (3.5)
        Total96 (83.9)3 (2.7)8 (7.1)4 (3.6)3 (2.7)114
    • Note:—Concordant hemispheres are in bold typeset.

    • * Kappa test: z = 2.09, P < .05 (not statistically significant).

    • † Kappa test: z = 3.03, P < .01.

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M. Caulo, C. Briganti, P.A. Mattei, B. Perfetti, A. Ferretti, G.L. Romani, A. Tartaro, C. Colosimo
New Morphologic Variants of the Hand Motor Cortex as Seen with MR Imaging in a Large Study Population
American Journal of Neuroradiology Sep 2007, 28 (8) 1480-1485; DOI: 10.3174/ajnr.A0597

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New Morphologic Variants of the Hand Motor Cortex as Seen with MR Imaging in a Large Study Population
M. Caulo, C. Briganti, P.A. Mattei, B. Perfetti, A. Ferretti, G.L. Romani, A. Tartaro, C. Colosimo
American Journal of Neuroradiology Sep 2007, 28 (8) 1480-1485; DOI: 10.3174/ajnr.A0597
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