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1 Neurosurgery, Johns Hopkins Hospital, Baltimore, MD, USA
* To whom correspondence should be addressed. E-mail: flenz1{at}jhmi.edu.
We explored the region of human thalamic somatic sensory nucleus (ventral caudal - Vc), corresponding to monkey VP (ventral posterior), with threshold microstimulation (TMIS) during stereotactic procedures for the treatment of tremor. Of 122 sites in 116 patients (124 thalami) where mechanical ('touch', 'pressure' and 'sharp') or movement ('movement through the body' ('movement') and 'vibration') sensations were evoked 72 sites were found in the core or in adjacent regions, posterior-inferior (33), inferior (4),and posterior to the core (13). Sites where TMIS evoked 'touch' were less frequent in the core than those where 'movement' or 'pressure' sensations were evoked. 'Pressure' was more commonly (p<0.05) evoked than 'vibration' at sites where cells had intraoral RFs. 'Touch' and 'vibration' were more commonly (p<0.05) evoked than 'pressure' at sites where cells had facial RFs, consistent with the relative density of RA receptors in the mouth and face. Sites described as 'deep' and 'movement' were found superior and anterior in the core, consistent with the location of cells responding to stimulation of muscle afferents. At 72 of 122 sites, TMIS evoked the same sensation at 2 or more sites in the same plane. Of these sites 58 sites are adjacent to each other, in a 'cluster', consistent with studies of the localization of cells responding to different modalities. These results demonstrate that mechanical and movement sensations can be evoked by stimulation in the region of Vc. The characteristics of these sites suggest that the sensations are evoked by stimulation of pathways specific to cutaneous and deep mechanoreceptors.
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