Cortical reorganization of hand motor function to face somatotopy in a patient with brain injury: a functional MRI study

We report on a patient with a meningioma whose hand motor function appeared to be reorganized mainly into the face somatotopy of the primary motor cortex (M1) following meningioma removal, using functional RMI (fMRI). A 76-year-old right-handed woman showed leukomalactic lesions in the left fronto-parietal lobes and subcortical white matter, including the upper portion of the precentral knob after meningioma removal. She recovered motor function to the point that she was able to extend the affected fingers against gravity at 6 weeks and extend the affected fingers against resistance at 12 weeks. The right primary sensori-motor cortex centered on the precentral knob was activated during movement of the unaffected (left) hand. By contrast, the face somatotopy and inferior portion of the precentral knob of the left primary motor cortex were activated during movement of the right hand. Peak activations were present at the left face somatotopy of the primary motor cortex during movement of the right hand and the right precentral knob during movement of the left hand. Motor function of the affected hand appeared to be reorganized mainly into the face somatotopy of the primary motor cortex and partially into the lower portion of the precentral knob after meningioma removal.