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Developing somatosensory projections bypass periventricular brain lesions

From the Department of Pediatric Neurology and Developmental Medicine, University Children's Hospital, Tübingen, Germany (M.S., I.K.-M.); Section Experimental MR of the CNS, Department of Neuroradiology, Radiological Clinic (M.S., M.E., W.G.), MEG Center, Institute for Medical Psychology and Behavioral Neurobiology (C.B.), and Cortical Physiology Research Group, Hertie Institute for Clinical Brain Research (C.G.), University of Tübingen, Tübingen, Germany.

Address correspondence and reprint requests to Dr. Martin Staudt, Department of Pediatric Neurology, University Children's Hospital, Hoppe-Seyler-Str. 1, D-72076 Tübingen, Germany; e-mail: martin.staudt{at}med.uni-tuebingen.de

The authors studied four hemiparetic patients with large unilateral periventricular brain lesions acquired during the early third trimester of pregnancy. fMRI and magnetoencephalography demonstrated that the primary somatosensory representation of their paretic hands was nevertheless located in the contralateral rolandic cortex. Thus, outgrowing thalamocortical somatosensory projections had apparently bypassed the lesion to reach their original cortical destination. Such somatosensory projections curving around the lesion were effectively visualized by magnetic resonance diffusion tractography.

Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the August 8 issue to find the title link for this article.

This work was supported by grants of the Deutsche Forschungsgemeinschaft (SFB 550-C4, C5, C6) and by the University of Tübingen (Fortüne 584-0 and 865-0).

Disclosure: The authors report no conflicts of interest.

Received January 13, 2006. Accepted in final form March 31, 2006.