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April 03, 2015ArticleOpen Access

Somatotopic fascicular organization of the human sciatic nerve demonstrated by MR neurography

Philipp Bäumer, Markus Weiler, Martin Bendszus and Mirko Pham
First published April 3, 2015, DOI: https://doi.org/10.1212/WNL.0000000000001526
Philipp Bäumer
From the Departments of Neuroradiology (P.B., M.B., M.P.) and Neurology (M.W.), Heidelberg University Hospital, Germany.
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Markus Weiler
From the Departments of Neuroradiology (P.B., M.B., M.P.) and Neurology (M.W.), Heidelberg University Hospital, Germany.
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Martin Bendszus
From the Departments of Neuroradiology (P.B., M.B., M.P.) and Neurology (M.W.), Heidelberg University Hospital, Germany.
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Mirko Pham
From the Departments of Neuroradiology (P.B., M.B., M.P.) and Neurology (M.W.), Heidelberg University Hospital, Germany.
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Somatotopic fascicular organization of the human sciatic nerve demonstrated by MR neurography
Philipp Bäumer, Markus Weiler, Martin Bendszus, Mirko Pham
Neurology Apr 2015, 10.1212/WNL.0000000000001526; DOI: 10.1212/WNL.0000000000001526

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Abstract

Objectives: To investigate whether the human sciatic nerve might have a consistent somatotopic organization according to proximal fascicle input by spinal nerves.

Methods: Twelve patients (55.3 ± 15.5 years) with confirmed lesions of either the L5 or S1 spinal nerve root underwent magnetic resonance neurography of sciatic nerve fascicles including thigh and knee levels (T2-weighted sequence with fat saturation, repetition time/echo time 7,552/52 milliseconds, voxel size 0.27 × 0.27 × 3.0 mm3). Twenty healthy subjects and 12 additional patients with an established diagnosis of peripheral polyneuropathy served as 2 separate age- and sex-matched control groups. Two blinded readers assessed patients and controls for presence of distinct lesion patterns. Spatial maps of normalized T2 signal were rendered after segmentation and coregistration of sciatic nerve voxels to detect fascicle lesion patterns.

Results: A clear somatotopic distribution of nerve fascicles was observed on cross-sections along the entire course of the sciatic nerve and was distinct between patients with L5 and those with S1 lesions. Fascicles emerging from L5 were ordered in anterolateral positions within sciatic nerve cross-sections, while fascicles emerging from S1 appeared posteromedially. Visual assessment discriminated these somatotopic lesions in all cases from both healthy and polyneuropathy controls.

Conclusion: A distinct pattern of somatotopy was identified within the sciatic nerve according to proximal fascicle input by L5 and S1 spinal nerves. Knowledge of human nerve somatotopy may have clinically useful implications in imaging-aided diagnosis of neuropathies.

  • Received November 29, 2014.
  • Accepted in final form January 15, 2015.
  • © 2015 American Academy of Neurology

This is an open access article distributed under the terms of the Creative Commons Attribution-Noncommercial No Derivative 3.0 License, which permits downloading and sharing the work provided it is properly cited. The work cannot be changed in any way or used commercially.

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