"Neuro-Fiber Mapping": An Original Concept of Spinal Cord Neural Network Spatial Targeting Using Live Electrostimulation Mapping to (Re-)Explore the Conus Medullaris Anatomy

Spinal cord (SC) anatomy is often assimilated to a morphologically encapsulated neural entity, but its functional anatomy remains only partially understood. We hypothesized that it could be possible to re-explore SC neural networks by performing live electrostimulation mapping, based on "super-...

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Bibliographic Details
Published in:Journal of clinical medicine 2023-02, Vol.12 (5), p.1747
Main Authors: Rigoard, Philippe, Moens, Maarten, Goudman, Lisa, Le Tutour, Tom, Rochette, Michel, Dany, Jonathan, Et Talby, Mohamed, Roulaud, Manuel, Hervochon, Rémi, Ounajim, Amine, Nivole, Kévin, David, Romain, Billot, Maxime
Format: Article
Language:English
Subjects:
Bioengineering
Clinical medicine
Control theory
Cooperation
Data analysis
Electric stimulation
Epidural
Human health and pathology
Life Sciences
Medical examination
Methods
Neural circuitry
Neural networks
Neuroimaging
Neurological research
Neurons and Cognition
Pain
Physiological aspects
Spinal cord
Tissues and Organs
Topography
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Summary:Spinal cord (SC) anatomy is often assimilated to a morphologically encapsulated neural entity, but its functional anatomy remains only partially understood. We hypothesized that it could be possible to re-explore SC neural networks by performing live electrostimulation mapping, based on "super-selective" spinal cord stimulation (SCS), originally designed as a therapeutical tool to address chronic refractory pain. As a starting point, we initiated a systematic SCS lead programming approach using live electrostimulation mapping on a chronic refractory perineal pain patient, previously implanted with multicolumn SCS at the level of the conus medullaris (T12-L1). It appeared possible to (re-)explore the classical anatomy of the conus medullaris using statistical correlations of paresthesia coverage mappings, resulting from 165 different electrical configurations tested. We highlighted that sacral dermatomes were not only located more medially but also deeper than lumbar dermatomes at the level of the conus medullaris, in contrast with classical anatomical descriptions of SC somatotopical organization. As we were finally able to find a morphofunctional description of "Philippe-Gombault's triangle" in 19th-century historical textbooks of neuroanatomy, remarkably matching these conclusions, the concept of "neuro-fiber mapping" was introduced.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm12051747