No abstract

SuMMARY1. An exploration of the occurrence of different functional cell types was made in the three cytoarchitectural subdivisions (areas 3, 1 and 2) of the hand area of the post-central gyrus of the monkey. The functional properties of 632 cells were studied using the transdural micro-electrode recording method.2. Over half of the neurones studied (57 %) belonged to the class of simple'skin neurones that were related either to rapidly adapting (272 neurones) or slowly adapting (seventeen neurones) cutaneous receptors or to both (seventy-one neurones). The simple skin neurones were particularly common in the anterior part of S I where they constituted 60% of the cells. More complicated cutaneous neurones made up 10 % of the total sample. They were more common in the posterior part of the gyrus.3. Altogether ninety-two neurones (15 %) were related to subcutaneous or deeper receptors. Another seventy-one neurones (11 %) exhibited convergence of skin input and input from deep receptors. A smaller group of forty-seven undamaged neurones (7 %) were unrelated to stimuli of the types described above.4. In tangential electrode penetrations made along the anterior and posterior banks of the gyrus, functional columns were found to be 500 /sm wide on the average; this width is comparable with that of ocular dominance columns and visual orientation hypercolumns. 5. Correlation of the functional types of cells with cytoarchitecture showed that the complexity of the functional properties of the neurones increased posteriorly. The receptive field size also increased toward posterior. The changes that take place in the functional properties of cells when moving across different cytoarchitectural areas suggests intracortical information processing which leads to handling of larger body regions and more complex combinations of information in the cellular elements of the posterior part of the post-central gyrus.

SUMMARY1. In the hand area of the post-central gyrus of three alert Macaca apeciosa monkeys neurones related to cutaneous receptors but not activated by simple touch on the receptive field were recorded using the transdural micro-electrode recording technique. Thirty-six cells were found to have complex cutaneous receptive field properties. These neurones were subdivided into the following three groups.2. Nine neurones were not activated by punctate stimuli on the receptive fields but responded well to movement along the skin. The activity of these neurones was not affected by the direction of movement; nor was it sensitive to different textures of the moving surface.3. Eighteen neurones responded to cutaneous movement along the skin surface in a particular direction giving no response to stimulation in the opposite direction and intermediate responses to intermediate directions. Similar responses were evoked from different subparts of the receptive field.4. Nine neurones responded well to an edge placed on the skin in an optimal orientation or moved along the skin in a direction perpendicular to the edge. A maximal response was produced by stimuli of the same optimal orientation in different parts of the receptive field. The significance of the stimuli to the monkey had only a minor influence on the magnitude of the responses of these neurones and no influence on the receptive field properties.5. The occurrence of the complex cutaneous cells increased from anterior to posterior within the post-central gyrus and most of them were found in Brodmann's area 2. Thus we postulate that the complex receptive field properties arise as a consequence of cortical processing in a network in which postsynaptic one-way lateral inhibition generates the directional properties of the neurones.6. The complex cutaneous neurones constituted only 6 % of the neurones studied in the hand area of the post-central gyrus. Thus the prevalence of neurones with elongated and direction-selective receptive fields is low in the primary somatosensory cortex in comparison with the visual cortex. These neurones may, however, serve the stereognostic capacity of the hand by contributing information about stimulus motion, orientation and direction of movement on the skin.

In a prospective study, 52 patients with a spontaneous supratentorial intracerebral hematoma (ICH) were randomly assigned to receive emergency surgery or conservative treatment within 48 hours after the bleed. Patients with a decreased level of consciousness and/or a severe neurological deficit were admitted to the study. The overall mortality rate at 6 months was 42%: 10 (38%) of the 26 patients in the conservative group and 12 (46%) of the 26 in the surgical group. Six (20%) of the 30 survivors at 6 months were able to conduct their activities of daily living independently: five (31%) of the 16 patients in the conservative group and one (7%) of the 14 in the operative group. These differences are not statistically significant. The mortality rate of semicomatose or stuporous patients (Glasgow Coma Scale score 7 to 10) was statistically significantly lower in the surgical group (none of the four patients) than in the conservative group (four of five patients) (p less than 0.05); however, all surviving patients in this subgroup were severely disabled. The study suggests that surgical treatment of this category of patients with ICH does not offer any definite advantage over conservative treatment. In semicomatose or stuporous patients, surgery may improve the length of survival, but the quality of life remains poor.