Using Extirpations to Understand the Human Motor Cortex

Abstract

During the last part of the 19th century and through the middle of the 20th century, surgeons sometimes extirpated parts of the human motor cortex to control abnormal involuntary movements. This procedure can be traced directly to Victor Horsley, who pioneered the first successful surgery of this type in 1886. Although many neurosurgeons followed Horsley's lead in performing this procedure, few used their results, as he did, to formulate concepts on the role of the motor cortex in movement control. Otfrid Foerster and Paul Bucy were the principal exceptions. We reviewed the surgical procedures these 3 notable neurosurgeons performed on the motor cortex and the hypotheses they subsequently developed on the functions of the motor cortex. We also evaluated these writings relative to contemporary views of motor cortex function.

Deep Brain Stimulation: An Evolving Technology

“…In 1936, Foerster, a German neurosurgeon, presented data from cases of surgical extirpation of motor cortex to control unwanted movements [10]. American neurosurgeon P. Bucy also successfully treated patients with tremors by lesioning their precentral motor cortices between 1932 and 1949 [11].…”

Deep Brain Stimulation: An Evolving Technology

“…In 1936, Foerster, a German neurosurgeon, presented data from cases of surgical extirpation of motor cortex to control unwanted movements [10]. American neurosurgeon P. Bucy also successfully treated patients with tremors by lesioning their precentral motor cortices between 1932 and 1949 [11].…”

Motor Cortex Stimulation for Pain and Movement Disorders

“…One does not normally link the treatment of pain per se with the treatment of movement disorders, but this has come to be the case with MCS. Although direct extirpation of M1 was tried by Bucy and others 1,2 to treat Parkinson's disease (PD) and other disorders, stimulation of regions in the brain on a chronic basis to treat movement disorders began in the 1970s, when Mundinger 3 tried stimulation of the sensory thalamus to treat spasticity and athetosis changes in five patients. 4 Removal of the sensory cortex (S1) to treat pain was tried by Penfield and Jasper in a patient with burning pain, but when the pain returned, resection of the precentral gyrus completely ablated the pain.…”

Deep Brain Stimulation: An Evolving Technology

“…In 1936, Foerster, a German neurosurgeon, presented data from cases of surgical extirpation of motor cortex to control unwanted movements [10]. American neurosurgeon P. Bucy also successfully treated patients with tremors by lesioning their precentral motor cortices between 1932 and 1949 [11].…”

Motor Cortex Stimulation for Pain and Movement Disorders

“…One does not normally link the treatment of pain per se with the treatment of movement disorders, but this has come to be the case with MCS. Although direct extirpation of M1 was tried by Bucy and others 1,2 to treat Parkinson's disease (PD) and other disorders, stimulation of regions in the brain on a chronic basis to treat movement disorders began in the 1970s, when Mundinger 3 tried stimulation of the sensory thalamus to treat spasticity and athetosis changes in five patients. 4 Removal of the sensory cortex (S1) to treat pain was tried by Penfield and Jasper in a patient with burning pain, but when the pain returned, resection of the precentral gyrus completely ablated the pain.…”

Deep Brain Stimulation: An Evolving Technology

“…In 1936, Foerster, a German neurosurgeon, presented data from cases of surgical extirpation of motor cortex to control unwanted movements [10]. American neurosurgeon P. Bucy also successfully treated patients with tremors by lesioning their precentral motor cortices between 1932 and 1949 [11].…”

Motor Cortex Stimulation for Pain and Movement Disorders

“…One does not normally link the treatment of pain per se with the treatment of movement disorders, but this has come to be the case with MCS. Although direct extirpation of M1 was tried by Bucy and others 1,2 to treat Parkinson's disease (PD) and other disorders, stimulation of regions in the brain on a chronic basis to treat movement disorders began in the 1970s, when Mundinger 3 tried stimulation of the sensory thalamus to treat spasticity and athetosis changes in five patients. 4 Removal of the sensory cortex (S1) to treat pain was tried by Penfield and Jasper in a patient with burning pain, but when the pain returned, resection of the precentral gyrus completely ablated the pain.…”