Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

“Neuro-Fiber Mapping”: An Original Concept of Spinal Cord Neural Network Spatial Targeting using Live Electrostimulation Mapping to (Re)explore the Conus Medullaris Anatomy

Philippe Rigoard
,
Maarten Moens
,
Lisa Goudman
ORCID logo ,
Tom Le Tutour
,
Michel Rochette
,
Jonathan Dany
,
Mohamed Et Talby
,
Manuel Roulaud
,
Rémi Hervochon
,
Amine Ounajim
ORCID logo ,
Kévin Nivole
,
Romain David
ORCID logo ,
Maxime Billot
*
Version 1 : Received: 17 October 2022 / Approved: 18 October 2022 / Online: 18 October 2022 (05:29:38 CEST)

How to cite: Rigoard, P.; Moens, M.; Goudman, L.; Le Tutour, T.; Rochette, M.; Dany, J.; Et Talby, M.; Roulaud, M.; Hervochon, R.; Ounajim, A.; Nivole, K.; David, R.; Billot, M. “Neuro-Fiber Mapping”: An Original Concept of Spinal Cord Neural Network Spatial Targeting using Live Electrostimulation Mapping to (Re)explore the Conus Medullaris Anatomy. Preprints 2022, 2022100250. https://doi.org/10.20944/preprints202210.0250.v1 Rigoard, P.; Moens, M.; Goudman, L.; Le Tutour, T.; Rochette, M.; Dany, J.; Et Talby, M.; Roulaud, M.; Hervochon, R.; Ounajim, A.; Nivole, K.; David, R.; Billot, M. “Neuro-Fiber Mapping”: An Original Concept of Spinal Cord Neural Network Spatial Targeting using Live Electrostimulation Mapping to (Re)explore the Conus Medullaris Anatomy. Preprints 2022, 2022100250. https://doi.org/10.20944/preprints202210.0250.v1

Abstract

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 reexplore 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 morpho-functional description of ‘Philippe-Gombault’s triangle’, in 19th century historical textbooks of neuroanatomy, matching remarkably with these conclusions, the concept of “Neuro-Fiber-Mapping” was introduced.

Keywords

anatomy; neuroanatomy; conus medullaris; Multicolumn Spinal Cord Stimulation (SCS); soma-totopy; dorsal columns; Computerized Electrical Modeling; Neuro-Fiber-Mapping; super-selective spinal cord stimulation

Subject

Medicine and Pharmacology, Neuroscience and Neurology

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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