OBJECTIVES: The brain potentials preceding and accompanying self-paced acral limb movements (Bereitschaftspotential/readiness potential (RP) paradigm) were studied in 12 patients. METHODS: Intracranial electrodes were implanted in order to explore intractable epilepsy. The electrodes were introduced into sites corresponding to the electroclinical characteristics of each patient's epileptic seizures. In 7 patients, several depth electrodes were implanted orthogonally, in the temporal, fronto-orbital and prefrontal cortex. In 4 patients, subdural strip electrodes were used for the exploration of the fronto-temporal convexity. There were no RPs recorded in these areas. No contacts were placed in the central region known to generate cortical RP. In all the patients, one or two diagonal electrodes passed through or touched the basal ganglia to reach the amygdala and the hippocampus. The putamen was explored in 11 patients (in 3 of them bilaterally); the caudate head was explored in two patients, and the pallidum was explored in two patients. RESULTS: RP with a clear amplitude gradient was present in all explored structures, however a phase reversal was never observed. RP was observed in the caudate in all recordings, and in the pallidum in one patient. It was recorded in the putamen in 8 out of the 11 explored patients. RPs were displayed contralaterally to the movement 9 times in 13 explorations, and ipsilaterally 4 times in 9 explorations. The shape of RP resembled the RP shape in the cortex and on the scalp. Movement accompanying potentials (MAPs) were also present in all 3 explored structures. The electrophysiological characteristics of MAP differed from RP, indicating separate generators. In the basal ganglia, RPs preceded the onset of movement by 500-1500 ms, at an average of 1080 (+/-330) ms. It seems that the RP in the basal ganglia starts slightly later than the RP in the motor cortices. That should be definitely demonstrated in patients with simultaneous recordings from cortical and subcortical structures. RP and MAP were displayed synchronously in the cortex and in the basal ganglia during most of the premovement period, as well as during the execution of movement. RP generators were reported by several authors in other deeply located structures, i.e. in the thalamus and in the brain-stem. CONCLUSIONS: Based on all these recordings, we presume that the RPs recorded on the scalp are generated simultaneously in several cortical as well as subcortical structures.

1st Department of Neurology Masaryk University St Anne's Hospital Pekarska 53 656 91 Brno Czech Republic

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