In defense of the sinistrals: anatomy of handedness and the safety of prenatal ultrasound

Laterality of seizure onset and the simple reaction time: revamping the Poffenberger's paradigm for seizure surgery

BACKGROUND

Crossed-uncrossed differentials (CUDs) are viewed as surrogates for interhemispheric transfer time (IHTT). Not uncommonly CUDs assume statistically significant negative values (inverted CUDs). This raises doubts of the accepted interpretation of CUDs, i.e. intra- and inter-hemispheric routings of signals in uncrossed and crossed responses, respectively.

METHOD

Based on the evidence supporting directionality in callosal traffic, data are provided indicating that callosal transfers exclusively involve non-dominant responses and such transfers are modality non-specific. The evidence also indicates that neural handedness corresponds to behavioral only in a statistical manner and the former remains unchanged regardless of the subject's life experience.

RESULTS

The neurally dominant side is the side that is directly connected to the major hemisphere (command center). The connection of the non-dominant side to the command center is via the corpus callosum; therefore, a delay occurs in the reaction time of all non-dominant effectors, corresponding to IHTT. Accordingly, negative CUDs indicate a mismatch of neural and behavioral (avowed) handedness of the subject. This group comprises a minority of 15-20% of the population.

CONCLUSION

Comparing the response time of symmetrically located effector is a robust way of lateralizing a person's major hemisphere. The latter is also the site of initiation of seizures, as the minor hemisphere is bereft of independent motor activity. Sensory signals arising from the nondominant side of the body traverse the callosum before reaching the major hemisphere. Searching for ipsilateral somatosensory evoked potentials provides another approach in lateralizing the non-dominant side of the body (ipsilateral to the major hemisphere). Practical uses of a conceptually revamped Poffenberger paradigm in neurosurgery are briefly reviewed.

Anatomy of handedness and the laterality of seizure onset: surgical implications of new understandings in motor control

OBJECTIVES

This article pursues another corollary of the anatomy of handedness, a code for the laterality of motor control. The latter indicates the absence of any motor communication from the minor (right, in the vast majority of population) to the major hemisphere (left, in the vast majority of right handers). It also indicates that all communications between the two hemispheres are excitatory in nature. This arrangement prohibits initiation of seizure within the minor and its propagation to the major hemisphere, via the callosum.

METHODS

A comprehensive review of the literature is undertaken regarding theoretical and technical reasons for the failure of seizure surgery in subjects undergoing the same for intractable epilepsy.

RESULTS

Whereas the laterality of motor control is heavily biased towards the left hemisphere (approximately 80%), the operation is performed equally on both hemispheres. Failures of surgery in some series were substantially higher among those who had undergone operations on the right hemisphere. Technical reasons for this are traced to the unreliability of tests commonly employed in securing laterality of seizure onset, which is the same as that of motor control. Accordingly, the failure rate of seizure surgery may equal the rate of false lateralization of the major hemisphere in these circumstances.

CONCLUSION

Given the dichotomous anatomy of handedness, the most robust test for lateralizing the hemisphere of onset of seizure is that of determining the reaction times of two symmetrically located effectors, one on each side of the body. The side with the shorter reaction time will always be opposite to the major hemisphere. The difference between the two values is commensurate to the inter-hemispheric transfer time.

Handedness and macular vision: laterality of motor control underpins both

This article pursues the corollaries of the anatomy of handedness recently discovered. Specifically, it addresses the issues concerning central vision as it relates to the command center and the circuitry of the saccades. It presents data that support the directionality of callosal traffic in motor and sensory realms even further. Evidence is presented that denotes a relationship between the anatomy sustaining movement control and that responsible for the part of the vision handled by the maculae. The evidence shows bypassing of the callosum by fibers serving the central vision. This aspect has ramifications for surgical approach to the third ventricle by callosotomy, relaxing the earlier prohibitions advocated in approaching the third ventricle via splenectomy.

Bimanual simultaneous movements and hemispheric dominance: Timing of events reveals hard-wired circuitry for action, speech, and imagination

The evidence that speech is the marker of hemisphere of action is overwhelming. Thus, contrary to the commonly accepted belief, the evidence indicates that both sides of the body are under the same command (major hemisphere) and that the nondominant side of the body is a callosum-width farther from the major hemisphere. Substantial controversy exists, however, as to the best method for determining the laterality of motor control in an individual case. According to the new understanding, ie, the one-way callosal traffic circuitry underpinning laterality of motor control, the larger excursions of effectors located opposite (contralateral to) the command center while performing bimanual simultaneous drawing tasks provides the best noninvasive and inexpensive approach for demonstrating the laterality of the major hemisphere of a person (who is able to perform such tasks). Here, it is documented pictorially that bimanual simultaneous drawing of geometrical designs or straight lines, as well as moving the arms simultaneously from side to side (or up and down) while noting the difference of speed of the two arms (represented by the distance between the two index fingers), both provide a reliable indication of the laterality of a person’s major hemisphere. In all these maneuvers the nondominant side of the body (even the diaphragms) lags behind the dominant side by an interval equal to the interhemispheric transfer time (IHTT). This lagging behind of the nondominant side of the body in bimanual simultaneous movements is the footprint of directionality of callosal traffic underpinning the laterality of motor control evidenced by worsening of the delay of the nondominant side following callosotomy (uncoupling). Here, the historical precedence of a novel understanding in motor control together with its neurological implications in daily life as well as in laterality of seizure onset are briefly addressed, pointing out the deleterious effects of Sir Isaac Newton’s influence in neurological research on interhemispheric connectivity by suggesting symmetrical representation of visual sense of space in the human brain.

Crossed-uncrossed difference (CUD) in a new light: anatomy of the negative CUD in Poffenberger's paradigm

Crossed Uncrossed Differentials (CUDs) have long been used as surrogate for the interhemispheric transfer time (IHTT). Evidence is presented that macular vision is the province of the major hemisphere, wherein all commands are initiated regardless of the laterality of the effectors of such commands. Using clinical and time-resolved data it is shown also that the above arrangement (i.e. neural handedness) corresponds to the subject's behavioral avowed (avowed, self-declared) handedness only in a statistical sense; with a substantial minority of humanity displaying a disparity of neural and behavioral handedness. Evidence is provided that the negative CUD in previously reported studies was a reflection of such incongruity in those subjects studied. Thus, to lateralize the command center it is sufficient to determine the reaction time of two symmetrically located effectors on the body. The side with longer reaction time is ipsilateral to the major hemisphere, with the difference of the two sides commensurate to transcallosal IHTT.