Corticomotor representation of the sternocleidomastoid muscle.

The topography of the cortical motor projection to the sternocleidomastoid (SCM) muscles was investigated in 15 normal subjects using the technique of transcranial magnetic stimulation. Contrary to the long-held view that the representation of the neck muscles in the motor strip is close to that of the face, our findings indicate that the projection to both the ipsilateral and contralateral SCM muscles arises from an area of cortex high up on the cerebral convexity close to the trunk representation and at a comparable level to the sensory representation of the neck in the post-central cortex. The use of shielded intramuscular recordings showed that surface recordings detect activity not only from the SCM muscle but also from the overlying platysma muscle whose cortical representation is lateral to that of the hand muscles. Our findings confirm that the corticomotor projection to the SCM muscle follows both a contralateral monosynaptic pathway, and an ipsilateral pathway, and indicate that the latter pathway may be disynaptic.