Scalp-recorded Bereitschaftspotential is the result of the activity of cortical and subcortical generators – a hypothesis

Objective: The source of scalp-recorded Bereitschaftspotential (BP) remains a subject of ongoing discussion. This paper presents arguments in favour of the hypothesis that explains scalp-recorded BP as the result of the activity of both cortical and subcortical BP generators. Methods: Intracranial recordings of BP were performed, mostly with depth electrodes in epilepsy surgery candidates. In some patients undergoing intracranial exploration, an electrode may have had contacts in the subcortical structures. Results: BP is generated in several cortical and subcortical structures that are known to be directly or indirectly linked with motor control. Cortical sources of BP were displayed contralaterally to the movement in the primary motor cortex and somatosensory cortex, and bilaterally in the supplementary motor area (SMA), in the preSMA, and in the cingulate. A few other generators may be revealed in structures that have not yet been sufficiently explored. Subcortical generators of BP were found in the putamen, pallidum, caudate, and in the thalamus. In earlier recordings, BP was described rostrally to the thalamic region and in the brainstem, i.e. in the pes peripedunculi, nucleus peripeduncularis, pulvinar, and medial geniculate. Conclusions: Our observations do not explain the generation of scalp-recorded BP by the contribution of either cortical or subcortical sources alone. Intracranial cortical recordings contradict a wide distribution of scalp-recorded BP. Widely synchronised cerebral electromagnetic activity can be recorded on the scalp. We presume that in the case of BP, the weak deep dipoles might reach the scalp, as they are produced by a relatively huge mass of subcortical neuronal tissue. We strongly suspect that scalp-recorded BP represents a summation of potentials that are generated simultaneously in several cortical as well as in several subcortical structures.