Lateral Premotor Research Articles

Exploring the detection of associatively novel events using fMRI

Identifying and evaluating events which are novel in a particular environment is crucially important for adaptive behavior. These events are often not just novel, as they typically violate expectations which may be formulated based on numerous features of our surroundings, one of which includes the ordinal structure (temporal order) of relevant stimuli. Events which violate such expectations, namely sequential deviants, constitute one category of associatively novel stimuli. The present event-related fMRI study investigated the detection of sequential deviants presented within three types of equivalently organized, attended visual sequences which differed in stimulus dimensions relevant for defining the sequential structure (position, rhythm, and object identity). Presenting deviants within perceptual sequences defined by position and rhythm stimulus properties triggered comparable patterns of activations within the lateral parietal, premotor, and prefrontal regions. However, the activations identified in the context of position sequences showed a more dorsal distribution when compared to those in rhythm sequences. In contrast, detection of deviants within object sequences was supported by right-lateralized parietal and temporal cortices. Thus, although the obtained results indicate similarities and partial overlap in activations triggered by specific pairs of deviants, differences in their processing were also revealed. This suggests that the general task context and specific stimulus features which define the deviant itself influence which brain regions within a widespread network incorporating lateral prefrontal, anterior premotor, and posterior (mainly lateral parietal) areas will become engaged in its processing.

Implicit awareness in anosognosia for hemiplegia: unconscious interference without conscious re-representation

Some patients with anosognosia for hemiplegia, i.e. apparent unawareness of hemiplegia, have been clinically observed to show 'tacit' or 'implicit' awareness of their deficits. Here we have experimentally examined whether implicit and explicit responses to the same deficit-related material can dissociate. Fourteen stroke patients with right hemisphere lesions and contralesional paralysis were tested for implicit and explicit responses to brief sentences with deficit-related themes. These responses were elicited using: (i) a verbal inhibition test in which patients had to inhibit completing each sentence with an automatic response (implicit task) and (ii) a rating procedure in which patients rated the self-relevance of the same sentences (explicit task). A group of anosognosic hemiplegic patients was significantly slower than a control group of aware hemiplegic patients in performing the inhibition task with deficit-related sentences than with other emotionally negative themes (relative to neutral themes). This occurred despite their explicit denial of the self-relevance of the former sentences. Individual patient analysis showed that six of the seven anosognosic patients significantly differed from the control group in this dissociation. Using lesion mapping procedures, we found that the lesions of the anosognosic patients differed from those of the 'aware' controls mainly by involving the anterior parts of the insula, inferior motor areas, basal ganglia structures, limbic structures and deep white matter. In contrast, the anosognosic patient without implicit awareness had more cortical lesions, mostly in frontal areas, including lateral premotor regions, and also in the parietal and occipital lobes. These results provide strong experimental support for a specific dissociation between implicit and explicit awareness of deficits. More generally, the combination of our behavioural and neural findings suggests that an explicit, affectively personalized sensorimotor awareness requires the re-representation of sensorimotor information in the insular cortex, with possible involvement of limbic areas and basal ganglia circuits. The delusional features of anosognosia for hemiplegia can be explained as a failure of this re-representation.

Comparison of diffusion tensor imaging tractography of language tracts and intraoperative subcortical stimulations

Diffusion tensor (DT) imaging tractography is increasingly used to map fiber tracts in patients with surgical brain lesions to reduce the risk of postoperative functional deficit. There are few validation studies of DT imaging tractography in these patients. The aim of this study was to compare DT imaging tractography of language fiber tracts by using intraoperative subcortical electrical stimulations. The authors included 10 patients with low-grade gliomas or dysplasia located in language areas. The MR imaging examination included 3D T1-weighted images for anatomical coregistration, FLAIR, and DT images. Diffusion tensors and fiber tracts were calculated using in-house software. Four tracts were reconstructed in each patient including the arcuate fasciculus, the inferior occipitofrontal fasciculus, and 2 premotor fasciculi (the subcallosal medialis fiber tract and cortical fibers originating from the medial and lateral premotor areas). The authors compared fiber tracts reconstructed using DT imaging with those evidenced using intraoperative subcortical language mapping. Seventeen (81%) of 21 positive stimulations were concordant with DT imaging fiber bundles (located within 6 mm of a fiber tract). Four positive stimulations were not located in the vicinity of a DT imaging fiber tract. Stimulations of the arcuate fasciculus mostly induced articulatory and phonemic/syntactic disorders and less frequently semantic paraphasias. Stimulations of the inferior occipitofrontal fasciculus induced semantic paraphasias. Stimulations of the premotor-related fasciculi induced dysarthria and articulatory planning deficit. There was a good correspondence between positive stimulation sites and fiber tracts, suggesting that DT imaging fiber tracking is a reliable technique but not yet optimal to map language tracts in patients with brain lesions. Negative tractography does not rule out the persistence of a fiber tract, especially when invaded by the tumor. Stimulations of the different tracts induced variable language disorders that were specific to each fiber tract.

Movement-related desynchronization of alpha rhythms is lower in athletes than non-athletes: A high-resolution EEG study

The "neural efficiency" hypothesis posits that neural activity is reduced in experts. Here we tested the hypothesis that compared with non-athletes, elite athletes are characterized by a reduced cortical activation during simple voluntary movement and that this is reflected by the modulation of dominant alpha rhythms (8-12 Hz). EEG data (56 channels; EB-Neuro) were continuously recorded in the following right-handed subjects: 10 elite karate athletes and 12 non-athletes. During the EEG recordings, they performed brisk voluntary wrist extensions of the right or left hand (right movement and left movement). The EEG cortical sources were estimated by standardized low-resolution brain electromagnetic tomography (sLORETA) freeware. With reference to a baseline period, the power decrease of alpha rhythms during the motor preparation and execution indexed the cortical activation (event-related desynchronization, ERD). During both preparation and execution of the right movements, the low- (about 8-10 Hz) and high-frequency alpha ERD (about 10-12 Hz) was lower in amplitude in primary motor area, in lateral and medial premotor areas in the elite karate athletes than in the non-athletes. For the left movement, only the high-frequency alpha ERD during the motor execution was lower in the elite karate athletes than in the non-athletes. These results confirmed that compared with non-athletes, elite athletes are characterized by a reduced cortical activation during simple voluntary movement. Cortical alpha rhythms are implicated in the "neural efficiency" of athletes' motor systems.

Selective long‐term reorganization of the corticospinal projection from the supplementary motor cortex following recovery from lateral motor cortex injury

Brain injury affecting the frontal motor cortex or its descending axons often causes contralateral upper extremity paresis. Although recovery is variable, the underlying mechanisms supporting favorable motor recovery remain unclear. Because the medial wall of the cerebral hemisphere is often spared following brain injury and recent functional neuroimaging studies in patients indicate a potential role for this brain region in the recovery process, we investigated the long-term effects of isolated lateral frontal motor cortical injury on the corticospinal projection (CSP) from intact, ipsilesional supplementary motor cortex (M2). After injury to the arm region of the primary motor (M1) and lateral premotor (LPMC) cortices, upper extremity recovery is accompanied by terminal axon plasticity in the contralateral CSP but not the ipsilateral CSP from M2. Furthermore, significant contralateral plasticity occurs only in lamina VII and dorsally within lamina IX. Thus, selective intraspinal sprouting transpires in regions containing interneurons, flexor-related motor neurons, and motor neurons supplying intrinsic hand muscles, which all play important roles in mediating reaching and digit movements. After recovery, subsequent injury of M2 leads to reemergence of hand motor deficits. Considering the importance of the CSP in humans and the common occurrence of lateral frontal cortex injury, these findings suggest that spared supplementary motor cortex may serve as an important therapeutic target that should be considered when designing acute and long-term postinjury patient intervention strategies aimed to enhance the motor recovery process following lateral cortical trauma.

Decreased Left Posterior Insular Activity during Auditory Language in Autism

Individuals with autism spectrum disorders often exhibit atypical language patterns, including delay of speech onset, literal speech interpretation, and poor recognition of social and emotional cues in speech. We acquired functional MR images during an auditory language task to evaluate systematic differences in language-network activation between control and high-functioning autistic populations. Forty-one right-handed male subjects (26 high-functioning autistic subjects, 15 controls) were studied by using an auditory phrase-recognition task, and areas of differential activation between groups were identified. Hand preference, verbal intelligence quotient (IQ), age, and language-function testing were included as covariables in the analysis. Control and autistic subjects showed similar language-activation networks, with 2 notable differences. Control subjects showed significantly increased activation in the left posterior insula compared with autistic subjects (P < .05, false discovery rate), and autistic subjects showed increased bilaterality of receptive language compared with control subjects. Higher receptive-language scores on standardized testing were associated with greater activation of the posterior aspect of the left Wernicke area. A higher verbal IQ was associated with greater activation of the bilateral Broca area and involvement of the prefrontal cortex and lateral premotor cortex. Control subjects showed greater activation of the posterior insula during receptive language, which may correlate with impaired emotive processing of language in autism. Subjects with autism showed greater bilateral activation of receptive-language areas, which was out of proportion to the differences in hand preference in autism and control populations.

Functional connectivity reveals inefficient working memory systems in post-traumatic stress disorder

We applied a covariance-based multivariate analysis to functional magnetic resonance imaging (fMRI) data to investigate abnormalities in working memory (WM) systems in patients with post-traumatic stress disorder (PTSD). Patients ( n = 13) and matched controls ( n = 12) were scanned with fMRI while updating or maintaining trauma-neutral verbal stimuli in WM. A multivariate statistical analysis was used to investigate large-scale brain networks associated with these experimental tasks. For the control group, the first network reflected brain activity associated with WM updating and principally involved bilateral prefrontal and bilateral parietal cortex. Controls' second network was associated with WM maintenance and involved regions typically activated during storage and rehearsal of verbal material, including lateral premotor and inferior parietal cortex. In contrast, PTSD patients appeared to activate a single fronto-parietal network for both updating and maintenance tasks. This is indicative of abnormally elevated activity during WM maintenance and suggests inefficient allocation of resources for differential task demands. A second network in PTSD, which was not activated in controls, showed regions differentially activated between WM tasks, including the anterior cingulate, medial prefrontal cortex, fusiform and supplementary motor area. These activations may be linked to hyperarousal and abnormal reactivity, which are characteristic of PTSD.

On the selection of words and oral motor responses: Evidence of a response-independent fronto-parietal network

Several brain areas including the medial and lateral premotor areas, and the prefrontal cortex, are thought to be involved in response selection. It is unclear, however, what the specific contribution of each of these areas is. It is also unclear whether the response selection process operates independent of response modality or whether a number of specialized processes are recruited depending on the behaviour of interest. In the present study, the neural substrates for different response selection modes (volitional and stimulus-driven) were compared, using sparse-sampling functional magnetic resonance imaging, for two different response modalities: words and comparable oral motor gestures. Results demonstrate that response selection relies on a network of prefrontal, premotor and parietal areas, with the pre-supplementary motor area (pre-SMA) at the core of the process. Overall, this network is sensitive to the manner in which responses are selected, despite the absence of a medio-lateral axis, as was suggested by Goldberg (1985). In contrast, this network shows little sensitivity to the modality of the response, suggesting of a domain-general selection process. Theoretical implications of these results are discussed.

Diffusion-Weighted Imaging Tractography-Based Parcellation of the Human Lateral Premotor Cortex Identifies Dorsal and Ventral Subregions with Anatomical and Functional Specializations

Lateral premotor cortex (PM) in the macaque monkey can be segregated into structurally and functionally distinct subregions, including a major division between dorsal (PMd) and ventral (PMv) parts, which have distinct cytoarchitecture, function, and patterns of connectivity with both frontal and parietal cortical areas. The borders of their subregions are less well defined in the human brain. Here we use diffusion tractography to identify a reproducible border between dorsal and ventral subregions of human precentral gyrus. We derive connectivity fingerprints for the two subregions and demonstrate that each has a distinctive pattern of connectivity with frontal cortex and lateral parietal cortex, suggesting that these areas correspond to human PMd and PMv. Although putative human PMd has a high probability of connection with the superior parietal lobule, dorsal prefrontal cortex, and cingulate cortex, human PMv has a higher probability of connection with the anterior inferior parietal lobule and ventral prefrontal cortex. Finally, we assess the correspondence between our PMd/PMv border and local sulcal and functional anatomy. The location of the border falls at the level of the gyral branch that divides the inferior precentral sulcus from the superior precentral sulcus and corresponded closely to the location of a functional border defined using previous functional magnetic resonance imaging studies.

Human Medial Frontal Cortex Mediates Unconscious Inhibition of Voluntary Action

SummaryWithin the medial frontal cortex, the supplementary eye field (SEF), supplementary motor area (SMA), and pre-SMA have been implicated in the control of voluntary action, especially during motor sequences or tasks involving rapid choices between competing response plans. However, the precise roles of these areas remain controversial. Here, we study two extremely rare patients with microlesions of the SEF and SMA to demonstrate that these areas are critically involved in unconscious and involuntary motor control. We employed masked-prime stimuli that evoked automatic inhibition in healthy people and control patients with lateral premotor or pre-SMA damage. In contrast, our SEF/SMA patients showed a complete reversal of the normal inhibitory effect—ocular or manual—corresponding to the functional subregion lesioned. These findings imply that the SEF and SMA mediate automatic effector-specific suppression of motor plans. This automatic mechanism may contribute to the participation of these areas in the voluntary control of action.

Compensatory cortical mechanisms in Parkinson's disease evidenced with fMRI during the performance of pre-learned sequential movements

We used fMRI to study brain activity associated with the performance of a pre-learned sequence of complex movements of the hand-made unimanually in a group of 13 Parkinson's disease patients and a group of 11 control volunteers. Patients were scanned “off” medication. In controls, sequential movements led to the activation of bilateral sensorimotor and premotor cortex, bilateral inferior parietal cortex, supplementary motor area, bilateral putamen and globus pallidus, and the left ventral lateral nucleus of the thalamus. Sequential movements in the Parkinson's disease group were associated with a similar pattern of activation, although relative decrease of activation in striatum and thalamic areas was observed. Patients in comparison with controls showed a hyperactivation in ipsilateral premotor areas and a hypoactivation in structures of the frontostriatal motor loop. Furthermore, patient scores in the motor scale of the UPDRS correlated positively with the activation thalamus and motor cortical areas during the sequential motor task. We concluded that in Parkinson's disease there is a compensatory mechanism of the dopamine deficit in frontostriatal motor circuits that increases participation in the execution of motor tasks of parietal–lateral premotor circuits.

The mind of expert motor performance is cool and focused

Extraordinary motor skills required for expert athletic or music performance require longstanding and intensive practice leading to two critical skills, a level of maximal performance that far exceeds that of non-experts and a degree of privileged focus on motor performance that excludes intrusions. This study of motor planning in expert golfers demonstrated their brain activation during their pre-shot routine to be radically different than in novices. The posterior cingulate, the amygdala–forebrain complex, and the basal ganglia were active only in novices, whereas experts had activation primarily in the superior parietal lobule, the dorsal lateral premotor area, and the occipital area. The fact that these differences are apparent before the golfer swings the club suggests that the disparity between the quality of the performance of novice and expert golfers lies at the level of the organization of neural networks during motor planning. In particular, we suggest that extensive practice over a long period of time leads experts to develop a focused and efficient organization of task-related neural networks, whereas novices have difficulty filtering out irrelevant information.

Electroacupuncture treatment of arrhythmias in myocardial ischemia

integrative medicine, sometimes also called complementary and alternative medicine (or CAM), has been classified by the National Center for Complementary and Alternative Medicine into five domains, including 1 ) alternative systems of medical practice, like traditional Chinese medicine; 2 ) mind-

The Neural Substrate of Human Empathy: Effects of Perspective-taking and Cognitive Appraisal

Whether observation of distress in others leads to empathic concern and altruistic motivation, or to personal distress and egoistic motivation, seems to depend upon the capacity for self-other differentiation and cognitive appraisal. In this experiment, behavioral measures and event-related functional magnetic resonance imaging were used to investigate the effects of perspective-taking and cognitive appraisal while participants observed the facial expression of pain resulting from medical treatment. Video clips showing the faces of patients were presented either with the instruction to imagine the feelings of the patient ("imagine other") or to imagine oneself to be in the patient's situation ("imagine self"). Cognitive appraisal was manipulated by providing information that the medical treatment had or had not been successful. Behavioral measures demonstrated that perspective-taking and treatment effectiveness instructions affected participants' affective responses to the observed pain. Hemodynamic changes were detected in the insular cortices, anterior medial cingulate cortex (aMCC), amygdala, and in visual areas including the fusiform gyrus. Graded responses related to the perspective-taking instructions were observed in middle insula, aMCC, medial and lateral premotor areas, and selectively in left and right parietal cortices. Treatment effectiveness resulted in signal changes in the perigenual anterior cingulate cortex, in the ventromedial orbito-frontal cortex, in the right lateral middle frontal gyrus, and in the cerebellum. These findings support the view that humans' responses to the pain of others can be modulated by cognitive and motivational processes, which influence whether observing a conspecific in need of help will result in empathic concern, an important instigator for helping behavior.

Functional connectivity in human cortical motor system: a cortico-cortical evoked potential study

In order to understand the complex functional organization of the motor system, it is essential to know the anatomical and functional connectivity among individual motor areas. Clinically, knowledge of these cortico-cortical connections is important to understand the rapid spread of epileptic discharges through the network underlying ictal motor manifestation. In humans, however, knowledge of neuronal in vivo connectivity has been limited. We recently reported a new method, 'cortico-cortical evoked potential (CCEP)', to electrically track the cortico-cortical connections by stimulating a part of the brain through subdural electrodes and recording the cortical evoked potentials that emanate from a distant region of the cortex via neuronal projections. We applied the CCEP methodology to investigate in vivo cortico-cortical connections between the lateral motor cortex [LMCx; sensorimotor (SM) and lateral premotor areas] and the medial motor cortex [MMCx; supplementary motor area proper (SMA), pre-SMA and foot SM]. Seven patients with intractable partial epilepsy were studied. These patients had chronic implantation of subdural electrodes covering part of the lateral and medial frontal areas. As a part of the routine pre-surgical evaluation, comprehensive cortical mapping was performed by electrical stimulation of the subdural electrodes, and the precise localization of the subdural electrodes was defined by MRI co-registration. Single-pulse electrical stimuli were delivered to MMCx (7 patients) and LMCx (4), and CCEPs time-locked to the stimuli were recorded by averaging electrocorticograms from LMCx and MMCx, respectively. Short-latency CCEPs were observed when stimulating MMCx and recording from LMCx (mean latency: 21.6 ms, range: 9-47 ms) and vice versa when stimulating LMCx and recording from MMCx (mean latency: 29.4 ms, range: 11-57 ms). In terms of the location of these stimulus sites and CCEP responses along the rostrocaudal axis, regression analysis revealed a consistent correlation between the sites of stimulation and maximum CCEP for stimulation of both MMCx and LMCx. Functionally, stimulation of the positive motor areas in MMCx elicited CCEPs at the somatotopically homologous regions in LMCx (71%). The same findings were observed in MMCx (82%) upon stimulation of LMCx. In four subjects in whom bi-directional connectivity was investigated by stimulating both MMCx and LMCx, reciprocality was observed in the majority of connections (78-94%). In conclusion, the present study demonstrated a human motor cortico-cortical network connecting (i) anatomically homologous areas of LMCx and MMCx along the rostrocaudal cognitive-motor gradient; and (ii) somatotopically homologous regions in LMCx and MMCx in a reciprocal manner.

Motor imagery of complex everyday movements. An fMRI study

The present study aimed to investigate the functional neuroanatomical correlates of motor imagery (MI) of complex everyday movements (also called everyday tasks or functional tasks). 15 participants imagined two different types of everyday movements, movements confined to the upper extremities (UE; e.g., eating a meal) and movements involving the whole body (WB; e.g., swimming), during fMRI scanning. Results showed that both movement types activated the lateral and medial premotor cortices bilaterally, the left parietal cortex, and the right basal ganglia. Direct comparison of WB and UE movements further revealed a homuncular organization in the primary sensorimotor cortices (SMC), with UE movements represented in inferior parts of the SMC and WB movements in superior and medial parts. These results demonstrate that MI of everyday movements drives a cortical network comparable to the one described for more simple movements such as finger opposition. The findings further are in accordance with the suggestion that motor imagery-based mental practice is effective because it activates a comparable cortical network as overt training. Since most people are familiar with everyday movements and therefore a practice of the movement prior to scanning is not necessarily required, the current paradigm seems particularly appealing for clinical research and application focusing on patients with low or no residual motor abilities.

Activation of premotor vocal areas during musical discrimination

Two same/different discrimination tasks were performed by amateur-musician subjects in this functional magnetic resonance imaging study: Melody Discrimination and Harmony Discrimination. Both tasks led to activations not only in classic working memory areas—such as the cingulate gyrus and dorsolateral prefrontal cortex—but in a series of premotor areas involved in vocal-motor planning and production, namely the somatotopic mouth region of the primary and lateral premotor cortices, Broca’s area, the supplementary motor area, and the anterior insula. A perceptual control task involving passive listening alone to monophonic melodies led to activations exclusively in temporal-lobe auditory areas. These results show that, compared to passive listening tasks, discrimination tasks elicit activation in vocal-motor planning areas.

Contribution of the frontal lobe to externally and internally specified verbal responses: fMRI evidence

It has been suggested that within the frontal cortex there is a lateral to medial shift in the control of action, with the lateral premotor area (PMA) involved in externally specified actions and the medial supplementary motor areas (SMA) involved in internally specified actions. Recent brain imaging studies demonstrate, however, that the control of externally and internally specified actions may involve more complex and overlapping networks involving not only the PMA and the SMA, but also the pre-SMA and the lateral prefrontal cortex (PFC). The aim of the present study was to determine whether these frontal regions are differentially involved in the production of verbal responses, when they are externally specified and when they are internally specified. Participants engaged in three overt speaking tasks in which the degree of response specification differed. The tasks involved reading aloud words (externally specified), or generating words aloud from narrow or broad semantic categories (internally specified). Using fMRI, the location and magnitude of the BOLD activity for these tasks was measured in a group of ten participants. Compared with rest, all tasks activated the primary motor area and the SMA-proper, reflecting their common role in speech production. The magnitude of the activity in the PFC (Brodmann area 45), the left PMAv and the pre-SMA increased for word generation, suggesting that each of these three regions plays a role in internally specified action selection. This confirms previous reports concerning the participation of the pre-SMA in verbal response selection. The pattern of activity in PMAv suggests participation in both externally and internally specified verbal actions.

Subcortical motor plasticity in patients with sporadic ALS: An fMRI study

Objective To address the potential contribution of subcortical brain regions in the functional reorganization of the motor system in patients with sporadic ALS (sALS) and to investigate whether functional changes in brain activity are different in sALS patients with predominant upper motor neuron (UMN) or lower motor neuron (LMN) dysfunction. Methods We studied 16 patients with sALS and 13 healthy controls, using BOLD-fMRI, while they performed a simple visually paced motor task. Seven patients had definite clinical UMN signs while nine patients had prevalent clinical and electrophysiological LMN involvement. fMRI data were analyzed with Brain Voyager QX. Results Task-related functional changes were identified in motor cortical regions in both patients and healthy controls. Direct group comparisons revealed relatively decreased BOLD fMRI responses in left sensorimotor cortex, lateral premotor area, supplementary motor area and right posterior parietal cortex ( p < 0.05 corrected) and relatively increased responses in the left anterior putamen ( p < 0.001 uncorrected) in sALS patients. Additional analyses between the two patients subgroups demonstrated significant BOLD fMRI response differences in the anterior cingulate cortex and right caudate nucleus ( p < 0.001 uncorrected) with more robust activation of these areas in patients with greater UMN burden. Importantly, there were no significant differences in performance of the motor task between sALS patients and controls as well as between sALS patient subgroups. Conclusions Our data demonstrate a different BOLD fMRI pattern between our sALS patients and healthy controls even during simple motor behavior. Furthermore, patients with sALS and greater UMN involvement show a different reorganization of the motor system compared to sALS patients with greater LMN dysfunction.

Neural correlates of counting of sequential sensory and motor events in the human brain

Little is known about the ability to enumerate small numbers of successive stimuli and movements. It is possible that there exist neural substrates that are consistently recruited both to count sensory stimuli from different modalities and for counting movements executed by different effectors. Here, we identify a network of areas that was involved in enumerating small numbers of auditory, visual, and somatosensory stimuli, and in enumerating sequential movements of hands and feet, in the bilateral premotor cortex, presupplementary motor area, posterior temporal cortex, and thalamus. The most significant consistent activation across sensory and motor counting conditions was found in the lateral premotor cortex. Lateral premotor activation was not dependent on movement preparation, stimulus presentation timing, or number word verbalization. Movement counting, but not sensory counting, activated the anterior parietal cortex. This anterior parietal area may correspond to an area recruited for movement counting identified by recent single-neuron studies in monkeys. These results suggest that overlapping but not identical networks of areas are involved in counting sequences of sensory stimuli and sequences of movements in the human brain.