Precentral Sulcus Research Articles

False memories activate distinct brain regions in females and males

The constructive process of memory is generally successful; however, it can also lead to memory failures such as false memories. Although true memories and false memories rely on some of the same brain regions, these memory types are also mediated by distinct neural substrates. Of relevance, there is a growing body of evidence that there are sex differences in the brain during true memories. However, no studies have investigated whether there are neural sex differences during false memories. In the current fMRI study, across all subjects, false memories produced activity in the precentral sulcus and superior parietal lobule, replicating previous findings. Males produced greater activity than females in the precuneus, posterior cingulate cortex, parietooccipital sulcus, and fusiform gyrus. Females produced greater activity than males in the medial prefrontal cortex, anterior cingulate cortex, paracentral lobule, supramarginal gyrus, lateral sulcus, cingulate sulcus, the putamen, and V1. An interaction analysis revealed a significant interaction between sex and region with a higher magnitude of activity in the hippocampus for males than females and a higher magnitude of activity in V1 for females than males. The current results suggest that false memories are supported by distinct brain regions and cognitive processes in females and males.

Free-floating thrombus and a fragment of atherosclerotic plaque in the lumen of the internal carotid artery – review of 2 cases

Free-floating thrombus or a fragment of atherosclerotic plaque (mobile plaque) in the lumen of the carotid artery is extremely rare. Atherosclerosis is the most common cause underlying their occurrence. The optimal treatment strategy has not been developed, at least in part due to the rarity of observations, as well as the lack of comparative studies between conservative and surgical treatment (carotid artery stenting, endovascular thrombectomy, endarterectomy). We present two cases that demonstrate the treatment tactics of these rather rare pathologies. Patient Yu., 62 years old, was hospitalized with focal neurological symptoms, National Institutes of Health Stroke Scale of 12. According to the CT of the brain, signs of an ischemic stroke in the right middle cerebral artery circulation were detected. Selective cerebral angiography diagnosed thrombosis of the arteries of the precentral and central sulcus of the right middle cerebral artery, critical stenosis of the mouth of the right internal carotid artery, and a free-floating thrombus in its lumen with a fixation point at the level of atherosclerotic plaque, which blocked the lumen of the artery by more than 60 %. Endovascular aspiration of a free-floating thrombus was performed, followed by angioplasty and stenting of critical stenosis with a favorable clinical outcome. Patient L., 73 years old, applied for carotid ultrasonography, during which a mobile atherosclerotic plaque was diagnosed at the level of the bifurcation of the right common carotid artery. Digital selective cerebral angiography confirmed a plaque fragment floating in the lumen of the artery. After applying a loading dose of ticagrelor without complications, an emergency implantation of a carotid stent was performed at the level of the bifurcation of the right common carotid artery.Taking into account the modern possibilities of interventional radiology and a wide range of tools, the endovascular approach to the treatment of complicated atherosclerotic plaque with a floating component or a formed blood clot is the best treatment option with a good safety profile.

A study on the age related anatomical variations of some of the cerebral cortical sulci of human brain

Background: The sulcal patterns may be useful in studying the mechanisms of both neuro developmental and neuro degenerative changes that occur during brain maturation and ageing. Magnetic resonance imaging has facilitated the non-invasive study of human cerebral and cognitive development.
 Aims and Objective: To find out the age related anatomical variations of some of the cerebral cortical sulci and gyri of the brain.
 Materials and Methods: The study was done using the MRI images of brain of normal healthy adults aged between 20-70 years. A total of 200 images were analysed consisting of that from 119 male subjects and 81 female subjects from the Department of Radiodiagnosis, Government Medical College Kottayam.
 Results: Using statistical analysis it was found that as the age advances there was decrease in the depth, in case of central sulcus, pre-central sulcus and post-central sulcus. The width of the pre-central sulcus and post-central sulcus was found to increase with age. The changes in the width of the central sulcus were not significant.
 Conclusion: The observations of the undertaken study indicated that age changes do occur in the sulci ofthe brain and there was a sequential change in relation to the different periods of adult life. These changes are probably due to the volume loss of the brain due to the atrophy that occurs during aging.

Skin landmarks to main cerebral structures: how to identify the main cerebral sulci? An anatomical study.

Neuronavigation is used in neurosurgical practice to locate the cortical structures. If this tool is unavailable, basic anatomical knowledge should be used. Craniometry has been rarely detailed in recent literature, systematically using bony landmarks. The aim of this study is to describe skin landmarks for neurosurgical practice. Dissection of 10 hemispheres with insertion of radio-opaque markers within the limits of lateral sulcus, central and pre-central sulci, and preoccipital notch. Computed tomography was performed in all cases and multiplanar reconstructions were performed. Maximal intensity projection (MIP) fusion images were used for measurements between known skin landmarks and sulci of interests. The Anterior Sylvian Point is measured 31.8 ± 2.8mm behind the orbital wall, 36.9 ± 3mm above the zygomatic arch. The horizontal part of the lateral sulcus is measured 59 ± 6mm above the tragus. The Superior Rolandic Point is measured 190.7 ± 4.5mm behind the nasion. The Pre-occipital Notch is measured 37.0 ± 6.9mm above the tragus and 67.1 ± 6.4mm behind. The Ideal Entry Points (IEP) for ventricular punctures are measured 120.2 ± 7mm behind the nasion and 33.8 ± 3mm laterally for the frontal IEP, and 61.3mm ± 2.5mm above and 64.7 ± 6.8mm behind the tragus for the parieto-occipital IEP. In this study, we described simple skin landmarks for lateral sulcus, central sulcus, preoccipital notch, and an IEP for ventricular drainage. Precise knowledge of brain sulcal anatomy will guide patient's positioning, skin incision, and craniotomies; and permits checking of imaging data provided by neuronavigation systems.

Occipital cortex is modulated by transsaccadic changes in spatial frequency: an fMRI study

Previous neuroimaging studies have shown that inferior parietal and ventral occipital cortex are involved in the transsaccadic processing of visual object orientation. Here, we investigated whether the same areas are also involved in transsaccadic processing of a different feature, namely, spatial frequency. We employed a functional magnetic resonance imaging paradigm where participants briefly viewed a grating stimulus with a specific spatial frequency that later reappeared with the same or different frequency, after a saccade or continuous fixation. First, using a whole-brain Saccade > Fixation contrast, we localized two frontal (left precentral sulcus and right medial superior frontal gyrus), four parietal (bilateral superior parietal lobule and precuneus), and four occipital (bilateral cuneus and lingual gyri) regions. Whereas the frontoparietal sites showed task specificity, the occipital sites were also modulated in a saccade control task. Only occipital cortex showed transsaccadic feature modulations, with significant repetition enhancement in right cuneus. These observations (parietal task specificity, occipital enhancement, right lateralization) are consistent with previous transsaccadic studies. However, the specific regions differed (ventrolateral for orientation, dorsomedial for spatial frequency). Overall, this study supports a general role for occipital and parietal cortex in transsaccadic vision, with a specific role for cuneus in spatial frequency processing.

Eye Movement Network Originating from Frontal Eye Field: Electric Cortical Stimulation and Diffusion Tensor Imaging.

This study investigated the networks originating from frontal eye fields (FEFs) using electric cortical stimulation and diffusion tensor imaging (DTI). Seven patients with intractable focal epilepsy, in which FEFs were identified by electrical cortical stimulation, were enrolled in this study. Electric stimulation at 50 Hz was applied to the electrodes for functional mapping. DTI was used to identify the subcortical fibers originating from the FEFs with two regions of interests (ROIs) in the FEF and contralateral paramedian pontine reticular formation (PPRF). FEFs were found in the superior precentral sulcus (pre-CS) in six patients and superior frontal gyrus (SFG) in three patients. DTI detected fibers connecting FEFs and contralateral PPRFs, passing within the internal capsule. The fibers were located close to the lateral antero-superior border of the subthalamic nucleus (STN) and medial posterior border of the globus pallidus internus (GPi). This study found the characteristic subcortical networks of the FEF. These tracts should be noted to prevent complications of deep brain stimulation (DBS) of the STN or GPi.

Regional Gray Matter Volume Identifies High Risk of Unsafe Driving in Healthy Older People.

In developed countries, the number of traffic accidents caused by older drivers is increasing. Approximately half of the older drivers who cause fatal accidents are cognitively normal. Thus, it is important to identify older drivers who are cognitively normal but at high risk of causing fatal traffic accidents. However, no standardized method for assessing the driving ability of older drivers has been established. We aimed to establish an objective assessment of driving ability and to clarify the neural basis of unsafe driving in healthy older people. We enrolled 32 healthy older individuals aged over 65 years and classified unsafe drivers using an on-road driving test. We then utilized a machine learning approach to distinguish unsafe drivers from safe drivers based on clinical features and gray matter volume data. Twenty-one participants were classified as safe drivers and 11 participants as unsafe drivers. A linear support vector machine classifier successfully distinguished unsafe drivers from safe drivers with 87.5% accuracy (sensitivity of 63.6% and specificity of 100%). Five parameters (age and gray matter volume in four cortical regions, including the left superior part of the precentral sulcus, the left sulcus intermedius primus [of Jensen], the right orbital part of the inferior frontal gyrus, and the right superior frontal sulcus), were consistently selected as features for the final classification model. Our findings indicate that the cortical regions implicated in voluntary orienting of attention, decision making, and working memory may constitute the essential neural basis of driving behavior.

Shared functional connectivity between the dorso-medial and dorso-ventral streams in macaques

Manipulation of an object requires us to transport our hand towards the object (reach) and close our digits around that object (grasp). In current models, reach-related information is propagated in the dorso-medial stream from posterior parietal area V6A to medial intraparietal area, dorsal premotor cortex, and primary motor cortex. Grasp-related information is processed in the dorso-ventral stream from the anterior intraparietal area to ventral premotor cortex and the hand area of primary motor cortex. However, recent studies have cast doubt on the validity of this separation in separate processing streams. We investigated in 10 male rhesus macaques the whole-brain functional connectivity of these areas using resting state fMRI at 7-T. Although we found a clear separation between dorso-medial and dorso-ventral network connectivity in support of the two-stream hypothesis, we also found evidence of shared connectivity between these networks. The dorso-ventral network was distinctly correlated with high-order somatosensory areas and feeding related areas, whereas the dorso-medial network with visual areas and trunk/hindlimb motor areas. Shared connectivity was found in the superior frontal and precentral gyrus, central sulcus, intraparietal sulcus, precuneus, and insular cortex. These results suggest that while sensorimotor processing streams are functionally separated, they can access information through shared areas.

White Matter-Governed Superior Frontal Sulcus Surgical Paradigm: A Radioanatomic Microsurgical Study-Part I.

Frontal subcortical and intraventricular pathologies are traditionally accessed via transcortical or interhemispheric-transcallosal corridors. To describe the microsurgical subcortical anatomy of the superior frontal sulcus (SFS) corridor. Cadaveric dissections were undertaken and correlated with magnetic resonance imaging/diffusion-tensor imaging-Tractography. Surgical cases demonstrated clinical applicability. SFS was divided into the following divisions: proximal, precentral sulcus to coronal suture; middle, 3-cm anterior to coronal suture; and distal, middle division to the orbital crest. Anatomy was organized as layered circumferential rings projecting radially towards the ventricles: (1) outer ring: at the level of the SFS, the following lengths were measured: (A) precentral sulcus to coronal suture=2.29 cm, (B) frontal bone projection of superior sagittal sinus (SSS) to SFS=2.37 cm, (C) superior temporal line to SFS=3.0 cm, and (D) orbital crest to distal part of SFS=2.32 cm; and (2) inner ring: (a) medial to SFS, U-fibers, frontal aslant tract (FAT), superior longitudinal fasciculus I (SLF-I), and cingulum bundle, (b) lateral to SFS, U-fibers, (SLF-II), claustrocortical fibers (CCF), and inferior fronto-occipital fasciculus, and (c) intervening fibers, FAT, corona radiata, and CCF. The preferred SFS parafascicular entry point (SFSP-EP) also referred to as the Kassam-Monroy entry point (KM-EP) bisects the distance between the midpupillary line and the SSS and has the following coordinates: x=2.3 cm (lateral to SSS), y≥3.5 cm (anterior to CS), and z=parallel corona radiata and anterior limb of the internal capsule. SFS corridor can be divided into lateral, medial, and intervening white matter tract segments. Based on morphometric assessment, the optimal SFSP-EP is y≥ 3.5cm, x=2.3 cm, and z=parallel to corona radiata and anterior limb of the internal capsule.

Distinct auditory and visual tool regions with multisensory response properties in human parietal cortex.

Left parietal cortex has been associated with the human-specific ability of sophisticated tool use. Yet, it is unclear how tool information is represented across senses. Here, we compared auditory and visual tool-specific activations within healthy human subjects to probe the relation of tool-specific networks, uni- and multisensory response properties, and functional and structural connectivity using functional and diffusion-weighted MRI. In each subject, we identified an auditory tool network with regions in left anterior inferior parietal cortex (aud-aIPL), bilateral posterior lateral sulcus, and left inferior precentral sulcus, and a visual tool network with regions in left aIPL (vis-aIPL) and bilateral inferior temporal gyrus. Aud-aIPL was largely separate and anterior/inferior from vis-aIPL, with varying degrees of overlap across subjects. Both regions displayed a strong preference for tools versus other stimuli presented within the same modality. Despite their modality preference, aud-aIPL and vis-aIPL and a region in left inferior precentral sulcus displayed multisensory response properties, as revealed in multivariate analyses. Thus, two largely separate tool networks are engaged by the visual and auditory modalities with nodes in parietal and prefrontal cortex potentially integrating information across senses. The diversification of tool processing in human parietal cortex underpins its critical role in complex object processing.

Gradients of functional organization in posterior parietal cortex revealed by visual attention, visual short-term memory, and intrinsic functional connectivity

Visual attention and visual working memory tasks recruit a common network of lateral frontal cortical (LFC) and posterior parietal cortical (PPC) regions. Here, we examine finer-scale organization of this frontoparietal network. Three LFC regions recruited by visual cognition tasks, superior precentral sulcus (sPCS), inferior precentral sulcus (iPCS), and mid inferior frontal sulcus (midIFS) exhibit differential patterns of resting-state functional connectivity to PPC. A broad dorsomedial to ventrolateral gradient is observed, with sPCS connectivity dominating in the dorsomedial PPC band, iPCS dominating in the middle band, and midIFS dominating in the ventrolateral band. These connectivity-defined subregions of PPC capture differential task activation between a pair of visual attention and working memory tasks. The relative functional connectivity of sPCS and iPCS also varies along the rostral-caudal axis of the retinotopic regions of PPC. iPCS connectivity is relatively stronger near the IPS0/IPS1 and IPS2/IPS3 borders, especially on the lateral portions of these borders, which each preferentially encode central visual field representations. In contrast, sPCS connectivity is relatively stronger elsewhere in retinotopic IPS regions which preferentially encode peripheral visual field representations. These findings reveal fine-scale gradients in functional connectivity within the frontoparietal visual network that capture a high-degree of specificity in PPC functional organization.

Anatomic Understanding of Subtotal Hemispherotomy Using Cadaveric Brain, 3-Dimensional Simulation Models, and Intraoperative Photographs.

When the epileptogenic foci skip the motor area, the epilepsy can be cured by surgery while preserving the motor function. This surgery has been reported as subtotal hemispherectomy. The disconnective variant of this surgery, subtotal hemispherotomy, is described. To demonstrate each step clearly, a cadaveric brain, 3-dimensional reconstruction and simulation model, and intraoperative photographs were used. A formalin-fixed cadaveric brain was dissected to show each step of this surgery. For the 3-dimensional model, several brain structures were reconstructed from preoperative images, and the surgery was simulated. Intraoperative photographs and postoperative magnetic resonance images were taken from the representative cases. Temporo-parieto-occipital disconnection is performed to disconnect these lobes and the insula, limbic system, and splenium of the corpus callosum. The postcentral sulcus is the anterior border of the disconnection. Next, prefrontal disconnection is performed to disconnect the frontal lobe and the insula, frontal lobe and basal ganglia, and the anterior part of the corpus callosum. The precentral sulcus is the posterior border of the disconnection. Finally, corpus callosotomy of the central part is performed. After these steps, subtotal hemispherotomy, with preservation of the pre- and postcentral gyrus, is achieved. The 3-dimensional model clearly shows the anatomic relationships between deep brain structures. In the representative cases, postoperative motor deterioration was transient or none, and seizure-free status was achieved after surgery. Subtotal hemispherotomy is generally difficult because of the complicated anatomy and narrow and deep surgical corridors. Combined use of these methods facilitates a clearer understanding of this surgery.

Disturbance of somatotopic spatial cognition and extra-territorial pain in carpal tunnel syndrome.

Several studies on carpal tunnel syndrome have reported pain that exists beyond the median nerve territory of the affected hand. However, the mechanism is unknown. We investigated the cause of extra-territorial pain by the analysis of clinical assessments and cortical activity using magnetoencephalography. To compare patients with and without extra-territorial pain, fourteen patients with carpal tunnel syndrome were assessed using clinical examination, such as patients' profile, paresthesia, physical tests, and psychological tests. The physical assessment included tactile threshold and static and moving two-point discrimination sensations on digital pulp. Neural activation in the cerebral cortex was also measured using z-scores calculated by magnetoencephalography. Among fourteen patients, ten patients had pain in the affected median nerve territory only and four patients had extra-territorial pain. When comparing the groups, the static and moving two-point discrimination sensation values in patients with extra-territorial pain were larger than those of patients without the pain (p < 0.05). The supra-marginal gyrus, mid-part of the precentral sulcus, angular gyrus in the left hemisphere, bilateral sensorimotor areas for legs, and bilateral isthmus-cingulate areas showed larger z-scores in patients with extra-territorial pain than in patients without the pain (p < 0.05). The static and moving two-point discrimination sensations signify the ability of tactile spatial acuity. Bilateral sensorimotor areas were activated in sites that were not the hand. Furthermore, the inferior parietal lobule in the left hemisphere, which synthesizes and integrates multiple sensations showed high activation. Our findings suggested that the mechanism of extra-territorial pain was associated with dysfunction of spatial cognition.

The role of early social rearing, neurological, and genetic factors on individual differences in mutual eye gaze among captive chimpanzees

Mutual eye gaze plays an important role in primate social development and communication. In the current study, we examined the underlying experiential, genetic, and neuroanatomical basis of mutual eye gaze variation in adult captive chimpanzees. A multivariate analysis of variance revealed a significant rearing effect on bout length, with human-reared chimpanzees engaging in longer bouts of mutual gaze compared to mother-reared and wild-born individuals. Next, we utilized source-based morphometry (SBM) to examine gray matter covariation in magnetic resonance imaging scans and determine the relationship between the resulting gray matter covariation components and mutual eye gaze. One SBM component was negatively correlated with gaze duration (nucleus accumbens and anterior insular cortex), while two components were positively correlated with bout length (posterior cingulate cortex, inferior occipital cortex, middle temporal cortex, hippocampus, and the precentral sulcus). Finally, heritability analyses revealed mutual eye gaze to be modestly heritable and significant genetic correlations between bout length and two gray matter covariation components. This study reveals that non-genetic factors, and to a lesser extent, genetic factors appear to influence mutual eye gaze in adult chimpanzees, and is the first to report neuroanatomical correlates of mutual eye gaze variation in chimpanzees.

Dissociable effects of tDCS polarity on latent decision processes are associated with individual differences in neurochemical concentrations and cortical morphology

Applying a weak electrical current to the cortex has the potential to modulate neural functioning and behaviour. The most common stimulation technique, transcranial direct current stimulation (tDCS), has been used for causal investigations of brain and cognitive functioning, and to treat psychiatric conditions such as depression. However, the efficacy of tDCS in modulating behaviour varies across individuals. Moreover, despite being associated with different neural effects, the two polarities of electrical stimulation – anodal and cathodal – can result in similar behavioural outcomes. Here we employed a previously replicated behavioural paradigm that has been associated with polarity non-specific disruption of training effects in a simple decision-making task. We then used the linear ballistic accumulator model to quantify latent components of the decision-making task. In addition, magnetic resonance imaging measures were acquired prior to tDCS sessions to quantify cortical morphology and local neurochemical concentrations. Both anodal and cathodal stimulation disrupted learning-related task improvement relative to sham (placebo) stimulation, but the two polarities of stimulation had distinct effects on latent task components. Whereas anodal stimulation tended to affect decision thresholds for the behavioural task, cathodal stimulation altered evidence accumulation rates. Moreover, performance variability with anodal stimulation was related to cortical thickness of the inferior frontal gyrus, whereas performance variability with cathodal stimulation was related to cortical thickness in the inferior precentral sulcus, as well as to prefrontal neurochemical excitability. Our findings demonstrate that both cortical morphology and local neurochemical balance are important determinants of individual differences in behavioural responses to electrical brain stimulation.

Increased Cortical Thickness in Attentional Networks in Parkinson's Disease with Minor Hallucinations.

Hallucinations are common in Parkinson's disease (PD). Based on functional brain MRI data, hallucinations are proposed to result from alterations in the dorsal attention network (DAN), ventral attention network (VAN), and default mode network. Using structural MRI data from Parkinson's Progression Markers Initiative (PPMI), we examined cortical thickness in these networks in PD patients with (n=30) and without (n=30) minor hallucinations who were matched on multiple clinical characteristics (e.g., age, sex, education, cognitive diagnosis, MoCA score, medication, disease duration, and severity) as well as healthy controls (n=30) matched on demographic variables. Multivariate analyses revealed mild hallucinations to be associated with thicker cortex in the DAN and VAN, and these effects were driven by the left superior precentral sulcus and postcentral sulcus for the DAN and by the right insular gyrus for the VAN. While these findings may seem at odds with prior work showing grey matter reductions, our patients are in earlier stages of the disease than those in other studies. This is consistent with an inverted U-shape pattern of cortical thickness alterations in other neurodegenerative diseases and warrants further investigations in longitudinal studies tracking brain correlates of PD psychosis progression.

Word inversion sensitivity as a marker of visual word form area lateralization: An application of a novel multivariate measure of laterality

An area within the ventral occipitotemporal cortex (vOTC), the "visual word form area" (VWFA), typically exhibits a strongly left-lateralized response to orthographic stimuli in skilled readers. While individual variation in VWFA lateralization has been observed, the behavioral significance of laterality differences remains unclear. Here, we test the hypothesis that differences in VWFA lateralization reflect differing preferences for holistic orthographic analysis. To examine this hypothesis, we implemented a new multivariate method that uses machine learning to assess functional lateralization, along with a traditional univariate lateralization method. We related these neural metrics to behavioral indices of holistic orthographic analysis (inversion sensitivity). The multivariate measure successfully detected the lateralization of orthographic processing in the VWFA, and as hypothesized, predicted behavioral differences in holistic orthographic analysis. An exploratory whole brain analysis identified further regions with a relationship between inversion sensitivity and lateralization: one near the junction of the inferior frontal and precentral sulci, and another along the superior temporal gyrus. We conclude that proficient native readers of English exhibit differences in cortical lateralization of the VWFA that have significant implications for reading behavior.

Causal Evidence for the Role of Neuronal Oscillations in Top-Down and Bottom-Up Attention.

Beta and gamma frequency neuronal oscillations have been implicated in top-down and bottom-up attention. In this study, we used rhythmic TMS to modulate ongoing beta and gamma frequency neuronal oscillations in frontal and parietal cortex while human participants performed a visual search task that manipulates bottom-up and top-down attention (single feature and conjunction search). Both task conditions will engage bottom-up attention processes, although the conjunction search condition will require more top-down attention. Gamma frequency TMS to superior precentral sulcus (sPCS) slowed saccadic RTs during both task conditions and induced a response bias to the contralateral visual field. In contrary, beta frequency TMS to sPCS and intraparietal sulcus decreased search accuracy only during the conjunction search condition that engaged more top-down attention. Furthermore, beta frequency TMS increased trial errors specifically when the target was in the ipsilateral visual field for the conjunction search condition. These results indicate that beta frequency TMS to sPCS and intraparietal sulcus disrupted top-down attention, whereas gamma frequency TMS to sPCS disrupted bottom-up, stimulus-driven attention processes. These findings provide causal evidence suggesting that beta and gamma oscillations have distinct functional roles for cognition.

Dissociating motor-speech from lexico-semantic systems in the left frontal lobe: insight from a series of 17 awake intraoperative mappings in glioma patients.

Functional brain mapping during awake surgery procedures is the gold standard technique in the management of left frontal lobe tumors. Nevertheless, a unified picture of the language subsystems encountered during left frontal lobe mapping is still lacking. We retrospectively analyzed the 49 cortical and the 33 axonal sites of functional language mapping performed in 17 patients operated for a left frontal lobe glioma under awake conditions. Sites were tagged on the postoperative MRI, based on anatomical landmarks and intraoperative photography. All MRIs and tags were then registered in the MNI template. Speech disturbances related to motor functions (speech arrest-with or without superior limb arrest-, stuttering, and vocalization) were grouped together as "motor-speech" responses. Anomias, semantic paraphasia, perseverations, and PPTT errors were classified as "lexico-semantic" responses. MNI-registered axonal sites were used as seed for computing disconnectome maps from a tractogram atlas of ten healthy individuals, as implemented in the BCB toolkit. The cortical distribution of lexico-semantic responses appeared to be located anteriorly (pars triangularis of the inferior frontal gyrus and posterior end of the middle and superior frontal gyrus) compared to motor-speech responses (lower end of the precentral gyrus and pars opercularis). Within the white matter, motor-speech responses and lexico-semantic responses overlapped on the trajectory of the aslant and fronto-striatal tracts, but the lexico-semantic sites were located more anteriorly (mean Y coordinate on the MNI system was 21.2mm for lexico-semantic sites and 14.3mm for the motor-speech sites; Wilcoxon test: W = 60.5, p = 0.03). Moreover, disconnectome maps evidenced a clear distinction between the two subsystems: posterior fronto-striatal and frontal aslant tracts, corpus callosum and cortico-spinal tract were related to the motor-speech sites, whereas anterior frontal aslant tract, inferior-fronto-occipital fasciculus (IFOF) and anterior thalamic radiations were related to the lexico-semantic sites. Hence, we evidenced distinct anatomical substrates for the motor-speech and lexico-semantic systems. Regarding the aslant/fronto-striatal system, an anterior to posterior gradient was found, with a lexico-semantic role for the anterior part and a motor-speech involvement for the posterior part. For tumors abutting the precentral sulcus, posterior boundaries of the resection are made of motor-speech sites, meaning that the anteriorly located lexico-semantic system is no more functional, as a result of network reorganization by plasticity.

Anatomo-functional characterisation of the human “hand-knob”: A direct electrophysiological study

The cortical area within the human primary motor cortex (M1) that hosts the representation of the hand and fingers is known as the ‘hand-knob’ and is essential for voluntary hand movement. The anatomo-functional heterogeneity described within the monkey primary motor cortex (M1) in a rostro-caudal direction suggests an internal subdivision in two sectors originating different systems of connections to the spinal cord. Direct investigation of the human hand-knob has been prevented, so far, by methodological constraints. The unique setting of brain tumour resection with the brain mapping technique in awake patients enables direct electrophysiological investigation of the functional properties of the human hand-knob. Motor-evoked potentials (MEPs) elicited by Direct Electrical Stimulation (DES) at high frequency (HF-DES) delivered along the hand-knob in rostro-caudal direction, i.e., from the central to the precentral sulcus, were recorded from the hand/arm muscles in patients at rest. The sites located near the precentral sulcus identified with HF-DES were then stimulated with low-frequency DES (LF-DES) during a hand manipulation task (HMt) to assess whether DES affected task execution. From the stimulated sites, corticofugal projections and U-shaped tracts connecting with adjacent gyri were traced using diffusion tensor and spherical deconvolution tractography. Analysis of MEPs showed a rostro-caudal gradient of cortical excitability along the hand-knob (the rostral sector being less excitable). Stimulation of rostral sites during the HMt impaired the task by inducing dysfunctional recruitment or, alternatively, suppression of distal muscles. Diffusion tractography showed different patterns of rostro-caudal connectivity for the U-shaped tracts. Overall data suggests, in humans, the anatomo-functional subdivision of the human hand-knob in two sectors, possibly subserving different roles in motor control.