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GORE JC: Principles and practice of functional MRI of the human brain J Clin Invest 112:4, 2003 HALSTEAD WC: Brain and Intelligence Chicago, University of Chicago Press, 1947 HARLOW JM: Quoted in Denny-Brown D: The frontal lobes and their functions, in Feiling A (ed): Modern Trends in Neurology New York, Hoeber-Harper, 1951, p 65 HEAD H, HOLMES G: Sensory disturbances from cerebral lesions Brain 34:102, 1911 HECAEN H: Clinical symptomatology in right and left hemispheric lesions, in Mountcastle VB (ed): Interhemispheric Relations and Cerebral Dominance Baltimore, Johns Hopkins University Press, 1962, chap 10, pp 215 263 HEILMAN KA, VALENSTEIN E: Clinical Neuropsychology, 4th ed New York, Oxford University Press, 2003 HENSCHEN SE: Klinische und Anatomische Beitrage zur Pathologie des Gehirns Vols 5 7 Stockholm, Nordiska Bokhandeln, 1920 1922 HOLMES G: Disturbances of visual orientation Br J Ophthalmol 2:449, 506, 1918 HOLMES G, HORRAX G: Disturbances of spatial orientation and visual attention with loss of stereoscopic vision Arch Neurol Psychiatry 1:385, 1919 HUBEL D: Exploration of the primary visual cortex Nature 299:515, 1982 HUBEL DH, WIESEL TN: Receptive elds, binocular interaction and functional architecture in the cat s visual cortex J Physiol 160:106, 1962 JACKSON JH, STEWART P: Epileptic attacks with a warning of crude sensation Brain 22:534, 1899 JACOBSEN CF: Functions of frontal association in primates Arch Neurol Psychiatry 33:558, 1935 KAAS JH: What if anything is S1 Organization of the rst somatosensory area of cortex Physiol Rev 63:206, 1983 KARNATH HO, CHRIST K, HARTJE W: Decrease of contralateral neglect by neck muscle vibration and spatial orientation of trunk midline Brain 116:383, 1993 KINSBOURNE M, WARRINGTON EK: A disorder of simultaneous form perception Brain 85:461, 1962 KINSBOURNE M, WARRINGTON EK: The localizing signi cance of limited simultaneous visual form perception Brain 86:697, 1963 KLEIST K: Gehirnpathologie Leipzig, Barth, 1934 KLEIST K: Sensory Aphasia and Amusia: The Myeloarchitectonic Basis Tr by Fish FJ, Stanton JB Oxford, England, Pergamon Press, 1962 KLUVER H, BUCY PC: An analysis of certain effects of bilateral temporal lobectomy in the rhesus monkey with special reference to psychic blindness J Psychol 5:33, 1938 LANDIS T, CUMMINGS JL, BENSON F, PALMER EP: Loss of topographic familiarity: An environmental agnosia Arch Neurol 43:132, 1986 LAPLANE D: La perte d auto-activation psychique Rev Neurol 146:397, 1990 LAPLANE D, TALAIRACH J, MEININGER V, et al: Motor consequences of motor area ablations in man J Neurol Sci 31:29, 1977a LAPLANE D, TALAIRACH J, MEININGER V, et al: Clinical consequences of corticectomies involving supplementary motor area in man J Neurol Sci 34:301, 1977b LASSONDE M, JEEVES MA (eds): Callosal Agenesis: A Natural Split Brain New York, Plenum Press, 1994 LE BIHAN D: Looking into the functional architecture of the brain with diffusion MRI Nat Rev Neurosci 4:469, 2003 LEVINE DN: Prosopagnosia and visual object agnosia Brain Lang 5:341, 1978 LEVINE DN, CALVANIO R: A study of the visual defect in verbal alexiasimultanagnosia Brain 101:65, 1978 LHERMITTE F: Human autonomy and the frontal lobes: II Patient behavior in complex and social situations The environmental dependency syndrome Ann Neurol 19:335, 1986 LHERMITTE F: Utilization behavior and its relation to lesions of the frontal lobes Brain 106:237, 1983.

Thus the prefrontal cortex, supplementary motor cortex, premotor cortex, and motor cortex are all responsive to various afferent stimuli and are involved in set discharges prior to and in coordinated fashion with a complex movement And, as remarked later on, the striatopallidum and cerebellum, which project to these cortical areas, are also activated prior to or concurrently with the discharge of corticospinal neurons (see Thach and Montgomery for a critical review of the physiologic data)

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This has been studied in the monkey by interrupting the descending motor pathways in the medulla and more rostral parts of the brainstem and tracing the distribution of the degenerating elements in the spinal gray matter On the basis of such experiments and other physiologic data, Lawrence and Kuypers proposed that the functional organization of the descending cortical and subcortical pathways is determined more by their patterns of termination and the motor capacities of the internuncial neurons upon which they terminate than by the location of their cells of origin Three groups of motor bers were distinguished according to their differential terminal distribution: (1) The corticospinal and corticobulbar tracts, which project to all levels of the spinal cord and brainstem, terminating diffusely throughout the nucleus proprius of the dorsal horn and the intermediate zone A portion of these connect directly with the large motor neurons that innervate the muscles of the ngers, face, and tongue; this system provides the capacity for a high degree of fractionation of movements, as exempli ed by independent nger movements As alluded to above, a large fraction of the bers in the corticospinal originate from the sensory cortex and appear to function in the modulation of movement by afferent neurons (2) A ventromedial pathway, which arises in the tectum (tectospinal tract), vestibular nuclei (vestibulospinal tract), and pontine and medullary reticular cells (reticulospinal tract) and terminates principally on the internuncial cells of the ventromedial part of the spinal gray matter This system is mainly concerned with axial movements the maintenance of posture, integrated movements of body and limbs, and total limb movements (3) A lateral pathway, which is derived mainly from the magnocellular part of the red nucleus and terminates in the dorsal and lateral parts of the internuncial zone This pathway adds to the capacity for independent use of the extremities, especially of the hands Reference has already been made to the corticomesencephalic, corticopontine, and corticomedullary ber systems that project onto the reticulospinal, vestibulospinal, rubrospinal, and tectospinal nuclei These control stability of the head (via labyrinthine re exes) and of the neck and body in relation to the head (tonic neck re exes) as well as postures of the body in relation to limb movements Lesions in these systems are less well understood than those of the corticospinal system They cause no paralysis of muscles but result in the liberation of unusual postures (eg, hemiplegic dystonia), heightened tonic neck and labyrinthine re exes, and decerebrate rigidity In a strict sense these are all extrapyramidal, as discussed in the next two chapters.

The corticospinal pathway may be interrupted by a lesion at any point along its course at the level of the cerebral cortex, subcor-