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Figure 22-5 The organization of neuronal systems in the granular cortex, following the plan of Lorente de No The black spheres represent points of synapse A Connections of efferent cortical neurons B Connections of intracortical neurons C Connections of afferent (thalamocortical) neurons D Mode of termination of afferent cortical bers P, pyramidal cell; M, Martinotti cell; S, spindle cell; 1, projection efferent; 2, association efferent; 3, speci c afferent; 4, association afferent

hemispheric ber tracts Some of these disconnections are indicated in Fig 22-6; the involved ber systems include the corpus callosum, anterior commissure, uncinate temporofrontal fasciculus, occipito- and temporoparietal tracts Extensive white matter lesions may virtually isolate certain cortical zones and result in a functional state that is the equivalent of destruction of the overlying cortical region An example is the isolation of the perisylvian language areas from the rest of the cortex, as occurs with anoxic-ischemic infarction of border zones between major cerebral arteries (see page 409)

The frontal lobes lie anterior to the central or rolandic sulcus and superior to the sylvian ssure (Fig 22-7) They are larger in humans (30 percent of the cerebrum) than in any other primate (9 percent in the macaque) Several different systems of neurons are located here, and they subserve different functions Brodmann s areas 4, 6, 8, and 44 relate speci cally to motor activities The primary motor cortex, ie, area 4, is directly connected with somatosensory neurons of the anterior part of the postcentral gyrus as well as with other parietal areas, thalamic and red nuclei, and the reticular formation of the brainstem The supplementary motor cortex, a portion of area 6, shares most of these connections As

pointed out in earlier chapters, all motor activity requires sensory guidance, and this comes from the somesthetic, visual, and auditory cortices and from the cerebellum via the ventral tier of thalamic nuclei Area 8 is concerned with turning the eyes and head contralaterally Area 44 of the dominant hemisphere (Broca s area) and the contiguous part of area 4 are centers of motor speech and related functions of the lips, tongue, larynx, and pharynx; bilateral lesions in these areas cause paralysis of articulation, phonation, and deglutition The medial-orbital gyri and anterior parts of the cingulate gyri, which are the frontal components of the limbic system, take part in the control of respiration, blood pressure, peristalsis, and other autonomic functions The most anterior parts of the frontal lobes (areas 9 to 12 and 45 to 47), sometimes referred to as the prefrontal areas, are particularly well developed in human beings but have imprecisely determined functions They are not, strictly speaking, parts of the motor cortex in the sense that electrical stimulation evokes no direct movement; the prefrontal cortex is said to be inexcitable Yet these areas are involved in the initiation of planned action and executive control of all mental operations, including emotional expression The frontal agranular cortex (areas 4 and 6) and, more specifically, pyramidal cells of layer V of the pre- and postcentral convolutions provide most of the cerebral efferent motor system that forms the pyramidal or corticospinal tract (see Figs 3-2 and 3-3) Another massive projection from these regions is the frontopontocerebellar tract In addition, there are other ber systems that pass from frontal cortex to the caudate and putamen, subthalamic and red nuclei, brainstem reticular formation, substantia nigra, and in-