FUNCTIONAL

AREAS OF
CEREBRAL
CORTEX
Functional areas of cerebral
cortex
Different neurobiologists divide
the cortex into a number of areas
• 20 areas of Cambell
• 52 areas of Brodmann
• 109 areas of Economo
• Over 200 areas of Vogt
Broadly speaking cortical areas
are subdivided into:
• Motor area
• Sensory area
• Psychical area
Motor area
It is further subdivided into:
• Primary motor area
• Pre-motor area
• Supplementary motor area
• Pre-frontal area
Primary motor area
(area 4)
• Includes precentral gyrus,
extends on to anterior part
of paracentral lobule on
the medial surface
• Structurally belongs to
agranular cortex (outer
and inner pyramidal layers
well developed and outer
and inner granular layers
poorly developed)
• Hence contains around
35,000 giant pyramidal
cells of Betz in 5th layer
[diameter of 15-60 µm and
height of 30-120 µm]. Cells
are confined to posterior
part of area 4 and numerous
in the paracentral lobule
Primary motor area
(area 4) - Connections
Afferent connection
• From ventral anterior
and ventral intermediate
nuclei of thalamus
• Thus the motor cortex is
influenced by the ipsilateral
corpus striatum and contra-
lateral cerebellar
hemisphere
• Connected by association
fibres with the postcentral
gyrus and other cortical
areas of the same
hemisphere
• Commissural fibres of
corpus callosum connect it
to the opposite hemisphere
Primary motor area (area 4) - Efferent connections
• Area 4 along with areas 6; 3,1,2; 5 & 7 provide principal origin to Corticospinal
and Corticobulbar tracts
• Motor and pre-motor areas give origin to fronto-pontine fibres [provide
information to the opposite cerebellar hemisphere, via nuclei pontis]
• Connected by efferent projection fibres to the corpus striatum, red nucleus,
and brain stem reticular nuclei – extra-pyramidal centers
Functions
• Controls voluntary movements on the
contra-lateral side of the body
• Some sensations such as tingling and
numbness may be experienced on the contra-
lateral side after artificial stimulation of motor
cortex
It is therefore suggested that the somatomotor
cortex [areas 4 and 6] is primarily motor and
secondarily sensory in function
Centers for movements are represented
somatotopically with the head end below and leg
end up (motor homunculus)
Sequence from below upwards – pharynx, larynx,
tongue, lips, face, neck, hand, wrist, shoulder, trunk
and thigh in precentral gyrus.
Leg and perineum in the anterior part of
paracentral lobule.
Effects of lesion
• Lesions in one hemisphere result in the paralysis of the opposite
side of the body (UMN paralysis)
• Ablation of the primary motor cortex results initially flaccid paresis
[weakness or loss of muscle tone resulting from injury or disease of the nerves
innervating the muscles] of contra-lateral movements with decreased
deep tendon reflexes and positive Babinski sign
• Destruction of primary motor area (area 4) produces more severe
paralysis than the destruction of secondary motor area (area 6)
• Destruction of both areas produce the most complete form of
paralysis
Pre-motor area [ area 6]
• Includes posterior parts of superior, middle and inferior frontal gyri.
• For coordinating the skillful voluntary movements
• Upper part of area 6 is believed to posses a writing center which is concerned
with the coordinated movements of writing.
In short pre-motor area is concerned with the programming of movements which are
executed by area 4 after the messages are corrected by the corpus striatum,
cerebellum, and thalamus
Pre-motor area [ areas 6]
• Lesion of pre-motor area alone produces difficulty in performing skilled
movements with little loss of strength.
• Jacksonian epileptic seizure – due to an irritative lesion of primary motor area.
• Convulsion begins in the part of the body represented in the motor area that is
being irritated.
• Convulsion may be restricted to one part of the body such as face, hand or foot .
Jacksonian epileptic seizure
• Tonic, or stiffening phase of the seizure
• Clonic or jerking movements
Frontal eye-field: Area 8 - found in the posterior part of middle frontal gyrus.
• Regulates the voluntary conjugate movements of the eyes
• Electrical stimulation produces conjugate eye movement towards the opposite side.
Lesion – causes the two eyes to deviate to the side of lesion and an inability to turn
the eyes to the opposite side.
Broca’s motor speech area: Areas 44 & 45 – present in left hemisphere in right
handed person, in the pars posterior and pars triangularis of inferior frontal
gyrus
• Regulates the coordinated movements of the lips, tongue, palate, larynx and
pharynx
Lesion – expressive aphasia [the person knows what he or she wants to say yet has
difficulty in communicating it to others]
Pre-frontal area: areas
9,10,11,12
• Anterior to frontal eye-field and
motor speech area
• Includes greater parts of the
superior, middle, inferior frontal
gyri; orbital gyri, medial frontal
gyrus and anterior part of
cingulate gyrus. Area 12 is
predominant on the orbital
surface
• Connected with thalamus,
hypothalamus, corpus striatum
and cerebellum and limbic
system
• It receives long association
fibres from almost all areas of
the cerebral cortex
Pre-frontal area: areas 9,10,11,12
Function
• Concerned with the make up of individual’s personality.
• Plays a role in the regulation of person’s depth of feeling.
• Responsible for abstract thinking, judgment, foresight, tactfulness and social
and emotional behavior.
• Since the function of this area is non-specific, it forms the so called ‘silent area of
the brain’
Lesion
• Results in person’s loosing initiative and judgment.
• Emotional changes – tendency to euphoria
• Patient no longer confirms to the expected mode of social behavior and becomes
careless of dress and appearance.
Prefrontal lobe syndrome
• The prefrontal lobe syndrome occurs in association with tumors, trauma, or
degenerative disease in the prefrontal and orbitofrontal cortices.
Characterized by a conglomerate (mass of) signs and symptoms that include:
Impairments in –
Decision making, Ability to plan, Social judgment, conduct, Modulation of affect and of
emotional response, and creativity (ABSTRACT THOUGHT DISTERBANCES)

Such patients lose spontaneity in motor as well as mental activities.

They do not appear to realize that they are neglecting themselves and their
responsibilities at home and work.
Affected patients may sit for hours looking at objects in front of them or staring out
through the window.
They manifest loss of inhibition in social behavior and are usually euphoric and
unconcerned.
They may become incontinent of stools and urine because of the lack of spontaneity.
Patients with prefrontal lobe syndrome exhibit inappropriate repetitive motor or speech
behavior (perseveration) because of their inability to disengage from a behavior that is
no longer useful.
Bilateral pre-frontal lobotomy is sometimes practiced in patients with mental illness
and distressing somatic pain, by severing the connection between pre-frontal area
and dorso-medial nucleus of thalamus. It is argued that this treatment does not
improve the condition much, rather it demotes the patient to sub-human forms.
Sensory areas: Includes
• Primary sensory or somesthetic area
• Secondary sensory area
• Sensory association areas
Primary sensory areas are basically three:
• Sensory or Somesthetic area
• Visual area
• Auditory area
Primary somesthetic area (areas 3,1,2)
• In postcentral gyrus and posterior part of
paracentral lobule
• Shows granular type of cortex – layers 2 & 4
(outer and inner granular layers) are well
developed. Contains more granule cells and
less pyramidal cells.
• Receives profuse thalamocortical
connections from VPL and VPM of
thalamus – all modalities of sensations.
• Contralateral body represented upside down.
Primary sensory area (Broadman’s
area 3,1,2)
• Lesion - results in altered or impaired
sensations on the opposite side of the
body. Most severe in the distal parts of the
limbs. Crude painful, tactile and thermal
stimuli often return (believed to be due to
the functions of thalamus). But the patient
is unable to judge the degrees of warmth,
unable to localize tactile stimuli and
unable to judge the weight of the objects.

Secondary somesthetic area

• Situated along the upper lip of posterior
ramus of lateral sulcus
• Involves the lower part of post-central and
pre-central gyri
• It receives several modalities of cutaneous
sensation but pain predominates
Sensory association areas [area 5 & 7]
• Present in superior parietal lobule, just behind the
post-central gyrus
• Connected reciprocally with the pulvinar end of
the thalamus
• Concerned with perception or recognition of
the general senses (steriognosis)
Lesion affecting this area produces tactile agnosia
[lack of ability to recognize objects through touch -
astereognosis] and tactile aphasia [inability to
understand spoken, written, or tactile speech symbols that
results from damage to Wernicke's area concerned with
language. (Wernicke's aphasia)].
Primary visual or striate area [Area 17]
• Present in the lips and walls of the posterior part
of the calcarine sulcus [in cuneus and lingual
gyrus].
• Occupies about 3% of entire cortical surface
and contains about one-tenth of the total
number of cortical neurons
• Visual cortex thinner than the cortex elsewhere
• Cortex is granular type
Primary visual or striate area [Area 17]……
• Outer band of Baillarger in lamina 4 is very prominent
in the visual cortex and forms the stria of Gennari.
• Pyramidal cells are replaced by stellate cells, and in the
lamina 5 the modified pyramidal cells are known as
solitary cells of Meynert, which provide origin for
efferent projection fibres
• Receives optic radiation from lateral geniculate
body – visual impulses from ipsilateral temporal half
of retina and contralateral nasal half of retina ie; from
opposite visual field.
• It is connected to area 18 [parastriate area] and area 19
[peristriate area] by short association fibres
Function
• The primary visual area receives sensory data from its
own half of each retina, and registers the opposite field
of vision
• The elicited visual impression from an object is simple
in nature and lacks in details of analysis and
discrimination
Primary visual area and visual association area
Visual association area (areas 18 & 19)
• parastriate and peristriate areas.
• stores past visual experiences
Connections
• Receives afferents from area 17
• Efferent fibres go to superior colliculus
and motor nuclei of extra-ocular muscles
Function:
Helps in recognition of objects by relating
the present impression with the past visual
experience
Lesions in the primary visual
area (area 17)
• Lesion in the visual area –
contralateral (crossed) homonymous
hemianopia – loss of sight in the
opposite visual field.
• Lesion in the upper lip of calcarine
sulcus – contralateral inferior
quadrantic hemianopia.
• Lesion in the lower lip of calcarine
sulcus – contralateral superior
quadrantic hemianopia
• Lesions of occipital poles – central
scotomas (loss of part or all of the
central vision)
• Most common causes of these lesions
are vascular disorders, tumors and
injuries from gunshot wounds.
Lesions of the secondary visual
(visual association) area - 18 &
19
• Results in the loss of ability to
recognize objects in the opposite visual
field.
Primary acoustic area (auditory area)
area 41, 42
• Present in the anterior transverse
temporal gyrus [Heschl’s gyrus] and
upper surface of superior temporal
gyrus.
• Structurally consists of granular hetero-
typical cortex
• Receives auditory radiation from medial
geniculate body.
• Unilateral lesion of the area will not
produce significant impairment of hearing,
since auditory information is bilaterally
projected to the cortex.
Auditory association area (Secondary
auditory area) area 22 or
Wernicke’s area
• Present in the posterior part of superior
temporal gyrus.
• Essential for the interpretation of sound
impulses in the light of past experiences
and comprehension of spoken language
Lesion of one primary auditory area will produce slight bilateral loss of hearing, but
the loss will be greater in the opposite ear. The main defect noted is a loss of
ability to locate the source of sound. Bilateral destruction of the primary auditory
areas causes complete deafness.
Lesion in secondary auditory area – results in an inability to interpret sound – word
deafness
Taste area ( Area 43)
• Present at the lower part of postcentral gyrus in the upper lip of the posterior
ramus of lateral sulcus and adjoining part of insula. It is responsible for
perception of taste.
• Receives projection fibers from VPM nucleus of thalamus.
Entorrhinal or olfactory area (area 28 – ventral entorhinal cortex) receives
impulses for smell and is involved in olfactory perception. The olfactory cortex
is located in the uncus which is found along the ventral surface of the temporal lobe
• Present in the uncus and anterior part of parahippocampal gyrus
The rhinal cortex (Rhinencephalon) is the cortex surrounding the rhinal fissure, including the
entorhinal cortex and the perirhinal cortex. It is a cortical region in the medial surface of the
temporal lobe that is made up of Brodmann’s areas 28, 34 (dorsal entorhinal cortex), 35
& 36 (perirhinal cortex). Input from all sensory cortices flow to the parahippocampal and
perirhinal cortex, from where it goes to the entorhinal cortex and precedes to the
hippocampus.
Cortical speech areas
• Present in the dominant
hemisphere (left hemisphere in
right handed persons) – verbal
or talking hemisphere
responsible for language
functions.
Broca’s motor speech area
(areas 44, 45)
• In pars triangularis and pars
opercularis.
• Connected to motor area
controlling movements of
vocal cords in precentral gyrus.
• Also connected to sensory
speech areas by arcuate
fasciculus.
• Responsible for spoken
speech (fluency of speech).
Sensory speech area – Wernicke’s area
• Different views as to the location and definition of the
area
Generally accepted – area 22, area 39 (angular gyrus)
and area 40 (supramarginal gyrus)
• Important in comprehension of received speech and
selection of words to express ideas. Can be equated to
a dictionary.
• Area 22 comprehends spoken language and recognizes
familiar sounds.
• Area 39 – responsible for visual speech or reading.
• Area 40 – responsible for recognition and naming of
objects by touch and proprioception .
All these areas interconnected and connected with motor
area
Aphasia – disturbance in the ability to speak or comprehend or write
or read the words.
Lesion of Broca’s area – causes motor aphasia (Expressive aphasia
or nonfluent aphasia).
• Characterized by - distorted and hesitant speech, agrammatical,
telegraphic in style. Patient can comprehend the meaning of written
or spoken words.
• Difficulty in Initiating speech and a decreased and labored language,
output of 10 words or less per minute, during which the patient
utilizes facial grimaces, body posturing, deep breaths, and hand
gestures to aid output; characteristically, small grammatical words
and the endings of nouns and verbs are omitted, resulting in
telegraphic speech.
The speech output is unmelodic and dysrhythmic (dysprosody).
Lesion of sensory speech area (Wernicke’s Area): Destructive lesions
restricted to these areas in dominant hemisphere produce a loss of ability
to understand the spoken or written words – RECEPTIVE APHASIA.
Speech is unimpaired and the patient can produce fluent speech.
Wernicke's aphasia is also known as fluent, posterior, sensory, or receptive aphasia.
In contrast to Broca's aphasia, the quantity of output in this type ranges from low
normal to supernormal, with an output in most patients of 100 to 150 words per minute.
Speech is produced with little or no effort, articulation and phrase length are normal,
and the output is melodic.
Pauses to search for a meaningful word are frequent, and substitution without language
(paraphasia) is common; this may be substitution of a syllable (literal paraphasia)
(wellow for yellow), phonemic substitution of a word (kench for wrench) (verbal
paraphasia), semantic substitution (knife for fork), or substitution of a meaningless
nonsense word (neologism).
If a word is not readily available, the patient may attempt to describe it, and the
description may necessitate yet another description, resulting in a meaningless output
(circumlocution).
However the patient is unaware of the meaning of the words he or she
uses and uses incorrect words or even nonexistent words.
The patient is always unaware of any mistakes.
Lesion of area 22 – word deafness – patient is unable to comprehend
the meaning of spoken words.
Unable to interpret the sounds.
Lesion of area 39 – word blindness –reading difficulty (alexia - inability to
comprehend written language - reading disability.) writing difficulty (agraphia).
• Most commonly, alexia without agraphia occurs as a result of infarction in the
territory of the left posterior cerebral artery that supplies neural structures involved.
• Usually, a right homonymous visual field defect is present.
• In alexia with agraphia, there is a defect in both reading comprehension and
writing.
• The reading disorder is usually verbal (inability to read words).
• The writing difficulty is usually severe.
• The anatomic substrate of this type of alexia is a lesion in the dominant angular
gyrus, hence the name parietal alexia.
• The concept of alexia as separate from other language disorders was developed in
1885 by the German neurologist Ludwig Lichtheim. The two types of acquired
alexia (without and with agraphia) were introduced by Dejerine in 1891 and 1892.
In addition – finger agnosia (inability to select or name one’s own fingers) and
dyscalculia (difficulty with simple mathematics)

• Agnosia is often modality specific: visual, auditory, and tactile.

• Visual agnosias include: visual object agnosia (inability to recognize objects
presented visually), visual color agnosia (inability to recognize colors),
prosopagnosia (i.e., inability to recognize faces, including one's own face, cars,
types of trees), picture agnosia, and simultanagnosia (inability to recognize the
whole body, although parts of the whole body are appreciated correctly).
Lesion of area 40 – causes tactile agnosia (inability to name objects
by touch)
Lesion in the arcuate fasciculus - (fibre bundle connecting motor and
sensory speech areas) - conduction aphasia where repetition of spoken
language is extremely difficult though comprehention is intact and
speech is fluent.
• Conduction aphasia is characterized by fluent paraphasic speech, intact comprehension,
poor naming, and repetition.
• Classically, patients with conduction aphasia cannot read out loud because of paraphasic
intervention.
• Patients with conduction aphasia cannot write to dictation, but write better when copying
text and in spontaneous composition.
• Pathology in these patients is usually located in the posterior perisylvian region and
interrupts the output from Wernicke's area to Broca's area via the arcuate fasciculus).

Lesion in both motor and sensory speech areas – global aphasia in

which the patient neither can speak nor can understand the spoken
words.
• Global aphasia is a severe form of aphasia in which all the major functions of language
(verbal output, comprehension, repetition, naming, reading, and writing) are severely
impaired.
Cerebral dominance
The left hemisphere is dominant or specialized for comprehension and
expression of language, arithmetic, and analytic functions, whereas -
the right hemisphere is specialized for complex nonverbal perceptual
tasks and for some aspects of visual (e.g., face) and spatial perception.
The right side of the brain is also dedicated to mapping feelings, bodily
sensations linked to emotions of happiness, anger, and fear.
Language is localized to the left hemisphere in more than 90% of right
handed people and two-thirds of left -handers.

Thus lesions of the left hemisphere are associated with disorders of

language (aphasia or dysphasia), whereas - lesions of the right
hemisphere are associated with impairment of visuospatial and
visuoconstructive skills.
Patients with right hemisphere lesions are more likely to show such
manifestations as constructional apraxia (inability to construct or to draw
figures and shapes), dressing apraxia, denial of the left side of the body
(denial that their left side is part of their body), and hemineglect (visual
and spatial neglect of the left side of their space, including their own
body parts).
Functional
areas

aphasia