THE CEREBRAL CORTEX

October 2015 1
General remarks
• The cerebral cortex alone probably contains in
excess of 19:23(F:M) billion neurons.
• Each of these neurons may have as many as 1,000
or more connections, the total number of possible
interactions is staggering(100 trillion (1014)
synapses)
A-The neocortex has arbitrary divisions.
– Two cerebral hemispheres and the gyri and sulci.
– Four lobes of the brain and the insular cortex.
– The various gyri and lobes also are characterized
by variations in their cellular structures,

October 2015 2
 .

B. The white matter (axonal) pathways that

interconnect the hemispheres, lobes, gyri, as well as
provide a means for the neocortex to communicate
with
• Subcortical structures
• Peripheral nervous system.

October 2015 3
SUPPORTIVE STRUCTURES OF THE CEREBRAL CORTEX

The Skull
The meninges
The Dura Mater- the outermost layer
The Arachnoid Mater
The Pia mater (or pia) - lies immediately in
contact with the brain tissue
The Ventricular System
Choroid Plexus and Cerebrospinal Fluid
Circulation
October 2015 4
 -

Arachnoid space, illustrating relationship to dura and pia and entry for
venous blood and CSF into the superior sagittal sinus.
October 2015 5
Schematic representation of the dura mater providing an external
covering for the brain and spinal cord.
October 2015 6
October 2015 7
 Dura

Superior sagittal sinus

(opened)
Interhemispheric fissure

Parieto-occipital fissure
Central fissure

October 2015 8
THE CEREBRAL HEMISPHERES
 2,500 to 3,000 years ago – two, seemingly
identical, hemispheres
 By the second half of the 19th century-
the functional asymmetry
 In 1968 -functional and anatomical
asymmetries

October 2015 9
 Anterior
cerebral artery

Corpus
callosum

October 2015 10
The Cerebral Gyri and Sulci
 The surface of the human cerebral cortex - the gyri
(ridges) and sulci (grooves)
 A very large (deep) sulcus is referred to as a
fissure
 superior longitudinal fissure - superior sagittal
fissure; the lateral or Sylvian fissure
 Pattern of sulci and gyri that gives the human brain
its characteristic convoluted appearance
 The major gyri and sulci generally are similar
across individuals

October 2015 11
 The Cerebral Gyri and Sulci
Lateral surfaces of the brain with major gyri and sulci

AG, angular gyrus; FP, frontal poleGR, gyrus rectus; POr, pars orbitalis; PTr, inferior
frontal gyrus, pars triangularis; CaSul, calcarine sulcus; SMg, supramarginal gyrus

October 2015 12
 The Cerebral Gyri and Sulci cont’d

GR, gyrus rectus

OTG, U, uncus
occipitotemporal
(fusiform) gyrus

CoS, collateral
sulcus

OG, orbital gyrus

Fl, flocculus

October 2015 13
Ventral surfaces of the brain with major gyri and sulci
 The Cerebral Gyri and Sulci cont’d
PcL, paracentral lobule

PcL,
paracentral
lobule

CaSul,
calcarine
sulcus

ON, optic
nerve

Medial surfaces of the brain with major gyri and sulci

October 2015 14
 Lobes of the Cerebral Cortex
 The cerebral cortex (neocortex) of the
telencephalon (forebrain) consists of four
distinct lobes within each hemisphere:
o Frontal
o Parietal
o Temporal
o Occipital lobes

October 2015 15
 -

Lateral surfaces of the brain.

October 2015 16
 .

Medial surfaces of the brain.

October 2015 17
 -

Ventral surfaces of the brain.

October 2015 18
 -

October 2015 19
 Precentral
Frontal eye Gyrus Postcentral
field (area 8 (area 4) gyrus
(areas 3, 1, 2)

Parietooccipit
fissure

October 2015 20
Broca’s Area Lateral fissure Wernicke’s area
The Frontal Lobe

October 2015 21
The Frontal Lobe
 The largest of the human brain, comprising
approximately one third of its lateral surface.
 Fairly clear anatomical boundaries exist.
 Divided
o Horizontally by the superior and inferior
frontal sulci into – 1)Superior frontal gyri,
2)Middle frontal gyri, 3)Inferior frontal gyri
o Vertically – 1)Posterior portion- the frontal
or frontal motor cortex, 2)A larger, anterior
portion -the prefrontal cortex.
October 2015 22
 .

Lateral surfaces of the brain with major gyri and sulci

October 2015 23
 .

SCG,
subcallosal
(parolfactory)
gyrus

AC, anterior commissure AG, angular gyrus LT, lamina terminalis

H, hypothalamus
Medial surfaces of the brain with major gyri and sulci
October 2015 24
October 2015 25
October 2015 26
 The Frontal Lobe cont’d

Play a critical role in carrying out the executive

functions of the brain.
A- Anterior portions of the frontal lobes –
1. The dorsolateral cortices-higher-order behaviors,
for example, deciding when, where, why, how,
and if
2. Orbital and inferiomedial frontal -important in
processing and/or modulating internal drive
states

October 2015 27
 .

3. The dorsomedial granular cortex

o Crucial for maintaining optimal arousal and
motivation.
B- The Posterior portion - The primary motor
and motor association area
o Responsible for the final organization,
control or modulation, and implementation
of the actual motoric response.

October 2015 28
 ..

Lesion of frontal lobe

1.Motor abnormality – spastic paralysis, motor
speech disturbance, release of frontal reflex
e.g. incontinence
2.Cognitive and intellectual changes – memory
defects-dementia, disturbance of abstract
thinking, easily distractible
3.Impairment or lack or initiative and spontaneity
– abulia, akinetic mutism
4.Personality changes – disinhibition, witzelsucht
5.Epilepsy – GTCS (GM), Complex Partial Seizure
October 2015 29
FRONTAL LOBE SYNDROME
1. Disinhibition: lose regard for  eat with gluttony,
customs or morals:  curse with no regard for company,
 tell coarse and crude jokes.
 Inappropriate sexual advances -
proposition much younger
individuals, even at times children.
 engage in reckless masturbation, at
the dinner table or in the front yard
2. Affective change  euphoria,
 irritability,
 depressed mood
3. Perseveration - Perseveration  repeatedly uttering the same phrase,
is characterized by a tendency  opening and closing a book,
to repeat the same behavior  or buttoning and unbuttoning a shirt
over and over
4. Apathy is characterized by  may either never come to the point of
lack of motivation. action
The orbitofrontal frontal lobe syndromes
 Disinhibition and affective changes (often either euphoria or irritability)
The dorsolateral frontal lobe syndromes
 Perseveration and apathy. October 2015 30
The Parietal Lobes

October 2015 31
 The Parietal Lobes
 The anterior extent of the parietal lobe is
demarcated by the central sulcus, which
also denotes the posterior boundary of
the frontal lobe.
 On its medial surface, the parietal lobe is
separated from the occipital lobe by the
parietooccipital sulcus.
 It is difficult to differentiate the boundary
between the parietal and temporal lobes

October 2015 32
 .

 The main surface features of the parietal lobe are

1. The postcentral gyrus (primary somatosensory cortex)
2. Superior parietal lobules - area 5, and 7
3. Inferior parietal lobules
 The inferior parietal lobule is composed of
o The supramarginal gyrus- Brodmann’s area (BA) 40]
o The angular gyrus(Area 39)

October 2015 33
 The Cerebral Gyri and Sulci

area 40

Lateral surfaces of the brain with major gyri and sulci

October 2015 34
 The Cerebral Gyri and Sulci cont’d
P-OS, parietooccipital sulcus PcL, paracentral lobule

PcL,
paracentral
lobule

GR,
gyrus CaSul,
rectus calcarine
sulcus

ON, optic
nerve

Medial surfaces of the brain with major gyri and sulci

October 2015 LG, lingual 35gyrus
The secondary (BA 18) and tertiary (BA 19) visual cortex is better appreciated
from the lateral view. The primary somesthetic cortex coincides with BA 1, 2, and
3. The superior parietal lobule coincides with BA 5 and 7 and the inferior parietal
lobule coincides with BA 39 (angular gyrus) and 40 (supramarginal gyrus).
October 2015 36
The primary visual cortex [Brodmann’s area(BA) 17] is largely buried within
the calcarine fissure. A greater portion of the superior parietal lobule (BA 5
and 7) lies along the midline
October 2015 37
 .

 The parietal lobes one of the lobes responsible for

processing and interpreting somatosensory input
 Collecting
 Encoding
 Integrating, and
 Storing sensory information
o Upon which the frontal lobes rely to carry out their
activities.
o In developing an appreciation of internal (body
schema) and extended or external space.

October 2015 38
 ..

Lesion of parietal lobe

 Stereognosis- unable to name (with eyes closed) a
familiar object held in his/her hand based on the
weight and three-dimensional characteristics of the
object
 Agraphesthesia- A number or letter written on the
patient’s skin will not be recognized by touch
 Agraphia- inability to write
 Acalculia – inability to calculate
 Apraxia – inability to perform motor function , in
absence of paralysis
 Finger agnosia- inability to recognize fingers

October 2015 39
 .

Agnosia- Impairment of recognition in a single modality, as

opposed to amnesia, in which impairment includes all
modalities.
1. Anosognosia: Unawareness of neurological deficit.
Usually from right parietal lesion.
2. Sensory neglect syndrome
Disregard of stimuli arising from one side of the body,
usually the left, from right parietal lesion.
 A lack of appreciation of spatial aspects of the opposite
side of the body.
 The patient does not recognize the opposite side of
his/her body and will not dress it (dressing apraxia)

October 2015 40
 .

3. Disturbance of Spatial orientation

 A confusion involving location in space
 Confusion about his/her current location
 Lose the concept of the spatial relationship of
objects

October 2015 41
The Temporal Lobes

October 2015 42
 The Temporal Lobes
 The dorsal limits of the anterior temporal
lobe are easily identified by the
PHR(Posterior horizontal ramus) of the
lateral fissure.
 The cranial vault essentially defines the
anterior and inferior extents of the temporal
lobes.

October 2015 43
 The Cerebral Gyri and Sulci

Lateral surfaces of the brain with major gyri and sulci

POn, preoccipital notch
October 2015 44
The superior, middle, and inferior temporal gyri

October 2015 45
 -

 Important regions of the temporal lobe include

o Heschl’s gyrus (primary auditory cortex)
o Auditory association cortex - includes the
plenum temporal in the temporal operculum
o The occipitotemporal (fusiform) gyrus.

October 2015 46
October 2015 47
 .

The temporal lobe can be divided into two regions: lateral

and ventromedial
A. The lateral region
 Supports cognitive functions associated with
several sensory systems. It is recognized as
neocortex.
 The processing of auditory input and with the
encoding of memory
 Play a substantial role in the processing of affective
information, language, and in certain aspects of
visual perception

October 2015 48
 .

B. The ventromedial region

 Contains major portions of the limbic system and
thus contributes significantly to emotional tone.
 Plays a part in the function of limbic system

October 2015 49
 ..

Lesion of tempral lobe

1.Neurologic functional loss – visual field defect,
cortical deafness, auditory agnosia, sensory
speech disturbance(Aphasia)
2.Perceptual disturbances – hallucinations and
illusions -auditory
3.Personality changes – apathy, placidity;
aggressive behavior, sexual disinhibition
4.Epilepsy – GTCS(GM), CPS

October 2015 50
The Occipital Lobes

October 2015 51
The Occipital Lobes
 The main portion of the occipital lobe lies on the
medial surface of the hemisphere
 Its main surface feature is the calcarine sulcus,
which separates the cuneus (above) from the
lingual gyrus (below).
Function
1.The Cuneus – processes information that comes
from the inferior visual field
2.The lingual gyrus - mediates input from the
superior visual field
October 2015 52
 The Cerebral Gyri and Sulci cont’d

P-OS,
parietooccipital
sulcus

CU-cuneus)
LG-lingual gyrus

Medial surfaces of the brain with major gyri and sulci

October 2015 53
 The Cerebral Gyri and Sulci

OL, occipital lobe

POn, preoccipital
notch

Lateral surfaces of the brain with major gyri and sulci

October 2015 54
The primary visual cortex [Brodmann’s area(BA) 17] is largely buried within
the calcarine fissure. A greater portion of the superior parietal lobule (BA 5
and 7) lies along the midline
October 2015 55
The secondary (BA 18) and tertiary (BA 19) visual cortex is better appreciated
from the lateral view. The primary somesthetic cortex coincides with BA 1, 2, and
3. The superior parietal lobule coincides with BA 5 and 7 and the inferior parietal
lobule coincides with BA 39 (angular gyrus) and 40 (supramarginal gyrus).
October 2015 56
 .

Major Function of occipital lobe

1.The occipital lobes are linked primarily to

visual perception, including color, form,
and motion.
2. Occipital lobes also are seen as critical for
a host of spatial, linguistic, and object
recognition functions.

October 2015 57
 ..

Lesion of occipital lobe

• Visual field defect
• Alexia
• Cortical blindness
• Perceptual disturbance- hallucinations and
illusions- visual
• Inability to name colors

October 2015 58
Cytoarchitectonic Organization of
the Cerebral Cortex

October 2015 59
• Highly differentiated neocortex, -comprises about 90%
.

of the cerebral hemispheres.

• More primitive allocortex contains three distinct layers
of cells and includes
– the olfactory cortex(paleocortex),
– the hippocampus, and dentate gyrus (archicortex)
• A third cortical region-mesocortex-, which includes
– the cingulate cortex
– portions of the parahippocampal gyrus, hipocampus
– is transitional from allocortex to neocortex, that
contains 4-5 layers

October 2015 60
 .

 The exterior layers of the neocortex (gray

matter) contain neurons, neuroglia
(supporting cells), and blood vessels.
o All the “neocortex” was similar in that six
distinct “layers” of cell organization
o Identified by the pattern, prominence, or
distribution of certain types of cells varied
from one area of the cortex to another.
• Brodmann (1909) -
• In 1929, von Economo
October 2015 61
 -

The neurons making up the gray matter of the cortical

mantle can be divided into two major types:
 Pyramidal - primarily are located in layers III and V,
the major source of cortical efferents(Motor - output)
 Nonpyramidal neurons- layers II and IV - granule cell
layers (stellate, polymorphic, granule, and Golgi type
II cells); the major sites of cortical afferents(Sensory-
inputs)

October 2015 62
 -

Schematic representation of the five fundamental types of isocortex according to

von Economo (1929). Roman numerals represent the cortical layers and Arabic
numerals indicate the five basicOctober
type2015
of neocortex: 63
 64
October 2015
-

Brodmann’s classification of cortical

areas based on cytoarchitectural
variations.
FUNCTIONAL ORGANIZATION
OF CEREBRAL CORTEX
A- Basic cortical connections with peripheral organ
B. Cerebral Commissures
C. Association Pathways
D. Projection Pathways

October 2015 65
.

A- Basic cortical connections with peripheral

organ
1. Sensory information is conveyed to the
idiotypic sensory cortex from peripheral
receptors after synapsing in the thalamus (via
ascending projection pathways).
2. After being processed in the primary sensory
cortex, this information is passed on to the
homotypic sensory cortices (via short
association fibers).

October 2015 66
 .

3. Reciprocal feedback with the frontal granular

and agranular cortices (via longer association
pathways) then allows for utilizing previous
and current sensory input to decide if a
response is indicated, and if so how that
response might best be planned, monitored,
and executed.
4. Finally, the primary motor cortex actually
executes the behavioral response (via
descending projection fibers).

October 2015 67
 .

B. Cerebral Commissures: By definition, commissural

fibers connect a region or area on one side of the
brain either with its homologous area, or a closely
related area, on the opposite side of the brain.
 The corpus callosum
 The posterior commissure
 The habenular commissure
 The fornical or hippocampal
 The anterior commissure

October 2015 68
 .

October 2015 69
 Anterior
cerebral artery

Corpus
callosum

October 2015 70
 0

October 2015 71
 p

C. Association Pathways:
Association pathways, by contrast, interconnect
different parts of the same hemisphere.
Cortex to cortex connection
Such association pathways may be very long, in
which case they are typically termed fasciculi.
– very long – fasciculi
– relatively short

October 2015 72
 -

Schematic drawing - Association pathways within the brain AF, arcuate

fasciculus; ILF, inferior longitudinal fasciculus
October 2015 ; IOF, inferior occipitofrontal 73
fasciculus; SLF, superior longitudinal fasciculus; U, U-fibers;
 -

D. Projection Pathways: Projection fibers by

contrast represent connections (projections)
either from the cortical to noncortical
structures or from the noncortical to cortical
structures. The former are descending
projection pathways, while the latter
represent ascending pathways.
Internal capsules
Cerebral peduncles
Optic radiations.

October 2015 74
 -

Optic radiations (a major projection pathway): OR, optic radiations; OT, optic Tract,
OC, optic chiasm;LGB, lateral geniculate body; MB,midbrain; ML, Meyer’s loop;75VC,
October 2015
visual cortex.
FUNCTIONAL ORGANIZATION OF CEREBRAL CORTEX

DISCONNECTION SYNDROMES
Result from the disruption of these pathways(long
axonal pathways within the brain - commissures,
association, and projection pathways) effectively
shutting off communication between or among
areas that they normally interconnect. These
include
Ideomotor apraxia
Alexia without agraphia
Conduction aphasia

October 2015 76
 p

Ideomotor apraxia
• An inability to carry out a discrete, previously
learned, skilled movement, most commonly to
verbal command, in the absence of any
primary language or sensorimotor deficits.
– Transitive action - e.g., demonstrating the
use of a tool- use of a hammer
– Intransitive action - e.g., a symbolic gesture
– saluting, blow out a candle

October 2015 77
HEMISPHERIC SPECIALIZATION

October 2015 78
 .

Asymmetry of the hemispheres

1. Structural asymmetries between the cerebral
hemispheres have been established
 anatomical asymmetries of language-related cortex
were proposed to be related to known functional
asymmetries
2. Functional Specialization-asymmetries
Handedness
 Referring to the fact that one side of the body is
“better” (i.e., more facile) in performing certain
skilled tasks
 unilateral preference is not an all-or-none
phenomenon; especially true of left-handers
October 2015 79
 .

Concepts of Cerebral Dominance

 A particular given function, such as language,
primarily is organized in, or mediated by, a particular
hemisphere.
 If critical areas of the “dominant” hemisphere were
damaged, that particular function should be expected
to suffer.
 Conversely, if the opposite, “nondominant”
hemisphere is lesioned, regardless of the site of the
injury, no disruption of that function should result

October 2015 80
 .

Refer to the dominant hemisphere, meaning the

hemisphere that is primarily responsible for
understanding and expressing language and,
in right-handers at least, the hemisphere
controlling the “dominant” hand.
The left hemisphere is the dominant
hemisphere in ~ 97% of the population

October 2015 81
 .

Anomalous Dominance
 Handedness and dominance for language
typically are mediated by the left hemisphere in
the vast majority of right-handed individuals
o Any pattern of organization that differs from
this “typical” pattern - Anomalous Dominance
 Approximately 30% of left-handers exhibit some
form of anomalous dominance for language (i.e.,
language being organized either primarily in the
right hemisphere or represented bilaterally).

October 2015 82
Left Hemisphere Specialization

October 2015 83
Left Hemisphere Specialization
 Language – various forms of aphasia
 Ideomotor Praxis
o Ideomotor apraxia - - the inability to
carry out an action
 Calculations
o Dyscalculias - disturbances in the
interpretation and/or manipulation of
mathematical symbols

October 2015 84
 Verbal Learning and Memory
.

o The left hemisphere assumes greater

importance when learning verbal
information
 Color Naming and Association - the left
hemisphere, particularly the inferior
occipitotemporal region
o Color naming in the absence of more
elementary color imperceptions
oThe ability to associate colors with
particular objects
October 2015 85
 Aphasic Syndromes
1. Broca’s Aphasia
2. Wernicke’s Aphasia

October 2015 86
 Precentral
Frontal eye Gyrus Postcentral
field (area 8 (area 4) gyrus
(areas 3, 1, 2)

Parietooccipit
fissure

October 2015 87
Broca’s Area Lateral fissure Wernicke’s area
 .

Broca’s Aphasia (Non-fluent, Motor, Expressive

aphasia)
 Speech: Effortful, dysarthric, agrammatic,
telegraphic, non-fluent (sparse output) speech
 Repetition: Impaired, but typically better than
spontaneous speech
 Auditory Comprehension: Some impairment, but
typically much better than expressive abilities
 Reading: Difficulty of reading aloud, paraphasic
errors; reading comprehension similar to auditory
 Writing: Similar to speech in terms of output and
errors; misspellings; poorly formed block letters
October 2015 88
 .

Wernicke’s Aphasia (Fluent, Sensory, Receptive

aphasia)
 Speech: Effortless, circumlocutory -loss of
substantive, content words
 Repetition: Impaired
 Auditory Comprehension: Significant
impairment
 Reading: Significant deficit, both aloud and silent
 Writing: Similar to speech in terms of content;
graphically fluent, but often meaningless

October 2015 89
TRANSCORTICAL MOTOR APHASIA

• Transcortical motor aphasia is essentially

identical to motor aphasia, with the exception
that repetition is preserved.
• Transcortical motor aphasia is most often
seen with lesions of the medial aspect of the
left frontal lobe, as may occur with infarctions
in the area of distribution of the anterior
cerebral artery

October 2015 90
 .

Conduction aphasia
• Speech is fluent
• There is a degree of incoherence and Paraphasia
are present.
• Comprehension is preserved.
• Patients are unable to repeat complex sentences.
Conduction - associated with damage to the arcuate
fasciculus

October 2015 91
Right Hemisphere Specialization

October 2015 92
Right Hemisphere Specialization
The right hemisphere is responsible for very
different kinds of mental activities
 Nonverbal, affective, Spatial, Perceptual
A.Emotional – affective processing
B.Visiospatial abilities - Spatial memory
C.Musical abilities
D.Directed Attention and Unilateral Neglect

October 2015 93
 p

A. Emotional–Affective Processes
1. Expressive affective prosody: verbal
Imparting the desired emotional valence to
one’s speech through appropriate affective
intonations (e.g., “sounding angry” when you
are indeed upset).
2 Expressive prosody: non-verbal
Expression of mood or emotional state
through non-verbal means (e.g., facial
expression, body posture).

October 2015 94
 -

3. Receptive prosody: non-verbal

Ability to accurately decipher the mood of others, or
the “message” they are sending by accurately
interpreting facial expressions or body postures.
4. Receptive affective prosody: verbal
Deciphering the meaning of oral verbal
communication or mood of the speaker by accurately
interpreting tonal inflections
5. Receptive linguistic prosody: verbal
Appreciation of humor, sarcasm, or emphasis in the
speech of others

October 2015 95
 .

B. Visio–Spatial Ability
Topographical orientation or topographical memory-
localization of cities on a schematic map, route
description or maps of familiar places
Visual–Constructive Ability: Drawing familiar patterns,
such as a clock or a daisy., Copying (drawing) two- or
“three-dimensional” designs, (e.g., a house, or a
cube)
Visual–Perceptual Abilities.
Discrimination among unfamiliar faces, (as opposed
to recognition of familiar faces or prosopagnosia);
Depth perception
October 2015 96
 -

Examples from the Hooper Visual Organization Test

October 2015 97
Block Design Test

October 2015 98
 .

C. Musical Abilities
 Appreciation as well as the expression of musical
melodies
D. Directed Attention and Unilateral Neglect
 Hemispatial Neglect- failure to attend to hemispace;
extinction
 Hemibody Awareness.
1. lack of awareness or suppression of tactile
stimuli
2. lack of or diminished awareness of impaired
capacity (denial of illness- Anosognosia)
3. failure to recognize one’s own limb(s).
October 2015 99