Grafton Scott T, Volz Lukas J
Department of Psychological and Brain Sciences, University of California Santa Barbara, Santa Barbara, CA, United States.
Department of Psychological and Brain Sciences, University of California Santa Barbara, Santa Barbara, CA, United States; Department of Neurology, University of Cologne, Cologne, Germany Department of Neurology, University of Cologne, Cologne, Germany.
Handb Clin Neurol. 2019;163:237-255. doi: 10.1016/B978-0-12-804281-6.00013-6.
The prefrontal cortex serves a critical role in the coordination and execution of motor actions via its involvement in goal setting, decision-making, motivation, and cognitive control. Using the macaque connectome, the anatomic pathways from prefrontal cortex to motor circuitry are summarized, revealing a remarkably limited set of direct connections. A highly similar connectivity pattern is inferred from human neuroimaging. The results motivate the prefrontal-premotor connector hub model, which highlights both functional segregation and a limited set of connector hub regions that provide a direct linking of prefrontal cortex to the (pre-)motor network. Moreover, the macaque connectome reveals a set of motor translator regions that provide the most direct projection from premotor to prefrontal areas. The connector hub model leads to important functional implications: Neural activation or disruption in connector hubs should lead to functional deficits that undermine integration between higher cognitive action control and motor performance ranging from response selection and inhibition to perceived agency of actions. Segregation of prefrontal-premotor networks challenges hierarchical models of motor control and underscores the critical role of the indirect pathway from prefrontal to premotor areas via the parietal cortex. The model provides a predictive framework to design neurostimulation paradigms for modulating skill learning or recovery in both healthy subjects and patient cohorts.
前额叶皮质通过参与目标设定、决策、动机和认知控制，在运动动作的协调和执行中发挥关键作用。利用猕猴连接组，总结了从前额叶皮质到运动回路的解剖学通路，揭示了一组非常有限的直接连接。从人类神经影像学中推断出高度相似的连接模式。这些结果推动了前额叶-运动前区连接枢纽模型的提出，该模型强调了功能分离以及一组有限的连接枢纽区域，这些区域提供了前额叶皮质与（运动前）运动网络的直接连接。此外，猕猴连接组揭示了一组运动转换区域，这些区域提供了从运动前区到前额叶区域的最直接投射。连接枢纽模型具有重要的功能意义：连接枢纽中的神经激活或破坏应导致功能缺陷，从而损害从反应选择和抑制到动作感知能动性等更高认知动作控制与运动表现之间的整合。前额叶-运动前区网络的分离对运动控制的层级模型提出了挑战，并强调了通过顶叶皮质从前额叶到运动前区的间接通路的关键作用。该模型为设计神经刺激范式提供了一个预测框架，用于调节健康受试者和患者群体的技能学习或恢复。
