A study of parietal-motor connectivity by intraoperative dual cortical stimulation

The function of the primate9s posterior parietal cortex in sensorimotor transformations is well-established, though in humans its complexity is still challenging. Well-established models indicate that the posterior parietal cortex influences motor output indirectly, by means of connections to the premotor cortex, which in turn is directly connected to the motor cortex. The possibility that the posterior parietal cortex could be at the origin of direct afferents to M1 has been suggested in humans but has never been confirmed directly. In the present work we assessed during intraoperative monitoring of the corticospinal tract in brain tumour patients the existence of short-latency effects of parietal stimulation on corticospinal excitability to the upper limb. We identified several foci within the inferior parietal lobule that drove short-latency influences on cortical motor output. Active foci were distributed along the postcentral gyrus and clustered around the anterior intraparietal area and around the parietal operculum. For the first time in humans, the present data show direct evidence in favour of a distributed system of connections from the posterior parietal cortex to the ipsilateral primary motor cortex.