Cerebral cortex

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29 Cerebral cortex

Structure

The cerebral cortex, or pallium (Gr. ‘shell’), varies in thickness from 2 to 4 mm, being thinnest in the primary sensory areas and thickest in the motor and association areas. More than half of the total cortical surface is hidden from view in the walls of the sulci. The cortex contains about 50 billion neurons; about 500 billion neuroglial cells; and a dense capillary bed.

Microscopy reveals the cortex to have both a laminar and a columnar structure. The general cytoarchitecture varies in detail from one region to another, permitting the cortex to be mapped into dozens of histologically different ‘areas’. Although considerable progress has been achieved in relating these to specific functions, the ‘areas’ are merely nodal points having widespread connections with other parts of the brain.

Laminar organization

A laminar (layered) arrangement of neurons is apparent in sections taken from any part of the cortex. Phylogenetically old elements, including the paleocortex of the uncus (concerned with olfaction), and the archicortex of the hippocampus in the medial temporal lobe (concerned with memory), are made up of three cellular laminae, whereas six laminae are seen in the neocortex (neopallium) covering the remaining 90% of the brain.

Cellular laminae of the neocortex (Figure 29.1)

Cell types

The three principal morphological cell types are pyramidal cells, spiny stellate cells, and smooth stellate cells (Figure 29.2).

Efferents

All efferents from the cerebral cortex are axons of pyramidal cells, and all are excitatory in nature. Axons of some pyramidal cells contribute to short or long association fibers. Others form commissural or projection fibers.

Examples of short association fiber projections are those entering the motor cortex from the sensory cortex and vice versa (Figure 29.1). Examples of long association fiber projections are the numerous backward projections from the prefrontal cortex – the cortex anterior to the motor areas (see below) to sensory association areas.
Projection fibers from the primary sensory and motor cortex form the largest input to the basal ganglia (Ch. 33). The thalamus receives projection fibers from all parts of the cortex. Other major projection systems are corticopontine (to the ipsilateral nuclei pontis), corticonuclear (to contralateral motor and somatic sensory cranial nerve nuclei in pons and medulla), and corticospinal (to anterior horn motor neurons).

Cortical Areas

The most widely used reference map is that of Brodmann, who divided the cortex into 47 areas on the basis of cytoarchitectural differences. Most of these areas are shown in Figure 29.4. Colored in that figure are the three principal primary sensory areas (somatic, visual, auditory) and the single primary motor area, together with the respective unimodal association areas. The rest of the neocortex comprises multimodal (polymodal) association areas receiving association fibers from more than one unimodal association area (e.g. receiving tactile and visual inputs, or visual and auditory).

Investigating functional anatomy

Two dominant methods are in use for localization of functions in the human brain. Both techniques depend upon the local increases in blood flow that meet the additional oxygen demand imposed by localized neural activity.

Positron emission tomography

Positron emission tomography (PET) measures oxygen consumption following injection of water labeled with oxygen-15 into a forearm vein. 15O is a positron-emitting isotope of oxygen; the positrons react with nearby electrons in the blood to create gamma rays which are counted by gamma-ray detectors. Alternatively, fluorine-18-labeled deoxyglucose may be used to measure glucose consumption. 18F-deoxyglucose is taken up by neurons as readily as glucose.

Image subtraction and image averaging are required for meaningful interpretation of PET studies, as explained in the caption to Figure 29.5.

For specialized investigations, radiolabeled drugs are used to quantify receptor function, e.g. radiolabeled dopamine in the corpus striatum in relation to Parkinson’s disease (Ch. 33); radiolabeled serotonin in brainstem and cortex in relation to depression (Ch. 26), and radiolabeled acetylcholinesterase in relation to Alzheimer disease (Ch. 34).

Functional magnetic resonance imaging

Functional magnetic resonance imaging (fMRI) (Figure 29.6) does not require introduction of any extraneous material. It depends upon the different magnetic susceptibility of oxygenated versus deoxygenated blood. As it happens, the local increases in blood flow are more than sufficient to meet oxygen demands, and it is the increase in the ratio of oxyhemoglobin to deoxyhemoglobin that is exploited to generate the MR signal.