RT Book, Section
A1 Mesulam, M.-Marsel
A2 Jameson, J. Larry
A2 Fauci, Anthony S.
A2 Kasper, Dennis L.
A2 Hauser, Stephen L.
A2 Longo, Dan L.
A2 Loscalzo, Joseph
SR Print(0)
ID 1183403829
T1 Aphasia, Memory Loss, Hemispatial Neglect, Frontal Syndromes, and Other Cerebral Disorders
T2 Harrison's Principles of Internal Medicine, 20e
YR 2018
FD 2018
PB McGraw-Hill Education
PP New York, NY
SN 9781259644016
LK accesspharmacy.mhmedical.com/content.aspx?aid=1183403829
RD 2024/04/18
AB The  cerebral  cortex  of  the  human  brain  contains  ~20  billion  neurons  spread  over  an  area  of  2.5  m2.  The  primary  sensory  and  motor  areas  constitute  10%  of  the  cerebral  cortex.  The  rest  is  subsumed  by  modality-selective,  heteromodal,  paralimbic,  and  limbic  areas  collectively  known  as  the  association  cortex(Fig.  26-1).  The  association  cortex  mediates  the  integrative  processes  that  subserve  cognition,  emotion,  and  comportment.  A  systematic  testing  of  these  mental  functions  is  necessary  for  the  effective  clinical  assessment  of  the  association  cortex  and  its  diseases.  According  to  current  thinking,  there  are  no  centers  for  “hearing  words,”  “perceiving  space,”  or  “storing  memories.”  Cognitive  and  behavioral  functions  (domains)  are  coordinated  by  intersecting  large-scale  neural  networks  that  contain  interconnected  cortical  and  subcortical  components.  Five  anatomically  defined  large-scale  networks  are  most  relevant  to  clinical  practice:  (1)  a  left-dominant  perisylvian  network  for  language,  (2)  a  right-dominant  parietofrontal  network  for  spatial  orientation,  (3)  an  occipitotemporal  network  for  face  and  object  recognition,  (4)  a  limbic  network  for  explicit  episodic  memory,  and  (5)  a  prefrontal  network  for  the  executive  control  of  cognition  and  comportment.  Investigations  based  on  functional  imaging  have  also  identified  a  default  mode  network,  which  becomes  activated  when  the  person  is  not  engaged  in  a  specific  task  requiring  attention  to  external  events.  The  clinical  consequences  of  damage  to  this  network  are  not  yet  fully  defined.