The role of the left somatosensory cortex in human hand movement.

Hemispheric dominance for motor control in the human brain is still unclear. Here we propose asymmetric sensorimotor integration during human hand movements. We investigated the dexterity of hand movements and related sensory functions in four right-handed patients with cerebrovascular lesions in the postcentral gyrus. To clarify the distributions of cortical damage, semiquantitative analysis of regional cerebral blood flow (rCBF) was performed using single photon emission computed tomography (SPECT), and a three-dimensional surface display was generated from SPECT. Scores on motor and sensory tasks and rCBF values in the patients were compared with those in control subjects. All patients presented with asymmetric clumsiness of complex finger movements, in association with impairments of combined sensations such as stereognosis. These findings were indicative of a disorder of sensory information processing necessary to guide the movements. Two patients with left hemispheric damage showed bilateral clumsy hands, predominating on the right side, while the other two patients with right hemispheric damage showed only a left clumsy hand. In agreement with asymmetric clumsiness, measurement of rCBF along with a three-dimensional surface display revealed cortical hypoperfused areas, mainly in the perirolandic cortices, comprising the primary motor and somatosensory cortices. Perirolandic cortical hypoperfusion was bilateral in the two patients with bilateral clumsy hands, but only on the right side in the other two patients with left clumsy hands. These results suggest a dominant role of the left somatosensory cortex in sensorimotor integration for complex finger movements of humans.