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This chapter explains how areas of the cerebral cortex and their descending pathways contribute to voluntary motor control in humans in the context of how these areas provide compensatory control for each other in the damaged brain. It reviews evidence that supports the current, more complex view of primary motor cortical (M1). The chapter discusses how the current view indicates that M1 is a flexible control system with an inherent capacity for plastic reorganization after brain injury. The non-primary motor cortical areas (NPMAs) are well-suited to provide compensatory control of voluntary movement after damage to M1. Motor control signals from M1 and the NPMAs travel to the spinal cord via several descending tracts. The corticospinal tract is the most direct pathway from the cerebral cortex to the spinal motoneurons. Finally, the chapter shows how spared territories and tracts might affect the capacity for functional recovery of movement.
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