This study was conducted to determine where in the human brain visual feedback of hand movements is processed to allow accurate pointing. Regional cerebral blood flow (rCBF) was measured with positron emission tomography (PET) and H2 15O in nine normal volunteers while performing one control and two reaching tasks. In all tasks, visual stimuli were presented on a head mounted display (HMD). A target board was placed in front of the subjects bearing six red light-emitting diodes (LEDs) aligned on a circle with a green LED at its center. The center green LED and one of the six red LEDs, randomly selected, were repeatedly switched on and off, alternatively. In the control task, subjects were instructed to gaze at the lit LED. In the two reaching tasks, the reaching with visual feedback (RwithF) task and the reaching without visual feedback (RwithoutF) task, they had to point to the lit red LED with their fight index fingers. In the RwithF task, their right hands were visible on the HMD before touching the target, whereas in the RwithoutF task, they were not visible. For each subject, subtraction images of each reaching task minus the control and the RwithF task minus the RwithoutF task were calculated after transformation of PET images into the standard brain shape with an adjustable computerized brain atlas. These subtraction rCBF images were then averaged among the subjects, and significant changes of rCBF were identified. Significant increases in rCBF not only in the RwithF task minus control image but also in the RwithF task minus the RwithoutF task image were observed in the supramarginal cortex, the premotor cortex and the posterior cingulate cortex of the left hemisphere, the caudate nucleus and the thalamus of the right hemisphere, and the right cerebellum and vermis. These results indicate that the supramarginal cortex, the premotor cortex, and the posterior cingulate cortex of the left hemisphere and the cerebellum are involved in integrating visual feedback of hand movements and execution of accurate pointing.
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