The striatum participates in parallel corticobasal ganglia–thalamocortical loops interconnecting its different territories with areas of the frontal lobe, forming partially segregated motor, oculomotor, associative, and limbic circuits.1 Human studies using resting-state fMRI2–4 and diffusion tensor imaging5–10 confirm the presence of a functional parcellation of the human striatum, particularly the caudate nucleus,11 based on segregated corticostriatal connections. However, the corticostriatal connections are complex, and there are extensive interactions among functional territories.12 Furthermore, the distinct territories of the striatum are functionally linked to cortical networks rather than specific cortical regions.13 There are specific patterns of coactivation of different portions of the striatum and cerebral cortex across distinct psychological tasks, which only partially overlap the parcellation of the striatum based on steady-state connectivity.14 The caudate nucleus contains several neuronal clusters that are functionally connected to cortical areas that are part of distributed networks involved in cognitive and emotional processing. This extensive connectivity explains the profound impairment in multiple cognitive and behavioral domains resulting from lesions of the caudate nucleus in humans.15,16 The following 2 representative cases illustrate the profound consequences of caudate lesions in cognition and behavior and the associated widespread changes in frontal lobe metabolism.

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