O ver 70 years ago, Penfield (1937) published his seminal work on the somatotopy of the human peri-rolandic cortex, fortifying the notion of the classic sensorimotor homunculus. Surprisingly, few additional investigations with direct electrocortical stimulation (ECS) have been undertaken to study the organization of the ventral half of the sensorimotor cortex (vSMC) in humans, where speech articulators and nearby language centers make this area unique. 1,4 Neuroanatomically, the vSMC is distinct from the dorsal sensorimotor cortex (dSMC). Its neurons project via the corticobulbar pathway to synapse in the brainstem motor nuclei, providing bilateral innervation to the muscles of the upper face, jaw, oropharynx, and vocal tract through cranial nerves (CNs) . diSclOSure Dr. Chang was funded by US National Institutes of Health grants R01-DC012379, R00-NS065120, and DP2-OD00862 and the Ester A. and Joseph Klingenstein Foundation. The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.A probabilistic map of the human ventral sensorimotor cortex using electrical stimulation OBJect The human ventral sensorimotor cortex (vSMC) is involved in facial expression, mastication, and swallowing, as well as the dynamic and highly coordinated movements of human speech production. However, vSMC organization remains poorly understood, and previously published population-driven maps of its somatotopy do not accurately reflect the variability across individuals in a quantitative, probabilistic fashion. The goal of this study was to describe the responses to electrical stimulation of the vSMC, generate probabilistic maps of function in the vSMC, and quantify the variability across individuals. methOdS Photographic, video, and stereotactic MRI data of intraoperative electrical stimulation of the vSMC were collected for 33 patients undergoing awake craniotomy. Stimulation sites were converted to a 2D coordinate system based on anatomical landmarks. Motor, sensory, and speech stimulation responses were reviewed and classified. Probabilistic maps of stimulation responses were generated, and spatial variance was quantified. reSultS In 33 patients, the authors identified 194 motor, 212 sensory, 61 speech-arrest, and 27 mixed responses. Responses were complex, stereotyped, and mostly nonphysiological movements, involving hand, orofacial, and laryngeal musculature. Within individuals, the presence of oral movement representations varied; however, the dorsal-ventral order was always preserved. The most robust motor responses were jaw (probability 0.85), tongue (0.64), lips (0.58), and throat (0.52). Vocalizations were seen in 6 patients (0.18), more dorsally near lip and dorsal throat areas. Sensory responses were spatially dispersed; however, patients' subjective reports were highly precise in localization within the mouth. The most robust responses included tongue (0.82) and lips (0.42). The probability of speech arrest was 0.85, highest 15-20 mm anterior to t...