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In mice, the corticomedullary coupling in both CauM and Lat-RM increased systematically along a ventro-medio-dorsal gradient, with the strongest links to primary motor and premotor cortices. In humans, higher\u2010order sensorimotor regions drove the strongest connectivity with CauM and Lat-RM, while the more medially located medial rostral medulla remained weakly engaged. Furthermore, simultaneous brain-spinal fMRI revealed distinct functional territories within the human C3\u2013C4 cervical spinal cord, with ventral regions exhibiting strong connectivity to the medulla and dorsal regions to lower cervical segments. Together, our findings identify a conserved corticomedullary network underlying forelimb movement control across species, while also uncovering variation in cortical involvement. They indicate the presence of an indirect pathway involving both the reticulospinal pathway and the C3\u2013C4 propriospinal system, which contributes to fine hand motor control in the mammalian brain.<\/jats:p>","DOI":"10.1073\/pnas.2518217123","type":"journal-article","created":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T16:58:41Z","timestamp":1769619521000},"update-policy":"https:\/\/doi.org\/10.1073\/pnas.cm10313","source":"Crossref","is-referenced-by-count":5,"title":["Medullary and C3\u2013C4 propriospinal pathways underlying mammalian forelimb movement control"],"prefix":"10.1073","volume":"123","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7018-7830","authenticated-orcid":false,"given":"Vishwas","family":"Jindal","sequence":"first","affiliation":[{"name":"Department of Applied Physiology and Kinesiology, University of Florida","place":["Gainesville"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo 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