Objectives: This study aimed to comprehensively investigate the functional connectivity of ten sub-regions within the premotor and supplementary motor areas (Right and Left Premotor 6d1, 6d2, 6d3, and Right and Left pre-Supplementary Motor (presma) and SMA). Using advanced magnetic resonance imaging (MRI), the objective was to understand the neurophysiological integrative characteristics of these regions by examining their connectivity with eight distinct functional brain networks. While previous studies have largely treated these areas as homogeneous entities, there is a significant gap in our understanding of the specific roles and connectivity profiles of their distinct sub-regions. The goal was to uncover the roles of these regions beyond conventional motor functions, contributing to a more holistic understanding of brain functioning. Methods: The study involved 198 healthy volunteers, with the primary methodology being functional connectivity analysis using advanced MRI techniques. Ten sub-regions within the premotor and supplementary motor areas served as seed regions, and their connectivity with eight distinct brain regional functional networks, including the Sensorimotor, Dorsal Attention, Language, Frontoparietal, Default Mode, Cerebellar, Visual, and Salience networks, was investigated. This approach allowed for the exploration of synchronized activity between these critical brain areas, shedding light on their integrated functioning and relationships with other brain networks. Results: The study revealed a nuanced landscape of functional connectivity for the premotor and supplementary motor areas with the main functional brain networks. Despite their high functional connectedness within the motor network, these regions displayed diverse functional integrations with other networks. There was moderate connectivity with the Sensorimotor and Dorsal Attention networks, highlighting their roles in motor execution and attentional processes. However, connectivity with the Language, Frontoparietal, Default Mode, Cerebellar, Visual, and Salience networks was generally low, indicating a primary focus on motor-related tasks. Conclusions: This study emphasized the multifaceted roles of the sub-regions of the premotor and supplementary motor areas. Beyond their crucial involvement in motor functions, these regions exhibited varied functional integrations with different brain networks. The observed disparities, especially in the Sensorimotor and Dorsal Attention networks, indicated a nuanced and specialized involvement of these regions in diverse cognitive functions. By delineating the specific connectivity profiles of these sub-regions, this study addresses the existing knowledge gap and suggests unique and distinct roles for each brain area in sophisticated cognitive tasks beyond their conventional motor functions. The results suggested unique and distinct roles for each brain area in sophisticated cognitive tasks beyond their conventional motor functions. This study underscores the importance of considering the broader neurophysiological landscape to comprehend the intricate roles of these brain areas, contributing to ongoing efforts in unravelling the complexities of brain function.
