Joint activation of the supplementary motor area and presupplementary motor area during simultaneous motor and language functional MRI

Abstract

Recent research showed that the supplementary motor area (SMA) can be divided into a rostral pre-SMA, involved in higher-level processing and a caudal SMA proper, involved with motor execution. As surgical insults to the medial frontal lobes may cause variable neurological deficits and an incomplete understanding of structure-function relationships of the SMA exists, we sought to determine whether a common locus of functionality can be established using functional MRI. Results reveal a commonly activated region between these two areas, using simultaneous motor and language tasks. A higher percentage signal change was measured in comparison with those found using individual tasks. Results contribute to the structural and functional knowledge of the SMA and may enable distinction between permanent and transient SMA syndromes.

Language Mapping Using fMRI and Direct Cortical Stimulation for Brain Tumor Surgery

“…1) The SMA is functionally divided into 2 regions; the anterior portion of the SMA (pre-SMA) subserves language planning and the posterior portion is responsible for planning motor execution. 45 This functional subdivision while likely variable in its precise localization has been delineated by the VCA line (vertical commisure anterior line) drawn vertically from the anterior commisure. 46 It has been suggested that there is a graded functionality separating the pre-SMA and the SMA proper.…”

“…46 It has been suggested that there is a graded functionality separating the pre-SMA and the SMA proper. Peck et al 45 showed an area of common activation during both motor and language tasks, suggesting that there may be a region of the SMA that might carry a high probability of deficit if damaged. However, operative deficits relative to this region were not examined in this study.…”

Cortical Plasticity in the Setting of Brain Tumors

“…16,17 The part related to motor planning is the caudal SMA proper and its function is intimately related to motor control. SMA localization is more difficult than the primary motor cortex (M1) on routine MRI examinations, as there is not a clear anatomical delineation.…”

Blood Oxygen Level Dependent Functional Magnetic Resonance Imaging for Presurgical Planning

“…25 The SMA has been shown to be involved in temporal planning and organization of motor movements before execution, in addition to sequencing multiple movements. 26 Peck and colleagues 25,27 characterized the role of the SMA in patients with high-grade gliomas and their role in cortical reorganization. The study used fMRI to look at the BOLD hemodynamic responses in the primary motor and SMA of tumor patients.…”