A Practical Approach to Imaging of the Supplementary Motor Area and Its Subcortical Connections

Abstract

Purpose of review: First, an anatomical and functional review of these cortical areas and subcortical connections with T-fMRI and tractography techniques; second, to demonstrate the value of this approach in neurosurgical planning in a series of patients with tumors close to the SMA.

Recent findings: Implications in language and cognitive networks with a clear hemispheric lateralization of these SMA/pre-SMA. The recommendation of the use of the advanced neuroimaging studies for surgical planning and preservation of these areas. The SMA/pre-SMA and their subcortical connections are functional areas to be taken into consideration in neurosurgical planning. These areas would be involved in the control/inhibition of movement, in verbal expression and fluency and in tasks of cognitive control capacity. Its preservation is key to the patient's postsurgical cognitive and functional evolution.

Keywords: Electrical cortical mapping; Electrical subcortical mapping; Presupplementary motor area; Resting-functional MRI; Supplementary motor area; Task-functional MRI; Tractography.