Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Feb;45(1):81-90.
doi: 10.1007/s10143-021-01566-6. Epub 2021 May 15.

The supplementary motor area syndrome: a neurosurgical review

Harry Pinson  1   2 , Jeroen Van Lerbeirghe  3 , Dimitri Vanhauwaert  3 , Olivier Van Damme  3 , Giorgio Hallaert  4 , Jean-Pierre Kalala  4
Affiliations
Review

The supplementary motor area syndrome: a neurosurgical review

Harry Pinson et al. Neurosurg Rev. 2022 Feb.

Abstract

The supplementary motor area (SMA) syndrome is a frequently encountered clinical phenomenon associated with surgery of the dorsomedial prefrontal lobe. The region has a known motor sequencing function and the dominant pre-SMA specifically is associated with more complex language functions; the SMA is furthermore incorporated in the negative motor network. The SMA has a rich interconnectivity with other cortical regions and subcortical structures using the frontal aslant tract (FAT) and the frontostriatal tract (FST). The development of the SMA syndrome is positively correlated with the extent of resection of the SMA region, especially its medial side. This may be due to interruption of the nearby callosal association fibres as the contralateral SMA has a particular important function in brain plasticity after SMA surgery. The syndrome is characterized by a profound decrease in interhemispheric connectivity of the motor network hubs. Clinical improvement is related to increasing connectivity between the contralateral SMA region and the ipsilateral motor hubs. Overall, most patients know a full recovery of the SMA syndrome, however a minority of patients might continue to suffer from mild motor and speech dysfunction. Rarely, no recovery of neurological function after SMA region resection is reported.

Keywords: Glioma surgery; Literature review; SMA syndrome.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Acioly MA, Cunha AM, Parise M, Rodrigues E, Tovar-Moll F (2015) Recruitment of contralateral supplementary motor area in functional recovery following medial frontal lobe surgery: an fMRI case study. J Neurol Surg A Cent Eur Neurosurg 76(6):508–512. https://doi.org/10.1055/s-0035-1558408 - DOI - PubMed
    1. Baker CM, Burks JD, Briggs RG, Smitherman AD, Glenn CA, Conner AK et al (2018) The crossed frontal aslant tract: a possible pathway involved in the recovery of supplementary motor area syndrome. Brain Behav 8(3):e00926. https://doi.org/10.1002/brb3.926 - DOI - PubMed - PMC
    1. Bozkurt B, Yagmurlu K, Middlebrooks EH, Karadag A, Ovalioglu TC, Jagadeesan B et al (2016) Microsurgical and tractographic anatomy of the supplementary motor area complex in humans. World Neurosurg 95:99–107. https://doi.org/10.1016/j.wneu.2016.07.072 - DOI - PubMed
    1. Briggs RG, Khan AB, Chakraborty AR, Abraham CJ, Anderson CD, Karas PJ et al (2020) Anatomy and white matter connections of the superior frontal gyrus. Clin Anat (New York, NY) 33(6):823–832. https://doi.org/10.1002/ca.23523 - DOI
    1. Catani M, Dell’acqua F, Vergani F, Malik F, Hodge H, Roy P et al (2012) Short frontal lobe connections of the human brain. Cortex 48(2):273–291. https://doi.org/10.1016/j.cortex.2011.12.001 - DOI - PubMed

LinkOut - more resources