Abstract
Purpose
The importance of supplementary motor area (SMA) for motor function and compensation for primary motor area (M1) has received increased attention.
Methods
We used diffusion tensor imaging (DTI) and transcranial magnetic stimulation (TMS) to evaluate structure and function of corticospinal projection originating from SMA. Fibers of corticospinal projection originating from M1 (CST) and SMA (ACST) were analyzed. ACST originating from mesial SMA area formed separate white matter bundles leaving the anterior part of M1 area, which then entered the posterior limb of the internal capsule. Projection and overlap of both CST and ACST were detected on medulla.
Results
Fibers of contralesional ACST were more than that of ipsilesional ACST in patients with SMA tumors (p<0.05). In patients with SMA tumor, all patients experienced temporary akinesia postoperatively. Seven hundred forty-one fibers of ipsilateral ACST and no fibers of ipsilateral CST were detected in the patient with M1 glioma, while most of contralateral limb movement was preserved. MEP could be evoked by stimulating SMA area as well as M1 area. ACST originated from SMA area and projected to the medial medulla.
Conclusion
SMA area and ACST integrity contributed to contralateral motor function and were a compensation for M1 lesion and damaged CST.
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Acknowledgments
We are grateful to our team and clinicians who made the study possible (Ming-xia Xu, especially).
Funding
This work was supported by National Natural Science Foundation of China (No. 81802492 to Pei-Sen Yao), Young and Middle-aged Backbone Key Research Project of National Health and Family Planning Commission of Fujian Province (No. 2017-ZQN-46 to Pei-Sen Yao), and Natural Science Funding of Fujian Province (No. 2018J01175 to Pei-Sen Yao and No. 2018J01176 to Shu-Fa Zheng) and Startup Fund for scientific research, Fujian Medical University(No.2019QH1087 to Ming-xia Xu).
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All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Ya-Wen Xu, Peng Lin, and Pei-Sen Yao. The first draft of the manuscript was written by Ya-Wen Xu, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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This retrospective chart review study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The Human Investigation Committee (IRB) of First Affiliated Hospital of Fujian Medical University approved this study.
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Our study was approved by the institutional review board, which waived informed consent because it was retrospective
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Xu, YW., Lin, P., Yao, PS. et al. Structure and function of corticospinal projection originating from supplementary motor area. Neuroradiology 63, 1283–1292 (2021). https://doi.org/10.1007/s00234-021-02669-z
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DOI: https://doi.org/10.1007/s00234-021-02669-z