White matter connections of the supplementary motor area in humans
Open accessAbstract
INTRODUCTION: The supplementary motor area (SMA) is frequently involved by brain tumours (particularly WHO grade II gliomas). Surgery in this area can be followed by the 'SMA syndrome', characterised by contralateral akinesia and mutism. Knowledge of the connections of the SMA can provide new insights on the genesis of the SMA syndrome, and a better understanding of the challenges related to operating in this region. METHODS: White matter connections of the SMA were studied with both postmortem dissection and advance diffusion imaging tractography. Postmortem dissections were performed according to the Klingler technique. 12 specimens were fixed in 10% formalin and frozen at -15°C for 2 weeks. After thawing, dissection was performed with blunt dissectors. For diffusion tractography, high-resolution diffusion imaging datasets from 10 adult healthy controls from the Human Connectome Project database were used. Whole brain tractography was performed using a spherical deconvolution approach. RESULTS: Five main connections were identified in both postmortem dissections and tractography reconstructions: (1) U-fibres running in the precentral sulcus, connecting the precentral gyrus and the SMA; (2) U-fibres running in the cingulate sulcus, connecting the SMA with the cingulate gyrus; (3) frontal 'aslant' fascicle, directly connecting the SMA with the pars opercularis of the inferior frontal gyrus; (4) medial fibres connecting the SMA with the striatum; and (5) SMA callosal fibres. Good concordance was observed between postmortem dissections and diffusion tractography. CONCLUSIONS: The SMA shows a wide range of white matter connections with motor, language and lymbic areas. Features of the SMA syndrome (akinesia and mutism) can be better understood on the basis of these findings.
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The frontal aslant tract connects the posterior inferior frontal cortex with the supplementary/pre-supplementary motor area.
“the frontal aslant tract that connects the posterior inferior frontal cortex with the supplementary/pre-supplementary motor area”
From Damage to Broca’s area does not contribute to long-term speech production outcome after stroke (2021) · cites this paper as Vergani et al., 2014
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- Authors
- Vergani, F., Lacerda, L., Martino, J., Attems, J., Morris, C., Mitchell, P., de Schotten, M. T., & Dell'Acqua, F.
- Affiliations
- Royal Victoria Infirmary (GB)
- Marqués de Valdecilla University Hospital (ES)
- Newcastle University (GB)
- Corresponding author
- Vergani, Francesco
- Venue
- Journal of Neurology, Neurosurgery & Psychiatry
- Publisher
- BMJ
- Published
- 2014-04-16
- Volume
- 85
- Issue
- 12
- Pages
- 1377-1385
- ISSN
- 0022-3050 (ISSN-L)
- 1468-330X
- OpenAlex
- W2160720878
- Cited by
- 183
- References
- 41
- Citations by year
- 2026: 6 · 2025: 14 · 2024: 12 · 2023: 18 · 2022: 16 · 2021: 20 · 2020: 25 · 2019: 11 · 2018: 18 · 2017: 12 · 2016: 17 · 2015: 11 · 2014: 3
- FWCI
- 11.21
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Neurology Neurosurgery & Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion, other-oa)
- UCL Discovery (University College London) (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- Newcastle University ePrints (Newcastle Univesity)
- Funders
- Alzheimer's Society
- Newcastle University (G0400074)
- Fundación Marqués de Valdecilla
- National Institutes of Health (1U54‐MH‐091657)
- McDonnell Center for Systems Neuroscience (1U54MH091657)
- Medical Research Council (G0400074, 1U54MH091657, MR/L016451/1)
- NIH Blueprint for Neuroscience Research (1U54-MH-091657)
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced Neuroimaging Techniques and Applications
- Life Sciences › Neuroscience › Cognitive Neuroscience › Functional Brain Connectivity Studies
- Health Sciences › Medicine › Anatomy › Medical and Biological Sciences
- Keywords
- supplementary motor area, white matter connections, glioma, diffusion tractography, postmortem dissection, precentral sulcus, cingulate gyrus, inferior frontal gyrus, striatum, corpus callosum, akinesia, mutism, surgical risk
- MeSH terms
- Adult, Humans, Limbic System, Motor Cortex, Movement, Neural Pathways, Speech, Diffusion Tensor Imaging, Connectome, White Matter
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