Neurosurgery

doi: 10.25005/2074-0581-2023-25-1-94-107
SUPPLEMENTARY MOTOR AREA AND CLINICAL PICTURE OF ITS LESION

I.M. Alekseev, A.A. Zuev

Pirogov National Medical and Surgical Center, Moscow, Russian Federation

Methods: The supplementary motor area (SMA) is a cortical region, that is located on the medial surface of the frontal lobe entirely within the interhemispheric fissure between the primary motor cortex (PMC) and prefrontal cortex (PFC). This area is a heterogeneous region in its structure, as well as in its connections with other parts of the brain; on the basis of these differences, the pre-SMA and SMA-proper regions are distinguished in it. Numerous neural connections with other parts of the central nervous system (CNS) suggest the involvement of the SMA in many cognitive functions, and not only in higher motor ones, as previously was thought. In particular, in the dominant hemisphere, the SMA performs the speech function through the frontal oblique fascicle (FOF), a bundle of association fibers that connects the SMA with Broca's area. In the event of various pathologies affecting the SMA and after neurosurgical manipulations in this area, a variety of neurological disorders can occur both motor and verbal. With the damage of this cortical region in the dominant hemisphere, SMA syndrome (akinetic mutism) can occur. This paper provides a review of the anatomical, cytoarchitectonic, and functional features of the SMA, as well as a detailed description of the clinical picture of the lesion of this cortical region.

Keywords: Brain, supplementary motor area, SMA syndrome.

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Authors' information:


Alekseev Ivan Maksimovich,
Neurosurgeon, Postgraduate Student of the Department of Neurosurgery of the Institute for Postgraduate Medical Education, Pirogov National Medical and Surgical Center
ORCID ID: 0000-0001-8107-3065
E-mail: alexeev.im@yandex.ru

Zuev Andrey Aleksandrovich,
Doctor of Medical Sciences, Head of the Department of Neurosurgery of the Institute for Postgraduate Medical Education, Pirogov National Medical and Surgical Center
ORCID ID: 0000-0003-2974-1462
E-mail: mosbrain@gmail.com

Information about support in the form of grants, equipment, medications

The authors did not receive financial support from manufacturers of medicines and medical equipment

Conflicts of interest: No conflict

Address for correspondence:


Alekseev Ivan Maksimovich
Neurosurgeon, Postgraduate Student of the Department of Neurosurgery of the Institute for Postgraduate Medical Education, Pirogov National Medical and Surgical Center

105203, Russian Federation, Moscow, Nizhnyaya Pervomayskaya str., 70

Tel.: +7 (918) 5844004

E-mail: alexeev.im@yandex.ru

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