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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 24:1837-1842, October 2003
© 2003 American Society of Neuroradiology

BRAIN

Supplementary Motor Area Activation in Patients with Frontal Lobe Tumors and Arteriovenous Malformations

Janet Sailor^a, M. Elizabeth Meyerand^b, Chad H. Moritz^a, Jason Fine^c, Lindsey Nelson^a, Behnam Badie^d and Victor M. Haughton^a

^a Department of Radiology, University of Wisconsin Medical School, Madison, Wisconsin
^b Department of Medical Physics, University of Wisconsin Medical School, Madison, Wisconsin
^c Department of Biostatistics, University of Wisconsin Medical School, Madison, Wisconsin
^d Department of Neurological Surgery, University of Wisconsin Medical School, Madison, Wisconsin

Address reprint requests to Victor M. Haughton, M.D., Department of Radiology, The University of Wisconsin Hospitals and Clinics, 600 Highland Ave, CSC E3/311, Madison, WI 53792-3252

BACKGROUND AND PURPOSE: Some patients who undergo surgical resection of portions of the supplementary motor area (SMA) have severe postoperative motor and language deficits, whereas others have no deficits. We tested the hypothesis that in some patients with lesions affecting the SMA, the contralateral SMA exhibits some of the activation normally associated with the ipsilateral SMA.

METHODS: Functional MR imaging studies in seven healthy volunteers and 19 patients with frontal lobe tumors or arteriovenous malformations were reviewed retrospectively. The hemisphere in which the SMA activation predominated was tabulated for right and left motor tasks. The relative hemispheric dominance in the SMA for the right and left motor tasks was compared in the healthy and patient groups and with the location of the lesion in the patient group.

RESULTS: None of the control subjects performing a right hand motor task activated predominantly the right SMA. Fifty percent of the patients with lesions overlapping the left SMA performing the right motor task activated predominantly the right SMA. Fifty-seven percent of control subjects performing the left hand motor task activated the left SMA predominantly. One hundred percent of patients with lesions overlapping the right frontal SMA performing the left motor task activated the left SMA predominantly. Differences between patients and controls were statistically significant.

CONCLUSION: A lesion that contacts or overlaps the SMA is associated with an increased functional MR imaging response within the contralateral SMA.

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