Abstract
IntroductionAlthough the pre-supplementary motor area (pre-SMA) is one of the most frequently reported areas of activation in functional imaging studies, the role of this brain region in cognition is still a matter of intense debate. Here we present a patient with a focal lesion of caudal pre-SMA who displays a selective deficit in updating a response plan to switch actions, but shows no impairment when required to withhold a response – stopping. Materials & methodsThe patient and a control group underwent three tasks designed to measure different aspects of cognitive control and executive function. ResultsThe pre-SMA patient displayed no impairment when responding in the face of distracting stimuli (Eriksen flanker paradigm), or when required to halt an on-going response (STOP task). However, a specific deficit was observed when she was required to rapidly switch between response plans (CHANGE task). ConclusionsThese findings suggest that the caudal pre-SMA may have a particularly important role in a network of brain regions required for rapidly updating and implementing response plans. The lack of any significant impairment on other measures of cognitive control suggests that this is not likely due to a global deficit in cognitive control. We discuss the implications of these results in the context of current theories of pre-SMA function.
Highlights
The pre-supplementary motor area is one of the most frequently reported areas of activation in functional imaging studies, the role of this brain region in cognition is still a matter of intense debate
In this study we explored the behavioural consequences of a lesion of the caudal right pre-supplementary motor area (pre-supplementary motor area (SMA)) on three standard measures of cognitive control
Our aim was to identify whether KP's behaviour had changed as a result of the lesion and how this could be integrated into contemporary accounts of pre-SMA function
Summary
The pre-supplementary motor area (pre-SMA) is one of the most frequently reported areas of activation in functional imaging studies, the role of this brain region in cognition is still a matter of intense debate. In humans the principal focus of a large number of studies has been to identify the contribution of pre-SMA to the performance of tasks designed to measure aspects of cognitive control and executive function (Curtis & D'Esposito, 2003; Nachev, Rees, Parton, Kennard, & Husain, 2005; Shima & Tanji, 2000) These paradigms often require participants to rapidly inhibit or alter a pre-potent response (Curtis & D'Esposito, 2003; Logan & Cowan, 1984; Mostofsky et al, 2003; Nachev et al, 2005), or to respond accurately in the presence of distractors (Botvinick, Nystrom, Fissell, Carter, & Cohen, 1999; Luks, Simpson, Dale, & Hough, 2007; Shima & Tanji, 2000). Evidence from functional imaging has implicated pre-SMA in stopping an ongoing response (Aron & Poldrack, 2006; Obeso, Robles, Marron, & Redolar-Ripoll, 2013; Picard & Strick, 1996; Sharp et al, 2010), selecting between conflicting response alternatives (Forstmann, van den Wildenberg, & Ridderinkhof, 2008; Garavan, Ross, Kaufman, & Stein, 2003; Mostofsky & Simmonds, 2008; Nachev et al, 2005; Van Gaal, Scholte, Lamme, Fahrenfort, & Ridderinkhof, 2011), and switching from automatic to voluntary action (Curtis & D'Esposito, 2003; Isoda & Hikosaka, 2007; Nachev, Wydell, O'Neill, Husain, & Kennard, 2007; Ullsperger & von Cramon, 2001)
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