Activity In Supplementary Motor Area Research Articles

Preserved brain adaptive properties in patients with benign multiple sclerosis

We investigated motor network function in patients with benign multiple sclerosis (BMS) and contrasted the results with those obtained from patients with secondary progressive multiple sclerosis (SPMS) and healthy controls (HC) to elucidate better the factors associated with a favorable clinical evolution in multiple sclerosis (MS). Diffusion tensor (DT) and fMRI scans during the performance of a simple motor task were prospectively acquired from 17 patients with BMS, 15 patients with SPMS, and 17 HC. Patients with BMS and SPMS were matched for age, gender, and disease duration. DT MRI histograms of the normal-appearing white matter (NAWM) and gray matter (GM) were derived. fMRI analysis was performed using SPM5 (Wellcome Department of Cognitive Neurology, London, UK). Compared with HC, patients with BMS and SPMS had increased activations of the left primary sensorimotor cortex. Patients with SPMS also showed increased activations of the left secondary sensorimotor cortex, left inferior frontal gyrus (IFG), right hippocampus, and several visual areas. Compared with HC and patients with BMS, patients with SPMS had reduced activations of the left supplementary motor area, left putamen, and right cerebellum. Compared with patients with BMS, patients with SPMS had increased activations of the left IFG and right middle occipital gyrus. In patients with MS, fMRI changes were correlated with T2 lesion volumes and DT MRI changes in the NAWM and GM. This study shows that, contrary to what happens in secondary progressive multiple sclerosis, the movement-associated pattern of activations seen in benign multiple sclerosis resembles that of healthy people, and its abnormalities are restricted to the sensorimotor network. The long-term preservation of brain functional adaptive mechanisms in these patients is likely to contribute to their favorable clinical course.

Changes in regional activity are accompanied with changes in inter-regional connectivity during 4 weeks motor learning

Structural equation modeling (SEM) and fMRI were used to test whether changes in the regional activity are accompanied by changes in the inter-regional connectivity as motor practice progresses. Ten healthy subjects were trained to perform finger movement task daily for 4 weeks. Three sessions of fMRI images were acquired within 4 weeks. The changes in inter-regional connectivity were evaluated by measuring the effective connectivity between the primary motor area (M1), supplementary motor area (SMA), dorsal premotor cortex (PMd), basal ganglia (BG), cerebellum (CB), and posterior ventrolateral prefrontal cortex (pVLPFC). The regional activities in M1 and SMA increased from pre-training to week 2 and decreased from week 2 to week 4. The inter-regional connectivity generally increased in strength (with SEM path coefficients becoming more positive or negative) as practice progressed. The increases in the strength of the inter-regional connectivity may reflect long-term reorganization of the skilled motor network. We suggest that the performance gain was achieved by dynamically tuning the inter-regional connectivity in the motor network.

Facilitatory conditioning of the supplementary motor area in humans enhances the corticophrenic responsiveness to transcranial magnetic stimulation

Inspiratory loading in awake humans is associated with electroencephalographic signs of supplementary motor area (SMA) activation. To provide evidence for a functional connection between SMA and the diaphragm representation in the primary motor cortex (M1(DIA)), we tested the hypothesis that modulating SMA activity using repetitive transcranial magnetic stimulation (rTMS) would alter M1(DIA) excitability. Amplitude and latency of diaphragm motor evoked potentials (MEP(DIA)), evoked through single pulse M1(DIA) stimulation, before and up to 16 min after SMA stimulation, were taken as indicators of M1(DIA) excitability. MEPs from the first dorsal interosseous muscle (FDI, MEP(FDI)) served as a control. Four SMA conditioning sessions were performed in random order at 1-wk intervals. Two aimed at increasing SMA activity (5 and 10 Hz, both at 110% of FDI active motor threshold; referred to as 5Hz and 10Hz, respectively), and two aimed at decreasing it (1 Hz either at 110% of FDI active or resting motor threshold, referred to as aMT or rMT, respectively). The 5Hz protocol increased MEP(DIA) and MEP(FDI) amplitudes with a maximum 11-16 min poststimulation (P = 0.04 and P = 0.02, respectively). The 10Hz protocol increased MEP(FDI) amplitude with a similar time course (P = 0.03) but did not increase MEP(DIA) amplitude (P = 0.32). Both aMT and rMT failed to decrease MEP(DIA) or MEP(FDI) amplitudes (P = 0.23 and P = 0.90, respectively, for diaphragm and P = 0.48 and P = 0.14 for FDI). MEP(DIA) and MEP(FDI) latencies were unaffected by rTMS. These results demonstrate that 5-Hz rTMS over the SMA can increase the excitability of M1(DIA). These observations are consistent with the hypothesis of a functional connection between SMA and M1(DIA).

High-frequency rTMS over the supplementary motor area improves bradykinesia in Parkinson's disease: Subanalysis of double-blind sham-controlled study

A double-blind sham-controlled study demonstrated that high-frequency repetitive transcranial magnetic stimulation (rTMS) over the supplementary motor area (SMA) provided relief of motor symptoms in patients with Parkinson's disease (PD). However, it remains to be determined which parkinsonian symptoms were improved by this treatment. Subanalysis of Unified Parkinson Disease Rating Scale revealed that rTMS over SMA significantly improved bradykinesia in PD. Results support the hypothesis that neuronal activity of SMA was profoundly associated with hypokinetic symptoms in PD.

A fMRI Study of Verbal Working Memory, Cardiac Output, and Ejection Fraction in Elderly Patients with Cardiovascular Disease

Cardiovascular disease (CVD) is associated with cognitive deficits even in the absence of stroke. We examined the relationship between cardiac performance, as measured by cardiac output (CO) and ejection fraction (EF), and brain activity during a verbal working memory (VWM) task in elderly CVD patients who tend to be at increased risk for vascular cognitive impairments. Seventeen patients were recruited from a cohort participating in an ongoing prospective study examining the effects of CVD on cognitive function in the elderly. Participants were diagnosed with CVD (age 68±8) and completed a 2-back VWM task in a 1.5T fMRI paradigm. CO and EF were calculated from echocardiogram measures. Task-related activation was averaged in a priori regions of interest. The relationship between CO, EF, and 2-back-related activity was modeled using partial correlations (two-tailed p<.05) controlling for age and 2-back accuracy. All participants were globally cognitively intact as indicated by Mini-Mental Status Exam and Dementia Rating Scale scores. Mean accuracy on the 2-back was 78±9% while reaction time averaged 1,027±192 ms. Mean CO and EF values showed a large range (CO: 3.55 to 6.31; EF: 0.36 to 0.76) but average values were within the normal range. After controlling for age and 2-back accuracy, lower EF was related to decrease in left insula activity (r=0.61, p=0.03). There were trends for EF to be related to accuracy (r=0.47, p=0.09) and reaction time (r=-0.48, p=0.09). CO was also related to insula activity (r=0.60, p=0.04) and activity in the supplementary motor area activity (r=0.66, p=0.01). Cardiac performance was related to decreased efficiency in task related brain areas and tended to be related to performance on a VWM task in elderly patients with CVD. Results have implications for a line of investigation indicating that cardiac and systemic vascular indices could be used as proxy measures to examine mechanisms of cerebrovascular dysfunction in the elderly.

Neural network of speech monitoring overlaps with overt speech production and comprehension networks: A sequential spatial and temporal ICA study

The neural correlates of speech monitoring overlap with neural correlates of speech comprehension and production. However, it is unclear how these correlates are organized within functional connectivity networks, and how these networks interact to subserve speech monitoring. We applied spatial and temporal independent component analysis (sICA and tICA) to a functional magnetic resonance imaging (fMRI) experiment involving overt speech production, comprehension and monitoring. SICA and tICA respectively decompose fMRI data into spatial and temporal components that can be interpreted as distributed estimates of functional connectivity and concurrent temporal dynamics in one or more regions of fMRI activity. Using sICA we found multiple connectivity components that were associated with speech perception (auditory and left fronto-temporal components) and production (bilateral central sulcus and default-mode components), but not with speech monitoring. In order to further investigate if speech monitoring could be mapped in the auditory cortex as a unique temporal process, we applied tICA to voxels of the sICA auditory component. Amongst the temporal components we found a single, unique component that matched the speech monitoring temporal pattern. We used this temporal component as a new predictor for whole-brain activity and found that it correlated positively with bilateral auditory cortex, and negatively with the supplementary motor area (SMA). Psychophysiological interaction analysis of task and activity in bilateral auditory cortex and SMA showed that functional connectivity changed with task conditions. These results suggest that speech monitoring entails a dynamic coupling between different functional networks. Furthermore, we demonstrate that overt speech comprises multiple networks that are associated with specific speech-related processes. We conclude that the sequential combination of sICA and tICA is a powerful approach for the analysis of complex, overt speech tasks.

Functional compensation of motor function in pre-symptomatic Huntington's disease

Involuntary choreiform movements are a clinical hallmark of Huntington's disease. Studies in clinically affected patients suggest a shift of motor activations to parietal cortices in response to progressive neurodegeneration. Here, we studied pre-symptomatic gene carriers to examine the compensatory mechanisms that underlie the phenomenon of retained motor function in the presence of degenerative change. Fifteen pre-symptomatic gene carriers and 12 matched controls performed button presses paced by a metronome at either 0.5 or 2 Hz with four fingers of the right hand whilst being scanned with functional magnetic resonance imaging. Subjects pressed buttons either in the order of a previously learnt 10-item finger sequence, from left to right, or kept still. Error rates ranged from 2% to 7% in the pre-symptomatic gene carriers and from 0.5% to 4% in controls, depending on the condition. No significant difference in task performance was found between groups for any of the conditions. Activations in the supplementary motor area (SMA) and superior parietal lobe differed with gene status. Compared with healthy controls, gene carriers showed greater activations of left caudal SMA with all movement conditions. Activations correlated with increasing speed of movement were greater the closer the gene carriers were to estimated clinical diagnosis, defined by the onset of unequivocal motor signs. Activations associated with increased movement complexity (i.e. with the pre-learnt 10-item sequence) decreased in the rostral SMA with nearing diagnostic onset. The left superior parietal lobe showed reduced activation with increased movement complexity in gene carriers compared with controls, and in the right superior parietal lobe showed greater activations with all but the most demanding movements. We identified a complex pattern of motor compensation in pre-symptomatic gene carriers. The results show that preclinical compensation goes beyond a simple shift of activity from premotor to parietal regions involving multiple compensatory mechanisms in executive and cognitive motor areas. Critically, the pattern of motor compensation is flexible depending on the actual task demands on motor control.

Mapping preclinical compensation in Parkinson's disease: An imaging genomics approach

Mutations in the Parkin (PARK2) and PINK1 gene (PARK 6) can cause recessively inherited Parkinson's disease (PD). The presence of a single Parkin or PINK1 mutation is associated with a dopaminergic nigrostriatal dysfunction and conveys an increased risk to develop PD throughout lifetime. Therefore neuroimaging of non-manifesting individuals with a mutant Parkin or PINK1 allele opens up a window for the investigation of preclinical and very early phases of PD in vivo. Here we review how functional magnetic resonance imaging (fMRI) can be used to identify compensatory mechanisms that help to prevent development of overt disease. In two separate experiments, Parkin mutation carriers displayed stronger activation of rostral supplementary motor area (SMA) and right dorsal premotor cortex (PMd) during a simple motor sequence task and anterior cingulate motor area and left rostral PMd during internal movement selection as opposed to externally cued movements. The additional recruitment of the rostral SMA and right rostral PMd during the finger sequence task was also observed in a separate group of nonmanifesting mutation carriers with a single heterozygous PINK1 mutation. Because mutation carriers were not impaired at performing the task, the additional recruitment of motor cortical areas indicates a compensatory mechanism that effectively counteracts the nigrostriatal dysfunction. These first results warrant further studies that use these imaging genomics approach to tap into preclinical compensation of PD. Extensions of this line of research involve fMRI paradigms probing nonmotor brain functions. Additionally, the same fMRI paradigms should be applied to nonmanifesting mutation carriers in genes linked to autosomal dominant PD. This will help to determine how "generically" the human brain compensates for a preclinical dopaminergic dysfunction.

Brain activation in adults who stutter under delayed auditory feedback: An fMRI study

It is well known that some people who stutter (PWS) show an immediate reduction of stuttering when they speak under a condition of delayed auditory feedback (DAF). In the present study, to investigate cortical activations during speech production through the DAF effect, we performed functional magnetic resonance imaging (fMRI) experiments under the NAF (non-altered feedback) and DAF conditions for PWS and people who do not stutter (PWNS). The results are that (1) the PWS showed the higher activation in the right inferior frontal gyrus (Brodmann Area (BA)45) than the PWNS under the NAF condition; (2) the activations of the right superior temporal gyrus and the right middle temporal gyrus were higher under the DAF condition than the NAF in both PWNS and PWS groups; (3) the PWNS showed the higher activation in the right supplementary motor area and superior temporal gyrus than the PWS under both NAF and DAF conditions; (4) the PWNS showed the higher activation in the inferior frontal gyrus(the right BA45 and the bilateral BA46) under the DAF condition than the NAF. These results reconfirm most of the previous findings with some slightly different activation areas, and underscore the involvement of inferior frontal gyrus and superior temporal gyrus in dysfluency.

Plasma Concentration of Prolactin, Testosterone Might Be Associated with Brain Response to Visual Erotic Stimuli in Healthy Heterosexual Males

ObjectiveMany studies have showed that excess or lack of sexual hormones, such as prolactin and testosterone, induced the sexual dysfunction in humans. Little, however, is known about the role of sexual hormones showing normal range in, especially, the basal state unexposed to any sexual stimulation. We hypothesized sexual hormones in the basal state may affect sexual behavior.MethodsWe investigated the association of the sexual hormones level in the basal hormonal state before visual sexual stimulation with the sexual response-related brain activity during the stimulation. Twelve heterosexual men were recorded the functional MRI signals of their brain activation elicited by passive viewing erotic (ERO), happy-faced (HA) couple, food and nature pictures. Both plasma prolacitn and testosterone concentrations were measured before functional MR scanning. A voxel wise regression analyses were performed to investigate the relationship between the concentration of sexual hormones in basal state and brain activity elicited by ERO minus HA, not food minus nature, contrast.ResultsThe plasma concentration of prolactin in basal state showed positive association with the activity of the brain involving cognitive component of sexual behavior including the left middle frontal gyrus, paracingulate/superior frontal/anterior cingulate gyri, bilateral parietal lobule, right angular, bilateral precuneus and right cerebellum. Testosterone in basal state was positively associated with the brain activity of the bilateral supplementary motor area which related with motivational component of sexual behavior.ConclusionOur results suggested sexual hormones in basal state may have their specific target regions or network associated with sexual response.

Gait capacity affects cortical activation patterns related to speed control in the elderly

Functional decline in locomotion is common among the elderly, and the prevalence of gait disorders increases with age. Recently, increasing interest has been focused on the influence of age-related decline in brain function and neurological disorders such as dementia and Alzheimer's disease on gait capacity. However, the neural mechanisms underlying gait control in the elderly remain poorly understood. We examined whether cortical activation patterns associated with the control of gait speed were related to the walking capacity in elderly subjects. Fifteen healthy elderly subjects participated in the study (mean +/- SD 63 +/- 4). Using functional near-infrared spectroscopy, we measured the changes in the cortical oxygenated hemoglobin (oxyHb) while the subjects walked on a treadmill at low, moderate, and high speeds corresponding to 30, 50, and 70% intensity of work load in each subject. We found a greater increase in oxyHb in the left prefrontal cortex (PFC) and the supplementary motor area (SMA) during walking at 70% intensity than at 50 or 30%. The degree of medial sensorimotor cortex (mSMC) and SMA activations was correlated with the locomotor speed and cadence. Heart rate response was only related with left PFC activation. Furthermore, at the highest speed, the change in the PFC activation was greater in subjects with low gait capacity than in those with high gait capacity. Our results indicate that the left PFC, SMA, and SMC control gait speed, and that the involvement of the left PFC might depend on an age-related decline in gait capacity in the elderly.

FMRI of Intrasubject Variability in ADHD: Anomalous Premotor Activity With Prefrontal Compensation

Objective Children with attention-deficit/hyperactivity disorder (ADHD) consistently display increased intrasubject variability (ISV) in response time across varying tasks, signifying inefficiency of response preparation compared to typically developing (TD) children. Children with ADHD also demonstrate impaired response inhibition; inhibitory deficits correlate with ISV, suggesting that similar brain circuits may underlie both processes. To better understand the neural mechanisms underlying increased ISV and inhibitory deficits in children with ADHD, functional magnetic resonance imaging was used to examine the neural correlates of ISV during Go/No-go task performance. Method Event-related functional magnetic resonance imaging was used to study 25 children with ADHD and 25 TD children ages 8 to 13 years performing a simplified Go/No-go task. Brain-behavior correlations were examined between functional magnetic resonance imaging activation and ISV within and between groups. Results For TD children, increased rostral supplementary motor area (pre-supplementary motor area) activation during No-go events was associated with less ISV, whereas the reverse was true for children with ADHD for whom increased pre-supplementary motor area activation was associated with more ISV. In contrast, children with ADHD with less ISV showed greater prefrontal activation, whereas TD children with more prefrontal activation demonstrated more ISV. Conclusions These findings add to evidence that dysfunction of premotor systems may contribute to increased variability and impaired response inhibition in children with ADHD and that compensatory strategies eliciting increased cognitive control may improve function. However, recruitment of prefrontal resources as a compensatory mechanism for motor task performance may preclude the use of those prefrontal resources for higher order, more novel executive functions with which children with ADHD often struggle.

FMRI analysis of active, passive and electrically stimulated ankle dorsiflexion

Ankle dorsiflexion (ADF) is an integral component in gait. The objective of this study was to define, using functional magnetic resonance imaging (fMRI) in healthy volunteers ( n = 12), the brain regions that are activated during Electrical Stimulation (ES)-induced ADF movements, and compare this to the pattern of activation occurring during active and passive ADF. Concurrent electromyography (EMG) was used to monitor the tibialis anterior muscle activity so as to allow EMG-guided fMRI analysis to be performed. Patterns of cortical and sub-cortical activation in response to active, passive and ES-induced ADF movement were identified. EMG-guided fMRI analysis was shown to improve detection and reduce inter-session variance for active and ES tasks. A significantly greater number of voxels were activated during active and ES-induced ADF compared to passive ADF in contralateral primary motor (M1), primary sensory (SI), and secondary somatosensory (SII) areas, as well as in supplementary motor area (SMA) and cingulate motor areas (CMA); bilateral dorsal and ventral premotor areas and cerebellum VI. The contrast of active greater than ES-induced ADF showed increased activation in SMA, contralateral PMdr; bilateral PMvr, dorsolateral prefrontal cortex and CMA; and ipsilateral cerebellum IV. Active ADF generated greater activation in brain areas responsible for motor planning, execution and visuomotor co-ordination. ES-induced activation was greater in bilateral SII and insula than for active ADF, hypothesised to result from increased sensory integration, but also possibly due to a nociceptive component to ES.

Infantile Autism: A Chronic Psychosis since Infancy due to Synaptic Pruning of the Supplementary Motor Area

The rise in Infantile Autism, learning problems, cognitive decline with age, Alzheimer's, Parkinson's Diseases and the SIDS epidemic, has a common cause in the rising dietary deficit in Omega-3 brain-food. This paper suggests that aside from the wider concept of Autism Spectrum Disorders (ASD) and Pervasive Developmental Disorders (PDD), the rise in Infantile Autism (IA) in the last decade is the effect of deficient brain-food (Omega-3). The consequent delay of development prolongs the 2nd regressive event in infancy to pruning of the centre in the Medial Frontal Lobe System that connects Hippocampus and Cingulum. With a consequently defective Supplementary Motor Area (SMA), the Delayed Response Function is affected leading to persistent psychosis. Post-Pubertal Episodic Psychoses are associated with acute reduction of excitation, a risk of breakdown of circuitry, insufficient fill-in mechanisms, and silent spots. An acute psychosis occurs if the silent spots comprise of SMA. Only two brain areas have continuous neurogenesis, indicating their important functions: the Hippocampus and Olfactory Bulb that belongs to the Lateral Frontal Lobe System essential to survival. Concerned with necessity of action in response to the environment, it relies upon short-term memory and Acute Feedback Mechanisms influenced by emotion and motivation from the external world. In contrast, the Medial Frontal Lobe network is controlled by Feed-Forward Predictive Mechanisms related to storage of information. The Delayed Response Function is mastered at 7 months, when 2nd event occurs with pruning of axons and dendrites. An abolished or defective Delayed Response Function seriously incapacitates an individual: A defective "Social Brain" with an inability for conscious action and to communicate, predominates in IA. There is a near lack of speech, despite normal vision and hearing in the minority without marked adversity in pregnancy, at delivery or in infancy. I propose that the recent rise in IA despite no rise in adversity signifies a rising deficiency in brain-food. That this is so is suggested by a changing clinical picture: no Mental Retardation in an IA majority. Deficit in Olfaction is pathognomonic in schizophrenia since 30 yrs and distinguishes the Asperger Syndrome. If brain-food deficiency alone sufficiently prolongs pruning to cause absent activity in SMA in infancy, less mentally retarded IA from other causes might be observed. Deficit in brain-food was evident in the Sudden Infant Death Syndrome: birthweight averaged 200-300 g lower than sibs, Omega-3 levels in brainstem were lower than controls. Only 20 % SIDS died in first hypoxic episode, suggesting such episodes are more frequent than we imagined. Children with learning-behaviour problems have similarly depressed birthweight. A general deficiency in Omega-3 contributes to the lacking reduction in Schizophrenia, despite early puberty predominates. Olfactory Bulb is first affected in the Alzheimer's and Parkinson's Disease. Cognitive decline with age, Hippocampal dysfunctions rise markedly irrespective of disease, but the major mental illnesses and Infantile Autism in particular, benefit from "brain-food" that might also prevent a development of these disorders. To secure optimal brain function in the coming generations, there is a need to change the diet now from its emphasis on protein for body growth to food for the brain. This means there is a need to increase fish and sea food consumption.

Error processing during online motor control depends on the response accuracy

We investigated which brain areas show error-related activity during online motor control while errors occur independently from decision making. During motor tasks, error is a deviation from accuracy or correctness. The effect of the accuracy level on error-related brain activity is unclear. Using functional Magnetic Resonance Imaging (fMRI), we investigated how error-related brain activity, especially in fronto-medial wall areas, depended on motor accuracy (MA). Subjects performed a force tracking task with the thumb–index grip: to continuously follow a moving target on a monitor with a cursor which position was controlled by the force amount produced by the fingers. Task difficulty varied with changes in the cursor size (the smaller the cursor, the more difficult the task). We measured the motor accuracy (mean distance between the cursor center and the target) and the error amount (cursor out of the target). Errors were produced when motor accuracy was low and also when motor accuracy was high. For fMRI data processing, we defined a model based on both the error amount and the motor accuracy. The results showed that supplementary motor area (SMA) and dorsal anterior cingulate cortex (ACC) activation increased with error and task difficulty independent of the accuracy of motor control. Interestingly, activity in the rostral part of left ACC only increased with error when the motor accuracy was low, independently from task difficulty. These results suggest a clear functional dissociation between dorsal and rostral ACC in error processing which depends on the amount of attentional resources allocated to motor accuracy.

Cerebral activation patterns related to initiation and inhibition of hand movement

Sequential ordering of purposeful movements includes distinct transitions between muscle contraction and relaxation. To explore cerebral activation patterns underlying such movement initiation and inhibition, we applied functional magnetic resonance imaging to test the effects of (1) ballistic movement (dominated by initiation), (2) movement with stepwise interruption (dominated by inhibition) and (3) smooth movements. Right-hand movements were performed by 21 healthy participants. In the basal ganglia, ballistic movements evoked putamen activation, indicating its specific contribution to initiation. Stepwise interrupted movement induced increased activation of the caudate nucleus, globus pallidus and subthalamic nucleus whereas, at the cortical level, supplementary motor area activation increased. This indicates a specific basal ganglia-thalamocortical circuit involved in motor inhibition.

Bereitschaftspotential as an indicator of movement preparation in supplementary motor area and motor cortex.

Topographical studies in humans of the Bereitschaftspotential (BP, or readiness potential, as averaged from the electroencephalogram) and the Bereitschaftsmagnetfeld (BM, or readiness magnetic field, as averaged from the magnetoencephalogram) revealed a widespread distribution of motor preparation over both hemispheres even before unilateral movement. This indicates the existence of several generators responsible for the BP, including generators in the ipsilateral hemisphere, which is in agreement with measurements of regional cerebral blood flow or regional cerebral energy metabolism. Nevertheless, two principal generators seem to prevail: (1) An early generator, starting its activity 1s or more before the motor act, with its maximum at the vertex. For this and other reasons, early BP generation probably stems from cortical tissue representing or including the supplementary motor area (SMA). (2) A later generator, starting its activity about 0.5s before the onset of movement and biased towards the contralateral hemisphere (contralateral preponderance of negativity, CPN). For unilateral finger movements the CPN succeeds the BP's initial bilateral symmetry in the later preparation period. Thus, this lateralized BP component probably stems from the primary motor area, MI (area 4, hand representation). While regional cerebral blood flow or regional cerebral energy metabolism show that the SMA is active in conjunction with motor acts, these data do not permit the conclusion that SMA activity precedes motor acts. This can only be shown by the Bereitschaftspotential, which proves that SMA activity occurs before the onset of movement and, what is more, before the onset of MI activity. This important order of events (first SMA, then MI activation) has been elucidated by our BP studies. It gives the SMA an important functional role: the initiation of voluntary movement. The recording of movement-related potentials associated with manual hand-tracking and motor learning points to the SMA and frontal cortex having an important role in these functions.

Combining Functional and Structural Brain Magnetic Resonance Imaging in Huntington Disease

To concurrently investigate with magnetic resonance (MR) the brain activation and regional brain atrophy in patients with Huntington disease (HD). Nine symptomatic HD patients and 11 healthy subjects underwent an MR study including functional MR acquisition during finger tapping of the right hand and high-resolution T1-weighted images. Functional and structural data were analyzed using Statistical Parametric Mapping 2 software. As compared with control subjects, HD patients showed decreased activation in the left caudate nucleus and medial frontal and anterior cingulate gyri and increased activation in the right supplementary motor area and supramarginal gyrus and left intraparietal sulcus. The pattern of atrophy included thinning of the gray matter (GM) in the insula, inferior frontal gyrus, caudate, lentiform nucleus, and thalamus, bilaterally, in the left middle frontal, middle occipital, and middle temporal gyri, and of periventricular, subinsular, right temporal lobe, and left internal capsule white matter. Only the decreased activation in the caudate nucleus correlated topographically with the caudate GM loss. The cortical areas of functional changes do not correspond to those of GM atrophy in patients with HD and are likely to reflect decreased output of the motor basal ganglia-thalamo-cortical circuit and compensatory recruitment of accessory motor pathways.

Characterizing anterior cingulate activation in chronic schizophrenia: a group and single‐subject fMRI study

Functional abnormalities of the dorsal anterior cingulate (dAC) region have been emphasized in schizophrenia, particularly in relation to cognitive deficits. In this study, we sought to further evaluate the notion of dAC hypofunction in chronic schizophrenia patients using a cognitive task specifically designed to activate this region, enabling both group and single-subject level analyses. Twelve male schizophrenia patients and 14 male healthy subjects were studied with functional magnetic resonance imaging (fMRI) and the multi-source interference task (MSIT). Patients and healthy subjects were matched for age, gender, education, task performance and gross surface morphology of the AC region. fMRI analyses were conducted at the group and single-subject levels using stringent whole-brain activation thresholds. Multi-source interference task performance was associated with large and significant activation of the dAC and supplementary motor area (SMA) in patients and healthy subjects. Standard comparison of the two groups indicated that the patients were comparable with healthy subjects in their dAC activation, but had a small cluster of greater SMA activation, while single-subject analyses identified minimal differences in the magnitude or spatial dispersion of dAC activation between the groups. These findings challenge existing notions of impaired dAC activation in chronic schizophrenia and suggest that the functional pathophysiology of this medial-wall region should be considered beyond straightforward models of hypoactivation.

Continuous information flow decreases the activity of continuous information flow decreases the activity of supplementary motor area (SMA) in coincident timing task

Continuous information flow decreases the activity of continuous information flow decreases the activity of supplementary motor area (SMA) in coincident timing task