Resting State Functional Connectivity of the Supplementary Motor Area to Motor and Language Networks in Patients with Brain Tumors

BACKGROUND AND PURPOSE: We examined the resting-state functional connectivity (RSFC) of the supplementary motor area (SMA) in brain tumor patients. We compared the SMA subdivisions (pre-SMA, SMA proper, central SMA) in terms of RSFC projected from each region to the motor gyrus and language areas. METHODS: We retrospectively identified 14 brain tumor patients who underwent task-based and resting-state fMRI, and who completed motor and language paradigms that activated the SMA proper and pre-SMA, respectively. Regions of interest (ROIs) obtained from task-based fMRI were generated in both areas and the central SMA to produce RSFC maps. Degree of RSFC was measured from each subdivision to the motor gyrus and Broca's area (BA). RESULTS: All patients showed RSFC between the pre-SMA and language centers and between the SMA proper and motor gyrus. Thirteen of 14 patients showed RSFC from the central SMA to both motor and language areas. There was no significant difference between subdivisions in degree of RSFC to BA (pre-SMA, r = .801; central SMA, r = .803; SMA proper; r = .760). The pre-SMA showed significantly less RSFC to the motor gyrus (r = .732) compared to the central SMA (r = .842) and SMA proper (r = .883) (P = .016, P = .001, respectively). CONCLUSIONS: The region between the pre-SMA and SMA proper produces reliable RSFC to the motor gyrus and language areas in brain tumor patients. This study is the first to examine RSFC of the central SMA in this population. Consequently, our results provide further validation to previous studies, supporting the existence of a central SMA with connectivity to both motor and language networks.