Liu Huaigui, Cai Wangli, Xu Lixue, Li Wei, Qin Wen
Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China.
Department of Radiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
Front Hum Neurosci. 2020 Feb 28;13:468. doi: 10.3389/fnhum.2019.00468. eCollection 2019.
: The human supplementary motor area (SMA) contains two functional subregions of the SMA proper and preSMA; however, the reorganization patterns of the two SMA subregions after stroke remain uncertain. Meanwhile, a focal subcortical lesion may affect the overall functional reorganization of brain networks. We sought to identify the differential reorganization of the SMA subregions after subcortical stroke using the resting-state functional connectivity (rsFC) analysis. : Resting-state functional MRI was conducted in 25 patients with chronic capsular stroke exhibiting well-recovered global motor function (Fugl-Meyer score >90). The SMA proper and preSMA were identified by the rsFC-based parcellation, and the rsFCs of each SMA subregion were compared between stroke patients and healthy controls. : Despite common rsFC with the fronto-insular cortex (FIC), the SMA proper and preSMA were mainly correlated with the sensorimotor areas and cognitive-related regions, respectively. In stroke patients, the SMA proper and preSMA exhibited completely different functional reorganization patterns: the former showed increased rsFCs with the primary sensorimotor area and caudal cingulate motor area (CMA) of the motor execution network, whereas the latter showed increased rsFC with the rostral CMA of the motor control network. Both of the two SMA subregions showed decreased rsFC with the FIC in stroke patients; the preSMA additionally showed decreased rsFC with the prefrontal cortex (PFC). : Although both SMA subregions exhibit functional disconnection with the cognitive-related areas, the SMA proper is implicated in the functional reorganization within the motor execution network, whereas the preSMA is involved in the functional reorganization within the motor control network in stroke patients.
人类辅助运动区（SMA）包含两个功能亚区，即SMA本部和前SMA；然而，中风后这两个SMA亚区的重组模式仍不确定。同时，局灶性皮质下病变可能会影响脑网络的整体功能重组。我们试图通过静息态功能连接（rsFC）分析来确定皮质下中风后SMA亚区的差异重组情况。
对25例慢性囊状中风且整体运动功能恢复良好（Fugl-Meyer评分>90）的患者进行了静息态功能磁共振成像检查。通过基于rsFC的脑区划分来确定SMA本部和前SMA，并比较中风患者和健康对照者每个SMA亚区的rsFC。
尽管SMA本部和前SMA与额岛叶皮质（FIC）有共同的rsFC，但SMA本部和前SMA分别主要与感觉运动区和认知相关区域相关。在中风患者中，SMA本部和前SMA表现出完全不同的功能重组模式：前者与运动执行网络的初级感觉运动区和尾侧扣带回运动区（CMA）的rsFC增加，而后者与运动控制网络的嘴侧CMA的rsFC增加。中风患者中两个SMA亚区与FIC的rsFC均降低；前SMA与前额叶皮质（PFC）的rsFC也降低。
尽管两个SMA亚区均与认知相关区域存在功能断开，但在中风患者中，SMA本部参与运动执行网络内的功能重组，而前SMA参与运动控制网络内的功能重组。
