Impaired procedural learning after damage to the left supplementary motor area (SMA).

Two paradigms of procedural learning, serial reaction time and tracking tasks, were given to a patient with damage to the supplementary motor area (SMA) of the left mesiofrontal cortex. This patient exhibited impaired procedural learning during the serial reaction time test and mirror reversed tracking. Unreversed tracking performance was normal. Therefore the SMA--as well as the cerebellum and the striatum--participate in the development of skills requiring internal elaboration of motor behaviour.