{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T05:35:41Z","timestamp":1789623341489,"version":"build-2803163510"},"reference-count":27,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2013,7]]},"abstract":"\nObject<\/jats:title>\nSupplementary motor area (SMA) resection often induces postoperative contralateral hemiparesis or speech disturbance. This study was performed to assess the neurological impairments that often follow SMA resection and to assess the risk factors associated with these postoperative deficits.<\/jats:p><\/jats:sec>\n\nMethods<\/jats:title>\nThe records for patients who had undergone SMA resection for pharmacologically intractable epilepsy between 1994 and 2010 were gleaned from an epilepsy surgery database and retrospectively reviewed in this study.<\/jats:p><\/jats:sec>\n\nResults<\/jats:title>\nForty-three patients with pharmacologically intractable epilepsy underwent SMA resection with intraoperative cortical stimulation and mapping while under awake anesthesia. The mean patient age was 31.7 years (range 15\u201363 years), and the mean duration and frequency of seizures were 10.4 years (range 0.1\u201330 years) and 14.6 per month (range 0.1\u2013150 per month), respectively. Pathological examination of the brain revealed cortical dysplasia in 18 patients (41.9%), tumors in 16 patients (37.2%), and other lesions in 9 patients (20.9%). The mean duration of the follow-up period was 84.0 months (range 24\u2013169 months). After SMA resection, 23 patients (53.5%) experienced neurological deficits. Three patients (7.0%) experienced permanent deficits, and 20 (46.5%) experienced symptoms that were transient. All permanent deficits involved contralateral weakness, whereas the transient symptoms patients experienced were varied, including contralateral weaknesses in 15, apraxia in 1, sensory disturbances in 1, and dysphasia in 6. Thirteen patients recovered completely within 1 month. Univariate analysis revealed that resection of the SMA proper, a shorter lifetime seizure history (< 10 years), and resection of the cingulate gyrus in addition to the SMA were associated with the development of neurological deficits (p = 0.078, 0.069, and 0.023, respectively). Cingulate gyrus resection was the only risk factor identified on multivariate analysis (p = 0.027, OR 6.530, 95% CI 1.234\u201334.562).<\/jats:p><\/jats:sec>\n\nConclusions<\/jats:title>\nResection of the cingulate gyrus in addition to the SMA was significantly associated with the development of postoperative neurological impairment.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2013.3.jns121492","type":"journal-article","created":{"date-parts":[[2013,5,3]],"date-time":"2013-05-03T14:25:31Z","timestamp":1367591131000},"page":"7-14","source":"Crossref","is-referenced-by-count":49,"title":["Risk factor analysis of the development of new neurological deficits following supplementary motor area resection"],"prefix":"10.3171","volume":"119","author":[{"given":"Young-Hoon","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Seoul National University College of Medicine;"},{"name":"Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi Heon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Seoul National University College of Medicine;"},{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"June Sic","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Seoul National University College of Medicine;"},{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang Kun","family":"Lee","sequence":"additional","affiliation":[{"name":"Neurology, Seoul National University Hospital, Seoul; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung Ho","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Seoul National University College of Medicine;"},{"name":"Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chae-Yong","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Seoul National University College of Medicine;"},{"name":"Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun Kee","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Seoul National University College of Medicine;"},{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns121492","series-title":"Br J Neurosurg","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1080\/026886900408379","article-title":"Post operative supplementary motor area syndrome: clinical features and outcome","volume":"14","author":"Bannur","year":"2000"},{"key":"b2-jns121492","series-title":"Adv Neurol","first-page":"217","article-title":"Surgical ablations of the mesial frontal lobe in humans","volume":"70","author":"Bleasel","year":"1996"},{"key":"b3-jns121492","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"593","DOI":"10.3171\/JNS\/2008\/109\/10\/0593","article-title":"Somatosensory, motor, and reaching\/grasping responses to direct electrical stimulation of the human cingulate motor areas","volume":"109","author":"Chassagnon","year":"2008"},{"key":"b4-jns121492","series-title":"Stereotact Funct Neurosurg","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1159\/000056496","article-title":"Delayed onset of the supplementary motor area syndrome after surgical resection of the mesial frontal lobe: a time course study using intraoperative mapping in an awake patient","volume":"76","author":"Duffau","year":"2001"},{"key":"b5-jns121492","series-title":"Neurosurgery","first-page":"297","article-title":"Somatotopy of the supplementary motor area: evidence from correlation of the extent of surgical resection with the clinical patterns of deficit","volume":"50","author":"Fontaine","year":"2002"},{"key":"b6-jns121492","series-title":"Turk Neurosurg","first-page":"306","article-title":"Surgical treatment of supplementary motor area lesions","volume":"19","author":"Hatipo\u011flu","year":"2009"},{"key":"b7-jns121492","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1152","DOI":"10.1227\/NEU.0b013e31823f6001","article-title":"Characterization of the supplementary motor area syndrome and seizure outcome after medial frontal lobe resections in pediatric epilepsy surgery","volume":"70","author":"Kasasbeh","year":"2012"},{"key":"b8-jns121492","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"1739","DOI":"10.1007\/s00701-011-1074-6","article-title":"Resection frequency map after awake resective surgery for non-lesional neocortical epilepsy involving eloquent areas","volume":"153","author":"Kim","year":"2011"},{"key":"b9-jns121492","series-title":"Neurology","doi-asserted-by":"publisher","first-page":"1323","DOI":"10.1212\/01.WNL.0000120547.83482.B1","article-title":"Role of the healthy hemisphere in recovery after resection of the supplementary motor area","volume":"62","author":"Krainik","year":"2004"},{"key":"b10-jns121492","series-title":"Neurology","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1212\/01.WNL.0000048206.07837.59","article-title":"Postoperative speech disorder after medial frontal surgery: role of the supplementary motor area","volume":"60","author":"Krainik","year":"2003"},{"key":"b11-jns121492","series-title":"J Neurol Sci","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1016\/0022-510X(77)90148-4","article-title":"Clinical consequences of corticectomies involving the supplementary motor area in man","volume":"34","author":"Laplane","year":"1977"},{"key":"b12-jns121492","series-title":"Electroencephalogr Clin Neurophysiol","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1016\/0013-4694(94)90068-X","article-title":"Functional anatomy of the human supplementary sensorimotor area: results of extraoperative electrical stimulation","volume":"91","author":"Lim","year":"1994"},{"key":"b13-jns121492","series-title":"J Comp Neurol","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1002\/cne.903220403","article-title":"Cingulate input to the primary and supplementary motor cortices in the rhesus monkey: evidence for somatotopy in areas 24c and 23c","volume":"322","author":"Morecraft","year":"1992"},{"key":"b14-jns121492","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1108","DOI":"10.3171\/jns.2002.97.5.1108","article-title":"Preoperative mapping of the supplementary motor area in patients harboring tumors in the medial frontal lobe","volume":"97","author":"Nelson","year":"2002"},{"key":"b15-jns121492","series-title":"The Human Nervous System","author":"Paxinos","year":"2004"},{"key":"b16-jns121492","series-title":"AMA Arch Neurol Psychiatry","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1001\/archneurpsyc.1951.02320090038004","article-title":"The supplementary motor area of the cerebral cortex; a clinical and experimental study","volume":"66","author":"Penfield","year":"1951"},{"key":"b17-jns121492","series-title":"Neurosurgery","first-page":"966","article-title":"Surgical resection of grade II astrocytomas in the superior frontal gyrus","volume":"50","author":"Peraud","year":"2002"},{"key":"b18-jns121492","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1152","DOI":"10.3171\/2010.6.JNS1090","article-title":"Prediction of neurological deficits and recovery after surgery in the supplementary motor area: a prospective study in 26 patients. Clinical article","volume":"113","author":"Rosenberg","year":"2010"},{"key":"b19-jns121492","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"62","DOI":"10.3171\/jns.1991.75.1.0062","article-title":"Postoperative deficits and functional recovery following removal of tumors involving the dominant hemisphere supplementary motor area","volume":"75","author":"Rostomily","year":"1991"},{"key":"b20-jns121492","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1227\/01.NEU.0000047670.56996.53","article-title":"Incidence and clinical evolution of postoperative deficits after volumetric stereotactic resection of glial neoplasms involving the supplementary motor area","volume":"52","author":"Russell","year":"2003"},{"key":"b21-jns121492","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"640","DOI":"10.3171\/2010.9.JNS10709","article-title":"Assessment of morbidity following resection of cingulate gyrus gliomas. Clinical article","volume":"114","author":"Tate","year":"2011"},{"key":"b22-jns121492","series-title":"Nat Neurosci","doi-asserted-by":"publisher","first-page":"920","DOI":"10.1038\/13224","article-title":"Response selection in the human anterior cingulate cortex","volume":"2","author":"Turken","year":"1999"},{"key":"b23-jns121492","series-title":"Turk Neurosurg","first-page":"286","article-title":"Surgical treatment of lesions involving the supplementary motor area: clinical results of 12 patients","volume":"18","author":"Ulu","year":"2008"},{"key":"b24-jns121492","series-title":"Nat Rev Neurosci","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1038\/nrn1704","article-title":"Pain and emotion interactions in subregions of the cingulate gyrus","volume":"6","author":"Vogt","year":"2005"},{"key":"b25-jns121492","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"900","DOI":"10.1227\/NEU.0b013e318237aaa3","article-title":"Epilepsy surgery of the cingulate gyrus and the frontomesial cortex","volume":"70","author":"von Lehe","year":"2012"},{"key":"b26-jns121492","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"542","DOI":"10.3171\/jns.1996.85.4.0542","article-title":"Functional results after resective procedures involving the supplementary motor area","volume":"85","author":"Zentner","year":"1996"},{"key":"b27-jns121492","series-title":"J Anat","first-page":"515","article-title":"Mapping of human and macaque sensorimotor areas by integrating architectonic, transmitter receptor, MRI and PET data","volume":"187","author":"Zilles","year":"1995"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/119\/1\/article-p7.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/119\/1\/article-p7.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/119\/1\/article-p7.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,14]],"date-time":"2022-08-14T17:19:26Z","timestamp":1660497566000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/119\/1\/article-p7.xml"}},"subtitle":["Clinical article"],"short-title":[],"issued":{"date-parts":[[2013,7]]},"references-count":27,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.3171\/2013.3.jns121492","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,7]]}}}