{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T04:35:18Z","timestamp":1792211718435,"version":"4.4.0"},"reference-count":43,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2021,3,5]],"date-time":"2021-03-05T00:00:00Z","timestamp":1614902400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Connectomics is the use of big data to map the brain\u2019s neural infrastructure; employing such technology to improve surgical planning may improve neuro-oncological outcomes. Supplementary motor area (SMA) syndrome is a well-known complication of medial frontal lobe surgery. The \u2018localizationist\u2019 view posits that damage to the posteromedial bank of the superior frontal gyrus (SFG) is the basis of SMA syndrome. However, surgical experience within the frontal lobe suggests that this is not entirely true. In a study on n = 45 patients undergoing frontal lobe glioma surgery, we sought to determine if a \u2018connectomic\u2019 or network-based approach can decrease the likelihood of SMA syndrome. The control group (n = 23) underwent surgery avoiding the posterior bank of the SFG while the treatment group (n = 22) underwent mapping of the SMA network and Frontal Aslant Tract (FAT) using network analysis and DTI tractography. Patient outcomes were assessed post operatively and in subsequent follow-ups. Fewer patients (8.3%) in the treatment group experienced transient SMA syndrome compared to the control group (47%) (p = 0.003). There was no statistically significant difference found between the occurrence of permanent SMA syndrome between control and treatment groups. We demonstrate how utilizing tractography and a network-based approach decreases the likelihood of transient SMA syndrome during medial frontal glioma surgery. We found that not transecting the FAT and the SMA system improved outcomes which may be important for functional outcomes and patient quality of life.<\/jats:p>","DOI":"10.3390\/cancers13051116","type":"journal-article","created":{"date-parts":[[2021,3,5]],"date-time":"2021-03-05T11:46:09Z","timestamp":1614944769000},"page":"1116","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":51,"title":["The Frontal Aslant Tract and Supplementary Motor Area Syndrome: Moving towards a Connectomic Initiation Axis"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9329-4471","authenticated-orcid":false,"given":"Robert G.","family":"Briggs","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6302-4793","authenticated-orcid":false,"given":"Parker G.","family":"Allan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anujan","family":"Poologaindran","sequence":"additional","affiliation":[{"name":"Brain Mapping Unit, Department of Psychiatry, University of Cambridge, Cambridge CB2 1TN, UK"},{"name":"Doctoral Program, The Alan Turing Institute, British Library, London NW1 2DB, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8657-187X","authenticated-orcid":false,"given":"Nicholas B.","family":"Dadario","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Prince of Wales Private Hospital, Sydney 2031, Australia"},{"name":"Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7639-6679","authenticated-orcid":false,"given":"Isabella M.","family":"Young","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Prince of Wales Private Hospital, Sydney 2031, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed A.","family":"Ahsan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Prince of Wales Private Hospital, Sydney 2031, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Teo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Prince of Wales Private Hospital, Sydney 2031, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael E.","family":"Sughrue","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Prince of Wales Private Hospital, Sydney 2031, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,3,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1016\/j.neuchi.2016.08.003","article-title":"Functional and Oncological Outcomes Following Awake Surgical Resection Using Intraoperative Cortico-Subcortical Functional Mapping for Supratentorial Gliomas Located in Eloquent Areas","volume":"63","author":"Pallud","year":"2017","journal-title":"Neurochirurgie"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Grafman, J. 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