Surgery ·
Study finds few motor deficits attributable to isolated SMA resection
A single-center retrospective study reviewed 80 patients who underwent dorsomedial frontal cortex resections for tumors or epilepsy from 2004 to 2025. New postoperative motor deficits occurred in 33.8%, but the authors attributed only 10.0% of cases to resections confined to the supplementary motor area (SMA); most new deficits resolved within weeks.
- New motor deficits occurred in 27 of 80 patients.
- SMA-specific deficits were reported in 8 of 80.
- Most new deficits resolved by a median of 13 days.
- Five patients had permanent deficits.
Researchers retrospectively reviewed records for 80 patients who underwent dorsomedial frontal cortex resections for tumors or epilepsy at one institution between 2004 and 2025. They assessed postoperative motor function and complications, with follow-up through 12 weeks. The analysis aimed to distinguish deficits associated with SMA resection from those involving adjacent eloquent regions.
New motor deficits occurred in 27 patients (33.8%). After excluding cases with concomitant primary motor cortex or cingulate gyrus involvement, the reported incidence of SMA-specific deficits was 10.0% (8/80). Of the 27 new deficits, 22 (81.5%) resolved by a median of 13 days, including 14 (51.9%) that recovered very rapidly. Five patients (6.3%) had permanent deficits. Motor strip involvement and postoperative complications were associated with new deficits; permanent deficits were more often associated with preoperative weakness and major postoperative complications.
This single-center retrospective study suggests that deficits after dorsomedial frontal resections may often reflect involvement of adjacent regions rather than isolated SMA removal. The findings may inform surgical risk discussions, but do not establish that mapping or other techniques caused safer outcomes: the study found no association between mapping use and new deficits, and its observational design limits causal conclusions.
In practice
For patients undergoing dorsomedial frontal resections for tumors or epilepsy, this single-center retrospective series suggests that postoperative motor deficits are not always attributable to isolated SMA resection: the reported SMA-specific incidence was 10%, while many deficits occurred with involvement of adjacent regions. Most new deficits resolved within a median of 13 days, but 6.3% of the cohort had permanent deficits. These estimates may inform counseling, but the study does not establish causation or show that mapping improves outcomes.
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Journal of Neurosurgery: The myth of the supplementary motor area syndrome: the etiology of motor deficits after dorsomedial frontal resections ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.