Supplementary Motor Complex and Disturbed Motor Control - a Retrospective Clinical and Lesion Analysis of XXXX after Anterior Cerebral Artery Stroke.

@entity1 @entity2194 @entity66 @entity33159 @entity425 @entity6128 @entity71052 @entity4940 @entity11280 @entity36120 @entity717
BACKGROUND: Both the @entity4940 ( @entity4940 ), consisting of the supplementary motor area ( @entity11280 ) proper, the pre- @entity11280 , and the @entity2194 cortex are supplied by the anterior cerebral artery (ACA) and are involved in higher motor control. The Bereitschaftspotential (BP) originates from the @entity4940 and reflects cognitive preparation processes before volitional movements. @entity6128 may lead to impaired motor control in the absence of limb @entity425 and evoke an @entity71052 ( @entity71052 ) in its extreme form. AIM: To characterize the clinical spectrum of disturbed motor control after @entity6128 , including signs attributable to @entity71052 and to identify the underlying neuroanatomical correlates. METHODS: A clinical assessment focusing on signs of disturbed motor control including intermanual conflict (i.e., bilateral hand movements directed at opposite purposes), lack of self-initiated movements, exaggerated grasping, motor perseverations, @entity33159 , and @entity36120 was performed. Symptoms were grouped into (A) @entity71052 -specific and (B) non- @entity71052 -specific signs of upper limbs, and (C) @entity36120 . Lesion summation mapping was applied to the @entity1 ' MRI or CT scans to reveal associated lesion patterns. The BP was recorded in two @entity1 . RESULTS: Ten @entity1 with @entity6128 (nine unilateral, one bilateral; mean age: 74.2   years; median NIH-SS at admission: 13.0) were included in this case series. In the acute stage, all cases had marked difficulties to perform volitional hand movements, while movements in response to external stimuli were preserved. In the chronic stage (median follow-up: 83.5   days) initiation of @entity717 improved, although all @entity1 showed persistent signs of disturbed motor control. Impaired motor control is predominantly associated with damaged voxels within the @entity4940 and the anterior and medial cingulate cortex, while lesions within the pre- @entity11280 are specifically related to @entity71052 . No BP was detected over the damaged hemisphere. CONCLUSION: @entity6128 involving the premotor cortices, particularly the pre- @entity11280 , are associated with @entity71052 -specific signs. In the acute phase, motor behavior is characterized by the inability to carry out self-initiated movements. Motor control deficits may persist to a variable degree beyond the acute phase. Alterations of the BP point to an underlying @entity66 in @entity71052 .
