Severity of Clinical Symptoms of Supplementary Motor Area Syndrome Correlates with the Extent of Tumor Resection in the Brain.

Abstract

A unified view on recovery from supplementary motor area syndrome after glioma resection is lacking. This study retrospectively examined the relationship between motor function, higher brain function, the ability to perform activities of daily living, and social reintegration and the extent of tumor resection in patients who underwent resection of tumors near the supplementary motor area. We assigned 24 consecutive patients into 3 groups according to the depth of tumor resection: resection involving (A) only the supplementary motor area (5 patients); (B) the supplementary motor area and cingulate gyrus (11 patients); and (C) the supplementary motor area, cingulate gyrus, and corpus callosum (8 patients). Motor paralysis, language function, and the ability to perform activities of daily living were evaluated perioperatively and 2 months postoperatively, whereas successful social reintegration was examined retrospectively. In group C, 62% of patients developed severe paralysis after surgery, with slow recovery and delayed ambulation (p = 0.0869). Patients with tumors in the left hemisphere, specifically those extending to the cingulate gyrus and corpus callosum, showed decreased scores for postoperative word recall; however, recovery was observed after 2 months. The Functional Instrumental Measure score, which indicates the activity of daily living ability, showed the largest difference preoperatively and postoperatively in group C. The World Health Organization tumor grade (p = 0.0445) and extent of tumor resection (p = 0.0011) were inversely correlated with social reintegration 6 months postoperatively. Overall, the findings suggest that early social reintegration is influenced by the World Health Organization tumor grade (2021 World Health Organization classification) and the extent of tumor resection.