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JMD > Epub ahead of print
   [Epub ahead of print]
The Supplementary Motor Complex in Parkinson’s Disease
Shervin Rahimpour1 , Shashank Rajkumar2 , Mark Hallett3
1Department of Neurosurgery, Clinical Neuroscience Center, University of Utah, Salt Lake City, UT, USA
2Department of Neurosurgery, Duke University Hospital, Durham, NC, USA
3Human Motor Control Section, Medical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
Corresponding Author: Shervin Rahimpour ,Tel: +1-8015816908, Email: shervin.rahimpour@utah.edu
Received: June 3, 2021;   Revised: August 23, 2021;   Accepted: September 14, 2021.
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ABSTRACT
Parkinson’s disease (PD) is a neurodegenerative disorder characterized by both motor and nonmotor symptoms. Although the basal ganglia is traditionally the primary brain region implicated in this disease process, this limited view ignores the roles of the cortex and cerebellum that are networked with the basal ganglia to support motor and cognitive functions. In particular, recent research has highlighted dysfunction in the supplementary motor complex (SMC) in patients with PD. Using the PubMed and Google Scholar search engines, we identified research articles using keywords pertaining to the involvement of the SMC in action sequencing impairments, temporal processing disturbances, and gait impairment in patients with PD. A review of abstracts and full-text articles was used to identify relevant articles. In this review of 63 articles, we focus on the role of the SMC in PD, highlighting anatomical and functional data to create new perspectives in understanding clinical symptoms and, potentially, new therapeutic targets. The SMC has a nuanced role in the pathophysiology of PD, with both hypo- and hyperactivation associated with various symptoms. Further studies using more standardized patient populations and functional tasks are needed to more clearly elucidate the role of this region in the pathophysiology and treatment of PD.
Key Words: Gait impairment; Parkinson’s disease; Sequence effect; Supplementary motor area; Supplementary motor complex; Temporal processing
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