Dissociation of supplementary motor area and primary motor cortex in human subjects when comparing index and little finger movements with functional magnetic resonance imaging.

This study provides the first investigation of supplementary motor area (SMA) and primary motor cortex (MI) activation with similar movements differing only in subjective difficulty of motor control. Brain activation with simple tapping of the right index finger (well trained during daily life and easy to perform) was compared with tapping of the little finger (less trained and difficult to perform) using functional magnetic resonance imaging at 3 Tesla. Due to optimised movement standardisation, extrinsic influences on activation levels such as movement complexity, amplitude and frequency were minimised. Fifth finger tapping significantly increased the number of activated SMA voxels by 450% whereas MI activation showed no significant difference between fingers. We conclude that with similar movements the degree of subjective difficulty specifically modifies SMA but not MI activation.