Identification of multiple nonprimary motor cortical areas with simple movements.

The human cortex reportedly contains at least five nonprimary motor areas: in the frontolateral convexity, the dorsal and ventral premotor cortex (PMd and PMv), and in the frontomesial wall, the presupplementary and supplementary motor areas (pre-SMA and SMA), and the rostral, dorsal and ventral cingulate areas (CMAr, CMAd, and CMAv). Activation of these regions in neuroimaging studies has been generally associated either with the performance of complex motor tasks or with reorganization occurring with motor recovery in the presence of pathology. Recent evidence from neuroimaging studies suggests that the same areas are activated with well controlled simple movements in healthy subjects providing support to the observation that their contribution may be more quantitative rather than exclusively specific to a certain aspect of motor behaviour. An important consequence of this observation is that activation of multiple nonprimary motor areas during simple motor tasks should not be considered unique to patients with upper or lower motoneuron lesions but rather as a normal physiological process.