The role of the human supplementary motor area in reactive motor operation.

The role of the supplementary motor area (SMA) in reactive motor operation was investigated with functional magnetic resonance imaging in 13 normal subjects. A visual cue was presented at a regular (1 Hz) or irregular (mean, 1 Hz) rate, and the subject pressed a button with the right index finger in a predictive or reactive manner. Brain regions associated with reactive movement were detected by comparing reactive with predictive movement tasks, and those with irregular movement by comparing irregular and regular cueing tasks. During regular cueing, the SMA showed greater activation for reactive than predictive movement. However, the SMA was equally activated between regular and irregular cueing once the subject reacted to the cue. The SMA is likely involved in reactive adjustment of movement to the external cue.