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Presupplementary Motor Area Activation during Sequence Learning Reflects Visuo-Motor Association

F. Frank LeFever flefever at ix.netcom.com
Sun Aug 1 23:24:46 EST 1999

In <933430839.761743 at server.australia.net.au> "John"
<johnhkm at netsprintXXXX.net.au> writes: 
>"The pre-SMA activation remained unchanged during learning of
>associations but decreased during learning of sequences, suggesting
that the
>pre-SMA is related to visuo-motor association rather than sequence"
Haven't read it, but I'll offer the following:

DECREASING activation has in some other contexts been related to
competing the learning of a task, I believe.

A patient of mine had some visual-associative prooblems which I
suggested might be due to problems with posterior circultation (I had
become much interested in transient vertebrobasilar insufficiency as
well as infarcts in various distal reaches of their distribution, after
myu first experience with a locked-in patient).  She also had enormous
difficulties with a sequencing task (actually an altrenating sequence
borrowed from Luria).

The attending (a neurologist) was scathing--"Vertebrobasilar lesions
are SO overdiagnosed!!"  However, after he, a visiting neurologist, and
one or two neurology residents couldn't decide whether they had
elicited a Babinski reflex, they ordered a CT, looking for enlarged
ventricles--i.e., normopressure hydrocephaly--to explain her "dementia"
(which I knew from my neuropsychological testing she definitely did NOT

  CT showed bilateral infarcts in (1) visual cortex or nearby
(verifying my suspicion about posterior circulation), and (2)
dorso-medial frontal cortex (i.e. SMA).

This lovely and definitely non-demented elderly lady was not dismayed
to learn she had a non-treatable condition, but was grateful to learn
that she did not have possibly hereditary dementing disorder to pass on
to her grandchildren...

F. Frank LeFever, Ph.D.
New York Neuropsychology Group

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