Article
Testing fine motor skills pre- and postoperatively in patients suffering from tumours in the supplementary motor area
Testung der feinmotorischen Fähigkeiten prä- und postoperativ bei Patienten mit Tumoren in supplementär-motorischen Arealen
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Published: | June 4, 2021 |
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Objective: Supplementary motor area (SMA) syndrome is a common neurosurgical sequela, however the incidence and time frame of its occurrence have not yet been characterized in a structured manner. This study therefore examines targeted fine motor skills of these patients preoperatively, postoperatively and after 3 months.
Methods: 13 patients (median age: 46.6 years, 62% males) suffering from a tumor (glioblastoma/astrozytoma/oligodendroglioma/metastasis) in the dorsal part of the superior frontal gyrus (10 right, 3 left) underwent preoperative, early postoperative and 3-month follow-up testing of the fine motor skills using the Jebsen-Taylor Hand Function Test (JHFT) consisting of 8 modalities for both upper extremities. Test completion times (TCTs) were recorded and compared between time points and sides.
Results: Preoperatively no patient suffered from impairment of motor strength. Postoperatively we detected paresis in 2 patients (BMRC 2/5) which remained clinically stable at 3-month follow-up. Except for page turning, every test from the JHFT showed highly statistically significant worsening and longer TCTs (p < 0.05) in the postoperative and 3-month follow-up examinations for the contralateral upper extremity. Excluding page turning, simulated feeding and the nine-hole peg test, we also detected highly statistically significant longer TCTs (p < 0.05) in the ipsilateral upper extremity. At 3 months following surgery an improvement of just writing (83.3% of all patients), page turning (50%) and simulated feeding (58.3%) could be detected in the contralateral upper extremity compared to postoperative state. In terms of the ipsilateral upper extremity only the writing function recovered after 3 months (53.8%). The other fine motor skills did not improve.
Conclusion: This study suggests persistent worsening of fine motor skills even 3 months after resection of tumors of the SMA region which indicates the necessity of targeted physical therapy for these patients.