Loss of fine motor function correlates with ataxia and decline of cognition in cerebellar tumor survivors.
BACKGROUND
Motor and cognitive function losses resemble handicaps in pediatric posterior fossa tumor survivors. Several factors determine type and extent of impairment. We quantified loss of fine motor function and its association with ataxia and intelligence in patients with and without adjuvant treatment.


METHODS
Fine motor function, extent of ataxia and cognitive function were assessed in 25 medulloblastoma (MB) and 16 cerebellar pilocytic astrocytoma (PA) patients at least 1 year after completion of therapy. Kinematic parameters (speed, automation, variability, and pressure) of different movement complexity levels were investigated employing a digitizing graphic tablet. Degree of ataxia was quantified using the International Cooperative Ataxia Rating Scale and cognition was determined using the Wechsler Intelligence Scale.


RESULTS
Kinematic parameters of low and high complexity tasks as well as ataxia of MB patients were strongly impaired. Fine motor impairment was weaker in PA patients, but still evident in the complex task of writing. Ataxia was significantly more pronounced in medulloblastoma patients. Young age and short recovery time correlated significantly with impaired kinematic parameters. Ataxia was strongly associated with inferior fine motor function. Cognition, especially performance IQ, was associated with dysfunctional kinematic parameters.


CONCLUSIONS
The digitizing tablet detected extent of fine motor function loss at varying levels of complexity of pediatric cerebellar tumor survivors. This tool promises to be a potentially effective method for measuring fine motor function in clinical trials and may be helpful in studying mechanisms of neurotoxicity in posterior fossa tumor patients as well as success of rehabilitation.
Rueckriegel
Stefan Mark
SM
Pediatric Neurooncology Program, Department of Pediatric Oncology and Hematology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Blankenburg
Friederike
F
Henze
Günter
G
Baqué
Herrmann
H
Driever
Pablo Hernáiz
PH
D000293:Adolescent; D000367:Age Factors; D001254:Astrocytoma / Q000523:psychology*; D001259:Ataxia / Q000523:psychology*; D001696:Biomechanical Phenomena; D002528:Cerebellar Neoplasms / Q000523:psychology*; D002648:Child; D003071:Cognition; D005260:Female; D006801:Humans; D007360:Intelligence; D008297:Male; D008527:Medulloblastoma / Q000523:psychology*; D009043:Motor Activity; D012307:Risk Factors