Loss of fine motor function correlates with ataxia and decline of cognition in cerebellar tumor survivors

Abstract

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.

Monitoring and Assessment of Neuropsychological Outcomes as a Standard of Care in Pediatric Oncology

“…Key domains of neuropsychological assessment that were supported by the pediatric cancer literature included the following: intelligence, attention, memory, language, executive functions (including inhibitory control, cognitive flexibility, working memory),[] neurosensory functioning, perceptual processing, and processing speed …”

Cerebral white matter fractional anisotropy and tract volume as measured by MR imaging are associated with impaired cognitive and motor function in pediatric posterior fossa tumor survivors

“…Fine‐motor function was assessed by instructing the patients to perform drawing and handwriting tasks on a digitizing graphic tablet using the software CSWin (Verlag MedCom, Munich, Germany) for analysis. The kinematic parameter automation of handwriting of the dominant hand (writing the German sentence “Der Ball rollt ins Tor”) was used for further analysis, because this was the most complex task of the task battery, and was shown to be impaired in both patient groups . Movements were segmented into vertical strokes.…”

“…Local injury due to the tumor and its resection is confined to structures of the posterior fossa. However, such injury was shown to be associated with specific sequelae such as ataxia as a symptom of loss of motor function . In addition, following Schmahman's concept of “dysmetria of thoughts,” damage to the cerebellum that orchestrates cognitive functions via frontocerebellar neuronal loops is often associated with deterioration of frontal lobe functions such as cognition and behavior .…”

Clinical characteristics, long-term complications and health-related quality of life (HRQoL) in children and young adults treated for low-grade astrocytoma in the posterior fossa in childhood

“…Studies using functional MRI have shown that the cerebellum coordinates executive functions and working memory in neural networks. Injuries may affect executive function, spatial cognition, personality and language [ 9 ] as well as fine-motor skills, most obvious in complex activities [ 10 ]. Children treated for tumours in the posterior fossa also perform worse in tests of gross-motor functions, especially when performing balance tasks [ 11 ].…”

“…A cerebellar cognitive affective syndrome has been described, characterised by deficits in executive function, spatial cognition, linguistic processing and affect regulation [ 12 ]. Difficulties are reported for all children treated for tumours in the posterior fossa, but more pronounced in children treated with both surgery and radiation [ 10 ].…”