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. 2024 Mar 14;47(1):114.
doi: 10.1007/s10143-024-02330-2.

Permanent deterioration of fine motor skills after the resection of tumors in the supplementary motor area

Stefanie Maurer #  1   2 , Vicki M Butenschoen #  1 , Anna Kelm  1 , Severin Schramm  3 , Axel Schröder  1 , Bernhard Meyer  1 , Sandro M Krieg  4   5
Affiliations

Permanent deterioration of fine motor skills after the resection of tumors in the supplementary motor area

Stefanie Maurer et al. Neurosurg Rev. .

Abstract

Supplementary motor area syndrome (SMAS) represents a common neurosurgical sequela. The incidence and time frame of its occurrence have yet to be characterized after surgery for brain tumors. We examined patients suffering from a brain tumor preoperatively, postoperatively, and during follow-up examinations after three months, including fine motor skills testing and transcranial magnetic stimulation (TMS). 13 patients suffering from a tumor in the dorsal part of the superior frontal gyrus underwent preoperative, early postoperative, and 3-month follow-up testing of fine motor skills using the Jebsen-Taylor Hand Function Test (JHFT) and the Nine-Hole Peg Test (NHPT) consisting of 8 subtests for both upper extremities. They completed TMS for cortical motor function mapping. Test completion times (TCTs) were recorded and compared. No patient suffered from neurological deficits before surgery. On postoperative day one, we detected motor deficits in two patients, which remained clinically stable at a 3-month follow-up. Except for page-turning, every subtest indicated a significant worsening of function, reflected by longer TCTs (p < 0.05) in the postoperative examinations for the contralateral upper extremity (contralateral to the tumor manifestation). At 3-month follow-up examinations for the contralateral upper extremity, each subtest indicated significant worsening compared to the preoperative status despite improvement to the immediate postoperative level. We also detected significantly longer TCTs (p < 0.05) postoperatively in the ipsilateral upper extremity. This study suggests a long-term worsening of fine motor skills even three months after SMA tumor resection, indicating the necessity of targeted physical therapy for these patients.

Keywords: Fine motor skills; Jebsen-Taylor Hand Function Test; Navigated transcranial magnetic stimulation; Nine-Hole Peg Test; Supplementary motor area.

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Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
Illustration of navigated Transcranial Magnetic Stimulation (nTMS) data within the neuronavigation. Grey: cortical areas with negative MEP answers, red: positive MEP answers displaying the functional motor cortex of this patient suffering from a tumor in the SMA
Fig. 2
Fig. 2
Test completion times before surgery, after surgery, and at follow-up examination for the contralateral and ipsilateral upper extremity
See this image and copyright information in PMC

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