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Motor profile and cognitive functioning in children with spina bifida
Anja Vinck1, Maria W G Nijhuis-van der Sanden, Nel J A Roeleveld
1Department of Medical Psychology, Radboud University Nijmegen Medical Centre, The Netherlands. a.vinck@cukz.umcn.nl
Insights
Children with spina bifida often have cognitive and motor impairments. However, these issues are not directly linked after accounting for intellectual ability, highlighting the need for personalized care.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Pediatric Neurology
Background:
- Spina bifida is a complex birth defect from incomplete neural tube closure.
- Neurodevelopmental outcomes, including motor and cognitive functions, vary significantly and are difficult to predict.
- Cerebral malformations are associated with spina bifida and impact neurodevelopment.
Purpose of the Study:
- To examine the relationship between cognitive function, fine motor skills, and motor quality in children with spina bifida myelomeningocele (SBM) and SB-only.
- To investigate the influence of cerebral malformations on these relationships.
- To differentiate outcomes between SBM and SB-only groups.
Main Methods:
- A cohort of 41 children (ages 6-14) with spina bifida underwent comprehensive cognitive and motor assessments.
- Evaluations included cognitive functioning, fine motor skills, visual-motor integration, and overall motor quality.
- Data were analyzed for the entire group and for non-retarded children (FSIQ ≥ 70) to isolate effects.
Main Results:
- Children with spina bifida exhibited higher rates of cognitive, fine motor, and motor quality impairments.
- After excluding children with intellectual disability, no direct association was found between cognitive functioning and motor profiles.
- Specific differences were observed between SBM and SB-only groups in performance IQ, visual-motor functioning, and motor quality, but not fine motor skills.
Conclusions:
- Cerebral malformations play a significant role in the neuropsychological outcomes of spina bifida.
- The complex interplay of developmental factors necessitates individualized management strategies for children with spina bifida.
- Further research is needed to understand the specific mechanisms linking cerebral malformations to neurodevelopmental deficits.
Background:
Spina bifida is a complex neuroembryological disorder resulting from incomplete closure of the posterior neural tube. Morbidity in the different fields of motor and cognitive neurodevelopment is variable in nature and severity, and often hard to predict.
Aims:
The current study investigates the relationship between cognitive functioning, fine motor performance and motor quality in children with spina bifida myelomeningocele (SBM) and SB-only, taking into consideration the cerebral malformations.
Material And Methods:
Forty-one children were included (22 girls and 19 boys aged between 6 and 14 years, mean age 10;0 years) in the study. A comprehensive assessment was conducted of cognitive functioning and motor profile, including fine motor and visual-motor functioning, and motor quality. The performance outcomes were analyzed for the total group of children and separately for the nonretarded children (FSIQ> or =70, N=30) to eliminate the influence of global intellectual impairment.
Results:
Although the children with spina bifida showed increased incidence of cognitive and fine motor impairment, and impaired motor quality, after exclusion of the overall retarded children no associations were found between cognitive functioning and motor profile. In the comparison of SBM to SB-only specific differences were found for performance IQ, visual-motor functioning and motor quality, but not fine motor functioning.
Conclusion:
Our findings underscore the role of cerebral malformation in spina bifida and its consequences for neuropsychological functioning. The complicated developmental interactions found strengthen the need for an individualized management of children with SB.
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