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Brain motor excitability and visuomotor coordination in 8-year-old children born very preterm
Véronique H Flamand1, Line Nadeau, Cyril Schneider
1Centre de recherche du CHUL-Centre hospitalier universitaire de Québec, Axe Neurosciences, QC, Canada. veronique.flamand.1@ulaval.ca
Insights
Very preterm children often have visuomotor coordination difficulties due to faulty primary motor cortex (M1) functioning. This study used transcranial magnetic stimulation (TMS) to reveal differences in M1 excitability and inhibition in these children.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Motor Control
Background:
- Children born very prematurely (gestational age ≤32 weeks) frequently exhibit motor skill deficits.
- Visuomotor coordination difficulties are common in this population, but underlying neural mechanisms remain unclear.
Purpose of the Study:
- To investigate the relationship between primary motor cortex (M1) functioning and visuomotor coordination in 8-year-old very preterm children.
- To compare neurophysiological measures between very preterm children and healthy term-born peers.
Main Methods:
- Ten very preterm children and seven term-born controls (all 8 years old) underwent clinical assessments for motor skills and visuomotor integration.
- Transcranial magnetic stimulation (TMS) was used to measure corticomotor excitability and short intracortical inhibition (SICI) over the M1 in the dominant hemisphere.
Main Results:
- Very preterm children scored significantly lower on visuomotor integration and motor skills assessments.
- These children showed altered M1 functioning, characterized by absent SICI and increased variability in corticomotor excitability compared to controls.
Conclusions:
- Faulty motor programming within the dominant M1 may underlie the observed visuomotor coordination deficits in very preterm children.
- Findings highlight potential neurophysiological mechanisms for motor difficulties in premature infants and suggest TMS as a future outcome measure for rehabilitation interventions.
Objective:
Our study aimed to test in 8 years old children born very prematurely whether a faulty primary motor cortex (M1) functioning could parallel visuomotor coordination difficulties.
Methods:
Ten very preterm children (PT; gestational age ≤32 weeks; 6 boys; 8 years 6 months, SD 4 months) were compared to seven healthy term peers (4 boys; 8 years 4 months, SD 4 months). Clinical assessment comprised two standardized tests for motor skills and visuomotor coordination. Transcranial magnetic stimulation (TMS) was applied over M1 area of the preactivated first dorsal interosseous muscle to measure the corticomotor excitability and the short intracortical inhibition (SICI).
Results:
PT scores were significantly lower on the Developmental Test of Visual-Motor Integration (p=0.0018) and on the Movement Assessment Battery for Children (p=0.038). In parallel, the dominant hemisphere worked differently with no SICI in PT (p=0.009) and more variability of corticomotor excitability (p=0.001).
Conclusions:
These intertwined neurophysiological findings suggest that a faulty motor programming in the dominant M1 of PT could explain visuomotor coordination deficits.
Significance:
Our study contributes to the understanding of possible mechanisms that underlie motor difficulties commonly observed in children who were born premature. In addition, the effectiveness of rehabilitation interventions may be better understood by applying TMS as an outcome measure in the future.
