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Reduced corticomotor excitability and motor skills development in children born preterm
Julia B Pitcher1, Luke A Schneider, Nicholas R Burns
1Research Centre for Early Origins of Health and Disease, Robinson Institute, School of Paediatrics & Reproductive Health, University of Adelaide, SA 5005, Australia. julia.pitcher@adelaide.edu.au
Insights
Preterm birth is linked to reduced motor cortex excitability, impacting motor skills like dexterity in children. This effect persists into childhood, highlighting the long-term neurological consequences of premature birth.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Motor Control
Background:
- Children born preterm often exhibit neurodevelopmental alterations without apparent brain lesions.
- These issues manifest as motor, cognitive, and behavioral dysfunction, impacting long-term educational and economic outcomes.
- The specific mechanisms of altered neurodevelopment in preterm infants remain unclear.
Purpose of the Study:
- To investigate corticomotor development in children born preterm without cerebral palsy.
- To determine the association between gestational age and corticomotor excitability.
- To explore the relationship between corticomotor function and motor skill development in this population.
Main Methods:
- Utilized transcranial magnetic stimulation (TMS) and functional assessments.
- Examined 151 children aged 10-13 years, born between 25-41 weeks of gestation.
- Assessed children without diagnosed cerebral palsy.
Main Results:
- Each week of reduced gestation correlated with decreased corticomotor excitability in late childhood.
- Reduced excitability was linked to poorer motor skill development, especially manual dexterity.
- Preterm birth was associated with reduced left hemisphere lateralization, independent of handedness.
Conclusions:
- Corticomotor development is altered in children born preterm, contributing to motor dysfunction.
- Factors like adiposity, sex, and early socioeconomic environment also significantly influence motor skill development.
- Findings suggest potential long-term impacts of preterm birth on motor function and neurodevelopment.
Abstract:
The mechanisms underlying the altered neurodevelopment commonly experienced by children born preterm, but without brain lesions, remain unknown. While individuals born the earliest are at most risk, late preterm children also experience significant motor, cognitive and behavioural dysfunction from school age, and reduced income and educational attainment in adulthood. We used transcranial magnetic stimulation and functional assessments to examine corticomotor development in 151 children without cerebral palsy, aged 10-13 years and born after gestations of 25-41 completed weeks. We hypothesized that motor cortex and corticospinal development are altered in preterm children, which underpins at least some of their motor dysfunction. We report for the first time that every week of reduced gestation is associated with a reduction in corticomotor excitability that remains evident in late childhood. This reduced excitability was associated with poorer motor skill development, particularly manual dexterity. However, child adiposity, sex and socio-economic factors regarding the child's home environment soon after birth were also powerful influences on development of motor skills. Preterm birth was also associated with reduced left hemisphere lateralization, but without increasing the likelihood of being left handed per se. These corticomotor findings have implications for normal motor development, but also raise questions regarding possible longer term consequences of preterm birth on motor function.
