Anomalous Putamen Volume in Children With Complex Motor Stereotypies
E Mark Mahone1, Deana Crocetti2, Laura Tochen3
1Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, Maryland; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Insights
Children with primary complex motor stereotypies show reduced putamen volume. This suggests the habitual pathway, involving the putamen, may underlie these repetitive movements.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Behavioral Neurology
Background:
- Complex motor stereotypies (CMS) are repetitive, purposeless movements seen in typically developing children and those with secondary conditions.
- These movements are hypothesized to involve premotor to posterior putamen circuits, suggesting a habitual behavior basis.
- Understanding the neurobiology of primary CMS is crucial for identifying underlying abnormalities.
Purpose of the Study:
- To investigate the neurobiologic basis of primary complex motor stereotypies (CMS) in children.
- To utilize structural neuroimaging to examine brain regions implicated in habitual behaviors.
- To clarify the underlying neuroanatomic abnormality in children with primary CMS.
Main Methods:
- High-resolution 3.0 Tesla anatomic magnetic resonance imaging (MRI) was used.
- The study included 20 children with primary CMS and 20 typically developing controls, aged 8-12 years.
- Delineation and volumetric analysis of frontal lobe subregions and striatal structures were performed.
Main Results:
- Children with primary CMS exhibited significantly reduced total putamen volume compared to controls (P=0.045).
- No significant differences were found in caudate, nucleus accumbens, or frontal subregion volumes between groups.
- Total cerebral volume did not differ between the stereotypies group and the control group.
Conclusions:
- Reduced putamen volume in children with primary CMS provides preliminary evidence for the involvement of the habitual pathway.
- These findings suggest the putamen, a key component of the habitual pathway, may be the underlying anatomic site for primary CMS.
- Further research is warranted to fully elucidate the neurobiological mechanisms of primary CMS.
Background:
Complex motor stereotypies in children are repetitive rhythmic movements that have a predictable pattern and location, seem purposeful, but serve no obvious function, tend to be prolonged, and stop with distraction, e.g., arm or hand flapping, waving. They occur in both "primary" (otherwise typically developing) and secondary conditions. These movements are best defined as habitual behaviors and therefore pathophysiologically hypothesized to reside in premotor to posterior putamen circuits. This study sought to clarify the underlying neurobiologic abnormality in children with primary complex motor stereotypies using structural neuroimaging, emphasizing brain regions hypothesized to underlie these atypical behaviors.
Methods:
High-resolution anatomic magnetic resonance images, acquired at 3.0 T, were analyzed in children aged eight to twelve years (20 with primary complex motor stereotypies and 20 typically developing). Frontal lobe subregions and striatal structures were delineated for analysis.
Results:
Significant reductions (P = 0.045) in the stereotypies group were identified in total putamen volume but not in caudate, nucleus accumbens, or frontal subregions. There were no group differences in total cerebral volume.
Conclusions:
Findings of a smaller putamen provide preliminary evidence suggesting the potential involvement of the habitual pathway as the underlying anatomic site in primary complex motor stereotypies.
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