Neural substrate and clinical significance of general movements: an update

Area of Science:

• Neuroscience
• Developmental Biology
• Pediatrics

Background:

• General movements (GMs) are crucial for neurodevelopmental assessment from fetal life to 5 months corrected age.
• Atypical GMs, especially during the fidgety phase, are significant predictors of cerebral palsy (CP).
• Understanding the neural underpinnings of GMs is vital for early detection and intervention.

Purpose of the Study:

• To update knowledge on the neural substrate of typical and atypical general movements.
• To elucidate the clinical significance of general movements in predicting neurodevelopmental outcomes.
• To review the transition in cortical network activity during early development.

Main Methods:

• Literature review focusing on neuroimaging and clinical studies of general movements.
• Analysis of the developmental trajectory of general movements from fetal to early infancy.
• Correlation of general movement patterns with neural network integrity.

Main Results:

• Typical GMs exhibit complexity and variation, initially modulated by the cortical subplate and later by the cortical plate.
• Fidgety movements signify a shift towards fragmented cortical network activity (sparsification).
• Atypical GMs, characterized by reduced complexity and variation, indicate impaired cortical-subcortical networks.

Conclusions:

• The integrity of cortical-subcortical networks, including the subplate and white matter, is essential for typical general movements.
• Absent fidgety movements are associated with severe network impairment and are highly predictive of cerebral palsy.
• General movements provide valuable insights into early brain development and neurological status.