Aberrant prefrontal cortical-striatal functional connectivity in children with primary complex motor stereotypies
Farhan Augustine1, Mary B Nebel2, Stewart H Mostofsky3
1Department of Neurology, Johns Hopkins University School of Medicine, USA; Department of Biological Sciences, University of Maryland Baltimore County, USA.
Insights
Children with primary complex motor stereotypies (CMS) show reduced frontal-striatal brain connectivity. This finding suggests a potential neurological basis for these movements in typically developing children.
Area of Science:
- Neuroscience
- Developmental Psychology
- Pediatrics
Background:
- Motor stereotypies are repetitive movements, previously associated mainly with neurodevelopmental disorders.
- Complex motor stereotypies (CMS) are increasingly recognized in typically developing children.
- The pathophysiology underlying primary CMS in neurodevelopmental disorder-free children remains unclear.
Purpose of the Study:
- To investigate the functional brain connectivity in children with primary complex motor stereotypies.
- To examine the role of frontal-striatal circuits in the pathophysiology of primary CMS.
- To differentiate connectivity patterns related to goal-directed versus habitual behaviors in primary CMS.
Main Methods:
- Resting-state functional magnetic resonance imaging (rs-fMRI) was employed.
- Functional connectivity was assessed within frontal-striatal circuits.
- Participants included children with primary complex motor stereotypies and typically developing controls.
Main Results:
- Reduced functional connectivity was observed between prefrontal cortical and striatal regions in children with primary CMS.
- Connectivity between motor/premotor and striatal regions did not differ between groups.
- These findings implicate altered prefrontal-striatal pathways in the manifestation of primary CMS.
Conclusions:
- Reduced prefrontal-striatal functional connectivity may underlie primary complex motor stereotypies in typically developing children.
- This specific neural alteration offers a potential mechanism for persistent, purposeless movements.
- Further research into these neural circuits could inform understanding and management of primary CMS.
Abstract:
Motor stereotypies are rhythmic, repetitive, prolonged, predictable, and purposeless movements that stop with distraction. Although once believed to occur only in children with neurodevelopmental disorders such as autism, the presence and persistence of complex motor stereotypies (CMS) in otherwise typically developing children (primary CMS) has been well-established. Little, however, is known about the underlying pathophysiology of these unwanted actions. The aim of the present study was to use resting-state functional magnetic resonance imaging to evaluate functional connectivity within frontal-striatal circuits that are essential for goal-directed and habitual activity in children with primary complex motor stereotypies. Functional connectivity between prefrontal cortical and striatal regions, considered essential for developing goal-directed behaviors, was reduced in children with primary CMS compared to their typically developing peers. In contrast, functional connectivity between motor/premotor and striatal regions, critical for developing and regulating habitual behaviors, did not differ between groups. This documented alteration of prefrontal to striatal connectivity could provide the underlying mechanism for the presence and persistence of complex motor stereotypies in otherwise developmentally normal children.
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