Advancing understanding of developmental coordination disorder in children: data from the literature

Developmental Coordination Disorder (DCD) should be considered as a multifaceted neurodevelopmental disorder characterized by extensive cerebral structural, functional, and connectivity patterns. DCD is commonly associated with other developmental conditions, including attention deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), learning disabilities (LD), speech-language delays and emotional and behavioral problems. This comprehensive review, using PRISMA method, analyzes in 72 studies the relation between neurophysiological and neurobiological principles of pediatric DCD (from 0 to 18 years), through several functional findings including EEG, functional neuroimaging (fNIRS and fMRI), eye-tracking, and gait analysis. We report data related to DCD associated with other neurodevelopmental comorbidities (as well as ADHD and ASD) in order to verify if there is some differences in the brain areas involved. There were excluded all the case reports, reviews, analyzing adult subjects or non-written in English. The results showed that in children with DCD structural, functional, and connectivity abnormalities in multiple brain areas can be found, compared with healthy individuals, showing atypical activation in the frontal lobes, parietal lobes, cerebellum, and basal ganglia during cognitive and sensorimotor processing. The most brain areas involved were the DLPFC, the right inferior frontal gyrus (IFG), the posterior cerebellum, the supplementary motor area (SMA). Furthermore, these studies highlight that comorbidity with ADHD and ASD are associated with a more severe neurobiological signature, even in a heterogeneous mode. Our findings proposed a holistic presentation of the DCD as a condition in which the cerebral network pattern of functioning might result in a complex functional phenotype. All these consequences can impact on the cognitive and attentional domains, and consecutively on the child's mental health at risk of internalizing disorders and social disengagement. Therefore, implementing multimodal strategies enabling the integration of neuroimaging, neuropsychological data, and clinical observation, could improve the early detection of biomarkers and the development of ad hoc and individualized therapeutic approach, optimizing long-term endpoints.