Neuroimaging and neurophysiological changes following structured interventions in children with developmental...

Longitudinal neuroimaging and neurophysiological studies can indicate whether structured interventions in developmental coordination disorder (DCD) are accompanied by neurobiological change, but this literature has not been synthesized across modalities, follow-up intervals, and analytic approaches.

To map longitudinal neurobiological outcomes after structured interventions in children and adolescents with DCD or probable DCD and the analytic approaches used, including neurobiological-clinical/functional linkage analyses.

We conducted a scoping review following JBI methodology, reported in accordance with PRISMA-ScR and PRISMA-S. Eligible sources included participants aged 0-18 years with confirmed or probable DCD, a structured intervention, and neurobiological assessment at baseline and ≥1 post-intervention time point. Two reviewers independently screened records and charted data. We searched six databases, two trial registries, and preprint platforms on January 10, 2026 (updated August 21, 2026), without date or language restrictions. Formal critical appraisal was not undertaken; methodological and reporting features were charted descriptively.

Of 747 records identified, 13 sources (eight independent cohorts) published between 2012 and 2025 met the inclusion criteria. Neurobiological sample sizes ranged from 20 to 88 (median 49). Designs included randomized controlled, non-randomized controlled, and quasi-experimental pre-post studies. Interventions clustered into Cognitive Orientation to daily Occupational Performance (CO-OP; 6 sources), exercise/motor-learning programs (4), and neuromuscular/biomechanical approaches (3). Modalities included diffusion tensor imaging, resting-state functional MRI, structural MRI/voxel-based morphometry, functional near-infrared spectroscopy, electroencephalography/event-related potentials, and surface electromyography. MRI-based longitudinal outcomes were reported exclusively in CO-OP cohorts, with several publications arising from shared registered trials and partial cohort overlap. Six sources included neurobiological follow-up beyond the immediate post-intervention assessment. Analytic approaches varied in pre-post versus group-by-time contrasts, region-of-interest versus whole-brain analyses, and correction for multiple comparisons. Seven sources reported neurobiological-clinical/functional linkage analyses; five tested change-based associations, and statistically significant findings were limited to individualized movement-quality outcomes.

The evidence base is small, heterogeneous, and unevenly distributed across intervention categories and modalities. Priorities include independent replication, longitudinal neuroimaging of non-CO-OP interventions where scientifically justified, more consistent follow-up, and prespecified, adequately powered linkage analyses.