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Reduced corticomotor excitability and motor skills development in children born preterm
Author(s) -
Pitcher Julia B.,
Schneider Luke A.,
Burns Nicholas R.,
Drysdale John L.,
Higgins Ryan D.,
Ridding Michael C.,
Nettelbeck Theodore J.,
Haslam Ross R.,
Robinson Jeffrey S.
Publication year - 2012
Publication title -
the journal of physiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.802
H-Index - 240
eISSN - 1469-7793
pISSN - 0022-3751
DOI - 10.1113/jphysiol.2012.239269
Subject(s) - transcranial magnetic stimulation , psychology , cerebral palsy , motor skill , gestational age , physical medicine and rehabilitation , gestation , neuroscience , medicine , stimulation , pregnancy , biology , genetics
Key points• Children born preterm commonly experience motor and cognitive difficulties, but the physiology underlying this dysfunction is unknown. • We used transcranial magnetic stimulation techniques and age‐appropriate assessments of motor skills development to investigate neurodevelopment in 151 children born between 25 and 41 weeks of gestation. • Reduced gestational age at birth was associated with a reduction in corticomotor excitability that persisted in late childhood, poorer development of manual dexterity skills and reduced hemispheric lateralization of hand preference. • We suggest this reduced corticomotor excitability at least partly reflects reduced white matter integrity and functional connectivity in the brain regions subserving movement control. • These findings show that preterm birth, which is increasingly common, impacts neuromotor development and related physiology into adolescence. Whether this altered neurophysiology and motor function persists in adulthood is unknown.Abstract The mechanisms underlying the altered neurodevelopment commonly experienced by children born preterm, but without brain lesions, remain unknown. While individuals born the earliest are at most risk, late preterm children also experience significant motor, cognitive and behavioural dysfunction from school age, and reduced income and educational attainment in adulthood. We used transcranial magnetic stimulation and functional assessments to examine corticomotor development in 151 children without cerebral palsy, aged 10–13 years and born after gestations of 25–41 completed weeks. We hypothesized that motor cortex and corticospinal development are altered in preterm children, which underpins at least some of their motor dysfunction. We report for the first time that every week of reduced gestation is associated with a reduction in corticomotor excitability that remains evident in late childhood. This reduced excitability was associated with poorer motor skill development, particularly manual dexterity. However, child adiposity, sex and socio‐economic factors regarding the child's home environment soon after birth were also powerful influences on development of motor skills. Preterm birth was also associated with reduced left hemisphere lateralization, but without increasing the likelihood of being left handed per se . These corticomotor findings have implications for normal motor development, but also raise questions regarding possible longer term consequences of preterm birth on motor function.