Hadders-Algra Mijna
Department of Neurology-Developmental Neurology, University of Groningen, Groningen, The Netherlands.
Neural Plast. 2003;10(1-2):39-50. doi: 10.1155/NP.2003.39.
Children presenting with Developmental Coordination Disorder or clumsiness often exhibit signs of minor neurological dysfunction (MND). The data of the Groningen Perinatal Project, a long-term follow-up project on the relations between prenatal and perinatal adversities and neurological, behavioral, and cognitive development revealed that two basic forms of MND can be distinguished: simple and complex MND. During school age children with simple MND are characterized by the presence of one or two dysfunctional clusters of MND, in adolescence by the presence of choreiform dyskinesia or hypotonia. Probably the major sources of origin of simple MND are genetic constitution and stress during early life. Simple MND might reflect the lower tail of the normal distribution of the quality of non-pathological brain function. In line with this hypothesis is the finding that simple MND is associatedwith only a moderately increased risk for learning- and behavioral problems. Children with complex MND present at school age with at least three dysfunctional clusters of MND, in adolescence with problems in fine manipulation or coordination. Perinatal adversities play an evident etiological role in the development of complex MND, suggesting that it might be attributed to a lesion of the brain at early age. In line with this idea is the finding that complex MND shows a strong correlation with attention and learning problems.
患有发育性协调障碍或动作笨拙的儿童往往表现出轻微神经功能障碍（MND）的迹象。格罗宁根围产期项目是一项关于产前和围产期不良因素与神经、行为和认知发展之间关系的长期随访项目，其数据显示，MND可分为两种基本形式：单纯型和复合型MND。在学龄期，患有单纯型MND的儿童表现为存在一两个MND功能障碍集群，在青春期则表现为舞蹈样运动障碍或肌张力减退。单纯型MND的主要起源可能是遗传体质和早期生活中的压力。单纯型MND可能反映了非病理性脑功能质量正态分布的下限。与此假设一致的是，研究发现单纯型MND仅与学习和行为问题的风险适度增加有关。患有复合型MND的儿童在学龄期表现为至少三个MND功能障碍集群，在青春期则表现为精细操作或协调方面的问题。围产期不良因素在复合型MND的发展中起着明显的病因学作用，这表明它可能归因于早期大脑损伤。与此观点一致的是，研究发现复合型MND与注意力和学习问题密切相关。
