Centre de recherche du CHUL-Centre hospitalier universitaire de Québec, Axe Neurosciences, QC, Canada.
Clin Neurophysiol. 2012 Jun;123(6):1191-9. doi: 10.1016/j.clinph.2011.09.017. Epub 2011 Oct 20.
Our study aimed to test in 8 years old children born very prematurely whether a faulty primary motor cortex (M1) functioning could parallel visuomotor coordination difficulties.
Ten very preterm children (PT; gestational age ≤32 weeks; 6 boys; 8 years 6 months, SD 4 months) were compared to seven healthy term peers (4 boys; 8 years 4 months, SD 4 months). Clinical assessment comprised two standardized tests for motor skills and visuomotor coordination. Transcranial magnetic stimulation (TMS) was applied over M1 area of the preactivated first dorsal interosseous muscle to measure the corticomotor excitability and the short intracortical inhibition (SICI).
PT scores were significantly lower on the Developmental Test of Visual-Motor Integration (p=0.0018) and on the Movement Assessment Battery for Children (p=0.038). In parallel, the dominant hemisphere worked differently with no SICI in PT (p=0.009) and more variability of corticomotor excitability (p=0.001).
These intertwined neurophysiological findings suggest that a faulty motor programming in the dominant M1 of PT could explain visuomotor coordination deficits.
Our study contributes to the understanding of possible mechanisms that underlie motor difficulties commonly observed in children who were born premature. In addition, the effectiveness of rehabilitation interventions may be better understood by applying TMS as an outcome measure in the future.
本研究旨在检测 8 岁极早产儿的初级运动皮层(M1)功能是否存在缺陷,以探讨其与视动协调困难之间的关系。
本研究纳入 10 名极早产儿(PT;胎龄≤32 周;6 名男性;8 岁 6 个月,标准差 4 个月),并将其与 7 名健康足月同龄人(PT;4 名男性;8 岁 4 个月,标准差 4 个月)进行比较。临床评估包括两项运动技能和视动协调的标准化测试。经颅磁刺激(TMS)应用于预先激活的第一背侧骨间肌的 M1 区,以测量皮质运动兴奋性和短程皮质内抑制(SICI)。
PT 在视觉运动整合发育测试(p=0.0018)和儿童运动评估测试(p=0.038)中的得分明显较低。同时,PT 的优势半球的工作方式不同,无 SICI(p=0.009),皮质运动兴奋性的变异性更大(p=0.001)。
这些神经生理学发现表明,PT 优势 M1 中的运动编程缺陷可能解释了视动协调困难的原因。
本研究有助于理解早产儿常见运动困难的潜在机制。此外,将来通过应用 TMS 作为结局指标,可能会更好地理解康复干预的效果。