Mahone E Mark, Crocetti Deana, Tochen Laura, Kline Tina, Mostofsky Stewart H, Singer Harvey S
Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, Maryland; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, Maryland.
Pediatr Neurol. 2016 Dec;65:59-63. doi: 10.1016/j.pediatrneurol.2016.08.023. Epub 2016 Sep 8.
Complex motor stereotypies in children are repetitive rhythmic movements that have a predictable pattern and location, seem purposeful, but serve no obvious function, tend to be prolonged, and stop with distraction, e.g., arm or hand flapping, waving. They occur in both "primary" (otherwise typically developing) and secondary conditions. These movements are best defined as habitual behaviors and therefore pathophysiologically hypothesized to reside in premotor to posterior putamen circuits. This study sought to clarify the underlying neurobiologic abnormality in children with primary complex motor stereotypies using structural neuroimaging, emphasizing brain regions hypothesized to underlie these atypical behaviors.
High-resolution anatomic magnetic resonance images, acquired at 3.0 T, were analyzed in children aged eight to twelve years (20 with primary complex motor stereotypies and 20 typically developing). Frontal lobe subregions and striatal structures were delineated for analysis.
Significant reductions (P = 0.045) in the stereotypies group were identified in total putamen volume but not in caudate, nucleus accumbens, or frontal subregions. There were no group differences in total cerebral volume.
Findings of a smaller putamen provide preliminary evidence suggesting the potential involvement of the habitual pathway as the underlying anatomic site in primary complex motor stereotypies.
儿童复杂运动刻板行为是重复性的节律性运动，具有可预测的模式和位置，看似有目的，但无明显功能，往往持续时间较长，且会因分心而停止，例如手臂或手部拍打、挥舞。它们在“原发性”（其他方面发育正常）和继发性情况下均会出现。这些运动最好被定义为习惯性行为，因此在病理生理学上推测其存在于运动前区至壳核后部回路中。本研究旨在通过结构神经影像学来阐明原发性复杂运动刻板行为儿童潜在的神经生物学异常，重点关注据推测是这些非典型行为基础的脑区。
对8至12岁儿童（20例原发性复杂运动刻板行为儿童和20例发育正常儿童）在3.0T条件下采集的高分辨率解剖磁共振图像进行分析。勾勒出额叶亚区和纹状体结构以进行分析。
刻板行为组的壳核总体积显著减少（P = 0.045），但尾状核、伏隔核或额叶亚区无此现象。两组的全脑体积无差异。
壳核较小的研究结果提供了初步证据，表明习惯性通路可能作为原发性复杂运动刻板行为的潜在解剖部位参与其中。
