Differences in White Matter Microstructure Among Children With Developmental Coordination Disorder
Differences in White Matter Microstructure Among Children With Developmental Coordination Disorder
复制标题
DOI：
10.1001/jamanetworkopen.2020.1184
复制
发表时间：
2020-03-18
影响因子：
13.8
通讯作者：
Zwicker, Jill G.
中科院分区：
文献类型：
--
作者：
Brown-Lum, Meisan;Izadi-Najafabadi, Sara;Zwicker, Jill G.
发育性协调障碍（DCD）是一种运动障碍，严重干扰日常生活活动。关于DCD的原因及其发展方式知之甚少，因此很难理解为什么患有DCD的儿童在学习运动技能时会遇到困难，并难以确定优化功能的最佳干预措施。目的应用扩散张量成像技术研究先天性发育性心脏病（DCD）患儿和正常儿童的白色物质差异。设计、设置和参与者这项横断面研究收集了2014年9月至2017年1月在加拿大不列颠哥伦比亚省温哥华的BC儿童医院研究所进行的扩散张量成像数据。使用方便的样本，患有DCD和没有DCD的8至12岁儿童进行磁共振成像。数据分析于二零一七年一月至二零二零年一月进行。主要结果和测量主要结果测量是扩散参数，包括分数各向异性和平均、轴向和径向扩散率，其被认为提供了白色物质微观结构的间接测量。基于区域的空间统计，扩散参数的体素统计分析，使用2组比较设计矩阵进行，年龄和注意力作为协变量。结果30名无DCD的儿童（平均[SD]年龄，9.9 [1.4]岁; 21名[70%]男孩）和31名患有DCD的儿童（平均[SD]年龄，10.1 [1.2]岁; 26名[84%]男孩）被纳入研究。与非DCD儿童相比，DCD儿童的特征是与运动和感觉运动处理相关的白色通路区域（包括皮质脊髓束）的各向异性分数和轴向扩散率显著降低（各向异性分数：平均值[SD]，0.54 [0.03] vs 0.51 [0.03]; P <0.001;轴向扩散率：平均值[SD]，0.13 [0.98] vs 0.12 [0.46]; P = .01），内囊豆状核后部分的丘脑后辐射（轴向扩散率：平均值[SD]，0.14 [0.57] vs 0.14 [0.44]; P = .01），小脑通路（例如，上级小脑脚，各向异性分数：平均值[SD]，0.49 [0.05] vs 0.46 [0.03]; P = 0.03;轴向扩散率：平均值[SD]，0.14 [0.66] vs 0.14 [0.63]; P = .009）。有和没有DCD的儿童之间的平均扩散率和径向扩散率没有显着差异。结论和相关性这些研究结果表明，儿童与DCD显示显着的大脑运动和感觉运动白色物质的途径相比，儿童没有DCD的差异。扩散参数的儿童与DCD的模式表明，轴突发育可能会被打乱，在这个neurodevelopmental disorder.Question什么白色物质的微结构差异与儿童发育协调障碍（DCD）与儿童相比，没有DCD？结果：在这项横断面研究中，31名儿童与DCD和30名儿童没有DCD，广泛的差异，指数的白色物质的微观结构，包括分数各向异性和轴向扩散，观察儿童与DCD相比，儿童没有DCD。这些发现表明，DCD并不简单地代表低端的典型的运动技能能力，这些孩子显示改变大脑发育的感觉运动pathways.This横断面研究使用扩散张量成像检查微结构差异白色物质与儿童之间没有发展协调障碍。
Importance Developmental coordination disorder (DCD) is a motor impairment that significantly interferes with activities of daily living. Little is known about the cause of DCD and how it develops, making it difficult to understand why children with DCD struggle in learning motor skills and to determine the best intervention to optimize function. Objective To characterize white matter differences using diffusion tensor imaging in children with and without DCD. Design, Setting, and Participants This cross-sectional study collected diffusion tensor imaging data at BC Children's Hospital Research Institute in Vancouver, British Columbia, Canada, from September 2014 to January 2017. Using a sample of convenience, children with DCD and children without DCD aged 8 to 12 years underwent magnetic resonance imaging. Data analysis was conducted from January 2017 to January 2020. Main Outcomes and Measures The main outcome measures were diffusion parameters, including fractional anisotropy and mean, axial, and radial diffusivity, which are thought to provide an indirect measure of white matter microstructure. Tract-based spatial statistics, a voxelwise statistical analysis of diffusion parameters, were conducted using a 2-group comparison design matrix with age and attention as covariates. Results Thirty children without DCD (mean [SD] age, 9.9 [1.4] years; 21 [70%] boys) and 31 children with DCD (mean [SD] age, 10.1 [1.2] years; 26 [84%] boys) were included in the study. Compared with children without DCD, children with DCD were characterized by significantly lower fractional anisotropy and axial diffusivity in regions of white matter pathways associated with motor and sensorimotor processing, including the corticospinal tract (fractional anisotropy: mean [SD], 0.54 [0.03] vs 0.51 [0.03]; P < .001; axial diffusivity: mean [SD], 0.13 [0.98] vs 0.12 [0.46]; P = .01), posterior thalamic radiation at the retrolenticular part of the internal capsule (axial diffusivity: mean [SD], 0.14 [0.57] vs 0.14 [0.44]; P = .01), and cerebellar pathways (eg, superior cerebellar peduncle, fractional anisotropy: mean [SD], 0.49 [0.05] vs 0.46 [0.03]; P = .03; axial diffusivity: mean [SD], 0.14 [0.66] vs 0.14 [0.63]; P = .009). There were no significant differences in mean diffusivity and radial diffusivity between children with and without DCD. Conclusions and Relevance These findings suggest that children with DCD show significant brain differences in motor and sensorimotor white matter pathways compared with children without DCD. The pattern of diffusion parameters in children with DCD suggests that axonal development may be disrupted in this neurodevelopmental disorder.Question What white matter microstructural differences are associated with children with developmental coordination disorder (DCD) compared with children without DCD? Findings In this cross-sectional study of 31 children with DCD and 30 children without DCD, widespread differences in indices of white matter microstructure, including fractional anisotropy and axial diffusivity, were observed in children with DCD compared with children without DCD. Meaning These findings suggest that DCD does not simply represent the low end of typical motor skill ability; these children display altered brain development in sensorimotor pathways.This cross-sectional study uses diffusion tensor imaging to examine microstructural differences in white matter among children with vs without developmental coordination disorder.