Neural Basis and Motor Imagery Intervention Methodology Based on Neuroimaging Studies in Children With Developmental Coordination Disorders: A Review

Abstract

Although the neural bases of the brain associated with movement disorders in children with developmental coordination disorder (DCD) are becoming clearer, the information is not sufficient because of the lack of extensive brain function research. Therefore, it is controversial about effective intervention methods focusing on brain function. One of the rehabilitation techniques for movement disorders involves intervention using motor imagery (MI). MI is often used for movement disorders, but most studies involve adults and healthy children, and the MI method for children with DCD has not been studied in detail. Therefore, a review was conducted to clarify the neuroscientific basis of the methodology of intervention using MI for children with DCD. The neuroimaging review included 20 magnetic resonance imaging studies, and the neurorehabilitation review included four MI intervention studies. In addition to previously reported neural bases, our results indicate decreased activity of the bilateral thalamus, decreased connectivity of the sensory-motor cortex and the left posterior middle temporal gyrus, bilateral posterior cingulate cortex, precuneus, cerebellum, and basal ganglia, loss of connectivity superiority in the abovementioned areas. Furthermore, reduction of gray matter volume in the right superior frontal gyrus and middle frontal gyrus, lower fractional anisotropy, and axial diffusivity in regions of white matter pathways were found in DCD. As a result of the review, children with DCD had less activation of the left brain, especially those with mirror neurons system (MNS) and sensory integration functions. On the contrary, the area important for the visual space processing of the right brain was activated. Regarding of characteristic of the MI methods was that children observed a video related to motor skills before the intervention. Also, they performed visual-motor tasks before MI training sessions. Adding action observation during MI activates the MNS, and performing visual-motor tasks activates the basal ganglia. These methods may improve the deactivated brain regions of children with DCD and may be useful as conditioning before starting training. Furthermore, we propose a process for sharing the contents of MI with the therapist in language and determining exercise strategies.

Pediatric care for children with developmental coordination disorder, can we do better?

“…Although there is consensus that DCD defines a heterogeneous group of children exhibiting marked impairment in motor skills, no consensus about symptoms and etiology has been established [ 9 ]. Recent reviews of the functional magnetic resonance imaging literature indicate that although several brain areas are unquestionably linked to DCD (frontal lobe, parietal lobe, basal ganglia, and cerebellum) no neural signature for DCD has yet been established [ 10 , 11 ]. For instance, children with DCD have less activation of the left brain, especially areas responsible for action observation and motor imagery (mirror neurons system) and areas for sensory integration [ 11 ].…”

“…Recent reviews of the functional magnetic resonance imaging literature indicate that although several brain areas are unquestionably linked to DCD (frontal lobe, parietal lobe, basal ganglia, and cerebellum) no neural signature for DCD has yet been established [ 10 , 11 ]. For instance, children with DCD have less activation of the left brain, especially areas responsible for action observation and motor imagery (mirror neurons system) and areas for sensory integration [ 11 ]. Based on whole-brain resting-state examination, children with DCD also demonstrate altered functional connectivity between the sensorimotor network and the posterior cingulate cortex, precuneus, and the posterior middle temporal gyrus, preventing efficient use of action-related knowledge and thereby potentially impairing motor learning [ 12 ].…”

Bibliometric analysis study on cognitive function in developmental coordination disorder from 2010 to 2022

“…Children with DCD had less activation of the left brain, especially those with mirror neuron system and sensory integration functions. Therefore, the intervention should activate the left-brain visuospatial processing area ( Irie et al, 2021 ).…”

“…Research on interventions for children with DCD has resulted in numerous interventions such as perceptual motor therapy (PMT), sensory integration therapy (SIT), group formats, individual coaching, motor imagery, weight-bearing exercises, writing exercises, kinesthetic training, specific skills training, and others ( Miyahara et al, 2017 ). Current interventions can be broadly divided into two categories: process-oriented and task-oriented ( Irie et al, 2021 ). These approaches are based on the fact that interventions reinforce underlying deficient processes and improve task performance by correcting impairments ( Noordstar et al, 2017 ).…”

Developmental Coordination Disorder and Most Prevalent Comorbidities: A Narrative Review

“…The definition suggests that there is a specific deficit profile on various levels in children with comorbidity [ 25 , 26 ]. As suggested by Irie and colleagues [ 27 ], research has shown that brain networks’ functioning in children who have DCD is different from that of children who have both DCD and ADHD. It is necessary for the progress of the research to highlight exclusion criteria in order to allow a deep knowledge of the cortical pathways through neuroimaging tools.…”