Fine Motor Skill Mediates Visual Memory Ability with Microstructural Neuro-correlates in Cerebellar Peduncles in Prematurely Born Adolescents

Abstract

Adolescents born preterm (PT) with no evidence of neonatal brain injury are at risk of deficits in visual memory and fine motor skills that diminish academic performance. The association between these deficits and white matter microstructure is relatively unexplored. We studied 190 PTs with no brain injury and 92 term controls at age 16 years. The Rey–Osterrieth Complex Figure Test (ROCF), the Beery visual-motor integration (VMI), and the Grooved Pegboard Test (GPT) were collected for all participants, while a subset (40 PTs and 40 terms) underwent diffusion-weighted magnetic resonance imaging. PTs performed more poorly than terms on ROCF, VMI, and GPT (all P < 0.01). Mediation analysis showed fine motor skill (GPT score) significantly mediates group difference in ROCF and VMI (all P < 0.001). PTs showed a negative correlation (P < 0.05, corrected) between fractional anisotropy (FA) in the bilateral middle cerebellar peduncles and GPT score, with higher FA correlating to lower (faster task completion) GPT scores, and between FA in the right superior cerebellar peduncle and ROCF scores. PTs also had a positive correlation (P < 0.05, corrected) between VMI and left middle cerebellar peduncle FA. Novel strategies to target fine motor skills and the cerebellum may help PTs reach their full academic potential.

Altered functional network connectivity relates to motor development in children born very preterm

“…These differences are of interest when considered in the context of the multiple prior investigations detailing prematurity-related reductions in cerebellar volumes and growth trajectories (Allin M et al 2001; Volpe JJ 2009; Bouyssi-Kobar M et al 2016). Prior work in VPT children has suggested stronger CB structural connectivity is linked with improved fine motor dexterity and visual-motor integration in adolescence (Thomas AR et al 2017), a finding consistent with the present functional connectivity results. Similarly, preterm children with diffuse PVL with lower GMFCS scores ( i.e.…”

Visual–motor integration and fine motor skills at 6½ years of age and associations with neonatal brain volumes in children born extremely preterm in Sweden: a population-based cohort study

“…A smaller precentral gyrus could, therefore, be expected to be correlated with reduced motor performance and also to diminished VMI performance, in line with our findings, since fine motor skills have been shown to be a mediator of visuomotor function, even though the cause of this mediation is not known. 47 Both the cerebellum and the brain stem are important for fine motor skills and VMI, as well as for other tasks that rely on the motor system, 48 and our results support their important role in this cross-modal function. In addition, the cerebellum has long been known to be involved in movement modulation, balance and coordination, and there is now evidence that it is also important for a number of cognitive functions, including visuospatial attention.…”

“…And, fine motor skills have been shown to be a facilitator of visuomotor function even though the causality of this mediation is not known. 47 The present study revealed positive correlations between better fine motor skills and larger volumes of the precentral gyrus, the cerebellum and the brainstem—motor areas of the brain that have been reported to be involved in fine motor skills. 50 The precentral gyrus, which is located in the frontal lobe, is the origin of the corticospinal tracts known to affect motor functions.…”

National population‐based cohort study found that visual‐motor integration was commonly affected in extremely preterm born children at six‐and‐a‐half years

“…Fine motor skills have been reported to be indirectly linked to mathematics through VMI in term-born children (21). This was in line with a study of preterm born adolescents that showed that fine motor skills largely mediate VMI function (22). As children born EPT are more likely to be left-handed (23), we also wanted to explore if this affected their VMI performance.…”