Objective: In healthy children (0-3 years), we investigated the association between developmental motor patterns and movement disorder features.

Background: The developing nervous system produces a variety of physiologically immature motor patterns, resembling features of movement disorders. In healthy children (4-16 years), we demonstrated that such “ataxic” and “dystonic” features are inversely related with age, implicating that longitudinal quantitative rating scales should be interpreted for age. In younger children, it is unknown whether developmental motor patterns resemble movement disorder features too.

Methods: In 32 healthy children (0, 3, 6, 9, 12, 18, 24 and 36 months of age; n=4/age category; m:f=1) we video-recorded general movements (GMs), spontaneous motor behaviour and standardized motor tasks (as included in BFMDRS and SARA). Five movement disorder investigators independently phenotyped anonymous videotapes according to movement disorder criteria. We calculated the % of the recognized movement disorders per child and per age category. We associated outcomes with specific age-related developmental motor patterns (i.e. writhing (0-9 weeks), fidgety (9-20 weeks), asymmetrical tonic neck reflex (ATNR, 0-6 months), startles (0-6 months), reaching (>4 months), scissoring- (9-12 months) or pincer grasp (>12 months) and toddlers gait (13-30 months)) by Cramer’s V.

Results: In children at 0, 3, 12, 24 and 36 months of age, we observed respectively dystonic (100%, 100%, 80%, 70% and 90%); choreatic (40%, 70%, 0%, 10% and 20%); myoclonic (30%, 60%, 0%, 0% and 0%) and ataxic (0%, 0%, 100%, 90% and 80%) movement disorder features. Concurrences between movement disorder features and developmental motor patterns were significant regarding: 1. dystonia with: ATNR (r=0.641); 2. chorea with: writhing GMs (r=0.544), fidgety GMs (r=0.732); 3. myoclonus with: writhing GMs (r=0.655), fidgety GMs (r=0.878), startles (r=0.808); 4. ataxia with: reaching (r=0.856), pincer grasp (r=0.771), toddlers gait (r=0.595).

Conclusions: In healthy children (0-3 years), developmental motor patterns concur with movement disorder features. As these immature movements are likely to reflect physiologically maturing cerebral motor networks, normative insight in the quantification of these motor patterns can help to avoid bias by falsely positive pathologic quantification.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/developmental-movement-patterns-resemble-movement-disorder-features-in-healthy-babies-and-toddlers/