Deterioration of fine motor skills and functional disability in patients with moderate-to-advanced Parkinson disease: A longitudinal follow-up study

INTRODUCTION

Parkinson disease (PD) caused substantially disability. The impairment of fine motor skills (FMSs) is correlated with the severity of functional disability (FD) cross-sectionally in people with PD (PwP). The present study investigated the decline in FMSs and the predictive value of baseline FMSs for the progression of FD.

METHODS

People with moderate-to-advanced PD who received two evaluations within 1-5 years were identified from the Taiwan Data Bank of Persons with Disability database. The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) was used to evaluate FD, and FMSs including pen-holding, buttoning, and knotting were assessed.

RESULTS

Our study included 2,271 people with moderate-to-advanced PD. We observed annual progression of FD in each domain of the WHODAS 2.0, with no difference between the sexes. The most significant correlation between FD and FMSs was that of decline in buttoning ability and deterioration of summary WHODAS 2.0 scores. Deterioration in FD across all domains of WHODAS 2.0 was associated with at least one FMS. The extent of disability in all three types of FMS at baseline was also correlated with deterioration of motility. Additionally, baseline disability in buttoning was significantly correlated with cognitive decline, and disability in knotting was significantly associated with the progression of FD.

CONCLUSION

FMSs may be reliable markers for further FD, particularly in the areas of cognition, motility, and life activity. Because of the significant FD observed in people with moderate-to-advanced PD, the availability of predictors is essential for applying precautionary measures and providing appropriate treatment.

Assessment of retention of training in improving the accuracy of needle penetration depth

[Purpose] This study aimed to assess whether the effects of training in fine motor skills, such as improving the accuracy of acupuncture depth, persisted after the training was completed. [Participants and Methods] Fifteen students (age, 28.0 ± 8.4 years) participated in the study. A 0.2 × 50 mm needle was inserted, as precisely as possible, against an acupuncture training gel at a depth of 15 mm. After explaining how to check the distance using their fingers as indicators and how to use a guide piece to check for depth, the students were instructed to train independently for two weeks. Error distance of the acupuncture depth was evaluated before the training (beginning of the training) and at training 1 (training for 7 days), training 2 (training for 14 days/end of training), and post-training (28 days after training 2). [Results] The error distance (absolute value) from 15 mm in training 1, training 2, and post-training decreased significantly compared with those before the training. The error distance was not significantly different between post-training and training 2. [Conclusion] After two weeks of acupuncture training, the error distance decreased significantly, suggesting that this technique was retained after 28 days of completing the training.

Mediating process between fine motor skills, finger gnosis, and calculation abilities in preschool children

Previous studies have found a relationship between fine motor skills, finger gnosis, and calculation skill. However, what mediates this association remains unclear. Therefore, this study investigated whether fine motor skills and finger gnosis are selectively associated with counting and symbolic comparison, and whether fine motor skills and finger gnosis are associated with calculation skills through numerical concepts to which they are selectively associated. We measured the counting, symbolic comparison, fine motor skills, finger gnosis, and working memory in preschool children (N = 48). The hierarchical multiple regression analysis results demonstrated that fine motor skills were selectively associated with counting, and finger gnosis with symbolic comparison. Moreover, based on the results of the mediation analysis, counting mediated the relationship between fine motor and calculation skills. However, the direct effects of fine motor skills and finger gnosis on calculation skills were also maintained. The findings were that fine motor skills and finger gnosis were related to numerical abilities, including counting, symbolic comparison, and calculations. Therefore, the findings were discussed in terms of the functional view and redeployment views, suggesting that the two views were complementary rather than exclusive.

Reduced fine motor competence in children with ADHD is associated with atypical microstructural organization within the superior longitudinal fasciculus

Recent work in healthy adults suggests that white matter organization within the superior longitudinal fasciculus (SLF) may, at least partly, explain individual differences in fine motor skills. The SLF is also often implicated in the neurobiology underlying attention deficit hyperactivity disorder (ADHD) as part of the attention network connecting frontal and parietal regions. While ADHD is primarily characterized by inattention, impulsivity and/or hyperactivity, atypical fine motor control is a common comorbid feature. This study aimed to investigate the association between reduced fine motor skills in ADHD and microstructural properties within the SLF. Participants were 55 right-handed children with ADHD and 61 controls aged 9-11 years. Fine motor control was assessed using the Grooved Pegboard task. Children underwent high angular resolution diffusion MRI. Following pre-processing, constrained spherical deconvolution tractography was performed to delineate the three SLF branches bilaterally. Children with ADHD showed significantly poorer fine motor performance relative to controls in the non-dominant hand, indicated by significantly slower left handed Grooved Pegboard task performance. This slower response time for the non-dominant (left) hand was significantly associated with reduced apparent fibre density within the right SLF I, and reduced right SLF I, II and III volume. This finding was independent of spatial attention performance. These data support previous reports indicating that children with ADHD have poorer fine motor performance than controls in their non-dominant hand, and indicates that the neurobiological basis for impaired fine motor control may involve white matter properties within the contralateral SLF. This suggests that white matter properties in fronto-parietal areas may have broader implications than attention.

Understanding motor difficulties in children with ADHD: A fixel-based analysis of the corticospinal tract

AIMS

Children with attention deficit hyperactivity disorder (ADHD) often present with deficits in fine motor control. The cortico-spinal tract (CST) is critical for voluntary motor control. Although neuroimaging work has identified anomalous microstructural properties in the CST in ADHD, no study to date has attempted to investigate the link between deficits in fine motor performance and microstructural properties of the CST in children with ADHD. This study aimed to address this gap using a novel fixel-based analysis (FBA).

METHODS

Participants were 50 right-handed medication naïve children with a history of ADHD and 56 non-ADHD controls aged 9-11 years. Fine motor control was assessed using the Grooved Pegboard task. Children underwent high angular resolution diffusion MRI. Following pre-processing, FBA was performed and the semi-automated deep-learning TractSeg was used to delineate the CST bilaterally. Fibre density (FD), fibre cross-section (FC-log), and fibre density/cross-section (FDC) were extracted for each tract.

RESULTS

Children with ADHD performed significantly worse than non-ADHD children on the Grooved Pegboard task when using their non-dominant hand. They also demonstrated widespread significantly lower diffusion metrics in both CSTs compared to non-ADHD controls. However, no correlations were observed between Grooved Pegboard performance and diffusion metrics for the CST in either hemisphere.

CONCLUSIONS

While we failed to detect a significant relationship between fine motor skill and FBA metrics in either group, this paper extends previous work by showing that children with ADHD and reduced fine motor competence demonstrate atypical microstructure within the CST relative to non-ADHD controls.

Hand fine motor skill disability correlates with dementia severity

BACKGROUND

The progression of dementia, which impairs motor skills and cognitive function, is a warning of greater disability. The present study investigated the association between hand fine motor skills, assessed according to the Functioning Disability Evaluation Scale - Adult Version (FUNDES-Adult), and dementia severity.

METHODS

People with mild and moderate to severe dementia were identified from the Taiwan Data Bank of Persons with Disability. The FUNDES-Adult was assessed for all enrollees, and the following hand fine motor skills were evaluated: pen-holding, buttoning, and knotting. Statistical analysis was performed using SAS, and P values < 0.05 were considered significant.

RESULTS

Disability in all the 3 fin. motor skills was significantly greater in patients with moderate to severe dementia than in those with mild dementia. Disability in any of the skills was sensitive to distinguish mild from moderate to severe dementia (sensitivity: 78.1 %, specificity: 55.2 %, area under the curve: 0.739, 95 % confidence interval [CI]: 0.734-0.745). Those with fine motor skill disability were at a significantly higher risk of moderate to severe dementia (odds ratio: 3.71, 95 % CI: 3.53-3.90, P <  .001).

CONCLUSION

Hand fine motor skill disability was more prevalent in patients with moderate to severe dementia than in patients with mild dementia. A straightforward motor skill assessment can serve as a screening tool in the community to detect the progression of dementia.

The effect of fine motor skills on handwriting legibility in preschool age children

[Purpose] The purpose of this study was to examine the effect that fine motor skills have on handwriting legibility in children of preschool age. [Subjects and Methods] The subjects of this study were 52 children of normal growth and development. In order to ascertain handwriting legibility, a Korean alphabet writing assessment was used; to measure fine motor skills, fine motor precision and manual dexterity, sub-items of BOT-2 were measured. Furthermore, in order to measure in-hand manipulation skills, a Functional Dexterity Test was conducted. [Results] The results of the study showed a high level of correlation between fine motor skills and handwriting legibility. The study revealed that the accuracy of hand and in-hand manipulation skills is factors that have an effect on handwriting legibility. [Conclusion] Through the current research, occupational therapists can provide activities that aid the development of fine motor precision and in-hand manipulation skills for children during the instruction and treatment of handwriting to preschool age children, which helps to conduct better legibility in their handwriting.

The role of older siblings in infant motor development

Previous research has suggested that infant motor skills may be affected by older siblings but has not considered whether this is due to specific characteristics of the older sibling or of the quality of the sibling relationship. The current study used a longitudinal diary method to record infant motor milestones from 23 infants with older siblings along with parent reports and standardized assessments of motor skills. Parent reports of the older siblings' motor skills and the sibling relationship were also collected until the infants were 18months old. The motor skills, age, and sex of the older siblings were not significantly related to any measure of infant motor development. A significant correlation was revealed between perceived agonism between siblings and infant fine motor skills at 18months, suggesting the importance of considering reciprocal effects of motor development on sibling relationships. Overall, the suggestion that older siblings may provide a good model of motor skills for infants is not supported by the current data. In the future, it will be important to assess the dynamic interactions between different factors in predicting infant motor development, allowing early identification of motor difficulties, which could affect other areas of cognitive development and health.

Sleep-dependent motor memory consolidation in older adults depends on task demands

It is often suggested that sleep-dependent consolidation of motor learning is impaired in older adults. The current study challenges this view and suggests that the degree of motor consolidation seen with sleep in older age groups depends on the kinematic demands of the task. We show that, when tested with a classic sequence learning task, requiring individuated finger movements, older adults did not show sleep-dependent consolidation. By contrast, when tested with an adapted sequence learning task, in which movements were performed with the whole hand, sleep-dependent motor improvement was observed in older adults. We suggest that age-related decline in fine motor dexterity may in part be responsible for the previously described deficit in sleep-dependent motor consolidation with aging.

Relations between fine motor skill and parental report of attention in young children with neurofibromatosis type 1

Neurofibromatosis type 1 (NF1) is one of the most common genetic disorders presenting in approximately 1 in 3,500 live births. NF1 is a highly variable condition with a large number of complications. A common complication is neuropsychological problems, including developmental delays and learning difficulties that affect as many as 60% of patients. Research has suggested that school-aged children with NF1 often have poorer fine motor skills and are at greater risk for attention difficulties than the general population. Thirty-eight children with NF1 and 23 unaffected children between the ages of 4 and 6 years, who are enrolled in a study of early development in NF1, were included in the present study. Varying levels of fine motor functioning were examined (simple to complex fine motor tasks). For children with NF1, significant difficulties were demonstrated on lab-based mid-level and complex fine motor tasks, even after controlling for nonverbal reasoning abilities, but not on simple fine motor tasks. Parental report also indicated difficulties in everyday adaptive fine motor functioning. No significant correlations were found between complex fine motor ability and attention difficulties. This study provides much needed descriptive data on the early emergence of fine motor difficulties and attention difficulties in young children with NF1.

Fine motor skills in children with rolandic epilepsy

This study aimed to evaluate fine motor skills in children with rolandic epilepsy (RE). The research included 44 children diagnosed with typical RE and 44 controls matched in terms of age, gender, and level of education. Fine motor skills were evaluated with the Purdue Pegboard Test, and intelligence was measured with the Wechsler Intelligence Scale for Children. After controlling for the effect of intelligence on fine motor skills, the results showed that the children with RE did not perform as well as the controls in the PPT dominant hand, both hands, and assembly subtests. Epileptic focus, treatment status, type of antiepileptic treatment, age at the time of the first seizure, time since the last seizure, and total number of seizures did not affect motor skills. Rolandic epilepsy negatively affected fine motor skills regardless of the children's level of intelligence.