Kamaldeep Gill, MScOT(C)1,2, Donna Lang PhD 2,3, Dan Goldowitz PhD 2,4, Jill G. Zwicker PhD, OT(C)1,2,3,51 Department of Occupational Science & Occupational Therapy, University of British Columbia; 2 BC Children’s Hospital Research Institute; 3 Department of Radiology, University of British Columbia;

4 Department of Medical Genetics, University of British Columbia; 5 Department of Pediatrics, University of British Columbia

INTRODUCTION

OBJECTIVE

Kamaldeep Gill is funded by CIHR and Kids Brain Health Network. Dr. Zwicker is funded by the Michael Smith Foundation for Health Research, Canadian Child Health Clinician Scientist Program, BC Children’s Hospital Research Institute, Sunny Hill Foundation, and CIHR.

METHODS

DISCUSSION & CONCLUSIONS

REFERENCES

ACKNOWLEDGEMENTS

RESULTS cont’dRESULTS

Cerebellar Differences in Children with Developmental Coordination Disorder

• Developmental Coordination Disorder (DCD) is a common motor disorder that affects over 400,000 Canadian children.1,2

• DCD significantly impairs a child’s ability to learn motor skills and to perform everyday activities

• Recent brain imaging and behavioural research point to the cerebellum as the dominant source of neuropathology in children with DCD. 3

• To characterize cerebellar morphology in DCD and typically developing (TD) children using Voxel Based Morphometry (VBM)

• Cross-sectional MRI study of 35 children (8-12 years of age) – 17 children with DCD and 18 typically-developing children

• Conducted VBM using spatially unbiased atlas cerebellum template (SUIT) to explore differences in subregional grey matter volumes4

A. Isolate and segment the cerebellum into grey matter (GM) and white matter (WM)

B. Normalize an individual cerebellum into the SUIT atlas template using DARTEL

C. Modulation: Multiple by Jacobian determinants to compensate for any volumetric differences introduced during normalization

D. Modulated GM images multiplied by structure probability maps (E) and the maximum likelihood probabilistic cerebellar atlas (F) to yield lobule-specific GM images of the 28 cerebellar lobules for each participant

Table 1. Participant Characteristics

Characteristics TDN (%) or Mean

(SD)

DCD N (%) or

Mean (SD)

p-value

Male 12 (67) 13 (76) 0.30

Age (years) 10.08 (1.46) 9.84 (1.42) 0.64

Total Intra-cranial Volume (liters) 1.58 (0.11) 1.50 (0.18) 0.59

Conners 3 ADHD Index (t-score) 57.00 (12.32) 85.94 (8.42) <0.001

• Compared to TD children, children with DCD show decreased grey matter volume in Left VIIIa, and Left IX Lobules

o These regions that are engaged during sensorimotor tasks (Lobule VIIIa) and visual guidance of movement (Lobule IX)

• Children with DCD show increased grey matter volume in Left VI, and Right Crus I/II Lobules when compared to TD childreno These regions are engaged during cognitive tasks

• These findings support why children with DCD learn motor skills more effectively through cognitive strategies

1. American Psychiatric Association (2013) DSM-5.2. Statistics Canada (2017). Population by sex and age group3. Zwicker et al. (2009). Neural correlates of DCD: A review of hypotheses; Journal of Child Neurology 24, 1273-1281.4. Fan et al. (2010). Research Report: Sexual dimorphism and asymmetry in human cerebellum: An MRI-based morphometric study. Brain Research, 135360-73. doi:10.1016/j.brainres.

• Data analysis: unpaired 2-tailed t-test to compare TD and DCD groups, corrected for multiple comparisons with age, attention, and total intra-cranial brain volume as covariates [Threshold (p-value): 0.05; Extent Threshold (voxels): 100]

Figure 1. Gray matter volumes greater in typically-developing childrencompared to children with DCD

Figure 2. Gray matter volumes greater in children with DCD compared to typically-developing children

Larger in DCDSmaller in DCD

Left VIIIa

Left VIIIa