Cerebral Activity Related to Primary Motor Stereotypies in Children: An EEG Study.
Condition: Movement Disorder
MeSH terms: Movement Disorders
Study type: Observational

Summary: 
      Background:

        -  Motor stereotypies are a movement disorder characterized by involuntary, repetitive, and
           rhythmic movements. These movements have a predictable pattern and seem purposeful, but
           they serve no obvious function, tend to be prolonged, and can be suppressed. Common
           examples of motor stereotypies include hand waving, head nodding, and body rocking.

        -  Researchers are interested in learning more about motor stereotypies. Many children with
           autism and other developmental disorders tend to exhibit these behaviors, but normal
           healthy children and even some adults have demonstrated motor stereotypies under certain
           conditions (including boredom and stress). More research is needed to determine the
           internal causes of and potential successful treatments for these behaviors.

      Objectives:

      - To use electroencephalography (EEG) to study cerebral activity related to stereotypies in
      children.

      Eligibility:

      - Children between 7 and 18 years of age who demonstrate stereotypy movements on a consistent
      basis (at least 10 times a day for at least 4 months).

      Design:

        -  The study will require two visits to the National Institutes of Health Clinical Center.

        -  First visit: Outpatient screening visit to determine the child s eligibility for the
           study, including questionnaires for parents/guardians and a medical assessment of the
           stereotypies.

        -  Second visit: Participating children will spend 1 day in a room at the NIH Clinical
           Center Pediatric Day Hospital. During the visit, participants will wear a portable EEG
           unit to measure brain activity. For the first hour of the visit, researchers will
           perform movement tests to study the brain activity related to normal movements. For the
           rest of the day, participants may play games, watch television or movies, read, or nap,
           while continuing to wear the EEG to monitor brain activity related to the stereotypic
           movements.

        -  Participants will receive a small amount of compensation for their time and
           participation.
    

Detailed description: 
      Objective

      Motor stereotypy is a common movement disorder observed in children and adolescents but whose
      pathophysiology is unknown. Therefore, our overall objective is to study cerebral activity
      related to stereotypies. First, we want to define whether motor stereotypies are preceded by
      a cortical potential, as it is observed before voluntary movements. We hypothesize that no
      pre-movement potentials will precede the stereotypies. However, if a pre-movement potential
      is observed, our secondary objective is to compare this potential to cortical potentials that
      precede voluntary movements. We also aim to study cortical potentials preceding voluntary
      movements in healthy children and to compare them with the potentials observed in children
      with stereotypies.

      Study population

      12 children presenting with primary motor stereotypies and 12 healthy children.

      Design

      Using 19 scalp electrodes, we will record the patients electroencephalographic (EEG) activity
      for up to 8 hours during one day. The electromyographic (EMG) activity of the muscles
      involved in the stereotypies will be recorded with surface EMG electrodes. Healthy children
      will undergo an EEG for 2 hours. During this EEG recording, they will be asked to perform
      arms movements.

      Outcome measures

      Primary outcomes: latency and amplitude of both evoked and induced activity (cortical
      potentials) related to motor stereotypies will be measured.

      Secondary outcomes: latency and amplitude of evoked and induced activity related to voluntary
      movements will be measured.
    

Time perspective: Prospective
Keywords: Children and Adolescents; Motor Control; Movement-Related Potential; Stereotypic Movement Disorder; Electroencephalogram (EEG)