Minor Neurological Dysfunction (MND)

The study


Two basic forms of MND may be distinguished: simple and complex MND. The criteria for the distinction is based on the child’s age. Before puberty, the two forms are distinguished on the basis of the number of domains with dysfunction. After the emergence of puberty, the distinction is based on the type of dysfunction. The criteria for the two forms of MND change at puberty, as the hormonal changes in puberty induce a considerable reduction of signs of MND.


Simple MND at school age implies the presence of dysfunction in one or two neurological domains. Simple MND has a relatively high prevalence (around 20%); and only shows weak relationships with prenatal, perinatal and neonatal adversities. This form of MND shows a relatively weak association with learning and behavioural disorders. The other form of MND, i.e., complex MND, has a lower prevalence (about 5-6%). At school age complex MND implies the presence of dysfunction in at least 3 domains with dysfunction. Complex MND is clearly associated with prenatal, perinatal and neonatal adversities and with learning- and behavioural problems.

Results of recent research

  • The assessment of MND is reliable
  • The large majority of children with autistic spectrum disorders has complex MND 
  •  In particular children with complex MND have a high risk for motor problems (DCD) and writing disorder.
  •  Especially dysfunction in the domains of co-ordination and fine manipulative ability are associated with motor problems (DCD), writing problems, IQ and specific cognitive problems, such as dyslexia.
  • In school age children born as healthy term neonates, in particular the type and not the severity of MND determines the risk of cognitive and behavioural problems. This risk differs for boys and girls. In girls especially co-ordination problems and dysfunctional posture and muscle tone regulation are associated with cognitive and behavioural disorders; in boys fine maniupulative disability carries this risk.


Collaborators

Mijna Hadders-Algra, MD, PhD                   
Developmental Neurology, UMCG


Lieke H.J. Peters, MD                           
Neurology, UMCG


Jessika F. Van Hoorn, MD                    
Centre for Rehabilitation, UMCG


Key publications

  • Hadders-Algra M: The examination of the child with minor neurological dysfunction. 3rd Ed. London: Mac Keith Press, 2010.
  • Hadders-Algra M. Two distinct forms of minor neurological dysfunction: perspectives emerging from a review of data of  the Groningen Perinatal Project. Dev Med Child Neurol 2002; 44: 561-71
  • Batstra L, Neeleman J, Hadders-Algra M. The neurology of learning and behavioral problems in pre-adolescent children. Acta Psychiatr Scand 2003; 108: 92-100.
  • Van Hoorn JF, Maathuis CGB, Peters LHJ, Hadders-Algra M. Handwriting, visuomotor integration and neurological condition at school age. Dev Med Child Neurol 2010;52:941-7
  • Punt M, De Jong M, De Groot E, Hadders-Algra M. Minor neurological dysfunction in children with dyslexia. Dev Med Child Neurol 2010;52:1127-32
  • Peters LHJ, Maathuis, CGB, Hadders-Algra M. Limited motor performance and minor neurological dysfunction at school age. Acta Paediatr 2011; 100: 271-8.
  • Kikkert HK, De Jong C, Hadders-Algra M. Minor neurological dysfunction and IQ in 9-year-olds born at term. Dev Med Child Neurol, 2011;53:e16-25.
  • De Jong M, Punt M, De Groot E, Minderaa RB, Hadders-Algra M. Minor neurological dysfunction in children with an autistic spectrum disorder. Dev Med Child Neurol 2011; 53: 641-6.
  • Kikkert HK, De Jong C, Hadders-Algra M. Minor neurological dysfunction and cognition in 9-year-olds born at term. Early Hum Dev 2013; 89:263-70.
  • Kikkert HK, De Jong C, Hadders-Algra M. Minor neurological dysfunction and behaviour in 9-year-olds born at term: evidence for sex-dimorphism. Dev Med Child Neurol 2013;55:1023-9.
  • Peters HJ, Maathuis CBG, Hadders-Algra. Neural correlates of Developmental Coordination Disorder. Dev Med Child Neurol 2013;55 (suppl 4):59-64.
  • Van Hoorn JF, Maathuis CGB, Hadders-Algra M. Neural correlates of paediatric dysgraphia. Dev Med Child Neurol 2013;55 (suppl 4):65-8.
  • Peters LHJ, Maathuis CGB, Hadders-Algra M. Children with behavioural problems and motor problems have a worse neurological condition than children with behavioural problems only, Early Hum Dev, 2014;90:803-807.
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