Neuroimaging perspectives on fetal motor behavior

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HIGHLIGHTSSupraspinal centres are likely to be an important driver in early motor behavior.CineMRI has established itself as the optimal modality for the analysis of fetal motor behaviour in health and disease.Intrauterine spatial constraints observed with cineMRI will sensorimotor pathways, with implications for CNS maturation.Motor behaviour analysis is an important biomarker for neurodevelopmental disease, and will be augmented by multimodal imaging.We are entering a new era of understanding human development with the ability to perform studies at the earliest time points possible. There is a substantial body of evidence to support the concept that early motor behaviour originates from supraspinal motor centres, reflects neurological integrity, and that altered patterns of behaviour precede clinical manifestation of disease. Cine Magnetic Resonance Imaging (cineMRI) has established its value as a novel method to visualise motor behaviour in the human fetus, building on the wealth of knowledge gleaned from ultrasound based studies. This paper presents a state of the art review incorporating findings from human and preclinical models, the insights from which, we propose, can proceed a reconceptualisation of fetal motor behaviour using advanced imaging techniques. Foremost is the need to better understand the role of the intrauterine environment, and its inherent unique set of stimuli that activate sensorimotor pathways and shape early brain development. Finally, an improved model of early motor development, combined with multimodal imaging, will provide a novel source of in utero biomarkers predictive of neurodevelopmental disorders.

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