Impaired Motor Learning in Children with Hydrocephalus

 
Children with hydrocephalus can have difficulty learning (cognitive deficits). These learning problems can even have an effect on movement or motor performance, because reflexes must be coordinated and "learned" (motor learning).
A typical patient pressing the F and J keys in response to the lines that are seen on the monitor.
A typical picture that the patient sees on the monitor. First the subject presses the J key. The height of the vertical lines tells the subject how long to wait before he/she presses the next key. With practice, children can become very accurate in this measurement of "timing interval".
Shunting can reverse these alterations, but even early treatment cannot bring all of these changes back to normal. Thus, "biological" treatments that could supplement shunting and either protect neurons from damage or promote their recovery are being pursued. Shunted hydrocephalic (n = 19) and non-hydrocephalic (n = 20) children in two age groups (averaged at 10 and 14 years old) were asked to learn 5 predetermined timing rhythm interval tasks (including timing duration and relative timing pattern) by pressing the F and J keys on a computer keyboard. In the acquisition phase, goal timing intervals and feed back were presented visually to all participants before and after their key-presses, respectively.

Modeled auditory information (sounds that resemble "clicks") was provided prior to each trial. A retention test without the auditory information and visualized feedback was administered 1 day later. Statistical ANOVA analysis indicated that motor skill learning and memory formation were impaired in children with hydrocephalus. Unlike the non-hydrocephalic controls, practice and age progression did not play a major role in improving relative timing learning in the children with hydrocephalus. The hydrocephalic patients were better able to learn less complicated motor skills.

These experiments show that sophisticated types of motor learning can be measured, and used as a diagnostic tool. These results are now being used to design better rehabilitation (training) procedures that can help hydrocephalic children overcome their learning problems.

Data showing that both the 10- (pink circles) and 14-(pink squares) year old children with hydrocephalus made more errors and did not retain motor learning (Reten) as well as same-aged children without hydrocephalus.