Motor activities and executive functions in early adolescence after hypothermia-treated neonatal hypoxic-ischemic encephalopathy

Appl Neuropsychol Child. 2025 Feb 12:1-9. doi: 10.1080/21622965.2025.2463498. Online ahead of print.

Abstract

Aim: To explore the relationship between motor activities and executive functions (EF) in children (aged 10-12 years) with a history of neonatal hypothermia-treated hypoxic-ischemic encephalopathy (HIE).

Material and methods: Forty-five children (mean age 11 years) with a history of neonatal hypothermia-treated HIE in Stockholm (2007-2009) were included in this cross-sectional study. The children were assessed with Movement Assessment Battery for Children-2 (MABC-2) and Wechsler Intelligence Scale for Children-V (WISC-V). Their parents completed Behavior Rating Inventory of Executive Function-2 (BRIEF-2), Five to Fifteen-R, and MABC-2 Checklist.

Results: Associations between motor capacity and EF, specifically Processing Speed, Working Memory, Flexibility, and Inhibition, were detected. Children scoring below the 15th percentile on MABC-2 had weaker EF, evident in Cognitive Proficiency Index from WISC-V (t43 = 2.515, p = 0.016) and a higher mean Global Executive Composition Score from BRIEF-2 (t43 = -2.890, p = 0.006). Children with stronger EF exhibited better motor capacity. Parental questionnaires indicated everyday difficulties in 52% of the children.

Conclusions: Weaker EF were associated with difficulties in motor activities in early adolescence following hypothermia-treated HIE. These results highlight the importance of evaluating both motor activities and EF to understand children's everyday challenges.

Keywords: Executive functions; hypoxic-ischemic encephalopathy; motor activities; perinatal asphyxia; therapeutic hypothermia.