Neuroimaging and neurophysiological changes following structured interventions in children with developmental coordination disorder: a scoping review

Neurobiological sample sizes ranged from 20 to 88 (median 49). Designs included randomized controlled, non-randomized controlled, and quasi-experimental pre–post studies. Interventions clustered into Cognitive Orientation to daily Occupational Performance (CO-OP; 6 sources), exercise/motor-learning programs (4), and neuromuscular/biomechanical approaches (3).

Modalities included diffusion tensor imaging, resting-state functional MRI, structural MRI/voxel-based morphometry, functional near-infrared spectroscopy, electroencephalography/event-related potentials, and surface electromyography. MRI-based longitudinal outcomes were reported exclusively in CO-OP cohorts, with several publications arising from shared registered trials and partial cohort overlap. Six sources included neurobiological follow-up beyond the immediate post-intervention assessment.

Analytic approaches varied in pre–post versus group-by-time contrasts, region-of-interest versus whole-brain analyses, and correction for multiple comparisons. Seven sources reported neurobiological–clinical/functional linkage analyses; five tested change-based associations, and statistically significant findings were limited to individualized movement-quality outcomes.</p> <p>The evidence base is small, heterogeneous, and unevenly distributed across intervention categories and modalities.

Priorities include independent replication, longitudinal neuroimaging of non-CO-OP interventions where scientifically justified, more consistent follow-up, and prespecified, adequately powered linkage analyses.</p>