Peppar Cyr

Program: Neurosciences

Current advisor: Christopher D. Smyser, MD

Undergraduate university: Princeton University

Research summary
People born too early grow up to have a wide range of motor abilities – including typical development, developmental coordination disorder (DCD), and the full range of cerebral palsy (CP; able to walk independently, able walk with mobility aids, unable to walk) – but it is difficult to tell early on how a child will develop, and children with mild disabilities are often missed until they have struggled for many years. People with all of these motor disabilities often (but not always) have lower quality of life than those without as both children and adults, because of chronic pain, discrimination and bullying, and difficulty interacting with inaccessible places, objects, and systems. How much each of these factors matter for a person and what is the best way to improve their quality of life can differ by how severe their disability is. For example, someone with CP who uses a wheelchair full-time and has little use of their hands is more likely to have chronic pain and to benefit from learning how to use an adapted power wheelchair early in life than someone with DCD. However, that person with DCD is more likely to struggle as teachers try to hold them to the same handwriting speed and readability standards as their nondisabled peers and might benefit from being allowed to type instead. Both people might appreciate meeting others like them, to learn from lived experience and feel less alone.

My research aims to allow doctors to better predict what infants’ motor abilities will be like as they grow up. This would allow them to help families to set appropriate expectations for their child, to access therapies and equipment with goals matched to a child’s expected development, to participate in adaptive activities, and to find disabled peers and community sooner. To do this, I built statistical models to determine what measures of infant brain activity and brain wiring best relate to scores on standardized movement tests at ages 2, 5, and 10 years old in a group of children born at least 2.5 months early. We found that different patterns of activity in the parts of the brain involved in movement (motor cortex, basal ganglia, and cerebellum) and the wiring between them and the body (corticospinal tract, anterior limb of the internal capsule) related differently to fine and gross motor outcomes in children who did and did not have bleeding or other forms of injury in their brains as infants. Specifically, in children with brain injury motor cortex activity was predictive of later gross and fine motor development. In children without brain injury, the basal ganglia and anterior limb of the internal capsule measures were related to fine motor development while the cerebellum and both anterior limb of the internal capsule and corticospinal tract measures were related to gross motor development. These models, using newborn brain data with or without later motor testing data, were up to 70-90% accurate in telling us whether a child would have motor problems at age 10.

Graduate publications
Cyr PEP, Lean RE, Kenley JK, Kaplan S, Meyer DE, Neil JJ, Alexopoulos D, Brady RG, Shimony JS, Rodebaugh TL, Rogers CE, Smyser CD. 2022 Neonatal motor functional connectivity and motor outcomes at age two years in very preterm children with and without high-grade brain injury. Neuroimage Clin, 36():103260.

Brenner RG, Smyser CD, Lean RE, Kenley JK, Smyser TA, Cyr PEP, Shimony JS, Barch DM, Rogers CE. 2021 Microstructure of the Dorsal Anterior Cingulum Bundle in Very Preterm Neonates Predicts the Preterm Behavioral Phenotype at 5 Years of Age. Biol Psychiatry, 89(5):433-42.


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