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Lin C, Chen B, Wang Z, Zou A, Ke M. Assessment of neural function recovery in premature infants at high risk of brain injury using amplitude integrated electroencephalography and GMs scales. J Neurosci Methods 2024; 410:110246. [PMID: 39127351 DOI: 10.1016/j.jneumeth.2024.110246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 07/15/2024] [Accepted: 08/05/2024] [Indexed: 08/12/2024]
Abstract
Preterm infants are a high-risk group for brain injury, and it is important to evaluate the neurological recovery of preterm infants. Therefore, this paper evaluates the neurological recovery in preterm infants at high risk of brain injury by amplitude-integrated EEG and GMs scale. The study collected basic information on preterm infants and performed amplitude integrated EEG examination and GMs scale evaluation. Amplitude integrated EEG examination attaches electrodes using multielectrode arrays onto specific areas of the premature head to record brain wave activity to monitor electrical activity in the preterm brain in real time and amplify and process through the signals received by the electrodes to obtain more detailed EEG data. The GMs scale evaluates the developmental and functional status of the child and allows an objective assessment of the development and recovery of neurological function by observing their performance in motor, language, cognition, and social interaction. Analysis of the data by statistical processing. The results showed that early brain injury was evident in high-risk infants. Amplitude integrated EEG parameters can have some predictive value for brain injury. There were also differences in GMs scale assessment between brain injury and non-brain injury. Amplitude integrated EEG combined with GMs scale has certain value in predicting brain injury and can provide an important basis for early intervention in children with preterm brain injury and help to improve their neurodevelopmental outcome.
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Affiliation(s)
- Chun Lin
- Department of Rehabilitation Medicine, Northern Jiangsu People's Hospital Affiliated to Yangzhou University (Clinical Medical College, Yangzhou University), 225002, China
| | - Bo Chen
- Department of Rehabilitation Medicine, Northern Jiangsu People's Hospital Affiliated to Yangzhou University (Clinical Medical College, Yangzhou University), 225002, China
| | - Zhiqiang Wang
- Department of Rehabilitation Medicine, Northern Jiangsu People's Hospital Affiliated to Yangzhou University (Clinical Medical College, Yangzhou University), 225002, China
| | - Andi Zou
- Department of Rehabilitation Medicine, Northern Jiangsu People's Hospital Affiliated to Yangzhou University (Clinical Medical College, Yangzhou University), 225002, China
| | - Minghui Ke
- Department of Rehabilitation Medicine, Northern Jiangsu People's Hospital Affiliated to Yangzhou University (Clinical Medical College, Yangzhou University), 225002, China.
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Mendonça KTD, Pascoal AFDS, Lanza FDC, Viñolas Prat B, Morais RLDS, Camargos ACR. Clinical Factors Related to Abnormal General Movements Trajectories: Development of a Multicriteria Index. Pediatr Phys Ther 2024; 36:440-447. [PMID: 39073072 DOI: 10.1097/pep.0000000000001129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
PURPOSE To create a multicriteria index with clinical factors associated with abnormal general movements (GMs) trajectories during a stay in the neonatal intensive care unit. METHODS A longitudinal study assessed abnormal GMs trajectories in preterm infants in the neonatal intensive care unit. The multicriteria index included clinical factors such as intraventricular hemorrhage, respiratory support, gestational age, patent ductus arteriosus, and infection based on multi-attribute utility theory. RESULTS A total of 52 preterm newborns, 57.7% male, were evaluated. The multicriteria index correlated with abnormal GMs trajectories and explained 26.5% of the variance in these trajectories. CONCLUSION The developed multicriteria index, with the inclusion of combined clinical factors, allowed the identification of part of the abnormal trajectories of GMs in preterm infants. The multicriteria analysis can help clinicians to identify infants who have a greater chance of poor developmental trajectories before hospital discharge.
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Affiliation(s)
- Karoline Tury de Mendonça
- Hospital das Clínicas/EBSERH, Belo Horizonte, Minas Gerais, Brazil (Ms Mendonça); Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil (Mss Mendonça and Pascoal and Drs Lanza and Camargos); Graduate Program in Health, Society and Environment, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil (Drs Viñolas Prat and Morais)
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Eto E, Maeda T, Kobayashi O, Ihara K. Intrauterine twin environment and genetic factors subliminally affecting general movements in preterm infants. Brain Dev 2024; 46:255-261. [PMID: 38705801 DOI: 10.1016/j.braindev.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 04/30/2024] [Accepted: 05/01/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND Understanding background factors is beneficial for interpreting general movements (GMs). This study examines the factors involved in preterm-writhing GMs by comparing twins and singletons. METHOD The subjects were 107 infants cared for at Oita University. The cohort consisted of very-low-birth-weight infants, including twins with a birth weight < 2000 g. The median gestational age (GA) was 29 weeks 1 day. The subjects consisted of 75 singletons, 32 twins (16 pairs), 20 monochorionic twins (M-twins), and 12 dichorionic twins (D-twins). GMs were scored according to the GMs optimality score (GMOS) and integrated into 6 items: the quality, neck-trunk and space, amplitude-speed, rotation, onset-offset and cramped, and tremulous score at 32-34 weeks, 35-36 weeks, and 37-42 weeks' GA. A hierarchical cluster analysis was performed using integrated GMOS, and the characteristics of clusters were examined according to clinical backgrounds. RESULTS Three clusters were identified. Cluster 1 was characterized by good-quality GMs, cluster 2 by a poor repertoire but optimal space and rotatory components, and cluster 3 by overall poor-quality GMs, respectively. The mean GMOSs were 36.6, 31.8 and 24.3 in clusters 1, 2, and 3, respectively. There were no marked differences in proportions within clusters with respect to sex and twins. Small-for-gestational age (SGA) was significantly more frequent in cluster 3 at 32-34 weeks' GA than in other clusters. Perinatal brain injury had a significantly lower proportion in cluster 1 and a higher proportion in cluster 3 at 35-36 weeks' GA and 37-42 weeks' GA. M-twin pairs tended to belong to the same clusters at 35-36 weeks' GA. CONCLUSION Preterm writhing GMs are associated with SGA and perinatal brain injury. Cluster matching in M-twins suggests that certain genetic factors may substantially influence GMs.
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Affiliation(s)
- Eriko Eto
- Department of Pediatrics, Oita University Faculty of Medicine, Oita, Japan
| | - Tomoki Maeda
- Department of Pediatrics, Oita University Faculty of Medicine, Oita, Japan.
| | - Osamu Kobayashi
- Department of Pediatrics, Oita University Faculty of Medicine, Oita, Japan
| | - Kenji Ihara
- Department of Pediatrics, Oita University Faculty of Medicine, Oita, Japan
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Dewan MV, Weber PD, Felderhoff-Mueser U, Huening BM, Dathe AK. A Simple MRI Score Predicts Pathological General Movements in Very Preterm Infants with Brain Injury-Retrospective Cohort Study. CHILDREN (BASEL, SWITZERLAND) 2024; 11:1067. [PMID: 39334600 PMCID: PMC11430197 DOI: 10.3390/children11091067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2024] [Revised: 08/22/2024] [Accepted: 08/28/2024] [Indexed: 09/30/2024]
Abstract
BACKGROUND/OBJECTIVES Very preterm infants are at increased risk of brain injury and impaired brain development. The Total Abnormality Score and biometric parameters, such as biparietal width, interhemispheric distance and transcerebellar diameter, are simple measures to evaluate brain injury, development and growth using cerebral magnetic resonance imaging data at term-equivalent age. The aim of this study was to evaluate the association between the Total Abnormality Score and biometric parameters with general movements in very preterm infants with brain injury. METHODS This single-center retrospective cohort study included 70 very preterm infants (≤32 weeks' gestation and/or <1500 g birth weight) born between January 2017 and June 2021 in a level-three neonatal intensive care unit with brain injury-identified using cerebral magnetic resonance imaging data at term-equivalent age. General movements analysis was carried out at corrected age of 8-16 weeks. Binary logistic regression and Spearman correlation were used to examine the associations between the Total Abnormality Score and biometric parameters with general movements. RESULTS There was a significant association between the Total Abnormality Score and the absence of fidgety movements [OR: 1.19, 95% CI = 1.38-1.03] as well as a significant association between the transcerebellar diameter and fidgety movements (Spearman ρ = -0.269, p < 0.05). CONCLUSIONS Among very preterm infants with brain injury, the Total Abnormality Score can be used to predict the absence of fidgety movements and may be an easily accessible tool for identifying high-risk very preterm infants and planning early interventions accordingly.
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Affiliation(s)
- Monia Vanessa Dewan
- Neonatology, Paediatric Intensive Care and Paediatric Neurology, Department of Paediatrics I, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, Germany; (M.V.D.); (U.F.-M.); (B.M.H.)
- Centre for Translational Neuro- and Behavioural Sciences, C-TNBS, Faculty of Medicine, University of Duisburg-Essen, 45122 Essen, Germany
| | - Pia Deborah Weber
- Neonatology, Paediatric Intensive Care and Paediatric Neurology, Department of Paediatrics I, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, Germany; (M.V.D.); (U.F.-M.); (B.M.H.)
| | - Ursula Felderhoff-Mueser
- Neonatology, Paediatric Intensive Care and Paediatric Neurology, Department of Paediatrics I, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, Germany; (M.V.D.); (U.F.-M.); (B.M.H.)
- Centre for Translational Neuro- and Behavioural Sciences, C-TNBS, Faculty of Medicine, University of Duisburg-Essen, 45122 Essen, Germany
| | - Britta Maria Huening
- Neonatology, Paediatric Intensive Care and Paediatric Neurology, Department of Paediatrics I, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, Germany; (M.V.D.); (U.F.-M.); (B.M.H.)
- Centre for Translational Neuro- and Behavioural Sciences, C-TNBS, Faculty of Medicine, University of Duisburg-Essen, 45122 Essen, Germany
| | - Anne-Kathrin Dathe
- Neonatology, Paediatric Intensive Care and Paediatric Neurology, Department of Paediatrics I, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, Germany; (M.V.D.); (U.F.-M.); (B.M.H.)
- Centre for Translational Neuro- and Behavioural Sciences, C-TNBS, Faculty of Medicine, University of Duisburg-Essen, 45122 Essen, Germany
- Department of Health and Nursing, Occupational Therapy, Ernst-Abbe-University of Applied Sciences, 07745 Jena, Germany
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Liu K, Lin N, Jin T, Xiang Y, Li J, Lai D, Xu H. Association between pediatric postoperative delirium and regional cerebral oxygen saturation: a prospective observational study. BMC Psychiatry 2024; 24:367. [PMID: 38750494 PMCID: PMC11097584 DOI: 10.1186/s12888-024-05832-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 05/09/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Postoperative delirium (POD) represents a prevalent and noteworthy complication in the context of pediatric surgical interventions. In recent times, a hypothesis has emerged positing that cerebral ischemia and regional cerebral oxygen desaturation might serve as potential catalysts in the pathogenesis of POD. The primary aim of this study was to methodically examine the potential relationship between POD and regional cerebral oxygen saturation (rSO2) and to assess the predictive and evaluative utility of rSO2 in the context of POD. METHODS This prospective observational study was conducted at the Children's Hospital, Zhejiang University School of Medicine, Zhejiang, China, spanning the period from November 2020 to March 2021. The research cohort comprised children undergoing surgical procedures within this clinical setting. To measure rSO2 dynamics, cerebral near-infrared spectroscopy (NIRS) was used to monitor rSO2 levels both before and after surgery. In addition, POD was assessed in the paediatric patients according to the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) criteria. The analysis of the association between the rSO2 index and the incidence of POD was carried out through the application of either the independent samples t-test or the nonparametric rank-sum test. To ascertain the threshold value of the adjusted rSO2 index for predictive and evaluative purposes regarding POD in the pediatric population, the Receiver Operating Characteristics (ROC) curve was employed. RESULTS A total of 211 cases were included in this study, of which 61 (28.9%) developed POD. Participants suffering delirium had lower preoperative rSO2mean, lower preoperative rSO2min, and lower postoperative rSO2min, higher ∆rSO2mean, higher amount of ∆rSO2mean, lower ∆rSO2min (P < 0.05). Preoperative rSO2mean (AUC = 0.716, 95%CI 0.642-0.790), ∆rSO2mean (AUC = 0.694, 95%CI 0.614-0.774), amount of ∆rSO2mean (AUC = 0.649, 95%CI 0.564-0.734), preoperative rSO2min (AUC = 0.702, 96%CI 0.628-0.777), postoperative rSO2min (AUC = 0.717, 95%CI 0.647-0.787), and ∆rSO2min (AUC = 0.714, 95%CI 0.638-0.790) performed well in sensitivity and specificity, and the best threshold were 62.05%, 1.27%, 2.41%, 55.68%, 57.36%, 1.29%. CONCLUSIONS There is a close relationship between pediatric POD and rSO2. rSO2 could be used as an effective predictor of pediatric POD. It might be helpful to measure rSO2 with NIRS for early recognizing POD and making it possible for early intervention.
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Affiliation(s)
- Kexian Liu
- Nursing Department, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, 310052, China
- Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Nan Lin
- Nursing Department, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, 310052, China
- Department of Neonatal Surgery, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, 310052, China
| | - Ting Jin
- Nursing Department, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, 310052, China
| | - Yujun Xiang
- Nursing Department, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, 310052, China
| | - Jiahuan Li
- Nursing Department, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, 310052, China
| | - Dengming Lai
- Department of Neonatal Surgery, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, 310052, China.
| | - Hongzhen Xu
- Nursing Department, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, 310052, China.
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Einspieler C, Bos AF, Spittle AJ, Bertoncelli N, Burger M, Peyton C, Toldo M, Utsch F, Zhang D, Marschik PB. The General Movement Optimality Score-Revised (GMOS-R) with Socioeconomically Stratified Percentile Ranks. J Clin Med 2024; 13:2260. [PMID: 38673533 PMCID: PMC11050782 DOI: 10.3390/jcm13082260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 04/04/2024] [Accepted: 04/07/2024] [Indexed: 04/28/2024] Open
Abstract
Background: The general movement optimality score (GMOS) quantifies the details of general movements (GMs). We recently conducted psychometric analyses of the GMOS and developed a revised scoresheet. Consequently, the GMOS-Revised (GMOS-R) instrument necessitated validation using new percentile ranks. This study aimed to provide these percentile ranks for the GMOS-R and to investigate whether sex, preterm birth, or the infant's country of birth and residence affected the GMOS-R distribution. Methods: We applied the GMOS-R to an international sample of 1983 infants (32% female, 44% male, and 24% not disclosed), assessed in the extremely and very preterm period (10%), moderate (12%) and late (22%) preterm periods, at term (25%), and post-term age (31%). Data were grouped according to the World Bank's classification into lower- and upper-middle-income countries (LMICs and UMICs; 26%) or high-income countries (HICs; 74%), respectively. Results: We found that sex and preterm or term birth did not affect either GM classification or the GMOS-R, but the country of residence did. A lower median GMOS-R for infants with normal or poor-repertoire GMs from LMICs and UMICs compared with HICs suggests the use of specific percentile ranks for LMICs and UMICs vs. HICs. Conclusion: For clinical and scientific use, we provide a freely available GMOS-R scoring sheet, with percentile ranks reflecting socioeconomic stratification.
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Affiliation(s)
- Christa Einspieler
- Interdisciplinary Developmental Neuroscience—iDN, Division of Phoniatrics, Medical University of Graz, 8010 Graz, Austria
| | - Arend F. Bos
- Division of Neonatology, Department of Pediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, 9712 GZ Groningen, The Netherlands
| | - Alicia J. Spittle
- Department of Physiotherapy, Melbourne School of Health Sciences, University of Melbourne, Melbourne, VIC 3010, Australia;
| | - Natascia Bertoncelli
- Neonatal Intensive Care Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University Hospital of Modena, 41124 Modena, Italy;
| | - Marlette Burger
- Physiotherapy Division, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 7505, South Africa;
| | - Colleen Peyton
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA;
| | - Moreno Toldo
- Department of Medical Rehabilitation, Kiran Society for Rehabilitation and Education of Children with Disabilities, Varanasi 221011, India;
| | - Fabiana Utsch
- Reabilitação Infantil, Rede SARAH de Hospitais de Reabilitação, Belo Horizonte 30510-000, Brazil;
| | - Dajie Zhang
- Interdisciplinary Developmental Neuroscience—iDN, Division of Phoniatrics, Medical University of Graz, 8010 Graz, Austria
- Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Ruprecht-Karls University, 69115 Heidelberg, Germany
| | - Peter B. Marschik
- Interdisciplinary Developmental Neuroscience—iDN, Division of Phoniatrics, Medical University of Graz, 8010 Graz, Austria
- Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Ruprecht-Karls University, 69115 Heidelberg, Germany
- Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Leibniz-ScienceCampus Primate Cognition, 37075 Göttingen, Germany
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institutet, 171 77 Stockholm, Sweden
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Chirigos AJ, Ostrander B, Burton VJ, Mirecki M, Maitre NL. Prechtl's General Movements Assessment at writhing age guides MRI use in clinical implementation network. Pediatr Res 2024; 95:1188-1190. [PMID: 37919380 DOI: 10.1038/s41390-023-02856-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 09/22/2023] [Accepted: 09/27/2023] [Indexed: 11/04/2023]
Affiliation(s)
- Allison J Chirigos
- Department of Pediatrics, University of Utah Hospital and Primary Children's Hospital, Salt Lake City, UT, USA
| | - Betsy Ostrander
- Department of Pediatrics, University of Utah Hospital and Primary Children's Hospital, Salt Lake City, UT, USA.
| | - Vera Joanna Burton
- Department of Neurology and Developmental Medicine, Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Neurology and Neurosurgery, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | | | - Nathalie L Maitre
- Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA, USA
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Abbasi H, Mollet SR, Williams SA, Lim L, Battin MR, Besier TF, McMorland AJC. Deep-Learning Markerless Tracking of Infant General Movements using Standard Video Recordings. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2023; 2023:1-4. [PMID: 38083202 DOI: 10.1109/embc40787.2023.10340116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Monitoring spontaneous General Movements (GM) of infants 6-20 weeks post-term age is a reliable tool to assess the quality of neurodevelopment in early infancy. Abnormal or absent GMs are reliable prognostic indicators of whether an infant is at risk of developing neurological impairments and disorders such as cerebral palsy (CP). Therapeutic interventions are most effective at improving neuromuscular outcomes if administered in early infancy. Current clinical protocols require trained assessors to rate videos of infant movements, a time-intensive task. This work proposes a simple, inexpensive, and broadly applicable markerless pose-estimation approach for automatic infant movement tracking using conventional video recordings from handheld devices (e.g., tablets and mobile phones). We leverage the enhanced capabilities of deep-learning technology in image processing to identify 12 anatomical locations (3 per limb) in each video frame, tracking a baby's natural movement throughout the recordings. We validate the capability of resnet152 and a mobile-net-v2-1 to identify body-parts in unseen frames from a full-term male infant, using a novel automatic unsupervised approach that fuses likelihood outputs of a Kalman filter and the deep-nets. Both deep-net models were found to perform very well in the identification of anatomical locations in the unseen data with high average Percentage of Correct Keypoints (aPCK) performances of >99.65% across all locations.Clinical relevance-Results of this research confirm the feasibility of a low-cost and publicly accessible technology to automatically track infants' GMs and diagnose those at higher risk of developing neurological conditions early, when clinical interventions are most effective.
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Mallmann GS, França ALN, Almeida PR, Oliveira LS, Merey LSF, Soares-Marangoni DA. Association between the General Movement Optimality Score and clinical features in newborns during hospitalization: A cross-sectional study. Early Hum Dev 2023; 177-178:105720. [PMID: 36773505 DOI: 10.1016/j.earlhumdev.2023.105720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/30/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023]
Abstract
AIMS To describe the General Movements (GMs) of hospitalized newborns to verify if their global and detailed GMA are related and if their GMs are associated with clinical features. METHODS Cross-sectional study. Thirty-eight preterm and full-term newborns, who were hospitalized in the neonatal intermediate care unit of a reference hospital, were included. Prechtl's General Movement Assessment (GMA), including the General Movement Optimality Score (GMOS) list, was used as an assessment tool. Clinical variables, such as preterm birth, birthweight, length of hospitalization, Apgar scores, pregnancy problems, admission at neonatal intensive care unit, use of invasive mechanical ventilation, and brain imaging findings were also collected. Newborns were videoed at a single time for 3 min before discharge. RESULTS Most newborns presented GMs with normal or poor repertoire quality. GMOS ranged from 17 to 42 points. Scores were lower in abnormal GMs. Abnormal GMs were associated with preterm birth, length of hospital stay >30 days and birthweight <2500 g. Accordingly, lower GMOSs were also associated with preterm birth, a birthweight <2500 g and a hospital stay >30 days but also with the invasive mechanical ventilation application. CONCLUSION Preterm and full-term newborns presented normal or abnormal GMs during hospitalization. Preterm birth, low birthweight, longer hospital stay and a time period of invasive ventilation were associated with worse GM behaviors.
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Affiliation(s)
- Geruza Souza Mallmann
- Graduate Program in Movement Sciences, Institute of Health, Federal University of Mato Grosso do Sul, Av. Costa e Silva, s/n, Cidade Universitaria, 79070-900 Campo Grande, MS, Brazil
| | - Andressa Lagoa Nascimento França
- Graduate Program in Health and Development, Faculty of Medicine, Federal University of Mato Grosso do Sul, Av. Costa e Silva, s/n, Cidade Universitaria, 79070-900 Campo Grande, MS, Brazil
| | - Priscila Rimoli Almeida
- Regional Hospital of Mato Grosso do Sul, Av. Eng. Lutero Lopes, 36, Aero Rancho, 79084-180 Campo Grande, MS, Brazil
| | - Lucimeire Souza Oliveira
- Institute of Health, Federal University of Mato Grosso do Sul, Av. Costa e Silva, s/n, Cidade Universitaria, 79070-900 Campo Grande, MS, Brazil
| | - Leila Simone Foerster Merey
- Institute of Health, Federal University of Mato Grosso do Sul, Av. Costa e Silva, s/n, Cidade Universitaria, 79070-900 Campo Grande, MS, Brazil
| | - Daniele Almeida Soares-Marangoni
- Graduate Program in Movement Sciences, Institute of Health, Federal University of Mato Grosso do Sul, Av. Costa e Silva, s/n, Cidade Universitaria, 79070-900 Campo Grande, MS, Brazil; Graduate Program in Health and Development, Faculty of Medicine, Federal University of Mato Grosso do Sul, Av. Costa e Silva, s/n, Cidade Universitaria, 79070-900 Campo Grande, MS, Brazil; Institute of Health, Federal University of Mato Grosso do Sul, Av. Costa e Silva, s/n, Cidade Universitaria, 79070-900 Campo Grande, MS, Brazil.
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de Mendonça KT, Lanza FC, de Sousa Morais RL, Camargos ACR. Clinical factors associated with abnormal general movements of preterm newborns during hospitalization in a neonatal intensive care unit. Early Hum Dev 2022; 174:105682. [PMID: 36206619 DOI: 10.1016/j.earlhumdev.2022.105682] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 08/22/2022] [Accepted: 09/27/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION There is no clarity about which clinical variables during hospitalization in the Neonatal Intensive Care Unit (NICU) are associated with abnormal General Movements (GMs). OBJECTIVE To describe the trajectory of GMs of preterm newborns and explore the association between clinical variables and the presence of abnormal GMs during the NICU stay. METHODS Fifty-eight preterm newborns (33 males), with a mean gestational age at birth of 31,93 week's postmenstrual age, were evaluated using the GMs assessment by Hadders-Algra method. Clinical variables recorded weekly throughout the hospitalization period. The weekly association between clinical variables and the presence of abnormal GMs was tested using the Generalized Estimating Equations (GEE) model. RESULTS Preterm infants were recorded for up to sixteen weeks and more than half of the infants (56.9 %) had abnormal movements in at least one week during hospitalization. The absence of peri-intraventricular hemorrhage (PIVH) grades I-II and non-invasive ventilatory support and/or oxygen therapy on the day of the evaluation reduced, respectively, by 77.3 % (OR = 0.23; p > 0.0001) and 64.3 % (OR = 0.36; p > 0.0001) the chance of having an abnormal classification. In addition, each day of increased invasive mechanical ventilation increased the chance of having an abnormal classification by 1.11 times (OR = 0.025; p > 0.0001). CONCLUSION PIVH grades I-II, longer durations of mechanical ventilation and the presence of non-invasive ventilatory support and/or oxygen therapy are associated with abnormal movements during stay in the neonatal period. The data suggest that development outcome of infants having these conditions should be closely monitored.
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Affiliation(s)
- Karoline Tury de Mendonça
- Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Fernanda Córdoba Lanza
- Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Rosane Luzia de Sousa Morais
- Graduate Program in Health, Society and Environment and Department of Physiotherapy, Universidade Federal do Vale do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
| | - Ana Cristina Resende Camargos
- Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
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Tuiskula A, Metsäranta M, Toiviainen‐Salo S, Vanhatalo S, Haataja L. Profile of minor neurological findings after perinatal asphyxia. Acta Paediatr 2022; 111:291-299. [PMID: 34599610 PMCID: PMC9299470 DOI: 10.1111/apa.16133] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 09/20/2021] [Accepted: 09/30/2021] [Indexed: 12/29/2022]
Abstract
Aim To characterise the spectrum of findings in sequential neurological examinations, general movements (GM) assessment and magnetic resonance imaging (MRI) of infants with perinatal asphyxia. Methods The prospective cohort study of term infants with perinatal asphyxia treated at Helsinki University Hospital's neonatal units in 2016–2020 used Hammersmith Neonatal Neurological Examination (HNNE) and brain MRI at 2 weeks and Hammersmith Infant Neurological Examination (HINE) and GM assessment at 3 months of age. Results Analysis included 50 infants: 33 displaying perinatal asphyxia without hypoxic‐ischaemic encephalopathy (HIE), seven with HIE1 and 10 with HIE2. Of the infants with atypical HNNE findings, 24/25 perinatal asphyxia without HIE cases, 5/6 HIE1 cases and all 10 HIE2 cases showed atypical findings in the HINE. The HINE identified atypical spontaneous movements significantly more often in infants with white matter T2 hyperintensity. Conclusion In this cohort, most infants with perinatal asphyxia, with or without HIE, presented atypical neurological findings in sequential examinations. The profile of neurological findings for children with perinatal asphyxia without HIE resembled that of children with HIE. White matter T2 hyperintensity was associated with atypical spontaneous movements in the HINE and was a frequent MRI finding also in perinatal asphyxia without HIE.
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Affiliation(s)
- Anna Tuiskula
- BABA Center Pediatric Research Center Department of Pediatrics, Children's Hospital Helsinki University Hospital and University of Helsinki Helsinki Finland
| | - Marjo Metsäranta
- Department of Neonatology, Children's Hospital BABA Center Pediatric Research Center Helsinki University Hospital and University of Helsinki Helsinki Finland
| | - Sanna Toiviainen‐Salo
- Department of Pediatric Radiology, Radiology, HUS Diagnostic Center BABA Center Pediatric Research Center Helsinki University Hospital and University of Helsinki Helsinki Finland
| | - Sampsa Vanhatalo
- Department of Clinical Neurophysiology, Children's Hospital BABA Center Pediatric Research Center Neuroscience Center, Helsinki Institute of Life Science Helsinki University Hospital and University of Helsinki Helsinki Finland
| | - Leena Haataja
- Department of Pediatric Neurology, Children's Hospital BABA Center Pediatric Research Center Helsinki University Hospital and University of Helsinki Helsinki Finland
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Wang J, Shen X, Hu X, Yang H, Yin H, Zhu X, Gao H, Wu Y, Meng F. Early detection relationship of cerebral palsy markers using brain structure and general movements in infants born <32 weeks gestational age. Early Hum Dev 2021; 163:105452. [PMID: 34543944 DOI: 10.1016/j.earlhumdev.2021.105452] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/13/2021] [Accepted: 08/17/2021] [Indexed: 11/28/2022]
Abstract
AIM To detect early brain structural and clinical functional markers of brain injury and development based on a magnetic resonance imaging (MRI) scoring system and a general movement assessment (GMA) for preterm infants later diagnosed with cerebral palsy (CP). STUDY DESIGN Retrospective cohort study. General movements (GMs) were scored according to a semiquantitative scoring system: the GMs optimality score (GMOS) at preterm and term ages and the Motor Optimality Score (MOS) at the corrected age of 3 months after birth. Brain magnetic resonance imaging (MRI) at term-equivalent age was scored using an MRI scoring system. We analyzed the relationship between the early degree of cerebral white matter (WM) abnormality and the GMOS and the MOS for infants born <32 weeks gestational age later diagnosed with CP in a comparison group of neurotypical controls. SUBJECTS Sixteen preterm infants were included in this study who underwent MRI and GMs assessment. 8 out of the 16 preterm infants were later diagnosed with CP, while the other 8 infants with normal motor development (N) were placed into the control group. Their median gestational age was 30w6d and 27w6d for each group respectively. RESULTS The cerebral WM MRI scores were significantly higher in the CP group than in the control group (p < 0.01). The GMOS and MOS were significantly higher in the control group than in the CP group (p < 0.05). The MOS showed a strong correlation to the cerebral WM MRI score (r = -0.88) and the subscale of cerebral WM items (the cystic degeneration and the focal signal abnormalities) of the MRI score (r = -0.94) in the CP group. The MOS also showed a correlation with corrected biparietal diameter (cBPD) in the preterm infant group with CP (r = 0.75). Results of linear regression analyses between term MRI and GMs measures in preterm infants with CP are presented. Cerebral WM scores were associated with the MOS (β = -0.63; 95%CI = -0.97, -0.29; p < 0.01). Cerebral WM injury, including the subscale of cystic degeneration and focal signal abnormalities was closely associated with the MOS (β = -0.83; 95%CI = -1.13, -0.54; p < 0.001). CONCLUSION Cerebral WM scores show a strong association with a decreased motor performance on the MOS in preterm infants later diagnosed with CP. Severe white matter injury and significantly decreased MOS scores may provide useful early markers and strong evidence to early predict the risk of later development of cerebral palsy in preterm infants.
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Affiliation(s)
- Jun Wang
- Department of Rehabilitation, Children's Hospital, Fudan University, Shanghai 201102, China
| | - Xiushu Shen
- Department of Rehabilitation, Children's Hospital, Fudan University, Shanghai 201102, China
| | - Xihong Hu
- Department of Radiology, Children's Hospital, Fudan University, Shanghai 201102, China.
| | - Hong Yang
- Department of Rehabilitation, Children's Hospital, Fudan University, Shanghai 201102, China.
| | - Huanhuan Yin
- Department of Rehabilitation, Children's Hospital, Fudan University, Shanghai 201102, China
| | - Xiaoyun Zhu
- Department of Rehabilitation, Children's Hospital, Fudan University, Shanghai 201102, China
| | - Herong Gao
- Department of Rehabilitation, Children's Hospital, Fudan University, Shanghai 201102, China
| | - Yun Wu
- Department of Rehabilitation, Children's Hospital, Fudan University, Shanghai 201102, China
| | - Fanzhe Meng
- Department of Rehabilitation, Children's Hospital, Fudan University, Shanghai 201102, China
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General movements: Longitudinal assessment better than cross-sectional. Brain Dev 2019; 41:563-564. [PMID: 30876685 DOI: 10.1016/j.braindev.2019.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 03/04/2019] [Indexed: 11/24/2022]
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