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Spoto G, Ceraolo G, Butera A, Di Rosa G, Nicotera AG. Exploring the Genetic Landscape of Chorea in Infancy and Early Childhood: Implications for Diagnosis and Treatment. Curr Issues Mol Biol 2024; 46:5632-5654. [PMID: 38921008 PMCID: PMC11202702 DOI: 10.3390/cimb46060337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 06/01/2024] [Accepted: 06/02/2024] [Indexed: 06/27/2024] Open
Abstract
Chorea is a hyperkinetic movement disorder frequently observed in the pediatric population, and, due to advancements in genetic techniques, an increasing number of genes have been associated with this disorder. In genetic conditions, chorea may be the primary feature of the disorder, or be part of a more complex phenotype characterized by epileptic encephalopathy or a multisystemic syndrome. Moreover, it can appear as a persistent disorder (chronic chorea) or have an episodic course (paroxysmal chorea). Managing chorea in childhood presents challenges due to its varied clinical presentation, often involving a spectrum of hyperkinetic movement disorders alongside neuropsychiatric and multisystemic manifestations. Furthermore, during infancy and early childhood, transient motor phenomena resembling chorea occurring due to the rapid nervous system development during this period can complicate the diagnosis. This review aims to provide an overview of the main genetic causes of pediatric chorea that may manifest during infancy and early childhood, focusing on peculiarities that can aid in differential diagnosis among different phenotypes and discussing possible treatment options.
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Affiliation(s)
- Giulia Spoto
- Unit of Child Neurology and Psychiatry, Department of Biomedical Sciences, Dental Sciences & Morpho-Functional Imaging, University of Messina, 98125 Messina, Italy;
| | - Graziana Ceraolo
- Unit of Child Neurology and Psychiatry, Department of Human Pathology of the Adult and Developmental Age “Gaetano Barresi”, University of Messina, 98125 Messina, Italy;
| | - Ambra Butera
- Unit of Child Neurology and Psychiatry, Department of Chemical, Biological, Farmaceutical & Environmental Science, University of Messina, 98125 Messina, Italy;
| | - Gabriella Di Rosa
- Unit of Child Neurology and Psychiatry, Department of Biomedical Sciences, Dental Sciences & Morpho-Functional Imaging, University of Messina, 98125 Messina, Italy;
| | - Antonio Gennaro Nicotera
- Unit of Child Neurology and Psychiatry, Maternal-Infantile Department, University of Messina, 98125 Messina, Italy;
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Peyton C, Aaby D, Millman R, Rodriguez S, Boswell L, Gaebler-Spira D, de Regnier RA, Barbosa VM, Sukal-Moulton T. Stability of the Motor Optimality Score Revised (MOS-R) in medically complex infants. Early Hum Dev 2024; 192:106008. [PMID: 38615539 DOI: 10.1016/j.earlhumdev.2024.106008] [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: 03/18/2024] [Revised: 04/08/2024] [Accepted: 04/09/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND The Motor Optimality Score-Revised (MOS-R) is a clinical test of infant spontaneous movement at 3-5 months of age and has been associated with neurodevelopmental outcomes in infants with medical complexity. However the stability of the MOS-R tested at different developmental ages is not yet known. AIM To determine if the repeated scoring of the MOS-R remained consistent when tested at two developmental ages in young infants. STUDY DESIGN In this prospective cohort study, infants were tested twice with the MOS-R between 12 and 13 weeks corrected age (CA) and 14-16 weeks CA. Bland Altman Plots were used to calculate agreement between the scores. Infants were grouped as having higher or lower medical complexity. MOS-R threshold scores were analyzed to assess changes over time within each group using Fisher's exact test. SUBJECTS 85 infants with history of hospitalization in a neonatal intensive care unit (NICU). RESULTS The MOS-R scores had a high agreement with negligible bias (0.058) between timepoints (95 % CI -1.10, 1.22). Using a MOS-R cut point of 19, infants with higher medical complexity were more likely to change groups between timepoints than infants with lower medical complexity (p = 0.008), but this was not significantly different using cut points of 20 or 21. CONCLUSION The MOS-R scores were stable when measured repeatedly in infants who were hospitalized in a NICU. Infants with high medical complexity had less stable MOS-R scores using certain cut points than infants with lower medical complexity.
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Affiliation(s)
- Colleen Peyton
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, 645 N Michigan Ave, Suite 1100, Chicago, IL, 60611, USA; Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
| | - David Aaby
- Department of Research Services, Northwestern University Libraries, Chicago, IL, USA; Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
| | - Ryan Millman
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, 645 N Michigan Ave, Suite 1100, Chicago, IL, 60611, USA
| | - Sarah Rodriguez
- Department of Ophthalmology and Visual Science, University of Chicago, Chicago, IL, USA
| | - Lynn Boswell
- Ann and Robert H Lurie Children's Hospital, Chicago, IL, USA
| | - Deborah Gaebler-Spira
- Ann and Robert H Lurie Children's Hospital, Chicago, IL, USA; Shirley Ryan AbilityLab, Chicago, IL, USA; Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University
| | - Raye-Ann de Regnier
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; Ann and Robert H Lurie Children's Hospital, Chicago, IL, USA
| | | | - Theresa Sukal-Moulton
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, 645 N Michigan Ave, Suite 1100, Chicago, IL, 60611, USA; Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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Caesar RA, Boyd RN, Cioni G, Ware RS, Doherty J, Jackson MP, Salthouse KL, Colditz PB. Early detection of developmental delay in infants born very preterm or with very low birthweight. Dev Med Child Neurol 2023; 65:346-357. [PMID: 37017185 PMCID: PMC10952560 DOI: 10.1111/dmcn.15381] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 07/14/2022] [Accepted: 07/15/2022] [Indexed: 12/19/2022]
Abstract
AIM This study aimed to identify early clinical biomarkers from birth to 16 weeks corrected age to predict typical outcome and developmental delay in infants born very preterm or with very low birthweight. METHOD A prospective cohort of infants on the Sunshine Coast, Australia, was assessed using the Premie-Neuro Examination, the General Movement Assessment (GMA), the Alberta Infant Motor Scale, and the Infant Sensory Profile 2. At 24 months corrected age, delay was identified using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) and Neurosensory Motor Developmental Assessment (NSMDA). RESULTS One hundred and four infants were recruited; 79 completed outcome assessments (43 females, 36 males; mean gestational age 30 weeks [SD 1 week 6 days], mean birthweight 1346 g [SD 323]). The incidence of developmental delay (motor or cognitive) was 6.3%. Suboptimal quality of fidgety general movements (temporal organization) at 16 weeks corrected age demonstrated the best predictive accuracy (Bayley-III motor: sensitivity 100% [95% confidence interval {CI} 3-100], specificity 75% [95% CI 63-84], area under the curve [AUC] 0.87); Bayley-III cognitive: sensitivity 100% [95% CI 3-100], specificity 75% [95% CI 64-84], AUC 0.88); NSMDA motor: sensitivity 100% [95% CI 40-100], specificity 81% [95% CI 70-90], AUC 0.91 [95% CI 0.86-0.95]). GMA trajectories that combined abnormal writhing general movements at 4 to 5 weeks corrected age with suboptimal quality of fidgety movement at 16 weeks corrected age were strongly predictive of developmental delay, superior to all other clinical tools, and perinatal and demographic variables investigated (p = 0.01, Akaike information criterion method 18.79 [score corrected for small sample size], accounting for 93% of the cumulative weight). INTERPRETATION Only the GMA had sufficient predictive validity to act as a biomarker for both conditions: typical outcome and developmental delay (motor or cognitive). GMA trajectories that assessed both writhing general movements at 4 to 5 weeks corrected age and quality of fidgety movement at 16 weeks corrected age predicted adverse neurodevelopmental outcome, accurately differentiating between infants with typical outcomes and those at increased risk for motor or cognitive delay.
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Affiliation(s)
- Rebecca A. Caesar
- Women's and Children's ServiceSunshine Coast University Hospital (SCUH), Sunshine Coast Hospital and Health Service District (SCHHS)Sunshine CoastAustralia
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of MedicineThe University of Queensland, Child Health Research CentreBrisbaneAustralia
| | - Roslyn N. Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of MedicineThe University of Queensland, Child Health Research CentreBrisbaneAustralia
| | - Giovanni Cioni
- Department of Developmental NeuroscienceIRCCS Fondazione Stella MarisPisaItaly
| | - Robert S. Ware
- Griffith University, Menzies Health Institute QueenslandGold CoastAustralia
| | - Julie Doherty
- Women's and Children's ServiceSunshine Coast University Hospital (SCUH), Sunshine Coast Hospital and Health Service District (SCHHS)Sunshine CoastAustralia
| | - Maxine P. Jackson
- Women's and Children's ServiceSunshine Coast University Hospital (SCUH), Sunshine Coast Hospital and Health Service District (SCHHS)Sunshine CoastAustralia
| | - Kaye L. Salthouse
- Women's and Children's ServiceSunshine Coast University Hospital (SCUH), Sunshine Coast Hospital and Health Service District (SCHHS)Sunshine CoastAustralia
| | - Paul B. Colditz
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of MedicineThe University of Queensland, Child Health Research CentreBrisbaneAustralia
- The University of Queensland Centre for Clinical Research, Faculty of MedicineThe University of Queensland, Royal Brisbane and Women's HospitalBrisbaneAustralia
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Sermpon N, Gima H. Relationship between fidgety movement and frequency of movement toward midline: An observational study. Early Hum Dev 2023; 177-178:105718. [PMID: 36801663 DOI: 10.1016/j.earlhumdev.2023.105718] [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: 10/04/2022] [Revised: 01/24/2023] [Accepted: 01/24/2023] [Indexed: 02/04/2023]
Abstract
BACKGROUND Infants show other movements and posture patterns during the fidgety movement period, including movement toward midline (MTM). Few studies have quantified MTM occurring during the fidgety movement period. AIMS This study aimed to examine the relationship between fidgety movements (FMs) and MTM frequency and occurrence rate per minute, from two video data sets (video attached to Prechtl video manual and accuracy data from Japan). STUDY DESIGN Observational study. SUBJECTS It encompassed 47 videos. Of these, 32 were deemed normal FMs. The study amalgamated FMs that were sporadic, abnormal, or absent into a category of aberrant (n = 15). OUTCOME MEASURES Infant video data were observed. MTM item occurrences were recorded and calculated for occurrence percentage and MTM rate of occurrence per minute. The differences between groups for the upper limbs, lower limbs, and total MTM were statistically analysed. RESULTS Twenty-three infant videos of normal FMs and seven infant videos of aberrant FMs showed MTM. Eight infant videos of aberrant FMs showed no MTM, and only four with absent FMs were included. There was a significant difference in the total MTM rate of occurrence per minute between normal FMs versus aberrant FMs (p = 0.008). CONCLUSIONS This study presented MTM frequency and rate of occurrence per minute in infants who showed FMs during the fidgety movement period. Those who showed absent FMs also demonstrated no MTM. Further study may need a larger sample size of absent FMs and information on later development.
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Affiliation(s)
- Nisasri Sermpon
- Department of Physical Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Japan; Faculty of Physical Therapy, Mahidol University, Thailand
| | - Hirotaka Gima
- Department of Physical Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Japan.
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The Early Motor Repertoire in Preterm Infancy and Cognition in Young Adulthood: Preliminary Findings. J Int Neuropsychol Soc 2023; 29:80-91. [PMID: 34974853 DOI: 10.1017/s1355617721001351] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Preterm birth poses a risk to cognition during childhood. The resulting cognitive problems may persist into young adulthood. The early motor repertoire in infancy is predictive of neurocognitive development in childhood. Our present aim was to investigate whether it also predicts neurocognitive status in young adulthood. METHOD We conducted an explorative observational follow-up study in 37 young adults born at a gestational age of less than 35 weeks and/or with a birth weight below 1200 g. Between 1992 and 1997, these individuals were videotaped up until 3 months' corrected age to assess the quality of their early motor repertoire according to Prechtl. The assessment includes general movements, fidgety movements (FMs), and a motor optimality score (MOS). In young adulthood, the following cognitive domains were assessed: memory, speed of information processing, language, attention, and executive function. RESULTS Participants in whom FMs were absent in infancy obtained lower scores on memory, speed of information processing, and attention than those with normal FMs. Participants with aberrant FMs, that is, absent or abnormal, obtained poorer scores on memory, speed of information processing speed, attention, and executive function compared to peers who had normal FMs. A higher MOS was associated with better executive function. CONCLUSIONS The quality of the early motor repertoire is associated with performance in various cognitive domains in young adulthood. This knowledge may be applied to enable the timely recognition of preterm-born individuals at risk of cognitive dysfunctions.
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Bektas H, Bektas MS, Dasdag S. Effect of mobile phone usage duration during pregnancy on the general motor movements of infants. BIOTECHNOL BIOTEC EQ 2022. [DOI: 10.1080/13102818.2022.2046505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Hava Bektas
- Department of Biophysics, Medical School of Van Yuzuncu Yil University, Van, Turkey
| | - Mehmet Selcuk Bektas
- Division of Neonatology, Department of Pediatrics, Lokman Hekim Hospital, Van, Turkey
| | - Suleyman Dasdag
- Department of Biophysics, Medical School of İstanbul Medeniyet University, İstanbul, Turkey
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Dicanio D, Spoto G, Alibrandi A, Minutoli R, Nicotera AG, Di Rosa G. Long-term predictivity of early neurological assessment and developmental trajectories in low-risk preterm infants. Front Neurol 2022; 13:958682. [PMID: 36237623 PMCID: PMC9551311 DOI: 10.3389/fneur.2022.958682] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 09/05/2022] [Indexed: 11/21/2022] Open
Abstract
Prematurity represents 10.6% of all births, and although preterm infants usually show adequate neurodevelopmental outcomes, some may develop significant and long-lasting neurological sequelae. Many studies have analyzed predictive factors for developing severe neurodevelopmental impairments (cerebral palsy, other motor and socio-relational disorders such as autism). In this study, 148 preterm infants were enrolled to investigate the neurodevelopmental trajectories in a population of low-risk premature infants using standardized assessment methods. Significant correlations were found between the general movements, the Hammersmith Infant Neurological Examination, and the Griffiths Mental and Development Scales. Moreover, this study showed their validity and predictivity for adverse neurodevelopmental outcomes even in low-risk infants.
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Affiliation(s)
- Daniela Dicanio
- Unit of Child Neurology and Psychiatry, Department of Human Pathology of the Adult and Developmental Age, “Gaetano Barresi” University of Messina, Messina, Italy
| | - Giulia Spoto
- Unit of Child Neurology and Psychiatry, Department of Human Pathology of the Adult and Developmental Age, “Gaetano Barresi” University of Messina, Messina, Italy
| | | | - Roberta Minutoli
- Unit of Child Neurology and Psychiatry, Department of Human Pathology of the Adult and Developmental Age, “Gaetano Barresi” University of Messina, Messina, Italy
| | - Antonio Gennaro Nicotera
- Unit of Child Neurology and Psychiatry, Department of Human Pathology of the Adult and Developmental Age, “Gaetano Barresi” University of Messina, Messina, Italy
- *Correspondence: Antonio Gennaro Nicotera
| | - Gabriella Di Rosa
- Unit of Child Neurology and Psychiatry, Department of Human Pathology of the Adult and Developmental Age, “Gaetano Barresi” University of Messina, Messina, Italy
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Krieber-Tomantschger M, Pokorny FB, Krieber-Tomantschger I, Langmann L, Poustka L, Zhang D, Treue S, Tanzer NK, Einspieler C, Marschik PB, Körner C. The development of visual attention in early infancy: Insights from a free-viewing paradigm. INFANCY 2022; 27:433-458. [PMID: 34981647 DOI: 10.1111/infa.12449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 11/19/2021] [Accepted: 12/07/2021] [Indexed: 12/30/2022]
Abstract
Theories of visual attention suggest a cascading development of subfunctions such as alertness, spatial orientation, attention to object features, and endogenous control. Here, we aimed to track infants' visual developmental steps from a primarily exogenously to more endogenously controlled processing style during their first months of life. In this repeated measures study, 51 infants participated in seven fortnightly assessments at postterm ages of 4-16 weeks. Infants were presented with the same set of static and dynamic paired comparison stimuli in each assessment. Visual behavior was evaluated by a newly introduced scoring scheme. Our results confirmed the suggested visual developmental hierarchy and clearly demonstrated the suitability of our scoring scheme for documenting developmental changes in visual attention during early infancy. Besides the general ontogenetic course of development, we also discuss intra- and interindividual differences which may affect single assessments, and highlight the importance of repeated measurements for reliable evaluation of developmental changes.
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Affiliation(s)
- Magdalena Krieber-Tomantschger
- Research Unit iDN - interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, Graz, Austria
| | - Florian B Pokorny
- Research Unit iDN - interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, Graz, Austria
| | - Iris Krieber-Tomantschger
- Research Unit iDN - interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, Graz, Austria
| | - Laura Langmann
- Research Unit iDN - interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, Graz, Austria
| | - Luise Poustka
- Child and Adolescent Psychiatry and Psychotherapy, Georg-August University Goettingen, University Medical Center Goettingen, Goettingen, Germany
| | - Dajie Zhang
- Research Unit iDN - interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, Graz, Austria
- Child and Adolescent Psychiatry and Psychotherapy, Georg-August University Goettingen, University Medical Center Goettingen, Goettingen, Germany
- Leibniz-ScienceCampus Primate Cognition, Goettingen, Germany
| | - Stefan Treue
- Leibniz-ScienceCampus Primate Cognition, Goettingen, Germany
- Cognitive Neuroscience Laboratory, German Primate Center - Leibniz Institute for Primate Research, Goettingen, Germany
- Bernstein Center for Computational Neuroscience, Goettingen, Germany
- Faculty for Biology and Psychology, University of Goettingen, Goettingen, Germany
| | | | - Christa Einspieler
- Research Unit iDN - interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, Graz, Austria
| | - Peter B Marschik
- Research Unit iDN - interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, Graz, Austria
- Child and Adolescent Psychiatry and Psychotherapy, Georg-August University Goettingen, University Medical Center Goettingen, Goettingen, Germany
- Leibniz-ScienceCampus Primate Cognition, Goettingen, Germany
- Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), Karolinska Institutet, Stockholm, Sweden
| | - Christof Körner
- Cognitive Psychology & Neuroscience, Institute of Psychology, University of Graz, Graz, Austria
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Lev-Enacab O, Sher-Censor E, Einspieler C, Jacobi OA, Daube-Fishman G, Beni-Shrem S. Spontaneous movements, motor milestones, and temperament of preterm-born infants: Associations with mother-infant attunement. INFANCY 2022; 27:412-432. [PMID: 34989463 DOI: 10.1111/infa.12451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 10/26/2021] [Accepted: 12/13/2021] [Indexed: 12/26/2022]
Abstract
Preterm-born infants and their mothers are at higher risk of showing less attuned interactions. We sought to identify characteristics of preterm-born infants associated with the attunement of mother-infant interactions at the corrected ages of 3-4 months, looking specifically at motor behaviors. We focused on infants' spontaneous movements, achievement of motor milestones, and temperament, which at this young age is often manifested via movement. Sixty preterm-born infants (Mdngestation age in weeks = 33, 57.38% male, corrected age Mdn = 14 weeks, interquartile range = 13-16) and their mothers participated. Independent observers rated mother-infant attunement, infants' spontaneous movements, and infants' achievement of motor milestones. Mothers reported infant temperament. We found infants' smooth and fluent movement character and continual fidgety movements were associated with better attunement in terms of higher maternal sensitivity and non-intrusiveness and higher infant responsiveness and involvement. Unexpectedly, infants' achievement of motor milestones was not significantly associated with mother-infant attunement, and maternal reports of infants' higher soothability were associated with lower maternal sensitivity. The study illustrates the value of including the assessment of infants' spontaneous movements, designed for early detection of neurological deficiencies, in research and in clinical practice with parents and preterm-born infants.
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Affiliation(s)
- Orna Lev-Enacab
- Maccabi Health Care Service, Haifa, Israel.,University of Haifa, Haifa, Israel
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Elliott C, Alexander C, Salt A, Spittle AJ, Boyd RN, Badawi N, Morgan C, Silva D, Geelhoed E, Ware RS, Ali A, McKenzie A, Bloom D, Sharp M, Ward R, Bora S, Prescott S, Woolfenden S, Le V, Davidson SA, Thornton A, Finlay-Jones A, Jensen L, Amery N, Valentine J. Early Moves: a protocol for a population-based prospective cohort study to establish general movements as an early biomarker of cognitive impairment in infants. BMJ Open 2021; 11:e041695. [PMID: 33837094 PMCID: PMC8043010 DOI: 10.1136/bmjopen-2020-041695] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/30/2020] [Accepted: 11/23/2020] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The current diagnostic pathways for cognitive impairment rarely identify babies at risk before 2 years of age. Very early detection and timely targeted intervention has potential to improve outcomes for these children and support them to reach their full life potential. Early Moves aims to identify early biomarkers, including general movements (GMs), for babies at risk of cognitive impairment, allowing early intervention within critical developmental windows to enable these children to have the best possible start to life. METHOD AND ANALYSIS Early Moves is a double-masked prospective cohort study that will recruit 3000 term and preterm babies from a secondary care setting. Early Moves will determine the diagnostic value of abnormal GMs (at writhing and fidgety age) for mild, moderate and severe cognitive delay at 2 years measured by the Bayley-4. Parents will use the Baby Moves smartphone application to video their babies' GMs. Trained GMs assessors will be masked to any risk factors and assessors of the primary outcome will be masked to the GMs result. Automated scoring of GMs will be developed through applying machine-based learning to the data and the predictive value for an abnormal GM will be investigated. Screening algorithms for identification of children at risk of cognitive impairment, using the GM assessment (GMA), and routinely collected social and environmental profile data will be developed to allow more accurate prediction of cognitive outcome at 2 years. A cost evaluation for GMA implementation in preparation for national implementation will be undertaken including exploring the relationship between cognitive status and healthcare utilisation, medical costs, health-related quality of life and caregiver burden. ETHICS AND DISSEMINATION Ethics approval has been granted by the Medical Research Ethics Committee of Joondalup Health Services and the Health Service Human Research Ethics Committee (1902) of Curtin University (HRE2019-0739). TRIAL REGISTRATION NUMBER ACTRN12619001422112.
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Affiliation(s)
- Catherine Elliott
- Curtin University, Perth, Western Australia, Australia
- Telethon Kids Institute, Nedlands, West Australia, Australia
| | | | - Alison Salt
- Perth Children's Hospital, Perth, Western Australia, Australia
| | | | - Roslyn N Boyd
- The University of Queensland, Brisbane, Queensland, Australia
| | - Nadia Badawi
- Cerebral Palsy Alliance Research Institute, Sydney, New South Wales, Australia
- Grace Centre for Newborn Intestive Care, The Childrens Hospital at Westmead, Sydney, New South Wales, Australia
- University of Sydney, Sydney, New South Wales, Australia
| | - Catherine Morgan
- Cerebral Palsy Alliance Research Institute, Sydney, New South Wales, Australia
- University of Sydney, Sydney, New South Wales, Australia
| | - Desiree Silva
- University of Western Australia, Perth, Western Australia, Australia
| | | | - Robert S Ware
- Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia
| | - Alishum Ali
- Curtin University, Perth, Western Australia, Australia
| | - Anne McKenzie
- University of Western Australia, Perth, Western Australia, Australia
| | - David Bloom
- Harvard University, Cambridge, Massachusetts, USA
| | - Mary Sharp
- University of Western Australia, Perth, Western Australia, Australia
| | - Roslyn Ward
- Curtin University, Perth, Western Australia, Australia
- University of Notre Dame, Perth, WA, Australia
| | - Samudragupta Bora
- The University of Queensland, Brisbane, Queensland, Australia
- Mothers, Babies and Women's Health Program, Mater Research Institute, Brisbane, Queensland, Australia
| | - Susan Prescott
- University of Western Australia, Perth, Western Australia, Australia
| | - Susan Woolfenden
- University of New South Wales, Kensington, New South Wales, Australia
| | - Vuong Le
- Deakin University, Geelong, Victoria, Australia
| | | | - Ashleigh Thornton
- Perth Children's Hospital, Perth, Western Australia, Australia
- University of Western Australia, Perth, Western Autralian, Australia
| | - Amy Finlay-Jones
- Curtin University, Perth, Western Australia, Australia
- Telethon Kids Institute, Nedlands, West Australia, Australia
| | - Lynn Jensen
- Curtin University, Perth, Western Australia, Australia
| | - Natasha Amery
- Curtin University, Perth, Western Australia, Australia
| | - Jane Valentine
- Perth Children's Hospital, Perth, Western Australia, Australia
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The ontogeny of limbs movements towards midline in healthy infants born at term. Early Hum Dev 2021; 155:105324. [PMID: 33581484 DOI: 10.1016/j.earlhumdev.2021.105324] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 01/04/2021] [Accepted: 01/24/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Movements towards midline are part of the age-adequate motor repertoire of infants. They develop contemporaneously to general movements, changing from occasional simple contact to proper midline motor patterns. AIM The aim of this study is to describe the ontogeny of movements towards midline in full term healthy infants. STUDY DESIGN Parents were asked to record their infant every second week, from term age to 22 weeks post-term. SUBJECTS 25 healthy full-term infants. RESULTS Three main epochs of development were detected: in the first one, between birth and 4 weeks post-term, movements towards midline were occasional, apparently due to the dominant flexed posture of elbow and knees and the adducted posture of shoulders and hips. In the second epoch, from 4 to 8 weeks, the limbs movements towards midline markedly decreased. In the third one, after 8 weeks, movements towards midline increased again in frequency, first appearing in lower limbs then in upper limbs, first solely as contact and thereafter as manipulation. A temporal overlapping with the occurrence of intermittent or continual fidgety movements was detected. CONCLUSIONS Movements towards midline progressively change, through a defined timeline, in full term healthy infants. The increased knowledge about the normal age-adequate motor repertoire can help physicians in clinical assessment of high risk infants.
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Lucaccioni L, Boncompagni A, Pugliese M, Talucci G, Della Casa E, Bertoncelli N, Coscia A, Bedetti L, Berardi A, Iughetti L, Ferrari F. Subtle impairment of neurodevelopment in infants with late fetal growth restriction. J Matern Fetal Neonatal Med 2021; 35:4927-4934. [PMID: 33455501 DOI: 10.1080/14767058.2021.1873267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Children with late fetal growth restriction (FGR) are at high risk of being born small for gestational age (SGA). These categories of newborns are at increased risk for neurodevelopment impairment. The general movements assessment, in particular at fidgety age, has been used to predict neurological dysfunctions. This study aimed to evaluate growth recovery, presence of fidgety movements at 3 months, and neurodevelopmental outcome at 2 years of age in term late FGR infants and adequate for gestational age (AGA) controls. METHODS Prospective clinical evaluation. At 3 months auxological parameters (AP) and neurological examination were evaluated while at 24 months neurodevelopment outcome by Griffiths Mental Development Scales (GMDS-R) was evaluated. RESULTS 38 late FGR and 20 AGA controls completed the study. Despite a significant catch up, at 3 months 13% of late FGR presented at least one auxological parameter <3° percentile. Moreover, 23.7% of late FGR infants did not show fidgety movements compared to 100% AGA controls (p < .001). Cranial circumference at birth resulted a positive predictive factor for FMs (p = .039). At 2 years of age, a difference statistically significant between late FGR and AGA was detected in GMDS-R. CONCLUSION Independently from growth recovery, fidgety movements resulted less expressed in late FGR infants, and at 2 years of age the neurodevelopmental assessment revealed differences in each domain of evaluation between late FGR and AGA infants, although within normal ranges.
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Affiliation(s)
- Laura Lucaccioni
- Neonatal Intensive Care Unit, Department of Clinical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Alessandra Boncompagni
- Neonatal Intensive Care Unit, Department of Clinical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Marisa Pugliese
- Department of Clinical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Giovanna Talucci
- Department of Clinical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Elisa Della Casa
- Neonatal Intensive Care Unit, Department of Clinical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Natascia Bertoncelli
- Neonatal Intensive Care Unit, Department of Clinical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Luca Bedetti
- Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Alberto Berardi
- Neonatal Intensive Care Unit, Department of Clinical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Lorenzo Iughetti
- Department of Clinical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Fabrizio Ferrari
- Neonatal Intensive Care Unit, Department of Clinical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
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Ferrari F, Bedetti L, Bertoncelli N, Roversi MF, Della Casa E, Guidotti I, Ori L, D'Amico R, Valeri L, Lugli L, Lucaccioni L, Berardi A. Foot-to-Foot Contact Among Initial Goal-Directed Movements Supports the Prognostic Value of Fidgety Movements in HIE-Cooled Infants. Front Pediatr 2021; 9:731021. [PMID: 35071123 PMCID: PMC8767005 DOI: 10.3389/fped.2021.731021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 11/22/2021] [Indexed: 11/23/2022] Open
Abstract
Background: Few studies conducted to date have observed general movements in infants affected by hypoxic-ischemic encephalopathy (HIE) who underwent therapeutic hypothermia. We investigated whether foot-to-foot contact (FF) could support the predictive value of fidgety movements (FMs) in infants affected by HIE and treated with brain cooling. Methods: Spontaneous motility was video recorded for 3-5 min at 12 weeks post-term age in 58 full-term newborn infants affected by perinatal asphyxia who were cooled due to moderate to severe HIE. FF and FMs were blindly scored by three independent observers. At 24 months, each patient underwent a neurological examination by Amiel-Tison and Grenier. Results: At 24 months, 47 infants had developed typically at neurological examination, eight had developed mild motor impairment, and three developed cerebral palsy (CP). At 12 weeks, 34 (58.6%) infants had shown normal FMs, four of whom developed mild motor impairment. Twenty-four infants (41.4%) exhibited abnormal or no FMs, four of whom developed mild motor impairment and three developed CP. FF was present in 20 infants (34.5%), two of whom developed mild motor impairment. FF was absent in 38 infants (65.5%), six of whom developed mild motor impairment and three developed CP. Both FMs and FF, considered separately, were 100% sensitive for predicting CP at 24 months, but only 61 and 36%, respectively, were specific. Summing the two patterns together, the specificity increases to 73%, considering only CP as an abnormal outcome, and increases to 74% when considering CP plus mild motor impairment. Unexpectedly, fidgety movements were absent in 24 infants with typical motor outcomes, 17 of whom showed a typical motor outcome. Conclusions: FF is already part of motor repertoire at 12 weeks and allows a comparison of spontaneous non-voluntary movements (FMs) to pre-voluntary movements (FF). FF supports FMs for both sensitivity and specificity. A second video recording at 16-18 weeks, when pedipulation is present in healthy infants, is suggested: it may better define the presence or absence of goal-directed motility.
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Affiliation(s)
- Fabrizio Ferrari
- Neonatal Intensive Care Unit, Women's and Children's Health Department, University Hospital of Modena, Modena, Italy
| | - Luca Bedetti
- Neonatal Intensive Care Unit, Women's and Children's Health Department, University Hospital of Modena, Modena, Italy.,PhD Program in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Natascia Bertoncelli
- Neonatal Intensive Care Unit, Women's and Children's Health Department, University Hospital of Modena, Modena, Italy
| | - Maria Federica Roversi
- Neonatal Intensive Care Unit, Women's and Children's Health Department, University Hospital of Modena, Modena, Italy
| | - Elisa Della Casa
- Neonatal Intensive Care Unit, Women's and Children's Health Department, University Hospital of Modena, Modena, Italy
| | - Isotta Guidotti
- Neonatal Intensive Care Unit, Women's and Children's Health Department, University Hospital of Modena, Modena, Italy
| | - Luca Ori
- Neonatal Intensive Care Unit, Women's and Children's Health Department, University Hospital of Modena, Modena, Italy
| | - Roberto D'Amico
- Unit of Statistics, Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Lara Valeri
- Pediatric Post-graduate School, University Hospital of Modena and Reggio Emilia, Modena, Italy
| | - Licia Lugli
- Neonatal Intensive Care Unit, Women's and Children's Health Department, University Hospital of Modena, Modena, Italy
| | - Laura Lucaccioni
- Pediatrics, Women's and Children's Health Department, University Hospital of Modena, Modena, Italy
| | - Alberto Berardi
- Neonatal Intensive Care Unit, Women's and Children's Health Department, University Hospital of Modena, Modena, Italy
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Einspieler C, Zhang D, Marschik PB. Die Bedeutung fötaler und neonataler Motorik für die kindliche Entwicklung und die Früherkennung von Entwicklungsstörungen. KINDHEIT UND ENTWICKLUNG 2021. [DOI: 10.1026/0942-5403/a000323] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Zusammenfassung. Theoretischer Hintergrund: Die von Central Pattern Generators (CPGs) generierten Bewegungen des Neugeborenen und jungen Säuglings haben eine lange pränatale Vorgeschichte. Fragestellung: Welche Bedeutung hat die Analyse der CPG-Aktivität, besonders der General Movements (GMs) in der entwicklungsneurologischen Diagnostik? Methode: Unsere Übersichtsarbeit bezieht sich auf Prechtl’s General Movement Assessment (GMA), das ab dem Frühgeborenenalter bis zum Ende des 5. Monats nach einer Termingeburt anwendbar ist. Ergebnisse: Das GMA ermöglicht die Vorhersage einer Zerebralparese mit einer Sensitivität von 98 % und einer Spezifität von 91 %. Abnormale cramped-synchronized GMs sind ein früher Marker für spastische Zerebralparesen. Das Fehlen von Fidgety Movements (im 3.–5. Monat) weist auf alle Formen der Zerebralparese hin und kann auch bei bestimmten genetischen Erkrankungen auftreten. Zwei von drei Säuglingen mit einer späteren Diagnose Autismus haben atypische GMs und fallen vor allem durch ihre Monotonie in den Bewegungen auf. Diskussion und Schlussfolgerung: Mittels GMA lassen sich mit großer Treffsicherheit typische Entwicklungsverläufe vorhersagen oder aber ein Risiko für einen atypischen Verlauf erkennen und somit frühzeitige Interventionen einleiten.
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Affiliation(s)
- Christa Einspieler
- iDN – interdisciplinary Developmental Neuroscience, Klinische Abteilung für Phoniatrie, Medizinische Universität Graz
| | - Dajie Zhang
- iDN – interdisciplinary Developmental Neuroscience, Klinische Abteilung für Phoniatrie, Medizinische Universität Graz
- Kinder- und Jugendpsychiatrie und Psychotherapie, Universitätsmedizin Göttingen, Georg-August-Universität Göttingen
- Leibniz-WissenschaftsCampus Primatenkognition, Göttingen
| | - Peter B. Marschik
- iDN – interdisciplinary Developmental Neuroscience, Klinische Abteilung für Phoniatrie, Medizinische Universität Graz
- Kinder- und Jugendpsychiatrie und Psychotherapie, Universitätsmedizin Göttingen, Georg-August-Universität Göttingen
- Leibniz-WissenschaftsCampus Primatenkognition, Göttingen
- Center of Neurodevelopmental Disorders (KIND), Department of Women’s and Children’s Health, Karolinska Institutet Stockholm
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Wu Y, Bouwstra H, Heineman KR, Hadders‐Algra M. Atypical general movements in the general population: Prevalence over the last 15 years and associated factors. Acta Paediatr 2020; 109:2762-2769. [PMID: 32335944 PMCID: PMC7754433 DOI: 10.1111/apa.15329] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 03/16/2020] [Accepted: 04/22/2020] [Indexed: 11/30/2022]
Abstract
AIM To determine the prevalence of atypical general movements (GMs) in the general population, to examine its time trend and associated factors. METHODS Participants consisted of 300 infants born in 2016-2018 (current cohort; gestational age 39.4 weeks (27-42); 162 boys), representative of the Dutch population. GMs were assessed at 2-4 months corrected age in terms of GM-complexity (definitely abnormal (DA) or not) and fidgety movements (present or absent). GM-complexity data from a cohort of 455 Dutch infants born in 2001-2002 were used to investigate the time trend. RESULTS In the current cohort, 10 infants (3%) showed DA GM-complexity and 8 (3%) absent fidgety movements. Only one infant had both GM-impairments (0.3%). The prevalence of DA GM-complexity did not differ from that in the 2001-2002 cohort (adjusted odds ratio (OR) = 1.47 [0.53, 4.06]). DA GM-complexity was associated with maternal smoking (adjusted OR = 3.59 [1.56, 8.28]) and marginally with prematurity (adjusted OR = 2.78 [1.00, 7.74]); absence of fidgety movements was curvilinearly associated with assessment age only (OR = 1.06 [1.01, 1.12]). CONCLUSION In the general population, the prevalence of DA GM-complexity and absent fidgety movements is 3%. The finding that they rarely co-occur and are associated with different factors indicates that GM-assessment needs to address both aspects.
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Affiliation(s)
- Ying‐Chin Wu
- University of Groningen, University Medical Center GroningenDepartment of PaediatricsDivision of Developmental NeurologyGroningenThe Netherlands
| | - Hylco Bouwstra
- University of Groningen, University Medical Center GroningenDepartment of PaediatricsDivision of Developmental NeurologyGroningenThe Netherlands
- Department of General Practice and Elderly Care MedicineAmsterdam UMCAmsterdamThe Netherlands
| | - Kirsten R. Heineman
- University of Groningen, University Medical Center GroningenDepartment of PaediatricsDivision of Developmental NeurologyGroningenThe Netherlands
- SEIN Stichting Epilepsie Instellingen NederlandZwolleThe Netherlands
| | - Mijna Hadders‐Algra
- University of Groningen, University Medical Center GroningenDepartment of PaediatricsDivision of Developmental NeurologyGroningenThe Netherlands
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Sokołów M, Adde L, Klimont L, Pilarska E, Einspieler C. Early intervention and its short-term effect on the temporal organization of fidgety movements. Early Hum Dev 2020; 151:105197. [PMID: 32979679 DOI: 10.1016/j.earlhumdev.2020.105197] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 09/15/2020] [Accepted: 09/17/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND The Prechtl General Movement Assessment (GMA) predicts various neurological and developmental disorders while also documenting therapeutic effects. AIMS To describe the temporal organization of fidgety general movements in infants with mild to moderate postural asymmetries and/or tonus regulation problems, and to analyze to what extent the temporal organization of fidgety movements will change after physiotherapy. STUDY DESIGN Repeated measure design. PARTICIPANTS Twelve infants (five females) with mild to moderate postural asymmetries and/or tonus regulation problems were admitted for an early intervention program. The gestational age ranged from 27 to 40 weeks (Median, 36 weeks; nine infants born preterm) with birth weights ranging from 740 g to 3500 g (Median, 2590 g). MEASURES Fidgety movements and their temporal organization were measured using the Prechtl GMA at 9 to 19 weeks post term age (Median, 14 weeks) before and after an early motor training procedure. The movements of one of the infants were analysed using a computer-based approach, measuring the mean and standard deviation of quantity of motion, height of motion and width of motion. RESULTS Seven infants had sporadic fidgety movements, and five had intermittent fidgety movements. None had continual fidgety movements before the intervention was initiated. After intervention, the temporal organization of fidgety movements increased in all infants. The observations of these movements were supported by computer-based analysis. CONCLUSION The study indicates that early intervention increases the temporal organization of fidgety movements in infants with postural asymmetries and/or tonus regulation problems. The clinical significance of this finding needs to be further evaluated.
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Affiliation(s)
- Michal Sokołów
- Medical University of Gdańsk, Department of Physical Therapy, Dębinki 7, 80-211 Gdansk, Poland; Centre of Early Intervention in Gdańsk, Jagiellońska 11, 80-371 Gdańsk, Poland.
| | - Lars Adde
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Olav Kyrres gt. 11, 7491 Trondheim, Norway; Clinics of Clinical Services, St. Olavs Hospital, Trondheim University Hospital, Olav Kyrres gt. 17, 7006 Trondheim, Norway.
| | - Liliana Klimont
- Akershus University Hospital, Dept of Pediatric and Adolescent Rehabilitation, Postboks 1000, 1478 Lørenskog, Norway.
| | - Ewa Pilarska
- Medical University of Gdańsk, Department of Developmental Neurology, Dębinki 7, 80-211 Gdańsk, Poland.
| | - Christa Einspieler
- iDN interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, Auenbruggerplatz 26, 8036 Graz, Austria.
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17
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Kinoshita N, Furui A, Soh Z, Hayashi H, Shibanoki T, Mori H, Shimatani K, Funabiki Y, Tsuji T. Longitudinal assessment of U-shaped and inverted U-shaped developmental changes in the spontaneous movements of infants via markerless video analysis. Sci Rep 2020; 10:16827. [PMID: 33033352 PMCID: PMC7545215 DOI: 10.1038/s41598-020-74006-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 09/23/2020] [Indexed: 11/13/2022] Open
Abstract
Various attempts have been made to elucidate the development patterns in the spontaneous movements of infants through longitudinal evaluations. Movement complexity has been found to demonstrate u-shaped changes in the measurements focusing on limb movements. However, researchers have not yet clarified how other characteristics, besides movement complexity, change over time. This paper presents a longitudinal evaluation of spontaneous movements in infants using evaluation indices calculated through markerless video analysis. Nine infants with corrected ages from \documentclass[12pt]{minimal}
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\begin{document}$$-1$$\end{document}-1 to 15 weeks participated in the experiments. We confirmed the change in indices over time using statistical methods. Index changes can be classified as positively correlated, u-shaped, inverted u-shaped, and uncorrelated. We also confirmed that the u-shaped and inverted u-shaped indices are negatively correlated. Furthermore, the principal component analysis revealed that the first principal component had the inverted u-shaped changes with the corrected age. These results suggest that it is important to synchronize the inverted u-shaped variations in the movement and velocity with the u-shaped changes in the movement complexity for infant development.
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Affiliation(s)
- Naoki Kinoshita
- Graduate School of Engineering, Hiroshima University, 1-4-1 Kagamiyama, Higashi-Hiroshima, Hiroshima, 739-8527, Japan
| | - Akira Furui
- Graduate School of Advanced Science and Engineering, Hiroshima University, 1-4-1 Kagamiyama, Higashi-Hiroshima, Hiroshima, 739-8527, Japan.
| | - Zu Soh
- Graduate School of Advanced Science and Engineering, Hiroshima University, 1-4-1 Kagamiyama, Higashi-Hiroshima, Hiroshima, 739-8527, Japan
| | - Hideaki Hayashi
- Faculty of Information Science and Electrical Engineering, Kyushu University, 744 Motooka, Nishi-Ku, Fukuoka, 819-0395, Japan
| | - Taro Shibanoki
- College of Engineering, Ibaraki University, 4-12-1 Nakanarusawa, Hitachi, Ibaraki, 316-8511, Japan
| | - Hiroki Mori
- Future Robotics Organization, Waseda University, 1-104 Totsuka, Shinjuku-Ku, Tokyo, 169-8050, Japan
| | - Koji Shimatani
- Department of Physical Therapy, Prefectural University of Hiroshima, 1-1 Gakuen, Mihara, Hiroshima, 723-0053, Japan
| | - Yasuko Funabiki
- Graduate School of Human and Environmental Studies, Kyoto University, Yoshida-Nihonmatsu-Cho, Sakyo-Ku, Kyoto, 606-8507, Japan
| | - Toshio Tsuji
- Graduate School of Advanced Science and Engineering, Hiroshima University, 1-4-1 Kagamiyama, Higashi-Hiroshima, Hiroshima, 739-8527, Japan.
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Wu YC, Straathof EJM, Heineman KR, Hadders-Algra M. Typical general movements at 2 to 4 months: Movement complexity, fidgety movements, and their associations with risk factors and SINDA scores. Early Hum Dev 2020; 149:105135. [PMID: 32795785 DOI: 10.1016/j.earlhumdev.2020.105135] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/02/2020] [Accepted: 07/07/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Movement complexity and the presence of fidgety movements (FMs) during general movements (GMs) both reflect aspects of neurological integrity in early infancy. AIM To assess interrelations between the degree of movement complexity and characteristics of FMs during typical GMs and to investigate associations between mildly impaired GMs and risk factors and neurodevelopmental condition. STUDY DESIGN Observational cohort study. SUBJECTS 283 infants (25 born preterm) at 2-4 months corrected age, representative of the general Dutch population. OUTCOME MEASURES GMs were classified in terms of GM-complexity (normal or mildly abnormal (MA)) and FMs (clearly present, sporadic, or exaggerated). Concurrent neurological, developmental and socio-emotional status were measured with the Standardized Infant NeuroDevelopmental Assessment (SINDA). RESULTS Infants with MA GM-complexity had a higher risk of having sporadic FMs and exaggerated FMs. Perinatal complications were not associated with mildly impaired GMs. MA GM-complexity was associated with advanced maternal age (adjusted OR = 2.29 [1.11, 4.76]) and having a non-native Dutch mother (adjusted OR = 2.93 [1.29, 6.64]). It was also associated with atypical neurological (OR = 7.62 [3.51, 16.54]) and developmental scores (OR = 2.38 [1.16, 4.88]). Sporadic and exaggerated FMs were associated with low-to-middle maternal education (adjusted OR = 2.88, [1.45, 5.72]) and having a non-native Dutch father (adjusted OR = 7.16 [1.41, 36.32]), respectively. However, neither sporadic nor exaggerated FMs were associated with the SINDA outcomes. CONCLUSIONS GM-complexity and FMs are two interrelated but different aspects of GMs. Mild impairments in GM-complexity and FMs share a non-optimal socio-economic background as risk factor, but only MA GM-complexity is associated with a concurrent non-optimal neurodevelopmental condition.
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Affiliation(s)
- Ying-Chin Wu
- University of Groningen, University Medical Center Groningen, Department of Paediatrics, Division of Developmental Neurology, Groningen, the Netherlands; Department of Physical Therapy, Chung Shan Medical University, Taichung, Taiwan
| | - Elisabeth J M Straathof
- University of Groningen, University Medical Center Groningen, Department of Paediatrics, Division of Developmental Neurology, Groningen, the Netherlands
| | - Kirsten R Heineman
- University of Groningen, University Medical Center Groningen, Department of Paediatrics, Division of Developmental Neurology, Groningen, the Netherlands; SEIN, Stichting Epilepsie Instellingen Nederland, Zwolle, the Netherlands
| | - Mijna Hadders-Algra
- University of Groningen, University Medical Center Groningen, Department of Paediatrics, Division of Developmental Neurology, Groningen, the Netherlands.
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Skworc A, Marciniak S, Sławska H. Influence of infections on the quality of general movements in premature infants. Early Hum Dev 2020; 148:105118. [PMID: 32673903 DOI: 10.1016/j.earlhumdev.2020.105118] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 06/19/2020] [Accepted: 06/23/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The task of contemporary neonatology is not only to save the lives of children born prematurely, but also to provide them with the highest possible quality of life. The Prechtl method, one of several methods of assessing the quality of general movement patterns, enables early identification of immaturity or damage to the central nervous system. AIM Dynamic assessment of the type and quality of general movement (GMs) in preterm infants to determine indications for early neurodevelopmental support and to identify the relationship between the occurrence of maternal and neonatal perinatal risk factors and the type and quality of general movements. MATERIAL AND METHOD 90 infants were assessed between 28 0/7 and 36 6/7 weeks gestational age. Dominant cases (57 cases) were infants born between 32 and 36 weeks GE. Most cases (48) received low Apgar score at 1 min (≤7), including two born in very severe condition. Neonatal infections were diagnosed in 26 infants. The study included three GM assessments: I - up to 14th day post-partum, II at term and III between 12 and 15 weeks corrected age. The analysis included gestational age, general condition of the newborn as per Apgar score as well as early and late infections. RESULTS Neonatal infections were found to show a close correlation with the occurrence of abnormal general movements. It was confirmed that gestational age and congenital infections are important variables affecting the occurrence of abnormal general movements.
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Affiliation(s)
- Aneta Skworc
- Department of Neonatology, Specialist Hospital No. 2, Bytom, Poland
| | - Sylwia Marciniak
- Department of Neonatology, Specialist Hospital No. 2, Bytom, Poland; Medical University of Silesia, Katowice, Poland.
| | - Helena Sławska
- Department of Neonatology, Specialist Hospital No. 2, Bytom, Poland; Medical University of Silesia, Katowice, Poland
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The Predictive Accuracy of the General Movement Assessment for Cerebral Palsy: A Prospective, Observational Study of High-Risk Infants in a Clinical Follow-Up Setting. J Clin Med 2019; 8:jcm8111790. [PMID: 31717717 PMCID: PMC6912231 DOI: 10.3390/jcm8111790] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 10/08/2019] [Accepted: 10/22/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Early prediction of cerebral palsy (CP) using the General Movement Assessment (GMA) during the fidgety movements (FM) period has been recommended as standard of care in high-risk infants. The aim of this study was to determine the accuracy of GMA, alone or in combination with neonatal imaging, in predicting cerebral palsy (CP). METHODS Infants with increased risk of perinatal brain injury were prospectively enrolled from 2009-2014 in this multi-center, observational study. FM were classified by two certified GMA observers blinded to the clinical history. Abnormal GMA was defined as absent or sporadic FM. CP-status was determined by clinicians unaware of GMA results. RESULTS Of 450 infants enrolled, 405 had scorable video and follow-up data until at least 18-24 months. CP was confirmed in 42 (10.4%) children at mean age 3 years 1 month. Sensitivity, specificity, positive and negative predictive values, and accuracy of absent/sporadic FM for CP were 76.2, 82.4, 33.3, 96.8, and 81.7%, respectively. Only three (8.1%) of 37 infants with sporadic FM developed CP. The highest accuracy (95.3%) was achieved by a combination of absent FM and abnormal neonatal imaging. CONCLUSION In infants with a broad range of neonatal risk factors, accuracy of early CP prediction was lower for GMA than previously reported but increased when combined with neonatal imaging. Sporadic FM did not predict CP in this study.
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21
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Einspieler C, Bos AF, Krieber-Tomantschger M, Alvarado E, Barbosa VM, Bertoncelli N, Burger M, Chorna O, Del Secco S, DeRegnier RA, Hüning B, Ko J, Lucaccioni L, Maeda T, Marchi V, Martín E, Morgan C, Mutlu A, Nogolová A, Pansy J, Peyton C, Pokorny FB, Prinsloo LR, Ricci E, Saini L, Scheuchenegger A, Silva CRD, Soloveichick M, Spittle AJ, Toldo M, Utsch F, van Zyl J, Viñals C, Wang J, Yang H, Yardımcı-Lokmanoğlu BN, Cioni G, Ferrari F, Guzzetta A, Marschik PB. Cerebral Palsy: Early Markers of Clinical Phenotype and Functional Outcome. J Clin Med 2019; 8:E1616. [PMID: 31590221 PMCID: PMC6833082 DOI: 10.3390/jcm8101616] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 09/21/2019] [Accepted: 09/25/2019] [Indexed: 11/17/2022] Open
Abstract
The Prechtl General Movement Assessment (GMA) has become a cornerstone assessment in early identification of cerebral palsy (CP), particularly during the fidgety movement period at 3-5 months of age. Additionally, assessment of motor repertoire, such as antigravity movements and postural patterns, which form the Motor Optimality Score (MOS), may provide insight into an infant's later motor function. This study aimed to identify early specific markers for ambulation, gross motor function (using the Gross Motor Function Classification System, GMFCS), topography (unilateral, bilateral), and type (spastic, dyskinetic, ataxic, and hypotonic) of CP in a large worldwide cohort of 468 infants. We found that 95% of children with CP did not have fidgety movements, with 100% having non-optimal MOS. GMFCS level was strongly correlated to MOS. An MOS > 14 was most likely associated with GMFCS outcomes I or II, whereas GMFCS outcomes IV or V were hardly ever associated with an MOS > 8. A number of different movement patterns were associated with more severe functional impairment (GMFCS III-V), including atypical arching and persistent cramped-synchronized movements. Asymmetrical segmental movements were strongly associated with unilateral CP. Circular arm movements were associated with dyskinetic CP. This study demonstrated that use of the MOS contributes to understanding later CP prognosis, including early markers for type and severity.
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Affiliation(s)
- Christa Einspieler
- Research Unit iDN, Division of Phoniatrics, Medical University of Graz, 8036 Graz, Austria.
| | - Arend F Bos
- University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Division of Neonatology, 9713 GZ Groningen, The Netherlands.
| | | | - Elsa Alvarado
- National Rehabilitation Institute, Cerebral Palsy Department, 14389 Mexico City, Mexico.
| | - Vanessa M Barbosa
- University of Illinois at Chicago, UI Health, Department of Occupational and Physical Therapy, Chicago, IL 60612, USA.
| | - Natascia Bertoncelli
- University of Modena and Reggio Emilia, Department of Clinical and Surgical Sciences for Mothers, Children and Adults, Neonatal Intensive Care Unit, 41124 Modena, Italy.
| | - Marlette Burger
- Stellenbosch University, Faculty of Medicine and Health Sciences, Department of Health and Rehabilitation Sciences, Cape Town 8000, South Africa.
| | - Olena Chorna
- IRCCS Fondazione Stella Maris, Department of Developmental Neuroscience, 56128 Pisa, Italy.
| | - Sabrina Del Secco
- IRCCS Fondazione Stella Maris, Department of Developmental Neuroscience, 56128 Pisa, Italy.
| | - Raye-Ann DeRegnier
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL 60611, USA.
| | - Britta Hüning
- University Hospital Essen, Department of Pediatrics I, 45122 Essen, Germany.
| | - Jooyeon Ko
- Daegu Health College, Department of Physical Therapy, 41453 Daegu, Korea.
| | - Laura Lucaccioni
- University of Modena and Reggio Emilia, Department of Clinical and Surgical Sciences for Mothers, Children and Adults, Neonatal Intensive Care Unit, 41124 Modena, Italy.
| | - Tomoki Maeda
- Oita University Faculty of Medicine, Department of Pediatrics, 879-5593 Oita, Japan.
| | - Viviana Marchi
- IRCCS Fondazione Stella Maris, Department of Developmental Neuroscience, 56128 Pisa, Italy.
- Institute of Life Sciences, Scuola Superiore Sant'Anna, 56127 Pisa, Italy.
| | - Erika Martín
- Children's Rehabilitation Institute Teleton, 72825 Puebla, Mexico.
| | - Catherine Morgan
- The University of Sydney Medical School, Children's Hospital at Westmead Clinical School, The Discipline of Child and Adolescent Health, Sydney 2050, NSW, Australia.
- The University of Sydney, Cerebral Palsy Alliance Research Institute, Sydney 2050, NSW, Australia.
| | - Akmer Mutlu
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Developmental and Early Physiotherapy Unit, 06100 Ankara, Turkey.
| | - Alice Nogolová
- Municipal Hospital of Ostrava, Children 's Department, 72880 Ostrava, Czech Republic.
- Masaryk University, Faculty of Medicine, 62500 Brno, Czech Republic.
| | - Jasmin Pansy
- Medical University of Graz, Department of Pediatrics and Adolescent Medicine, Division of Neonatology, 8036 Graz, Austria.
| | - Colleen Peyton
- Northwestern University, Department of Physical Therapy and Human Movement Science, Chicago, IL 60611, USA.
| | - Florian B Pokorny
- Research Unit iDN, Division of Phoniatrics, Medical University of Graz, 8036 Graz, Austria.
| | - Lucia R Prinsloo
- Cerebral Palsy Association Eastern Cape, Port Elizabeth 6001, South Africa.
| | - Eileen Ricci
- University of New England/Maine LEND Program, Portland, ME 04103, USA.
| | - Lokesh Saini
- Post Graduate Institute of Medical Education and Research, Department of Pediatrics, Pediatric Neurology Division, Chandigarh 160012, India.
| | - Anna Scheuchenegger
- Medical University of Graz, Department of Pediatrics and Adolescent Medicine, Division of Neonatology, 8036 Graz, Austria.
| | - Cinthia R D Silva
- Rede SARAH de Hospitais de Reabilitação, Reabilitação Infantil, 30510-000 Belo Horizonte, Brazil.
| | - Marina Soloveichick
- Lady Davis Carmel Medical Center, NICU Developmental Follow-up Clinic, 34362 Haifa, Israel.
| | - Alicia J Spittle
- University of Melbourne, School of Health Sciences, Department of Physiotherapy, Parkville 3052, Australia.
- Murdoch Children's Research Institute, Parkville 3052, Victoria, Australia.
| | - Moreno Toldo
- Kiran Society for Rehabilitation and Education of Children with Disabilities, Varanasi 221011, India.
| | - Fabiana Utsch
- Rede SARAH de Hospitais de Reabilitação, Reabilitação Infantil, 30510-000 Belo Horizonte, Brazil.
| | - Jeanetta van Zyl
- Stellenbosch University, Faculty of Medicine and Health Sciences, Department of Paediatrics and Child Health, Cape Town 8000, South Africa.
| | - Carlos Viñals
- National Rehabilitation Institute, Cerebral Palsy Department, 14389 Mexico City, Mexico.
| | - Jun Wang
- Children's Hospital of Fudan University, Department of Rehabilitation, Shanghai 201102, China.
| | - Hong Yang
- Children's Hospital of Fudan University, Department of Rehabilitation, Shanghai 201102, China.
| | - Bilge N Yardımcı-Lokmanoğlu
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Developmental and Early Physiotherapy Unit, 06100 Ankara, Turkey.
| | - Giovanni Cioni
- IRCCS Fondazione Stella Maris, Department of Developmental Neuroscience, 56128 Pisa, Italy.
| | - Fabrizio Ferrari
- University of Modena and Reggio Emilia, Department of Clinical and Surgical Sciences for Mothers, Children and Adults, Neonatal Intensive Care Unit, 41124 Modena, Italy.
| | - Andrea Guzzetta
- IRCCS Fondazione Stella Maris, Department of Developmental Neuroscience, 56128 Pisa, Italy.
| | - Peter B Marschik
- Research Unit iDN, Division of Phoniatrics, Medical University of Graz, 8036 Graz, Austria.
- University Medical Center Göttingen, Child and Adolescent Psychiatry and Psychotherapy, 37075 Göttingen, Germany.
- Karolinska Institutet, Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), 11330 Stockholm, Sweden.
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22
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Kwong AKL, Olsen JE, Eeles AL, Einspieler C, Lee KJ, Doyle LW, Cheong JLY, Spittle AJ. Occurrence of and temporal trends in fidgety general movements in infants born extremely preterm/extremely low birthweight and term-born controls. Early Hum Dev 2019; 135:11-15. [PMID: 31185386 DOI: 10.1016/j.earlhumdev.2019.05.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 05/20/2019] [Accepted: 05/21/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Fidgety general movements have high predictive validity for later cerebral palsy (CP) but their temporal organisation requires further understanding for assessment accuracy. AIMS To describe the occurrence of and temporal trends in fidgety movements, and whether they differ between infants born preterm and at term. STUDY DESIGN Cohort study. SUBJECTS We assessed 155 EP/ELBW infants and 185 term-born infants born extremely preterm (EP; <28 weeks' gestation) and/or extremely low birthweight (ELBW; <1000 g birthweight) or at term (37-42 weeks' gestation) in the state of Victoria, Australia. OUTCOME MEASURES Parents of infants submitted up to two videos at 12-13+6 and/or 14-16+6 weeks' corrected age of infants' general movements. Videos were scored using the Prechtl General Movements Assessment (GMA) (fidgety) and classified as normal or absent/abnormal. Infants with at least one normal GMA were classified as normal. Individual GMA trajectories were analysed over time using logistic regression. RESULTS Overall, infants born EP/ELBW were more likely to have absent/abnormal fidgety movements than term-born infants (23% versus 3%, odds ratio [OR] 8.50 (95% confidence interval (CI) 3.48-20.8, p < 0.001). Fewer EP/ELBW and term-born infants showed absent/abnormal fidgety movements with each week of increasing age (EP/ELBW OR 0.46, 95% CI 0.25-0.84, p = 0.01; term-born OR 0.35, 95% CI 0.16-0.8, p = 0.01; interaction, p = 0.53). CONCLUSIONS Absent/abnormal fidgety movements are more prevalent in infants born EP/ELBW than at term. Fidgety movements normalise with older age in both infants born EP/ELBW and at term between 12 and 16+6 weeks' corrected age.
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Affiliation(s)
- Amanda K L Kwong
- Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Physiotherapy, The University of Melbourne, Parkville, Victoria, Australia; Newborn Research, The Royal Women's Hospital, Parkville, Victoria, Australia.
| | - Joy E Olsen
- Murdoch Children's Research Institute, Parkville, Victoria, Australia; Newborn Research, The Royal Women's Hospital, Parkville, Victoria, Australia
| | - Abbey L Eeles
- Murdoch Children's Research Institute, Parkville, Victoria, Australia; Newborn Research, The Royal Women's Hospital, Parkville, Victoria, Australia
| | - Christa Einspieler
- iDN - Interdisciplinary Developmental Neuroscience, Department of Phoniatrics, Medical University of Graz, Graz, Austria
| | - Katherine J Lee
- Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Lex W Doyle
- Murdoch Children's Research Institute, Parkville, Victoria, Australia; Newborn Research, The Royal Women's Hospital, Parkville, Victoria, Australia; Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Jeanie L Y Cheong
- Murdoch Children's Research Institute, Parkville, Victoria, Australia; Newborn Research, The Royal Women's Hospital, Parkville, Victoria, Australia; Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, Victoria, Australia
| | - Alicia J Spittle
- Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Physiotherapy, The University of Melbourne, Parkville, Victoria, Australia; Newborn Research, The Royal Women's Hospital, Parkville, Victoria, Australia
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23
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Pansy J, Barones C, Urlesberger B, Pokorny FB, Bartl-Pokorny KD, Verheyen S, Marschik PB, Einspieler C. Early motor and pre-linguistic verbal development in Prader-Willi syndrome - A case report. RESEARCH IN DEVELOPMENTAL DISABILITIES 2019; 88:16-21. [PMID: 30825843 DOI: 10.1016/j.ridd.2019.01.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 10/26/2018] [Accepted: 01/29/2019] [Indexed: 05/27/2023]
Abstract
BACKGROUND Prader-Willi syndrome (PWS) is a rare genetic disorder. Infants with PWS show a neurodevelopmental dysfunction which entails a delayed motor and language development, but studies on their spontaneous movements (i.e. general movements) or pre-linguistic speech-language development before 6 months of age are missing so far. AIM To describe early motor and pre-linguistic verbal development in an infant with PWS. METHODS AND PROCEDURES Prospective case report; in addition to the assessment of general movements and the concurrent movement repertoire, we report on early verbal forms, applying the Stark Assessment of Early Vocal Development-Revised. OUTCOMES AND RESULTS General movements were abnormal on days 8 and 15. No fidgety movements were observed at 11 weeks; they only emerged at 17 weeks and lasted until at least 27 weeks post-term. The movement character was monotonous, and early motor milestones were only achieved with a delay. At 27 weeks the infant produced age-adequate types of vocalisations. However, none of the canonical-syllable vocalisations that typically emerge at that age were observed. Early vocalisations appeared monotonous and with a peculiarly harmonic structure. CONCLUSIONS AND IMPLICATIONS Early motor and pre-linguistic verbal behaviours were monotonous in an infant with PWS throughout his first 6 months of life. This suggests that early signs of neurodevelopmental dysfunction (i.e. abnormal general movements) might already be diagnosed in infants with PWS during their first weeks of life, potentially enabling us to diagnose and intervene at an early stage.
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Affiliation(s)
- Jasmin Pansy
- Division of Neonatology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria.
| | - Cornelia Barones
- Division of Neonatology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Berndt Urlesberger
- Division of Neonatology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Florian B Pokorny
- iDN - Interdisciplinary Developmental Neuroscience, Department of Phoniatrics, Medical University of Graz, Graz, Austria; Machine Intelligence & Signal Processing Group, MMK, Technical University of Munich, Munich, Germany
| | - Katrin D Bartl-Pokorny
- iDN - Interdisciplinary Developmental Neuroscience, Department of Phoniatrics, Medical University of Graz, Graz, Austria
| | - Sarah Verheyen
- Institute of Human Genetics, Medical University of Graz, Graz, Austria
| | - Peter B Marschik
- iDN - Interdisciplinary Developmental Neuroscience, Department of Phoniatrics, Medical University of Graz, Graz, Austria; Child and Adolescent Psychiatry and Psychotherapy, iDN - Interdisciplinary Developmental Neuroscience, University Medical Center Goettingen, Goettingen, Germany; Center of Neurodevelopmental Disorders (KIND), Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - Christa Einspieler
- iDN - Interdisciplinary Developmental Neuroscience, Department of Phoniatrics, Medical University of Graz, Graz, Austria
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24
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Kepenek-Varol B, Tanrıverdi M, İşcan A, Alemdaroğlu-Gürbüz İ. The acute effects of physiotherapy on general movement patterns in preterm infants: A single-blind study. Early Hum Dev 2019; 131:15-20. [PMID: 30798037 DOI: 10.1016/j.earlhumdev.2019.02.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 12/27/2018] [Accepted: 02/13/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND The General Movement Assessment (GMA) is a video analysis method developed by Heinz Prechtl that examines the infant's spontaneous movements. In recent years, although many studies have been performed in preterm infants by applying GMA, few studies have shown the effects of early intervention on GMA. AIMS Current study was planned to determine the acute effects of a single-session early physiotherapy approach on preterm infants' general spontaneous movements, and to reveal the change in Motor Optimality Scale (MOS) score including FMs. STUDY DESIGN Prospective, single-blind study. SUBJECTS Current study was carried out with 32 preterm infants at postterm 12-16 weeks. OUTCOME MEASURES The infants included in the study were videotaped by a physiotherapist during 10-15 min before the physiotherapy session at postterm 12-16 weeks for GMA. After a single physiotherapy session, the same physiotherapist performed the same video footage second time. A blind evaluator assessed the videos taken before and after session and scored Motor Optimality Scale (MOS). RESULTS AND CONCLUSIONS There was no statistically significant difference between MOS sub-category and total score of the infants before and after the session (p > 0.05). According to the results of present study, a single-session early physiotherapy intervention did not have an acute effect on the spontaneous movements of preterm infants at postterm 12-16 weeks. Future studies are needed to demonstrate the short and long-term effects of early physiotherapy approaches to risky infants.
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Affiliation(s)
- Büşra Kepenek-Varol
- Nuh Naci Yazgan University, Faculty of Health Sciences, Physiotherapy and Rehabilitation Department, Kayseri, Turkey
| | - Müberra Tanrıverdi
- Bezmialem Vakıf University, Faculty of Health Sciences, Physiotherapy and Rehabilitation Department, İstanbul, Turkey.
| | - Akın İşcan
- Bezmialem Vakıf University, Faculty of Medicine, Pediatric Neurology Department, İstanbul, Turkey
| | - İpek Alemdaroğlu-Gürbüz
- Hacettepe University, Faculty of Health Sciences, Physiotherapy and Rehabilitation Department, Ankara, Turkey.
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25
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Spittle AJ, Morgan C, Olsen JE, Novak I, Cheong JLY. Early Diagnosis and Treatment of Cerebral Palsy in Children with a History of Preterm Birth. Clin Perinatol 2018; 45:409-420. [PMID: 30144846 DOI: 10.1016/j.clp.2018.05.011] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Infants born preterm are at increased risk of cerebral palsy (CP), with the risk increasing with decreasing gestational age. Although preterm children are at increased risk of CP compared with their term-born peers, most preterm children do not have CP and thus, it is important to have a standardized process for detecting those children at high risk of CP early. A combination of clinical history, neuroimaging, and physical examination is recommended to ensure early, accurate diagnosis. Early detection of CP is essential for timely early intervention to optimize outcomes for children and their families.
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Affiliation(s)
- Alicia J Spittle
- Physiotherapy, University of Melbourne, 161 Barry Street, Parkville 3052, Australia; Victorian Infant Brain Studies, Murdoch Children's Research Institute, 50 Flemington Road, Parkville 3052, Australia; Neonatal Services, The Royal Women's Hospitals, Cnr Flemington Road and Grattan Street, Parkville 3052, Australia.
| | - Catherine Morgan
- Cerebral Palsy Alliance, Child and Adolescent Health, The University of Sydney, Sydney NSW 2006, Australia
| | - Joy E Olsen
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, 50 Flemington Road, Parkville 3052, Australia; Neonatal Services, The Royal Women's Hospitals, Cnr Flemington Road and Grattan Street, Parkville 3052, Australia
| | - Iona Novak
- Cerebral Palsy Alliance, Child and Adolescent Health, The University of Sydney, Sydney NSW 2006, Australia
| | - Jeanie L Y Cheong
- Physiotherapy, University of Melbourne, 161 Barry Street, Parkville 3052, Australia; Victorian Infant Brain Studies, Murdoch Children's Research Institute, 50 Flemington Road, Parkville 3052, Australia; Neonatal Services, The Royal Women's Hospitals, Cnr Flemington Road and Grattan Street, Parkville 3052, Australia
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26
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Hadders-Algra M. Early human motor development: From variation to the ability to vary and adapt. Neurosci Biobehav Rev 2018; 90:411-427. [PMID: 29752957 DOI: 10.1016/j.neubiorev.2018.05.009] [Citation(s) in RCA: 129] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 05/01/2018] [Accepted: 05/04/2018] [Indexed: 12/17/2022]
Abstract
This review summarizes early human motor development. From early fetal age motor behavior is based on spontaneous neural activity: activity of networks in the brainstem and spinal cord that is modulated by supraspinal activity. The supraspinal activity, first primarily brought about by the cortical subplate, later by the cortical plate, induces movement variation. Initially, movement variation especially serves exploration; its associated afferent information is primarily used to sculpt the developing nervous system, and less to adapt motor behavior. In the next phase, beginning at function-specific ages, movement variation starts to serve adaptation. In sucking and swallowing, this phase emerges shortly before term age. In speech, gross and fine motor development, it emerges from 3 to 4 months post-term onwards, i.e., when developmental focus in the primary sensory and motor cortices has shifted to the permanent cortical circuitries. With increasing age and increasing trial-and-error exploration, the infant improves its ability to use adaptive and efficicient forms of upright gross motor behavior, manual activities and vocalizations belonging to the native language.
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Affiliation(s)
- Mijna Hadders-Algra
- University of Groningen, University Medical Center Groningen, Dept. Pediatrics - Section Developmental Neurology, Groningen, The Netherlands.
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27
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Hadders-Algra M. Neural substrate and clinical significance of general movements: an update. Dev Med Child Neurol 2018; 60:39-46. [PMID: 28832987 DOI: 10.1111/dmcn.13540] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/20/2017] [Indexed: 12/20/2022]
Abstract
UNLABELLED General movements are present from early fetal life to 3 to 5 months corrected age. Atypical general movements, especially in the last, so-called fidgety general movement phase, are predictive of cerebral palsy (CP). This review updates knowledge on the neural substrate and clinical significance of typical and atypical general movements. Typical general movements are primarily characterized by complexity and variation. Presumably these core characteristics are initially induced by modulating activity of the cortical subplate. When the subplate gradually dissolves between 3 months before term and 3 months corrected age the cortical plate takes over. This coincides with the fidgety general movement phase. Conceivably, fidgety activity reflects 'sparsification', i.e. fragmentation of cortical network activity. The quintessential feature of atypical general movements is reduced complexity and variation. This is attributed to impaired integrity of extensive cortical-subcortical networks, in which the subplate and periventricular white matter play a prominent role. The most serious forms of network impairment are associated with absent fidgety movements. WHAT THIS PAPER ADDS The emergence of fidgety movements reflects a developmental transition from widespread to fragmented cortical network activity. Atypical general movements characterized by reduced complexity and variation are attributed to impaired integrity of extensive cortical-subcortical networks.
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Affiliation(s)
- Mijna Hadders-Algra
- University of Groningen, University Medical Center Groningen, Department of Paediatrics - Developmental Neurology, Groningen, the Netherlands
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28
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Fjørtoft T, Ustad T, Follestad T, Kaaresen PI, Øberg GK. Does a parent-administrated early motor intervention influence general movements and movement character at 3months of age in infants born preterm? Early Hum Dev 2017; 112:20-24. [PMID: 28672273 DOI: 10.1016/j.earlhumdev.2017.06.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 05/13/2017] [Accepted: 06/23/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Studies of preterm and term-born infants have shown absent fidgety movements and an abnormal movement character to be related to brain lesions and unfavourable neurological outcomes. AIMS The present study examines what effect a parent-administered early intervention program applied to preterm infants in a randomised control trial (RCT) between 34 and 36weeks gestational age has on their fidgety movements and overall movement character at three months of age. STUDY DESIGN The study was part of the RCT in an early intervention programme including preterm infants born between 2010 and 2014 at three Norwegian university hospitals. SUBJECTS 130 preterm infants participated in the study, with 59 of them in the control group and 71 in the intervention group. OUTCOME MEASURES Fidgety movements and overall movement character at three months corrected age. RESULTS No difference was found between the intervention group and the control group in terms of fidgety movements or movement character. Approximately half of the infants in both groups showed an abnormal movement character. CONCLUSION No evidence was found in this RCT to suggest that an intervention at 34 to 37weeks gestational age has a significant effect on the fidgety movements or overall movement character of preterm infants. This is in line with the assumption that absent fidgety movements and an abnormal movement character are due to permanent brain injury and are therefore good predictors for later neurological impairments.
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Affiliation(s)
- Toril Fjørtoft
- Clinics of Clinical services, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Tordis Ustad
- Clinics of Clinical services, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Turid Follestad
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Per Ivar Kaaresen
- Faculty of Clinical Medicine, University of Tromsø, The Arctic University of Norway, Norway; Pediatric and Adolescent Department, University Hospital North Norway, Tromsø, Norway
| | - Gunn Kristin Øberg
- Department of Health and Care Sciences, University of Tromsø, The Arctic University of Norway, Norway
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