1
|
Skorup JC, Pierce SR, Ruwaih N, DeMauro SB, Johnson MJ, Prosser LA. Hammersmith Neonatal and Infant Neurological Examinations Scores in Typically Developing Infants Aged 1-6 Months. J Child Neurol 2024:8830738241282722. [PMID: 39327954 DOI: 10.1177/08830738241282722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/28/2024]
Abstract
The Hammersmith Neonatal (HNNE) and Infant (HINE) Neurological Examinations are increasingly used to evaluate developing neuromotor control in infants at risk for physical disability, but there is no global consensus on score interpretation across the first 6 months after birth. We report scores for typically developing, full-term infants aged 1 month for the HNNE and aged 2-6 months for the HINE. The median HNNE and HINE scores are consistent with previously published data. These normative data can be used to aid in the interpretation of HNNE and HINE scores from infants at risk for neuromotor impairment.
Collapse
Affiliation(s)
- Julie C Skorup
- Department of Physical Therapy, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Samuel R Pierce
- Department of Physical Therapy, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Noor Ruwaih
- Clinical Research Support Offices, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Sara B DeMauro
- Division of Neonatology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Michelle J Johnson
- Department of Physical Medicine and Rehabilitation, University of Pennsylvania, Philadelphia, PA, USA
- Rehabilitation Robotics Lab, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA, USA
| | - Laura A Prosser
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Division of Rehabilitation Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| |
Collapse
|
2
|
Jonsson H, Gaily E, Stjerna S, Joensuu T, Johari M, Lehesjoki A, Linnankivi T. Epilepsies with onset during the first year of life: A prospective study on syndromes, etiologies, and outcomes. Epilepsia Open 2024; 9:1393-1405. [PMID: 38785332 PMCID: PMC11296082 DOI: 10.1002/epi4.12966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 04/06/2024] [Accepted: 05/03/2024] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVE Infantile seizures cause great concern for both doctors and parents. In addition to modern neuroimaging and genetics, clinical tools helpful in predicting the course of the disease are needed. We prospectively studied the incidence, electroclinical characteristics and etiologies of epilepsy syndromes with onset before the age of 12 months and looked for prognostic determinants of outcome by age 24 months. METHODS From February 2017 through May 2019, we recruited all eligible infants diagnosed with epilepsy at our unit. Data on electroclinical studies, genetic investigations and drug response were gathered prospectively. The infants were given a structured neurological examination (Hammersmith Infantile Neurological examination [HINE] and Griffiths scales) at predetermined intervals until age 24 months at which age neurocognitive evaluation with Bayley scales was performed. RESULTS Included were 60 infants (27 female). The mean onset age of epilepsy was 5.3 (±2.5 standard deviation) months. The incidence of epilepsy in the population-based cohort was 131 (95% confidence interval 99-172)/100 000. Epilepsy syndrome was identified in 80% and etiology in 58% of infants. Self-limited infantile epilepsy was the second most common syndrome (incidence 18/100 000) after infantile epileptic spasms syndrome. PRRT2 was the most common monogenic cause. At age 24 months, 37% of the infants had drug-resistant epilepsy (DRE) and half had a global developmental delay (GDD). Abnormal first HINE was the strongest predictor of GDD, followed by DRE and identified etiology. DRE was associated with structural etiology and GDD. Those with normal first HINE and good response to treatment had favorable outcomes, irrespective of the identified etiology. SIGNIFICANCE Our results support a high incidence of self-limited epilepsy in infancy and PRRT2 as the genetic cause in the first year of life. Notwithstanding the advances in etiological discovery, we want to highlight the importance of clinical evaluation as standardized neurological examination with HINE proved a valuable tool in prognostication. PLAIN LANGUAGE SUMMARY One in every 700-800 babies develop epilepsy within the first year after birth. Our study identified an epilepsy syndrome in 80% and the cause of epilepsy in 60% of the participants. By age 2 years, over one-third of the children still experienced seizures, and almost half faced significant developmental delay. Structural brain abnormalities increased the likelihood of difficult epilepsy and developmental challenges. Babies whose epilepsy was caused by a gene defect varied widely in development and response to medications. Babies with normal neurological examination at first visit, especially if their seizures stopped quickly, had favorable development.
Collapse
Affiliation(s)
- Henna Jonsson
- Epilepsia Helsinki, full member of ERN Epicare and Division of Child Neurology, Children's Hospital and Pediatric Research CenterUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Eija Gaily
- Epilepsia Helsinki, full member of ERN Epicare and Division of Child Neurology, Children's Hospital and Pediatric Research CenterUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Susanna Stjerna
- BABA Center, Pediatric Research Center, Children's Hospital and Division of Neuropsychology, HUS NeurocenterHelsinki University Hospital and University of HelsinkiHelsinkiFinland
| | - Tarja Joensuu
- Folkhälsan Research CenterHelsinkiFinland
- Department of Medical and Clinical Genetics, MedicumUniversity of HelsinkiHelsinkiFinland
| | - Mridul Johari
- Folkhälsan Research CenterHelsinkiFinland
- Department of Medical and Clinical Genetics, MedicumUniversity of HelsinkiHelsinkiFinland
- Harry Perkins Institute of Medical Research, Centre for Medical ResearchUniversity of Western AustraliaNedlandsWestern AustraliaAustralia
| | - Anna‐Elina Lehesjoki
- Folkhälsan Research CenterHelsinkiFinland
- Department of Medical and Clinical Genetics, MedicumUniversity of HelsinkiHelsinkiFinland
| | - Tarja Linnankivi
- Epilepsia Helsinki, full member of ERN Epicare and Division of Child Neurology, Children's Hospital and Pediatric Research CenterUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
| |
Collapse
|
3
|
Cutrona C, de Sanctis R, Coratti G, Capasso A, Ricci M, Stanca G, Carnicella S, Utlulig M, Bersani G, lazzareschi I, Leoni C, Buonsenso D, Luciano R, Vento G, Finkel RS, Pane M, Mercuri E. Can the CHOP-INTEND be used as An Outcome Measure in the First Months of Age? Implications for Clinical Trials and Real World Data. J Neuromuscul Dis 2024; 11:85-90. [PMID: 37980678 PMCID: PMC10789347 DOI: 10.3233/jnd-221644] [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] [Accepted: 10/04/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND The CHOP-INTEND is an established outcome measure used to assess motor function in young and weak SMA patients previously validated in type I infants older than 3 months. OBJECTIVE The aim of our study was to assess the maturation of the CHOP-INTEND scores in a group of healthy infants, establishing which items of the scale can be reliably used in individuals younger than 3 months. METHODS This is a prospective observational study. The whole cohort was divided into 5 age groups. Each of the 16 CHOP-INTEND items was analyzed looking at the frequency distribution of the scores in each age subgroup. An item was considered developmentally appropriate when > 85% of the infants achieved a full score. RESULTS our study includes 61 assessments collected < 2 weeks, 25 at 2-4 weeks, 20 at 5-8 weeks, 25 at 9-12 weeks and 20 at 13-17 weeks. Eight of the 16 items were developmentally appropriate already in the first week and another by the end of the first month. The remaining 7 items had more variable responses in the first three months and full scores were consistently achieved only after the third month. CONCLUSIONS Our findings suggest that the CHOP-INTEND can be used before the age of 3 months, but the results should be interpreted with caution, considering which items are developmentally appropriate at the time of testing. This will also help to establish whether the changes observed following early treatments are a sign of efficacy or at least partly reflect maturational aspects.
Collapse
Affiliation(s)
- Costanza Cutrona
- Centro Clinico Nemo Pediatrico, Fondazione Policlinico “A. Gemelli” IRCCS, Rome, Italy
- Pediatric Neurology Unit, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Roberto de Sanctis
- Centro Clinico Nemo Pediatrico, Fondazione Policlinico “A. Gemelli” IRCCS, Rome, Italy
- Pediatric Neurology Unit, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giorgia Coratti
- Centro Clinico Nemo Pediatrico, Fondazione Policlinico “A. Gemelli” IRCCS, Rome, Italy
- Pediatric Neurology Unit, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Anna Capasso
- Centro Clinico Nemo Pediatrico, Fondazione Policlinico “A. Gemelli” IRCCS, Rome, Italy
- Pediatric Neurology Unit, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Martina Ricci
- Centro Clinico Nemo Pediatrico, Fondazione Policlinico “A. Gemelli” IRCCS, Rome, Italy
- Pediatric Neurology Unit, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giulia Stanca
- Centro Clinico Nemo Pediatrico, Fondazione Policlinico “A. Gemelli” IRCCS, Rome, Italy
| | - Sara Carnicella
- Centro Clinico Nemo Pediatrico, Fondazione Policlinico “A. Gemelli” IRCCS, Rome, Italy
| | - Meric Utlulig
- Pediatric Neurology Unit, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giulia Bersani
- Departmen of Woman & Child Health & Pubblic Health, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - Ilaria lazzareschi
- Departmen of Woman & Child Health & Pubblic Health, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - Chiara Leoni
- Departmen of Woman & Child Health & Pubblic Health, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - Danilo Buonsenso
- Departmen of Woman & Child Health & Pubblic Health, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - Rita Luciano
- Neonatology Unit, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
- Neonatology Unit, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giovanni Vento
- Neonatology Unit, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
- Neonatology Unit, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Richard S. Finkel
- Center for Experimental Neurotherapeutics, Department of Paediatric Medicine, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Marika Pane
- Centro Clinico Nemo Pediatrico, Fondazione Policlinico “A. Gemelli” IRCCS, Rome, Italy
- Pediatric Neurology Unit, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Eugenio Mercuri
- Centro Clinico Nemo Pediatrico, Fondazione Policlinico “A. Gemelli” IRCCS, Rome, Italy
- Pediatric Neurology Unit, Università Cattolica del Sacro Cuore, Rome, Italy
| |
Collapse
|
4
|
Green EA, Metz D, Galinsky R, Atkinson R, Skuza EM, Clark M, Gunn AJ, Kirkpatrick CM, Hunt RW, Berger PJ, Nold-Petry CA, Nold MF. Anakinra Pilot - a clinical trial to demonstrate safety, feasibility and pharmacokinetics of interleukin 1 receptor antagonist in preterm infants. Front Immunol 2022; 13:1022104. [PMID: 36389766 PMCID: PMC9647081 DOI: 10.3389/fimmu.2022.1022104] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 10/10/2022] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Bronchopulmonary dysplasia (BPD), its complication pulmonary hypertension (BPD-PH) and preterm brain and gut injury lead to significant morbidity and mortality in infants born extremely prematurely. There is extensive evidence that the pro-inflammatory cytokine interleukin 1 (IL-1) plays a key role in the pathophysiology of these illnesses. Two decades of clinical use in paediatric and adult medicine have established an excellent safety and efficacy record for IL-1 blockade with IL-1 receptor antagonist (IL-1Ra, medication name anakinra). Building on robust pre-clinical evidence, the Anakinra Pilot trial aims to demonstrate safety and feasibility of administering anakinra to preterm infants, and to establish pharmacokinetics in this population. Its ultimate goal is to facilitate large studies that will test whether anakinra can ameliorate early-life inflammation, thus alleviating multiple complications of prematurity. METHODS AND ANALYSIS Anakinra Pilot is an investigator-initiated, single arm, safety and feasibility dose-escalation trial in extremely preterm infants born between 24 weeks 0 days (240) and 276 weeks of gestational age (GA). Enrolled infants will receive anakinra intravenously over the first 21 days after birth, starting in the first 24 h after birth. In the first phase, dosing is 1 mg/kg every 48 h, and dosage will increase to 1.5 mg/kg every 24 h in the second phase. Initial anakinra dosing was determined through population pharmacokinetic model simulations. During the study, there will be a interim analysis to confirm predictions before undertaking dose assessment. Anakinra therapy will be considered safe if the frequency of adverse outcomes/events does not exceed that expected in infants born at 240-276 weeks GA. CLINICAL TRIAL REGISTRATION https://clinicaltrials.gov/, identifier NCT05280340.
Collapse
Affiliation(s)
- Elys A. Green
- Department of Paediatrics, Monash University, Melbourne, VIC, Australia
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, VIC, Australia
- Monash Newborn, Monash Children’s Hospital, Melbourne, VIC, Australia
| | - David Metz
- Department of Paediatrics, Monash University, Melbourne, VIC, Australia
- Monash Children’s Hospital, Melbourne, VIC, Australia
- Murdoch Children’s Research Institute, Melbourne, VIC, Australia
| | - Robert Galinsky
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, VIC, Australia
| | - Rebecka Atkinson
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, VIC, Australia
- Monash Newborn, Monash Children’s Hospital, Melbourne, VIC, Australia
| | - Elizbeth M. Skuza
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, VIC, Australia
| | - Megan Clark
- Monash Newborn, Monash Children’s Hospital, Melbourne, VIC, Australia
- Faculty of Pharmacy and Pharmaceutical Science, Monash University, Melbourne, VIC, Australia
| | - Alistair J Gunn
- Department of Physiology, The University of Auckland, Auckland, New Zealand
| | - Carl M. Kirkpatrick
- Monash Institute for Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia
| | - Rod W. Hunt
- Department of Paediatrics, Monash University, Melbourne, VIC, Australia
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, VIC, Australia
- Monash Newborn, Monash Children’s Hospital, Melbourne, VIC, Australia
| | - Philip J. Berger
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, VIC, Australia
| | - Claudia A. Nold-Petry
- Department of Paediatrics, Monash University, Melbourne, VIC, Australia
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, VIC, Australia
| | - Marcel F. Nold
- Department of Paediatrics, Monash University, Melbourne, VIC, Australia
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, VIC, Australia
- Monash Newborn, Monash Children’s Hospital, Melbourne, VIC, Australia
| |
Collapse
|
5
|
Gajewska E, Sobieska M, Moczko J. Position of pelvis in the 3rd month of life predicts further motor development. Hum Mov Sci 2018; 59:37-45. [PMID: 29602050 DOI: 10.1016/j.humov.2018.03.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Revised: 03/05/2018] [Accepted: 03/18/2018] [Indexed: 11/28/2022]
Abstract
The aim of the study is to select elements of motor skills assessed at 3 months that provide the best predictive properties for motor development at 9 months. In all children a physiotherapeutic assessment of the quantitative and qualitative development at the age of 3 months was performed in the prone and supine positions, which was presented in previous papers as the quantitative and qualitative assessment sheet of motor development. The neurological examination at the age of 9 months was based on the Denver Development Screening Test II and the evaluation of reflexes, muscle tone (hypotony and hypertony), and symmetry. The particular elements of motor performance assessment were shown to have distinct predictive value for further motor development (as assessed at 9 months), and the pelvis position was the strongest predictive element. Irrespective of the symptomatic and anamnestic factors the inappropriate motor performance may already be detected in the 3rd month of life and is predictive for further motor development. The assessment of the motor performance should be performed in both supine and prone positions. The proper position of pelvis summarizes the proper positioning of the whole spine and ensures proper further motor development. To our knowledge, the presented motor development assessment sheet allows the earliest prediction of motor disturbances.
Collapse
Affiliation(s)
- Ewa Gajewska
- Department of Developmental Neurology, Poznan University of Medical Sciences, Poland.
| | - Magdalena Sobieska
- Department of Rheumatology and Rehabilitation, Poznan University of Medical Sciences, Poland
| | - Jerzy Moczko
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, Poland
| |
Collapse
|
6
|
Tokariev A, Videman M, Palva JM, Vanhatalo S. Functional Brain Connectivity Develops Rapidly Around Term Age and Changes Between Vigilance States in the Human Newborn. Cereb Cortex 2015; 26:4540-4550. [DOI: 10.1093/cercor/bhv219] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
|
7
|
Visual fixation in human newborns correlates with extensive white matter networks and predicts long-term neurocognitive development. J Neurosci 2015; 35:4824-9. [PMID: 25810513 DOI: 10.1523/jneurosci.5162-14.2015] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Infants are well known to seek eye contact, and they prefer to fixate on developmentally meaningful objects, such as the human face. It is also known, that visual abilities are important for the developmental cascades of cognition from later infancy to childhood. It is less understood, however, whether newborn visual abilities relate to later cognitive development, and whether newborn ability for visual fixation can be assigned to early microstructural maturation. Here, we investigate relationship between newborn visual fixation (VF) and gaze behavior (GB) to performance in visuomotor and visual reasoning tasks in two cohorts with cognitive follow-up at 2 (n = 57) and 5 (n = 1410) years of age. We also analyzed brain microstructural correlates to VF (n = 45) by voxel-based analysis of fractional anisotropy (FA) in newborn diffusion tensor imaging. Our results show that newborn VF is significantly related to visual-motor performance at both 2 and 5 years, as well as to visual reasoning at 5 years of age. Moreover, good newborn VF relates to widely increased FA levels across the white matter. Comparison to motor performance indicated that early VF is preferentially related to visuocognitive development, and that early motor performance relates neither to white matter integrity nor to visuocognitive development. The present findings suggest that newborn VF is supported by brainwide subcortical networks and it represents an early building block for the developmental cascades of cognition.
Collapse
|
8
|
Gajewska E, Barańska E, Sobieska M, Moczko J. Motor performance in the third, not the second month, predicts further motor development. J Mot Behav 2014; 47:246-55. [PMID: 25415833 DOI: 10.1080/00222895.2014.974495] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The aim was to verify if motor performance at second or third month of life better predicts further development. The global motor development was assessed by a neurologist and by a physiotherapist in 111 children at 2, 3, 6, and 9 months. At 2 and 3 months a physiotherapist also performed the assessment of qualitative elements. The physiotherapeutic assessment in the third month showed higher compatibility with the neurological assessment. Proper motor performance at third month could ensure the level of at least 7 months in the ninth month of life. Qualitative score above 7 of 15 points in the third month ensured proper development in ninth month. Third month of life is a better predictor of further motor development.
Collapse
Affiliation(s)
- Ewa Gajewska
- a Department of Rheumatology and Rehabilitation , Poznań University of Medical Sciences , Poland
| | | | | | | |
Collapse
|
9
|
Amess P, McFerran C, Khan Y, Rabe H. Early prediction of neurological outcome by term neurological examination and cranial ultrasound in very preterm infants. Acta Paediatr 2009; 98:448-53. [PMID: 18976368 DOI: 10.1111/j.1651-2227.2008.01062.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM To assess the value of term neurological examination and cranial ultrasound in the early prediction of neurological outcome at 12 months corrected age in a cohort of very preterm infants. METHODS A cohort of 102 preterm infants born at <32 weeks gestation or with a birth weight of <1500 g were assessed using the Hammersmith Term Neurological Examination. They underwent cranial ultrasound examinations according to local guidelines. The Hammersmith Infant Neurological Examination was performed at 12 months corrected age. Scores for the term examinations were compared with scores derived from healthy infants born at term and with scores from low-risk preterm infants at term equivalent age. Term neurological scores and cranial ultrasound findings were compared in the prediction of 12-month neurological outcome. RESULTS Seventy-eight (76.5%) preterm infants had suboptimal total neurological scores at term when compared to healthy infants born at term. However, most went on to have optimal neurological scores at 12 months corrected age. When our cohort was compared with low-risk preterm infants at term equivalent age only 14 (13.7%) scored outside the normal range. Neither system of scoring predicted neurological outcome at 12 months corrected age as reliably as cranial ultrasound (sensitivity 0.83, specificity 0.87). CONCLUSION Neurological examination of preterm babies at term may be unreliable in the prediction of neurological outcome at 12 months corrected age. For early prediction of neurological outcome cranial ultrasound examination was found to be more reliable.
Collapse
Affiliation(s)
- P Amess
- Department of Neonatology, Brighton and Sussex University Hospitals, Brighton, UK.
| | | | | | | |
Collapse
|
10
|
Ilić N, Obradović S, Dindić J, Kostić G, Laban O, Vuletić B. [Correlation between neurological finding and gestational maturity of newborns determined by neurosonography]. MEDICINSKI PREGLED 2008; 61:281-285. [PMID: 19102076 DOI: 10.2298/mpns0806281i] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
INTRODUCTION Maturity is a complex functional condition influenced especially by the development of the vital functions of a fetus, primarily by the degree of the development of its central nervous system. The aim of this investigation was to establish the gestational maturity of the nervous system by neurosonography and neurological status. MATERIAL AND METHODS The parameter of the neurological maturity, compared in this research are a neurological status and the degree of girification established by the ultrasound. RESULTS All the coefficients of correlation between the gestation age determined by the ultrasound and the establishing of the gestation based on the neurological findings show a statistically significant correlation for p < 0.01. Of particular parametres of the neurological evaluation , the most appropriate ones appeared to be reflexes (the reflex of crossed extension, Moro reflex and the reflex of the main points), then volar flexion of a hand and the poplietal corner as the indicator of the passive tonus, whereas within the area of the evaluation of the active tonus, the motility was the most valid for establishing the maturity of a neonatal. The lowest coefficients of the correlations were in the automatic walk and the active tonus of the neck flexor, which are the ones of the most common neurological indicators of hypoxic ischemic encephalopathy of a neonatal. CONCLUSIONS Bearing in mind that the premature babies are a risky group for existence of perinatal brain damages, we believe the neurosonographic establishing of the gestation age to be a precise and comfortable indicator of the maturity of the nervous system.
Collapse
Affiliation(s)
- Nevenka Ilić
- Pedijatrijska ordinacija "Cika Jova Zmaj", Kragujevac.
| | | | | | | | | | | |
Collapse
|
11
|
Heineman KR, Bos AF, Hadders-Algra M. The Infant Motor Profile: a standardized and qualitative method to assess motor behaviour in infancy. Dev Med Child Neurol 2008; 50:275-82. [PMID: 18279412 DOI: 10.1111/j.1469-8749.2008.02035.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A reliable and valid instrument to assess neuromotor condition in infancy is a prerequisite for early detection of developmental motor disorders. We developed a video-based assessment of motor behaviour, the Infant Motor Profile (IMP), to evaluate motor abilities, movement variability, ability to select motor strategies, movement symmetry, and fluency. The IMP consists of 80 items and is applicable in children from 3 to 18 months. The present study aimed to test intra- and interobserver reliability and concurrent validity of the IMP with the Alberta Infant Motor Scale (AIMS) and Touwen neurological examination. The study group consisted of 40 low-risk term (median gestational age [GA] 40 wks, range 38-42 wks) and 40 high-risk preterm infants (median GA 29.6 wks, range 26-33 wks) with corrected ages 4 to 18 months (31 females, 49 males). Intra- and interobserver agreement of the IMP were satisfactory (Spearman's rho=0.9). Concurrent validity of IMP and AIMS was good (Spearman's rho=0.8, p<0.005). The IMP was able to differentiate between infants with normal neurological condition, simple minor neurological dysfunction (MND), complex MND, and abnormal neurological condition (p<0.005). This means that the IMP may be a promising tool to evaluate neurological integrity during infancy, a suggestion that needs confirmation by means of assessment of larger groups of infants with heterogeneous neurological conditions.
Collapse
Affiliation(s)
- Kirsten R Heineman
- Department of Neurology, Institute of Developmental Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | | |
Collapse
|