Related Experiment Videos
Prediction of outcome at school age in neonatal intensive care unit graduates using neonatal neurologic tools
1School of Physical and Occupational Therapy, Department of Neurology, McGill University-Montreal Children's Hospital, PQ, Canada. amajne@po-box.mcgill.ca
Insights
Somatosensory evoked potentials (SEPs) are the most accurate tool for predicting long-term neurodevelopmental outcomes in high-risk newborns. This study highlights the lasting predictive validity of neonatal SEPs for school-age development.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Clinical Neurophysiology
Background:
- Predicting neurodevelopmental outcomes in neonatal intensive care unit (NICU) graduates is crucial for family counseling and early intervention.
- Evoked potentials (EPs) show prognostic value for early childhood neurological outcomes, but their long-term predictive validity requires further investigation.
- Neonatal neurological assessments are vital for identifying at-risk infants.
Purpose of the Study:
- To prospectively evaluate the long-term predictive value of three neonatal neurologic assessments.
- To determine the accuracy of brainstem auditory evoked potentials (BAEPs), somatosensory evoked potentials (SEPs), and the Einstein Neonatal Neurobehavioral Assessment Scale (ENNAS) in predicting school-age outcomes.
- To assess the continued significance of neonatal neurological assessments at school age.
Main Methods:
- Prospective study involving 78 high-risk newborns and 28 healthy controls.
- Neonatal assessments included BAEPs, SEPs, and ENNAS.
- Follow-up evaluations at 8–9 years of age using psychologic, sensorimotor, and neurologic measures.
Main Results:
- Somatosensory evoked potentials (SEPs) demonstrated the highest accuracy in predicting school-age outcomes.
- SEPs exhibited high specificity (83-100%) and good sensitivity (80-100%) for intellectual and sensorimotor abilities.
- Brainstem auditory evoked potentials (BAEPs) were limited by false-negatives, and the Einstein Neonatal Neurobehavioral Assessment Scale (ENNAS) produced numerous false-positives.
Conclusions:
- Neonatal somatosensory evoked potentials (SEPs) are highly predictive of developmental sequelae persisting into school age.
- SEPs offer a reliable method for long-term outcome prediction in high-risk newborns.
- This study confirms the enduring prognostic value of neonatal SEPs for neurodevelopmental assessment.
Abstract:
Prediction of outcome for neonatal intensive care unit graduates is clinically useful to counsel families effectively and target those who may benefit from early interventions. Evoked potentials have proven prognostic value of neurologic outcomes in early childhood; however, their long-term predictive validity remains to be determined. The objective of this prospective study was to determine the long-term predictive value of three neonatal neurologic assessments: brainstem auditory evoked potentials, somatosensory evoked potentials, and the Einstein Neonatal Neurobehavioral Assessment Scale. Seventy-eight high-risk newborns and 28 healthy controls were recruited and were assessed in the newborn period using these tests. At 8 to 9 years of age, 42 subjects and 13 controls were re-evaluated for developmental progress using a range of psychologic, sensorimotor, and neurologic measures. Findings indicated that the somatosensory evoked potential was most accurate at predicting outcome at school age, with high specificity (83-100%) across all domains tested and good sensitivity (80-100%) for intellectual performance and sensorimotor abilities. The brainstem auditory evoked potential was limited by false-negatives, whereas the neonatal neurobehavioral assessment yielded many false-positives. This study provides new evidence that associations between neonatal somatosensory evoked potentials and developmental sequelae continue to be significant at school age.