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A Battery of Motor Tests in a Neonatal Mouse Model of Cerebral Palsy
Published on: November 3, 2016
Movement, imaging and neurobehavioral assessment as predictors of cerebral palsy in preterm infants
J C Constantinou1, E N Adamson-Macedo, M Mirmiran
1Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA. Janet.constantinou@stanford.edu
Insights
Magnetic resonance imaging and general movements at 52 weeks best predict cerebral palsy in high-risk infants. Combining MRI and neurobehavioral assessment improves early detection accuracy.
Area of Science:
- Neonatal neurology
- Developmental pediatrics
Background:
- Early identification of cerebral palsy (CP) is crucial for timely intervention.
- Predictive accuracy of early markers in high-risk infants remains an area of active research.
Purpose of the Study:
- To compare the efficacy of three early predictors for cerebral palsy.
- To evaluate magnetic resonance imaging (MRI), general movements (GMs), and neurobehavioral assessments.
Main Methods:
- 130 preterm infants (<1500g birth weight) were studied.
- Spontaneous general movements recorded at 36 and 52 weeks postconceptional age.
- MRI and neurobehavioral assessment at 36 weeks; neurological exam and Bayley scales at 18 months corrected age.
Main Results:
- MRI demonstrated highest specificity (91%) and accuracy (84%).
- General movements at 52 weeks showed improved accuracy over 36 weeks.
- Combining MRI and neurobehavioral assessment yielded 80% sensitivity for CP prediction.
Conclusions:
- A combination of neuroimaging and functional assessments offers a superior approach for early CP detection.
- Infants with normal early assessments generally maintained a neurologically intact status at follow-up.
Objective:
To study the relative efficacy of three early predictors of cerebral palsy.
Method:
One Hundred and thirty infants with birth weight <1500 g were recruited. Video recordings of spontaneous general movements were made at 36 and 52 weeks postconceptional age. Magnetic resonance imaging and the neurobehavioral assessment of the preterm infant were done at 36 weeks postconceptional age. Follow-up neurological examination and Bayley assessments were made at 18 months corrected age to make early identification of cerebral palsy.
Results:
Magnetic resonance imaging gave the best specificity and accuracy of 91 and 84% respectively. General movements at 52 weeks showed an improved specificity and accuracy over performance at 36 weeks postconceptional age. The negative predictive value for all methods tested was between 90 and 97%. Combining the results of magnetic resonance imaging and the neurobehavioral assessment improved the sensitivity of prediction to 80%, suggesting that a holistic approach to early detection of cerebral lesions is preferable to a single test.
Conclusions:
The majority of infants who appeared to behave within normal limits and exhibit normal brain structure in the newborn period were classified as neurologically intact at follow-up.
