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A Battery of Motor Tests in a Neonatal Mouse Model of Cerebral Palsy
Published on: November 3, 2016
Early prediction of cerebral palsy after neonatal intensive care using motor development trajectories in infancy
Nathalie L Maitre1, James C Slaughter, Judy L Aschner
1Department of Pediatrics, Monroe Carell Children's Hospital at Vanderbilt, Nashville, TN, USA. nathalie.maitre@vanderbilt.edu
Insights
Early identification of cerebral palsy (CP) in neonatal intensive care unit (NICU) infants is possible. A decline in motor scores by 12 months predicts CP, enabling timely intervention.
Area of Science:
- Neonatal neurology
- Developmental pediatrics
- Pediatric rehabilitation
Background:
- Neonatal intensive care unit (NICU) infants face high risks for developmental disabilities, including cerebral palsy (CP).
- Delayed diagnosis of CP, particularly in preterm infants, hinders effective rehabilitation.
- Early identification is crucial for timely intervention and improved outcomes.
Purpose of the Study:
- To determine if longitudinal motor trajectory evaluations in NICU follow-up clinics can predict CP development by age 3.
- To identify early markers for CP in high-risk infants.
Main Methods:
- Retrospective study of 606 NICU patients (birth weight <1500g or hypoxic ischemic encephalopathy).
- Utilized neurologic exams, Developmental Assessment of Young Children (DAYC), Bayley Scales of Infant Development (BSID), and Gross Motor Function Classification Scale.
Main Results:
- A significant decrease in DAYC scores between 6 and 12 months was observed in infants who later developed CP, unlike those without CP (-23 vs. +1.5, p<0.001).
- Decreased DAYC scores in infancy strongly predicted later CP diagnosis (p<0.001).
- BSID scores indicated severe motor delays but did not enhance CP prediction.
Conclusions:
- Standardized motor milestone assessments quantitatively predict CP risk in former NICU patients by 12 months.
- This allows for earlier diagnosis, counseling, and therapy initiation for high-risk infants.
- Longitudinal motor evaluations are valuable tools for early CP detection.
Unlabelled:
Neonatal intensive care unit (NICU) patients are at high risk for developmental disabilities such as cerebral palsy (CP). Early identification of CP is essential to effective rehabilitation, but diagnosis is often delayed, especially in preterm infants. We hypothesized that through the longitudinal evaluation of motor trajectories in the NICU follow-up clinic, we could distinguish infants who develop CP by 3 years of age.
Study Design And Subjects:
This was a retrospective study of 606 patients in the NICU Follow-up Clinic at Vanderbilt University with birth weight < 1500g or a diagnosis of hypoxic ischemic encephalopathy.
Outcomes Measures:
Assessments included neurologic exams, the Developmental Assessment of Young Children (DAYC), the Bayley Scales of Infant Development (BSID) and the Gross Motor Function Classification Scale.
Results:
A decrease in DAYC scores between 6 and 12 months was present in preterm and term infants later diagnosed with CP, but not in children without CP (-23 vs. +1.5, p<0.001). DAYC score decreases in infancy were highly predictive of later CP (p<0.001). BSID scores quantified severe motor delays but did not add to prediction of CP diagnosis.
Conclusion:
Standardized assessments of motor milestones quantitatively predict the risk of CP in former NICU patients by 12 months, allowing for timely diagnosis, counseling and therapy in high-risk infants.
