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Minor neurological dysfunction in five year old very preterm children is associated with lower processing speed
Tinka Kurpershoek1, Eva S Potharst-Sirag2, Cornelieke S H Aarnoudse-Moens2
1Department of Neonatology, Emma Children's Hospital, Academic Medical Centre, Postbox 22660, 1100 DD, Amsterdam, The Netherlands.
Insights
Children born very preterm (VP) with complex minor neurological dysfunction (c-MND) show poorer motor skills and slower reaction times. Early identification of c-MND is crucial for predicting neurocognitive deficits in VP children.
Area of Science:
- Pediatrics
- Neuroscience
- Developmental Psychology
Background:
- Minor neurological dysfunction (MND) affects 25-33% of very preterm (VP) infants.
- Complex (c)-MND is linked to learning, behavioral, and motor impairments in children.
Purpose of the Study:
- To investigate the association between c-MND and neurocognitive/motor disabilities at age five in VP children without cerebral palsy (CP).
Main Methods:
- Assessed 94 VP children (gestational age <30 weeks and/or birth weight <1000g) at corrected age five.
- Classified MND using Touwen criteria; measured intelligence (WPPSI-III-NL), processing speed, attention, visuomotor coordination (Amsterdam Neuropsychological Tasks), working memory (Digit Span Task), and motor skills (M-ABC2).
Main Results:
- 19% of VP children had abnormal neurological findings (c-MND or mild CP).
- The abnormal group exhibited significantly lower processing speed quotient (PSQ), poorer motor skills (M-ABC2 percentile), and slower simple reaction time.
- No significant differences were found in IQ, working memory, attention, or visuomotor coordination.
Conclusions:
- VP children with c-MND demonstrate reduced processing speed, slower reaction times, and impaired motor skills compared to peers without c-MND.
- Identifying c-MND through neurological examination aids in detecting VP children at risk for neurocognitive disabilities.
Background:
Minor neurological dysfunction (MND) is present in one quarter to one third of children born very preterm (VP). The more severe form, complex (c)-MND has been associated with learning disabilities, behavioural and motor problems.
Objective:
To study the association between c-MND and neurocognitive and motor disabilities at age five in VP children without CP.
Methods:
Ninety-four children born with gestational age<30weeks and/or a birth weight<1000g were assessed at five years corrected age. MND was classified according to Touwen. The Wechsler Preschool and Primary School Scale of Intelligence (WPPSI-III-NL) was used to measure intelligence. Simple reaction time, focused attention and visuomotor coordination were measured using the Amsterdam Neuropsychological Tasks, and working memory using a Digit Span Task. For motor skills the Movement Assessment Battery for children (M-ABC2) was used.
Results:
Eighty-one percent was classified as 'normal' (no or simple (s-)-MND) and 19% as 'abnormal'(c-MND or mild CP). The abnormal group had a significantly lower processing speed quotient (PSQ), M-ABC percentile score and slower simple Reaction Time than the normal group. Verbal IQ, Performance IQ, working memory, focused attention and visuomotor coordination did not differ between groups. Exclusion of the mild CP cases (n=4) led to similar results.
Conclusions:
Five year old VP children with c-MND have lower PSQ, slower reaction time, and poorer motor skills, than those without c-MND. Neurological examination should include identification of MND to help identify children at risk for neurocognitive disabilities.
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