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A Battery of Motor Tests in a Neonatal Mouse Model of Cerebral Palsy
Published on: November 3, 2016
Cerebral Palsy: Early Markers of Clinical Phenotype and Functional Outcome
Christa Einspieler1, Arend F Bos2, Magdalena Krieber-Tomantschger3
1Research Unit iDN, Division of Phoniatrics, Medical University of Graz, 8036 Graz, Austria. christa.einspieler@medunigraz.at.
Insights
The Motor Optimality Score (MOS) effectively predicts cerebral palsy (CP) severity and type in infants. Non-optimal MOS and absent fidgety movements are key early indicators of CP prognosis.
Area of Science:
- Neurology
- Developmental Pediatrics
- Movement Science
Background:
- Prechtl General Movement Assessment (GMA) is crucial for early cerebral palsy (CP) identification.
- Fidgety movements (3-5 months) and Motor Optimality Score (MOS) offer insights into infant motor function.
- Early identification of CP markers aids in prognosis and intervention planning.
Purpose of the Study:
- To identify early specific markers for ambulation, gross motor function, topography, and type of CP.
- To analyze the correlation between MOS and Gross Motor Function Classification System (GMFCS) levels.
- To establish the prognostic value of MOS in a large international cohort of infants.
Main Methods:
- Utilized the Prechtl General Movement Assessment (GMA) in a cohort of 468 infants.
- Assessed fidgety movements and calculated the Motor Optimality Score (MOS).
- Correlated MOS with Gross Motor Function Classification System (GMFCS) levels, CP topography, and type.
Main Results:
- 95% of infants with CP lacked fidgety movements; 100% had non-optimal MOS.
- MOS strongly correlated with GMFCS levels (MOS > 14 for GMFCS I-II; MOS ≤ 8 for GMFCS IV-V).
- Specific movements (e.g., atypical arching, cramped-synchronized, asymmetrical segmental, circular arm) associated with CP severity, topography, and type.
Conclusions:
- The MOS is a valuable tool for understanding later CP prognosis.
- Early markers identified through MOS assessment can predict CP type and severity.
- Integrating MOS assessment into early evaluations enhances CP diagnosis and management strategies.
Abstract:
The Prechtl General Movement Assessment (GMA) has become a cornerstone assessment in early identification of cerebral palsy (CP), particularly during the fidgety movement period at 3-5 months of age. Additionally, assessment of motor repertoire, such as antigravity movements and postural patterns, which form the Motor Optimality Score (MOS), may provide insight into an infant's later motor function. This study aimed to identify early specific markers for ambulation, gross motor function (using the Gross Motor Function Classification System, GMFCS), topography (unilateral, bilateral), and type (spastic, dyskinetic, ataxic, and hypotonic) of CP in a large worldwide cohort of 468 infants. We found that 95% of children with CP did not have fidgety movements, with 100% having non-optimal MOS. GMFCS level was strongly correlated to MOS. An MOS > 14 was most likely associated with GMFCS outcomes I or II, whereas GMFCS outcomes IV or V were hardly ever associated with an MOS > 8. A number of different movement patterns were associated with more severe functional impairment (GMFCS III-V), including atypical arching and persistent cramped-synchronized movements. Asymmetrical segmental movements were strongly associated with unilateral CP. Circular arm movements were associated with dyskinetic CP. This study demonstrated that use of the MOS contributes to understanding later CP prognosis, including early markers for type and severity.
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