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Updated: Jul 31, 2025
Preterm EEG: A Multimodal Neurophysiological Protocol
Published on: February 18, 2012
Early markers of neurodevelopmental disorders based on general movements for very preterm infants: study protocol for
Jun Wang1, Xiushu Shen1, Hong Yang2
1Department of Rehabilitation, Children's Hospital of Fudan University, Shanghai, China.
Insights
General Movements Assessment (GMA) can identify early markers for neurodevelopmental challenges in very preterm (VPT) infants. This helps in timely intervention for better outcomes.
Area of Science:
- Neonatology
- Developmental Pediatrics
- Movement Science
Background:
- Very preterm (VPT) infants face significant neurodevelopmental challenges.
- Early identification of neurodevelopmental disorders in VPT infants is crucial for timely intervention.
- Current early markers for neurodevelopmental disorders in VPT infants are limited, potentially delaying crucial interventions.
Purpose of the Study:
- To determine the diagnostic value of General Movements Assessment (GMA) in identifying early markers for atypical neurodevelopmental outcomes in VPT infants.
- To establish the relationship between General Movement Optimality Scores (GMOS) and Motor Optimality Scores (MOS) for predicting clinical phenotypes.
- To facilitate precise, early interventions by identifying specific predictive markers in VPT infants.
Main Methods:
- A nationwide, multicentric prospective cohort study involving 577 infants born before 32 weeks of gestation.
- Qualitative assessment of general movements (GMs) at writhing and fidgety stages using GMA, with GMOS to classify normal, poor repertoire, and cramped-synchronized movements.
- Evaluation of neurodevelopmental outcomes at 2 years using the Griffiths Development Scales-Chinese, correlating with GMOS and MOS.
Main Results:
- The study aims to establish percentile ranks for GMOS across different GM categories (N, PR, CS).
- Analysis will focus on the relationship between GMOS in writhing movements and MOS in fidgety movements.
- Exploration of GMOS subcategories to identify specific early markers for predicting clinical phenotypes and functional outcomes in VPT infants.
Conclusions:
- GMA provides a valuable tool for early detection of neurodevelopmental risks in VPT infants.
- Identifying specific early markers through GMA can enable precise, timely interventions during critical developmental windows.
- This research will inform hierarchical management strategies for optimizing developmental trajectories in preterm infants.
Introduction:
Very preterm (VPT) infants may experience varying degrees of neurodevelopmental challenges. Lack of early markers for neurodevelopmental disorders may delay referral to early interventions. The detailed General Movements Assessment (GMA) could help us to identify early markers for VPT infants at risk of atypical neurodevelopmental clinical phenotype in the very early stage of life as soon as possible. Preterm infants with high risk of atypical neurodevelopmental outcomes will have the best possible start to life if early precise intervention in critical developmental windows is allowed.
Methods And Analysis:
This is a nationwide, multicentric prospective cohort study that will recruit 577 infants born <32 weeks of age. This study will determine the diagnostic value of the developmental trajectory of general movements (GMs) at writhing and fidgety age with qualitative assessment for different atypical developmental outcomes at 2 years evaluated by the Griffiths Development Scales-Chinese. The difference in the General Movement Optimality Score (GMOS) will be used to distinguish normal (N), poor repertoire (PR) and cramped sychronised (CS) GMs. We plan to build the percentile rank of GMOS (median, 10th, 25th, 75th and 90th percentile rank) in N, PR and CS of each global GM category and analyse the relationship between GMOS in writhing movements and Motor Optimality Score (MOS) in fidgety movements based on the detailed GMA. We explore the subcategories of the GMOS list, and MOS list that may identify specific early markers that help us to identify and predict different clinical phenotypes and functional outcomes in VPT infants.
Ethics And Dissemination:
The central ethical approval has been confirmed from the Research Ethical Board of Children's Hospital of Fudan University (ref approval no. 2022(029)) and the local ethical approval has been also obtained by the corresponding ethics committees of the recruitment sites. Critical analysis of the study results will contribute to providing a basis for hierarchical management and precise intervention for preterm infants in very early life.
Trial Registration Number:
ChiCTR2200064521.
