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Published on: November 20, 2015
Prevention of Neurological Sequelae in Preterm Infants
Eduardo Gonzalez-Moreira1, Thalía Harmony2, Manuel Hinojosa-Rodríguez2
1Center for Biomedical Imaging and Neuromodulation, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY 10962, USA.
Insights
Katona neurohabilitation improved cognitive and motor outcomes in preterm infants. Early MRI findings, like corpus callosum and ventricle volumes, along with sepsis, predicted long-term development.
Area of Science:
- Neonatal Neurology
- Developmental Pediatrics
- Neuroimaging
Background:
- Preterm birth affects 5-18% of newborns globally, leading to white matter injuries and neurodevelopmental issues.
- Preterm infants face risks of brain damage from prenatal and perinatal factors.
- Hypomyelination in preterm infants is linked to preoligodendrocyte deficits.
Purpose of the Study:
- To investigate the impact of brain risk factors and MRI findings on motor and cognitive development at age 3 in preterm infants.
- To assess the effectiveness of Katona neurohabilitation on long-term outcomes.
- To identify predictors of neurodevelopmental outcomes in this population.
Main Methods:
- 166 preterm infants underwent clinical and MRI evaluations before 4 months of age.
- 89% of infants showed abnormal MRI findings.
- Bayley Scales of Infant Development II (Mental Developmental Index and Psychomotor Developmental Index) were compared at 3 years between 128 treated and 38 untreated infants.
Main Results:
- Infants receiving Katona neurohabilitation demonstrated higher MDI and PDI scores.
- Placental disorders, sepsis, corpus callosum, and left lateral ventricle volumes predicted both MDI and PDI.
- Apgar scores < 7 and right lateral ventricle volume predicted PDI.
Conclusions:
- Katona neurohabilitation significantly enhances neurodevelopmental outcomes in preterm infants by age 3.
- Sepsis and early MRI measurements of the corpus callosum and lateral ventricles are significant predictors of 3-year outcomes.
- Early intervention and monitoring of specific MRI parameters are crucial for preterm infant neurodevelopment.
Background:
Preterm birth is one of the world's critical health problems, with an incidence of 5% to 18% of living newborns according to various countries. White matter injuries due to preoligodendrocytes deficits cause hypomyelination in children born preterm. Preterm infants also have multiple neurodevelopmental sequelae due to prenatal and perinatal risk factors for brain damage. The purpose of this work was to explore the effects of the brain risk factors and MRI volumes and abnormalities on the posterior motor and cognitive development at 3 years of age.
Methods:
A total of 166 preterm infants were examined before 4 months and clinical and MRI evaluations were performed. MRI showed abnormal findings in 89% of the infants. Parents of all infants were invited to receive the Katona neurohabilitation treatment. The parents of 128 infants accepted and received Katona's neurohabilitation treatment. The remaining 38 infants did not receive treatment for a variety of reasons. At the three-year follow-up, Bayley's II Mental Developmental Index (MDI) and the Psychomotor Developmental Index (PDI) were compared between treated and untreated subjects.
Results:
The treated children had higher values of both indices than the untreated. Linear regression showed that the antecedents of placenta disorders and sepsis as well as volumes of the corpus callosum and of the left lateral ventricle significantly predicted both MDI and PDI, while Apgar < 7 and volume of the right lateral ventricle predicted the PDI.
Conclusions:
(1) The results indicate that preterm infants who received Katona's neurohabilitation procedure exhibited significantly better outcomes at 3 years of age compared to those who did not receive the treatment. (2) The presence of sepsis and the volumes of the corpus callosum and lateral ventricles at 3-4 months were significant predictors of the outcome at 3 years of age.
