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Correlations between Head Ultrasounds Performed at Term-Equivalent Age in Premature Neonates and General Movements
Adrian Ioan Toma1,2, Vlad Dima3, Adelina Alexe4
1Life Memorial Hospital, 010719 Bucharest, Romania.
Insights
This study links specific atypical general movement (GM) patterns in preterm infants to brain structure abnormalities. These findings help identify brain regions involved in motor control deficits.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Medical Imaging
Background:
- Premature infants often exhibit atypical general movement (GM) patterns, such as cramped-synchronized (CS) or poor repertoire (PR).
- These motor pattern abnormalities may indicate underlying neurological issues affecting brain development and function.
- Identifying the specific brain structures involved is crucial for understanding and managing these deficits.
Purpose of the Study:
- To investigate correlations between brain structure measurements from ultrasound and atypical GM patterns in preterm neonates.
- To identify specific cerebral structures potentially injured or affected, leading to observed GM pattern abnormalities.
- To provide evidence for the neuroanatomical basis of motor control deficits in formerly premature infants.
Main Methods:
- 44 preterm neonates were assessed at term-equivalent age (TEA) using general movement (GM) assessments and head ultrasounds.
- Ultrasound measurements included ventricular index, lateral ventricle dimensions, basal ganglia width, and cerebellar/pons diameters.
- Statistical analysis (FANOVA) was used to compare measurements between normal, CS, and PR GM pattern groups (p < 0.05).
Main Results:
- The cramped-synchronized (CS) pattern correlated with enlarged ventricles and decreased basal ganglia width.
- The poor repertoire (PR) pattern was associated with increased sinocortical width and decreased pons diameter.
- These correlations were consistent even in a subgroup of infants with gestational age ≤ 32 weeks.
Conclusions:
- Atypical GM patterns (CS and PR) in preterm infants are significantly correlated with specific abnormalities in measured brain structure dimensions.
- These findings suggest that ultrasound-assessed brain structure abnormalities are linked to specific motor control deficits.
- The study provides insights into the neuroanatomical correlates of GM pattern abnormalities in formerly premature neonates.
Background And Aim:
Our research aims to find correlations between the brain imaging performed at term-corrected age and the atypical general movement (GM) patterns noticed during the same visit a-cramped-synchronized (CS) or poor repertoire (PR)-in formerly premature neonates to provide evidence for the structures involved in the modulation of GM patterns that could be injured and result in the appearance of these patterns and further deficits.
Materials And Methods:
A total of 44 preterm neonates ((mean GA, 33.59 weeks (+2.43 weeks)) were examined in the follow-up program at Life Memorial Hospital Bucharest at term-equivalent age (TEA). The GM and ultrasound examinations were performed by trained and certified specialists. Three GM pattens were noted (normal, PR, or CS), and the measurements of the following cerebral structures were conducted via head ultrasounds: ventricular index, the short and long axes of the lateral ventricles, the midbody distance of the lateral ventricle, the diagonal of the caudate nucleus, the width of the basal ganglia, the width of the interhemispheric fissure, the sinocortical width, the length and thickness of the callosal body, the anteroposterior diameter of the pons, the diameter of the vermis, and the transverse diameters of the cerebellum and vermis. The ultrasound measurements were compared between the groups in order to find statistically significant correlations by using the FANOVA test (significance p < 0.05).
Results:
The presence of the CS movement pattern was significantly associated with an increased ventricular index (mean 11.36 vs. 8.90; p = 0.032), increased midbody distance of the lateral ventricle-CS versus PR (8.31 vs. 3.73; p = 0.001); CS versus normal (8.31 vs. 3.34; p = 0.001), increased long and short axes of the lateral ventricles (p < 0.001), and decreased width of the basal ganglia-CS versus PR (11.07 vs. 15.69; p = 0.001); CS versus normal pattern (11.07 vs. 15.15; p = 0.0010). The PR movement pattern was significantly associated with an increased value of the sinocortical width when compared to the CS pattern (p < 0.001) and a decreased anteroposterior diameter of the pons when compared to both the CS (12.06 vs. 16.83; p = 0.001) and normal (12.06 vs. 16.78; p = 0.001) patterns. The same correlations were present when the subgroup of infants with a GA ≤ 32 weeks was analyzed.
Conclusions:
Our study demonstrated that there are correlations between atypical GM patterns (cramped-synchronized-CS and poor repertoire-PR) and abnormalities in the dimensions of the structures measured via ultrasound at the term-equivalent age. The correlations could provide information about the structures that are affected and could lead to a lack of modulation in the GM patterns.
