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Subcortical Change and Neurohabilitation Treatment Adherence Effects in Extremely Preterm Children
Susana A Castro-Chavira1, Claudia C Gutiérrez-Hernández1, Cristina Carrillo-Prado2
1Unidad de Investigación en Neurodesarrollo "Dr. Augusto Fernández Guardiola", Instituto de Neurobiología, Universidad Nacional Autónoma de México, Santiago de Querétaro 76230, Mexico.
Insights
Katona neurohabilitation may increase subcortical brain volumes in extremely preterm infants. However, treatment adherence is crucial for positive neurodevelopmental outcomes in these children.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Rehabilitation Medicine
Background:
- Extremely preterm birth (before 28 weeks gestation) is linked to higher risks of developmental deficits and multimorbidity.
- The number of gestation weeks at birth is inversely correlated with the risk of developmental issues.
- Neurodevelopmental outcomes in extremely preterm infants require targeted interventions and monitoring.
Purpose of the Study:
- To evaluate subcortical volume changes in extremely preterm infants following Katona neurohabilitation.
- To assess the impact of subcortical volume and treatment adherence on neurodevelopmental outcomes at three years of age.
- To determine the relationship between adherence to Katona neurohabilitation and neurodevelopmental progress.
Main Methods:
- A cohort of fifteen extremely preterm infants received Katona neurohabilitation from 2 months to 2 years of age.
- Magnetic resonance imaging (MRI) was used to measure subcortical brain volumes before and after the intervention.
- Neurodevelopmental assessments and treatment adherence were evaluated at three years of age.
Main Results:
- Absolute subcortical brain volumes increased post-treatment, but adjusted volumes (by intracranial volume) decreased.
- Decreased adjusted subcortical volumes may indicate functional inhibition, promoting cortical control and connectivity.
- While post-treatment hippocampal volumes showed limited predictive value, high treatment adherence strongly correlated with better mental and psychomotor neurodevelopment.
Conclusions:
- Katona neurohabilitation influences subcortical brain volumes in extremely preterm infants.
- The effectiveness of Katona neurohabilitation is significantly dependent on the child's adherence to the treatment regimen.
- Optimizing treatment adherence is essential for maximizing the neurodevelopmental benefits of Katona neurohabilitation in this population.
Abstract:
Extremely preterm birth entails an increased risk for multimorbidity and the prevalence of developmental deficits because this risk is negatively correlated to the number of gestation weeks. This work evaluated subcortical volume changes in children born extremely preterm who received Katona neurohabilitation, as well as the effects of subcortical volume and treatment adherence on their three-year-old neurodevelopment outcomes. Fifteen extremely preterm-born participants were treated from two months to two years old and followed up until past three years of age. The participants received Katona neurohabilitation, which provides vestibular and proprioceptive stimulation and promotes movement integration through the early, intensive practice of human-specific elementary movements. Subcortical brain volumes from magnetic resonance images were obtained at the beginning and after treatment. Also, treatment adherence to Katona neurohabilitation and neurodevelopment outcomes were measured. The results showed that absolute subcortical volumes increased after treatment; however, when adjusted by intracranial volume, these volumes decreased. Subcortical function inhibition allows cortical control and increased connectivity, which may explain decreased adjusted volume. Regression analyses showed that after-treatment hippocampal volumes had a discrete predictive value. However, treatment adherence showed a clear effect on mental and psychomotor neurodevelopment. Thus, the effectiveness of Katona neurohabilitation is constrained by treatment adherence.
