Predictive utility of a simple cranial magnetic resonance imaging score at term-equivalent age for cerebral palsy

To evaluate the predictive value of the simple Total Abnormality Score (TAS) for assessing cranial magnetic resonance images to predict cerebral palsy (CP).

In this retrospective cohort study, 137 infants with a gestational age no more than 32 + 0 weeks and/or with a birthweight less than 1500 g, born between 2017 and 2021, were included. Findings from cranial magnetic resonance imaging at term-equivalent age were assessed using the TAS. At approximately 24 months (corrected age), the diagnosis of CP and its severity using the Gross Motor Function Classification System (GMFCS) were determined interdisciplinarily. A binary logistic regression with CP as the outcome parameter and a Spearman's rank correlation with TAS and GMFCS were performed in SPSS.

The TAS was higher in infants with CP (median 11, interquartile range 10-15, n = 9) than in infants without CP (median 2, interquartile range 2-4, n = 128). The odds ratio for CP was 1.31 per one-point increase in TAS. The optimal cut-off value of the TAS for predicting CP was 9.5 (sensitivity 88.9%, specificity 91.4%). There was a correlation between the TAS and GMFCS (Spearman's rho = 0.34, p < 0.001).

The TAS is a useful, quick tool for risk stratification of CP in this cohort. Future studies should consider replication in a larger sample and combination with additional tools.