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Updated: May 14, 2026
Preterm EEG: A Multimodal Neurophysiological Protocol
Published on: February 18, 2012
Neurodevelopmental Trajectories in Preterm Neonates: Integrating Neuroimaging Modalities with Clinical Neurological
Andreea Ioana Necula1,2, Roxana Pavalache-Stoiciu2, Larisa Nicoleta Andrasoaie2
1Doctoral School, "Carol Davila" University of Medicine and Pharmacy, 020956 Bucharest, Romania.
Insights
Integrating neuroimaging and functional assessments in preterm infants improves early identification of motor risks. Combining head ultrasound (HUS) and MRI with General Movements (GMs) offers superior prognostic accuracy.
Area of Science:
- Neonatal neurology
- Developmental pediatrics
- Neuroimaging
Background:
- Preterm infants face risks for long-term motor and psychiatric issues.
- Early identification of these risks is crucial for timely intervention.
- Neuroimaging and functional assessments are key tools in evaluating preterm infants.
Purpose of the Study:
- To review and synthesize evidence on integrating neuroimaging with functional assessments for identifying long-term risks in preterm infants.
- To evaluate the role of head ultrasound (HUS) and Magnetic Resonance Imaging (MRI) alongside General Movements (GMs) assessments.
- To determine the prognostic accuracy of term-equivalent age (TEA) assessments.
Main Methods:
- Narrative review of 12 studies published in the last 5 years.
- Focused on preterm infants (<37 weeks' gestational age).
- Analyzed correlations between neuroimaging (HUS, MRI), head circumference (HC), and functional assessments (GMs).
Main Results:
- MRI offers higher sensitivity than HUS for subtle white matter injury.
- Both HUS and MRI show high negative predictive values at TEA for excluding severe motor deficits.
- Structural markers like ventricular size and gyration, along with lesion laterality, correlate with Cerebral Palsy (CP) and motor delays.
- TEA assessments are more accurate than early neonatal scans for prognosis.
Conclusions:
- Integrating neuroimaging (HUS/MRI) with functional assessments (GMs) and parental support enhances prognostic accuracy for preterm infants.
- A tiered HUS/MRI protocol with routine GMs assessment facilitates precise risk counseling.
- Long-term outcome correlation requires follow-up beyond 24 months.
Abstract:
This narrative review aims to demonstrate how integrating neuroimaging with functional assessments and standardized protocols enhances the identification of long-term motor and psychiatric risks. This review synthesized 12 studies from the last 5 years. The analysis focused on preterm infants (<37 weeks' gestational age) and evaluated the correlation between neuroimaging (head ultrasound (HUS) and Magnetic Resonance Imaging (MRI)), head circumference (HC), and functional assessments like Prechtl General Movements (GMs). While HUS remains the primary bedside tool, its sensitivity for subtle, non-cystic white matter injury is limited compared to MRI. Both modalities demonstrate high negative predictive values at term-equivalent age (TEA) for excluding severe motor deficits. Structural markers, including increased ventricular midbody size, immature gyration, and bilateral lesion laterality, were strongly associated with Cerebral Palsy (CP) and gross motor delays. Furthermore, TEA assessments provided superior prognostic accuracy compared to early neonatal scans. Optimal outcomes were linked to the integration of neuroimaging with functional assessments (GMs) and reliable parental support to ensure follow-up compliance. A tiered HUS/MRI protocol combined with routine GMs assessment enables precise prognostic counseling. Correlating TEA imaging with long-term findings necessitates follow-up beyond 24 months.
