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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Finger movements and fingers postures in pre-term infants are not a good indicator of brain damage
1Department of Developmental Neurology, University Hospital Groningen, Netherlands.
Insights
Abnormal finger movements and postures in pre-term infants are not reliable diagnostic indicators for brain lesions. Wide overlap exists between normal and brain-damaged infants, limiting diagnostic utility.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Movement Science
Background:
- Assessing neurological status in pre-term infants is crucial for early intervention.
- Previous studies have explored motor patterns in infants, but detailed finger movement analysis requires further investigation.
Purpose of the Study:
- To re-analyze videorecordings of pre-term infants to classify finger movements and postures.
- To determine the diagnostic utility of specific finger movement patterns in identifying brain lesions in pre-term infants.
Main Methods:
- Re-analysis of existing videorecordings from studies by Cioni and Prechtl (normal infants) and Ferrari et al. (brain-damaged infants).
- Random selection of three general movements per infant for detailed assessment of finger movement patterns.
- Classification of finger movements into distinct patterns (A-, B, B+, C+, D, E, E+).
Main Results:
- Specific finger movement patterns (B, D, E) were more frequently observed during arm movements.
- Fisting without arm movement (A-) was less common in control infants compared to those with flares or unilateral lesions.
- Patterns C+ were more frequent in infants with flares and unilateral lesions, while B+ and E+ were less frequent in severely damaged infants.
- Significant overlap in finger movement patterns was observed between normal and brain-damaged infant groups.
- No significant difference in fisting patterns was found between low-risk and neurologically abnormal pre-term infants.
Conclusions:
- Abnormal finger movements and postures in pre-term infants lack diagnostic specificity for confirmed brain lesions.
- The substantial overlap between movement patterns in normal and brain-damaged infants limits their use as reliable diagnostic markers.
- Further research may be needed to identify more specific biomarkers for early detection of neurological impairments in pre-term infants.
Abstract:
The aim of the study was to analyse, with a more detailed classification the occurrence of movements and postures of the fingers in normal and brain damaged pre-term infants. To this end the same videorecordings of normal subjects of the study described by Cioni and Prechtl and those with defined brain lesions from the investigation by Ferrari et al. have been reanalysed. In three general movements, selected randomly from each infant, we assessed the finger movement. There was no systematic trend with age and the repertoire of finger patterns per observation varied between different individuals. Only one or two finger(s) move (pattern B) and synchronized finger opening-closing (pattern D) and the complex and variable movement of three or more fingers (pattern E) are all more often or even only seen during arm movements. Fisting without arm movement (pattern A-) was only seen less frequently in the control cases, in the infants with flares and one-sided lesions. On the other hand, the two latter groups had more often pattern C+ (opening of all fingers with arm movement) while B+ (only one or two fingers move with arm movement) and E+ (three or more fingers move variably with arm movement) was less frequent in the severely damaged infants. Albeit significant differences, the plotted data immediately show the large overlap of the findings between the groups. There was no difference in the fisting between low-risk and neurologically abnormal pre-term infants. These findings corroborate the conclusions that abnormal movements and postures are not useful in the diagnosis of pre-term infants with confirmed brain lesions because of the wide overlap between the values for normal and brain damaged infants.
