An early marker for neurological deficits after perinatal brain lesions
An early marker for neurological deficits after perinatal brain lesions
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DOI：
10.1016/s0140-6736(96)10182-3
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发表时间：
1997-05-10
期刊：
影响因子：
168.9
通讯作者：
Sontheimer, D
中科院分区：
文献类型：
--
作者：
Prechtl, HFR;Einspieler, C;Sontheimer, D
背景：在正常清醒的婴儿中，6周至20周的婴儿可以看到坐立不安的动作。本研究的目的是检验婴幼儿自主运动缺失或异常对以后神经功能缺陷发展的预测价值。方法在一项由5家医院参与的合作研究中，收集了130名婴幼儿的正常和异常坐立不安运动质量的数据，并将其与2岁前进行的纵向神经发育评估进行了比较。根据超声扫描，婴儿被归类为神经功能缺陷的低风险或高风险。婴儿从出生到出院每周进行Ih录像，然后每3-4周记录15分钟；评估一般运动的质量，并重复进行神经评估，直到矫正年龄24个月。结果发现，在70名烦躁的婴儿中，67名(96%)的神经系统结果正常。在60名婴儿中，57名(95%)出现质量异常或完全没有坐立不安的运动，随后出现神经异常(49名脑瘫，8名发育迟缓或轻微神经体征)。坐立不安运动评估的特异度和敏感度分别为96%和95%，高于婴儿脑部超声成像的特异度和敏感度(分别为83%和80%)。解释我们的自发运动活动评估技术可以识别和区分需要早期干预的婴儿和不需要早期干预的婴儿。我们的技术简单、非侵入性、可靠、快速，可以在非常小的婴儿身上进行。
Background In normal awake infants, fidgety movements are seen from the age of 6 weeks to 20 weeks. The aim of the study was to test the predictive value of absent or abnormal spontaneous movements in young infants for the later development of neurological deficits.Methods In a collaborative study involving five hospitals we collected data on the normal and abnormal quality of fidgety movements of 130 infants and compared it with assessments of neurological development done longitudinally until the age of 2 years. On the basis of ultrasound scans infants were classified as at low-risk or at high-risk of neurological deficits. Infants were videoed for Ih every week from birth to discharge and then for 15 min every 3 to 4 weeks; quality of general movements was assessed, Repeated neurological assessments were also done until 24 months of corrected age.Findings 67 (96%) of 70 infants with normal fidgety movements had a normal neurological outcome. Abnormal quality or total absence of fidgety movements was followed by neurological abnormalities in 57 (95%) of the 60 infants (49 had cerebral palsy and eight had developmental retardation or minor neurological signs). Specificity and sensitivity of fidgety movement assessment were higher (96% and 95%, respectively) than of ultrasound imaging of the infants' brain (83% and 80%, respectively).Interpretation Our technique of assessing spontaneous motor activity can identify and distinguish between those infants who require early intervention for neurological abnormalities and those who do not. Our technique is simple, non-intrusive, reliable, quick, and can be done on very young infants.