REHABILITATION, BRAIN LESIONS, AND MOVEMENT IN INFANTS

该项目的主要目标是评估以下参数 通过极低出生体重的运动学技术测量的运动 (VLBW)患有和不患有新生儿白质障碍(NWMD)和 超声检测无NWMD的健康足月(FT)婴儿(美国) 或出生前18个月以上的磁共振(MRI)校正年龄 评价运动参数的预测关系 与后来的功能障碍的关系，并比较 成像和运动学技术；以及评估未成熟的 大脑从NWMD中恢复的能力。在基地，我们相信我们会 开始描述NWMD的早期自然历史和发展 大脑对结构损伤的补偿能力。 建议的项目是对40个极低出生体重的纵向前瞻性研究。 出生时有NWMD记录的婴儿和40名未记录NWMD的VLBW婴儿 20例无NWMD的FT患儿。要确定位置和位置 病变的大小及其随时间的变化，包括其 外观超过新生儿期，高分辨率颅脑超声将 在新生儿期和3个月时重复CA和MRI 在CA的6个月给药。自发的、引发的运动 三组婴儿的下肢和上肢的图案将 在2、5、9和18个月的CA时使用运动学技术进行评估。这个 婴儿的临床和功能状况将用 新生儿期两次新生儿行为评定量表(NBAS) 用艾伯塔省婴儿运动筛查(MMS)在5个月和9个月CA； 在6个月和18个月时进行标准神经学检查 儿科神经科医生；皮博迪发育运动量表--和 在18个月时使用儿童残疾评估问卷(PEDI) 加州。此外，为了对经验的作用进行初步评估， 衡量照看质量的三份问卷 将对环境进行管理。 我们预计患有NWMD的婴儿，特别是靠近额部的婴儿- 顶壁交界处有或无脑室增大或出血，将 表现出早期非典型的运动组织，可通过 运动学技术。

The primary goals of this project are to evaluate the parameters of movement as measured by kinematic techniques of Very Low Birth weight (VLBW) infants with and without Neonatal White Matter Disorder (NWMD) and healthy full term (FT) infants without NWMD as detected by ultrasound (US) or magnetic resonance (MRI) over the first 18 months of life corrected age (CA); to evaluate the predictive relations of the parameters of movement to later dysfunction and to compare the prognostic effectiveness of imaging and kinematic techniques; as well as, to evaluate the immature brain's ability to recover from NWMD. At the base, we believe we will begin to describe the early natural history of NWMD and the developing brain's ability to compensate for structural damage. The proposed project is a longitudinal prospective study of 40 VLBW infants with documented NWMD at birth and 40 VLBW infants free of such lesions and 20 FT infants free of NWMD. To characterize the location and size of the lesions and their changes over time, including their appearance beyond the neonatal period, high resolution cranial US will be repeated during the neonatal period and at 3 months CA and MRI will be administered at 6 months CA. The spontaneous and elicited movement patterns of the lower and upper limbs of the three groups Of infants will be evaluated at 2, 5, 9 and 18 months CA using kinematic techniques. The clinical and functional status of the infants will be evaluated with the Neonatal Behavioral Assessment Scale (NBAS) twice during the neonatal period; with the Alberta Infant Motor Screen (MMS) at 5 and 9 months CA; with a standard neurological examination at 6 and 18 months carried out by a pediatric neurologist; with the Peabody Developmental Motor Scales- and with the Pediatric Evaluation of Disability Inventory (PEDI) at 18 months CA. Additionally, to make an initial evaluation of the role of experience, three questionnaires that measure the quality of the caretaking environment will be administered. We expect that infants who have NWMD, particularly near the fronto- parietal junction with or without ventriculomegaly or hemorrhage, will manifest early atypical organization of movement which can be detected by kinematic techniques.