Joy E Olsen1, Nisha C Brown2, Abbey L Eeles2, Christa Einspieler3, Katherine J Lee4, Deanne K Thompson4, Peter J Anderson4, Jeanie L Y Cheong5, Lex W Doyle5, Alicia J Spittle6. 1. Victorian Infant Brain Studies, Clinical Sciences, Murdoch Childrens Research Institute, The Royal Children's Hospital, Flemington Rd, Parkville, Victoria 3052, Australia; Newborn Research, The Royal Women's Hospital, 20 Flemington Rd, Parkville, Victoria 3052, Australia. Electronic address: joy.olsen@thewomens.org.au. 2. Victorian Infant Brain Studies, Clinical Sciences, Murdoch Childrens Research Institute, The Royal Children's Hospital, Flemington Rd, Parkville, Victoria 3052, Australia. 3. Institute of Physiology, Center for Physiological Medicine, Medical University of Graz, Universitätsstrasse 15, 8010 Graz, Austria. 4. Victorian Infant Brain Studies, Clinical Sciences, Murdoch Childrens Research Institute, The Royal Children's Hospital, Flemington Rd, Parkville, Victoria 3052, Australia; Department of Paediatrics, University of Melbourne, The Royal Children's Hospital, Flemington Rd, Parkville, Victoria 3052, Australia. 5. Victorian Infant Brain Studies, Clinical Sciences, Murdoch Childrens Research Institute, The Royal Children's Hospital, Flemington Rd, Parkville, Victoria 3052, Australia; Newborn Research, The Royal Women's Hospital, 20 Flemington Rd, Parkville, Victoria 3052, Australia; Department of Obstetrics and Gynaecology, University of Melbourne, The Royal Women's Hospital, 20 Flemington Rd, Parkville, Victoria 3052, Australia. 6. Victorian Infant Brain Studies, Clinical Sciences, Murdoch Childrens Research Institute, The Royal Children's Hospital, Flemington Rd, Parkville, Victoria 3052, Australia; Newborn Research, The Royal Women's Hospital, 20 Flemington Rd, Parkville, Victoria 3052, Australia; Physiotherapy Department, University of Melbourne, 7th Floor, Alan Gilbert Building, Grattan St, Parkville, Victoria 3052, Australia.
Abstract
BACKGROUND: Neurodevelopmental assessments and brain magnetic resonance imaging (MRI) at term-equivalent age (TEA) predict developmental outcomes in preterm infants. However, the relationship between neurodevelopment prior to term and cerebral structure is currently unknown. AIMS: To examine the relationships between General Movements (GMs) assessed from birth to TEA and brain MRI at TEA in infants born <30weeks' gestation. STUDY DESIGN: Prospective cohort study. GMs (categorised as 'normal' or 'abnormal') were recorded weekly from birth to 32weeks, and at 34 and 36weeks' postmenstrual age. At TEA, GMs were assessed concurrently with brain MRI (using a validated scoring system). SUBJECTS: 149 infants born <30weeks' gestation were recruited from a tertiary hospital. RESULTS: 103 infants had MRI at TEA and GMs recorded. Abnormal GMs prior to term were associated with cortical grey matter abnormality (p<0.03), deep grey matter abnormality (p=0.02) and increased interhemispheric distance (p<0.02). Abnormal GMs at TEA (n=55/90) were associated with more global brain abnormality (p<0.01) and cortical grey matter abnormality (p=0.01), and decreased transcerebellar diameter (p=0.04) on concurrent brain MRI. CONCLUSIONS: Abnormal GMs both prior to term and at TEA were associated with more marked brain abnormality, and smaller brains at TEA. Abnormal GMs are an early marker of brain abnormalities in very preterm infants.
BACKGROUND: Neurodevelopmental assessments and brain magnetic resonance imaging (MRI) at term-equivalent age (TEA) predict developmental outcomes in preterm infants. However, the relationship between neurodevelopment prior to term and cerebral structure is currently unknown. AIMS: To examine the relationships between General Movements (GMs) assessed from birth to TEA and brain MRI at TEA in infants born <30weeks' gestation. STUDY DESIGN: Prospective cohort study. GMs (categorised as 'normal' or 'abnormal') were recorded weekly from birth to 32weeks, and at 34 and 36weeks' postmenstrual age. At TEA, GMs were assessed concurrently with brain MRI (using a validated scoring system). SUBJECTS: 149 infants born <30weeks' gestation were recruited from a tertiary hospital. RESULTS: 103 infants had MRI at TEA and GMs recorded. Abnormal GMs prior to term were associated with cortical grey matter abnormality (p<0.03), deep grey matter abnormality (p=0.02) and increased interhemispheric distance (p<0.02). Abnormal GMs at TEA (n=55/90) were associated with more global brain abnormality (p<0.01) and cortical grey matter abnormality (p=0.01), and decreased transcerebellar diameter (p=0.04) on concurrent brain MRI. CONCLUSIONS: Abnormal GMs both prior to term and at TEA were associated with more marked brain abnormality, and smaller brains at TEA. Abnormal GMs are an early marker of brain abnormalities in very preterm infants.
Authors: J M George; S Fiori; J Fripp; K Pannek; J Bursle; R X Moldrich; A Guzzetta; A Coulthard; R S Ware; S E Rose; P B Colditz; R N Boyd Journal: AJNR Am J Neuroradiol Date: 2017-05-18 Impact factor: 3.825