Neonatal hypoxic-ischaemic encephalopathy: Motor impairment beyond cerebral palsy
Neonatal hypoxic-ischaemic encephalopathy: Motor impairment beyond cerebral palsy
BACKGROUND: Research investigating neuromotor function in the absence of cerebral palsy (CP) for children who had neonatal HIE is limited.
AIMS: To investigate school-age neurological and neuromotor function, and correlations with attention, neonatal Magnetic Resonance Imaging (MRI), and neuromotor assessments at toddler age.
METHODS: Twenty-seven children with neonatal HIE without CP who underwent hypothermia treatment and a comparison group of 20 children were assessed at age 5-7 years for Minor Neurological Dysfunction (MND; simplified Touwen), motor skills (Movement Assessment Battery for Children-2; MABC-2), parental concern over motor function (MABC Checklist), general cognition (Wechsler Preschool and Primary Scale of Intelligence-IV, WPPSI), and attention (DuPaul ADHD Rating Scale). Neurological examination and motor development, using Bayley-3 scales, at age 24-months was extracted from the clinical database. Clinical neonatal MRI was assessed for hypoxic-ischaemic injury.
RESULTS: In the HIE group, MND was more prevalent (p = 0.026) and M-ABC performance (total score p = 0.006; balance subtest p = 0.008) was worse; parents were more concerned about children's motor function (p = 0.011). HIE group inattention scores were higher (p = 0.032), which correlated with lower MABC-2 scores (rs = -0.590, p = 0.004). Neurological examination at 24-months correlated with MND (rs = 0.437, p = 0.033); Bayley-3 motor scores did not correlate with M-ABC-2 scores (rs = 368, p = 0.133). Neonatal MRI findings were not associated with school-age MND (rs = 0.140, p = 0.523) or MABC-2 (rs = 0.300, p = 0.165).
CONCLUSIONS: Children with neonatal HIE, without CP, treated with hypothermia may be more likely to develop MND and motor difficulties than typically developing peers. Inattention may contribute to motor performance. In the absence of CP, neonatal MRI and toddler age assessment of motor development have limited predictive value for school-age outcome. Since this was an exploratory study with a small sample size, findings should be confirmed by a definite larger study.
Attention, Hypoxic-ischaemic encephalopathy, Magnetic resonance imaging, Minor neurological dysfunction, Neuromotor function
74-81
Erdi-Krausz, Gergo
7810c612-2a22-421e-a6e7-33e083cebd16
Rocha, Ruben
8249c24c-b57d-4701-95fe-48c34f46fc8a
Brown, Alice
bd945700-0cc8-434e-8b63-ad5a5e3ddc53
Myneni, Archana
8339697a-fb01-4d86-bf04-d6bf0ea3ed2e
Lennartsson, Finn
e9fb1096-1bc5-45ae-8972-560aa86f45ba
Romsauerova, Andrea
35b70c50-fa0b-499a-91ce-099a693e787c
Cianfaglione, Rina
bf9b4507-4a79-4f72-b7e2-7244b9dea9ef
Edmonds, Caroline J
5f0f6f0f-3f28-46ba-8fea-002d1443208f
Vollmer, Brigitte
044f8b55-ba36-4fb2-8e7e-756ab77653ba
November 2021
Erdi-Krausz, Gergo
7810c612-2a22-421e-a6e7-33e083cebd16
Rocha, Ruben
8249c24c-b57d-4701-95fe-48c34f46fc8a
Brown, Alice
bd945700-0cc8-434e-8b63-ad5a5e3ddc53
Myneni, Archana
8339697a-fb01-4d86-bf04-d6bf0ea3ed2e
Lennartsson, Finn
e9fb1096-1bc5-45ae-8972-560aa86f45ba
Romsauerova, Andrea
35b70c50-fa0b-499a-91ce-099a693e787c
Cianfaglione, Rina
bf9b4507-4a79-4f72-b7e2-7244b9dea9ef
Edmonds, Caroline J
5f0f6f0f-3f28-46ba-8fea-002d1443208f
Vollmer, Brigitte
044f8b55-ba36-4fb2-8e7e-756ab77653ba
Erdi-Krausz, Gergo, Rocha, Ruben, Brown, Alice, Myneni, Archana, Lennartsson, Finn, Romsauerova, Andrea, Cianfaglione, Rina, Edmonds, Caroline J and Vollmer, Brigitte
(2021)
Neonatal hypoxic-ischaemic encephalopathy: Motor impairment beyond cerebral palsy.
European Journal of Paediatric Neurology, 35, .
(doi:10.1016/j.ejpn.2021.10.005).
Abstract
BACKGROUND: Research investigating neuromotor function in the absence of cerebral palsy (CP) for children who had neonatal HIE is limited.
AIMS: To investigate school-age neurological and neuromotor function, and correlations with attention, neonatal Magnetic Resonance Imaging (MRI), and neuromotor assessments at toddler age.
METHODS: Twenty-seven children with neonatal HIE without CP who underwent hypothermia treatment and a comparison group of 20 children were assessed at age 5-7 years for Minor Neurological Dysfunction (MND; simplified Touwen), motor skills (Movement Assessment Battery for Children-2; MABC-2), parental concern over motor function (MABC Checklist), general cognition (Wechsler Preschool and Primary Scale of Intelligence-IV, WPPSI), and attention (DuPaul ADHD Rating Scale). Neurological examination and motor development, using Bayley-3 scales, at age 24-months was extracted from the clinical database. Clinical neonatal MRI was assessed for hypoxic-ischaemic injury.
RESULTS: In the HIE group, MND was more prevalent (p = 0.026) and M-ABC performance (total score p = 0.006; balance subtest p = 0.008) was worse; parents were more concerned about children's motor function (p = 0.011). HIE group inattention scores were higher (p = 0.032), which correlated with lower MABC-2 scores (rs = -0.590, p = 0.004). Neurological examination at 24-months correlated with MND (rs = 0.437, p = 0.033); Bayley-3 motor scores did not correlate with M-ABC-2 scores (rs = 368, p = 0.133). Neonatal MRI findings were not associated with school-age MND (rs = 0.140, p = 0.523) or MABC-2 (rs = 0.300, p = 0.165).
CONCLUSIONS: Children with neonatal HIE, without CP, treated with hypothermia may be more likely to develop MND and motor difficulties than typically developing peers. Inattention may contribute to motor performance. In the absence of CP, neonatal MRI and toddler age assessment of motor development have limited predictive value for school-age outcome. Since this was an exploratory study with a small sample size, findings should be confirmed by a definite larger study.
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Accepted/In Press date: 9 October 2021
e-pub ahead of print date: 14 October 2021
Published date: November 2021
Additional Information:
Funding Information:
Funding: This work was supported by the Sir Halley Stewart Trust, UK . The Sir Halley Stewart Trust had no role in the study design, the collection, analysis and interpretation of data, the writing of the report, or the decision to submit the article for publication.
Publisher Copyright:
© 2021
Keywords:
Attention, Hypoxic-ischaemic encephalopathy, Magnetic resonance imaging, Minor neurological dysfunction, Neuromotor function
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Local EPrints ID: 452479
URI: http://eprints.soton.ac.uk/id/eprint/452479
PURE UUID: 7819dba4-b23e-4432-856c-af09f170644c
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Date deposited: 11 Dec 2021 11:16
Last modified: 17 Mar 2024 03:46
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Contributors
Author:
Gergo Erdi-Krausz
Author:
Ruben Rocha
Author:
Alice Brown
Author:
Archana Myneni
Author:
Finn Lennartsson
Author:
Andrea Romsauerova
Author:
Caroline J Edmonds
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