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Neonatal hypoxic-ischaemic encephalopathy : Motor impairment beyond cerebral palsy

Erdi-Krausz, Gergo ; Rocha, Ruben ; Brown, Alice ; Myneni, Archana ; Lennartsson, Finn LU ; Romsauerova, Andrea ; Cianfaglione, Rina ; Edmonds, Caroline J. and Vollmer, Brigitte (2021) In European Journal of Paediatric Neurology 35. p.74-81
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... (More)

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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author
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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Attention, Hypoxic-ischaemic encephalopathy, Magnetic resonance imaging, Minor neurological dysfunction, Neuromotor function
in
European Journal of Paediatric Neurology
volume
35
pages
8 pages
publisher
Elsevier
external identifiers
  • pmid:34666231
  • scopus:85117161886
ISSN
1090-3798
DOI
10.1016/j.ejpn.2021.10.005
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2021
id
3b05a66a-356a-4138-8d85-1b2441167993
date added to LUP
2021-11-01 14:29:30
date last changed
2024-06-15 19:45:50
@article{3b05a66a-356a-4138-8d85-1b2441167993,
  abstract     = {{<p>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.</p>}},
  author       = {{Erdi-Krausz, Gergo and Rocha, Ruben and Brown, Alice and Myneni, Archana and Lennartsson, Finn and Romsauerova, Andrea and Cianfaglione, Rina and Edmonds, Caroline J. and Vollmer, Brigitte}},
  issn         = {{1090-3798}},
  keywords     = {{Attention; Hypoxic-ischaemic encephalopathy; Magnetic resonance imaging; Minor neurological dysfunction; Neuromotor function}},
  language     = {{eng}},
  pages        = {{74--81}},
  publisher    = {{Elsevier}},
  series       = {{European Journal of Paediatric Neurology}},
  title        = {{Neonatal hypoxic-ischaemic encephalopathy : Motor impairment beyond cerebral palsy}},
  url          = {{http://dx.doi.org/10.1016/j.ejpn.2021.10.005}},
  doi          = {{10.1016/j.ejpn.2021.10.005}},
  volume       = {{35}},
  year         = {{2021}},
}