Department of Pediatric Neurology, University Children's Hospital Bern, PO-Box CH-3010, Bern, Switzerland.
Exp Brain Res. 2013 Jun;227(4):433-46. doi: 10.1007/s00221-013-3504-6. Epub 2013 May 28.
Qualitative assessment of spontaneous motor activity in early infancy is widely used in clinical practice. It enables the description of maturational changes of motor behavior in both healthy infants and infants who are at risk for later neurological impairment. These assessments are, however, time-consuming and are dependent upon professional experience. Therefore, a simple physiological method that describes the complex behavior of spontaneous movements (SMs) in infants would be helpful. In this methodological study, we aimed to determine whether time series of motor acceleration measurements at 40-44 weeks and 50-55 weeks gestational age in healthy infants exhibit fractal-like properties and if this self-affinity of the acceleration signal is sensitive to maturation. Healthy motor state was ensured by General Movement assessment. We assessed statistical persistence in the acceleration time series by calculating the scaling exponent α via detrended fluctuation analysis of the time series. In hand trajectories of SMs in infants we found a mean α value of 1.198 (95 % CI 1.167-1.230) at 40-44 weeks. Alpha changed significantly (p = 0.001) at 50-55 weeks to a mean of 1.102 (1.055-1.149). Complementary multilevel regression analysis confirmed a decreasing trend of α with increasing age. Statistical persistence of fluctuation in hand trajectories of SMs is sensitive to neurological maturation and can be characterized by a simple parameter α in an automated and observer-independent fashion. Future studies including children at risk for neurological impairment should evaluate whether this method could be used as an early clinical screening tool for later neurological compromise.
对婴儿早期自发性运动活动进行定性评估在临床实践中得到了广泛应用。它可以描述健康婴儿和有神经发育损伤风险的婴儿的运动行为的成熟变化。然而,这些评估既耗时又依赖于专业经验。因此,一种简单的生理学方法来描述婴儿自发性运动(SM)的复杂行为将是有帮助的。在这项方法学研究中,我们旨在确定健康婴儿在妊娠 40-44 周和 50-55 周时的运动加速度测量的时间序列是否表现出分形特征,以及该加速度信号的自相似性是否对成熟敏感。通过全身运动评估来确保健康的运动状态。我们通过对时间序列进行去趋势波动分析来计算标度指数 α,从而评估加速度时间序列的统计持久性。在手的 SM 轨迹中,我们发现 40-44 周时的平均 α 值为 1.198(95%CI 1.167-1.230)。在 50-55 周时,α 值显著变化(p=0.001),平均为 1.102(1.055-1.149)。补充的多层次回归分析证实,随着年龄的增长,α 值呈下降趋势。SM 手轨迹中波动的统计持久性对神经成熟敏感,可以通过一个简单的参数 α 以自动化和观察者独立的方式进行特征描述。未来包括有神经发育损伤风险的儿童在内的研究应评估该方法是否可用作神经发育迟缓的早期临床筛查工具。