Lori S, Bertini Giovanna, Bastianelli M, Gabbanini S, Gualandi D, Molesti E, Dani C
Neurophysiology Unit, Neuro-Musculo-Skeletal Department, Careggi University Hospital, Florence, Italy.
Department of Neurosciences, Psychology, Drug Research and Children's Health, University of Florence, Largo Brambilla, n°3, 50134, Florence, Italy.
Childs Nerv Syst. 2018 Jun;34(6):1145-1152. doi: 10.1007/s00381-018-3778-x. Epub 2018 Apr 10.
To study the evolution of sensory-motor nerves in the upper and lower limbs in neurologically healthy preterm infants and to use sensory-motor studies to compare the rate of maturation in preterm infants at term age and full-term healthy neonates.
The study comprised 26 neurologically normal preterm infants born at 23-33 weeks of gestational age, who underwent sensory nerve conduction and motor nerve conduction studies from plantar medial and median nerves and from tibial and ulnar nerves, respectively. We repeated the same neurophysiological studies in 19 of the preterm infants every 2 weeks until postnatal term age. The data from the preterm infants at term was matched with a group of ten full-term babies a few days after birth.
The motor nerve conduction velocity of the tibial and ulnar nerves showed progressive increases in values in relation to gestational age, but there was a decrease of values in distal latencies and F wave latencies. Similarly, there was a gradual increase of sensory nerve conduction velocity values of the medial plantar and median nerves and decreases in latencies in relation to gestational age. At term age, the preterm infants showed significantly lower values of conduction velocities and distal latencies than the full-term neonates. These results were probably because the preterm infants had significantly lower weights, total length and, in particular, distal segments of the limbs at term age.
The sensory-motor conduction parameters were clearly related to gestational age, but extrauterine life did not affect the maturation of the peripheral nervous system in the very preterm babies who were neurologically healthy.
研究神经功能正常的早产儿上下肢感觉运动神经的发育情况，并通过感觉运动研究比较足月龄早产儿与足月健康新生儿的成熟速率。
本研究纳入了26例孕23 - 33周出生的神经功能正常的早产儿，分别对其足底内侧神经和正中神经、胫神经和尺神经进行感觉神经传导和运动神经传导研究。我们每2周对19例早产儿重复进行相同的神经生理学研究，直至出生后足月龄。将足月龄早产儿的数据与一组出生几天后的10例足月儿的数据进行匹配。
胫神经和尺神经的运动神经传导速度值随胎龄增加而逐渐升高，但远端潜伏期和F波潜伏期值降低。同样，足底内侧神经和正中神经的感觉神经传导速度值随胎龄增加而逐渐升高，潜伏期降低。在足月龄时，早产儿的传导速度和远端潜伏期值显著低于足月新生儿。这些结果可能是因为足月龄时早产儿的体重、总长度，尤其是肢体远端节段明显更低。
感觉运动传导参数与胎龄明显相关，但宫外生活并未影响神经功能正常的极早产儿外周神经系统的成熟。
