Gazi University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, 06500 Ankara, Turkey.
Tokat Gaziosmanpaşa University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, 60250 Tokat, Turkey.
Early Hum Dev. 2021 Dec;163:105487. doi: 10.1016/j.earlhumdev.2021.105487. Epub 2021 Oct 14.
The use of neuroimaging, the General Movement Assessment (GMA), and the Hammersmith Infant Neurological Examination (HINE) to identify the risk of neurodevelopmental delay in early infancy is recommended.
The aim of this study was to examine the predictive power of neuroimaging, GMA and HINE for neurodevelopmental delay and cerebral palsy (CP) in infants with hypoxic ischemic encephalopathy (HIE) who were treated with hypothermia.
Retrospective cohort.
This retrospective study included 47 (18 female and 29 male) infants who were treated with hypothermia due to HIE. Neonates with a diagnosis of HIE were followed and assessed using neuroimaging, GMA, HINE and the Bayley Scales of Infant and Toddler Development-II (Bayley II) between 3 m and 2 years of age.
Out of the 47 infants with HIE, no fidgety movements were observed in 5 infants. The sensitivity and specificity in determining the psychomotor developmental index (PDI) score were 97% and 100%, respectively, for MRI; 92.9% and 100% for GMA; and 91.9% and 80% for the HINE. The sensitivity and specificity in determining the mental developmental index (MDI) score were 95% and 85.7%, respectively, for MRI; 90.5% and 80% for GMA; and 91.9% and 50% for HINE. The sensitivity and specificity in determining CP diagnosis at the age of 2 years were 83.3% and 95%, respectively, for MRI; 83.3% and 100% for GMA; and 83.3% and 87.8% for HINE.
The interpretation of MRI, GMA, and HINE that are performed within the early period of life may be the gold standard for the early detection of neurodevelopmental risks in 2-year-old infants with HIE. Clinical implementation of these methods in the early period in the follow-up of these infants offers useful information for the early identification of neurodevelopmental risk and for planning early intervention.
建议使用神经影像学、全身运动评估（GMA）和哈默史密斯婴儿神经检查（HINE）来识别早期婴儿神经发育迟缓的风险。
本研究旨在探讨神经影像学、GMA 和 HINE 对接受低温治疗的缺氧缺血性脑病（HIE）婴儿神经发育迟缓及脑瘫（CP）的预测能力。
回顾性队列研究。
本回顾性研究纳入 47 例（18 例女性，29 例男性）因 HIE 接受低温治疗的婴儿。对诊断为 HIE 的新生儿进行随访，并在 3 个月至 2 岁时使用神经影像学、GMA、HINE 和贝利婴幼儿发育量表第二版（Bayley II）进行评估。
在 47 例 HIE 婴儿中，有 5 例婴儿未观察到不安运动。MRI 对确定精神运动发育指数（PDI）评分的灵敏度和特异性分别为 97%和 100%；GMA 分别为 92.9%和 100%；HINE 分别为 91.9%和 80%。MRI 对确定精神发育指数（MDI）评分的灵敏度和特异性分别为 95%和 85.7%；GMA 分别为 90.5%和 80%；HINE 分别为 91.9%和 50%。MRI 对 2 岁时 CP 诊断的灵敏度和特异性分别为 83.3%和 95%；GMA 分别为 83.3%和 100%；HINE 分别为 83.3%和 87.8%。
对生命早期进行的 MRI、GMA 和 HINE 解读可能是早期发现 HIE 2 岁婴儿神经发育风险的金标准。在这些婴儿的随访早期实施这些方法，可以为早期识别神经发育风险和规划早期干预提供有用信息。
