Quality of general movements is related to white matter pathology in very preterm infants

Spittle, Alicia J., Brown, Nisha C., Doyle, Lex W., Boyd, Roslyn N., Hunt, Rod W., Bear, Merilyn and Inder, Terrie E. (2008) Quality of general movements is related to white matter pathology in very preterm infants. Pediatrics, 121 5: e1184-e1189. doi:10.1542/peds.2007-1924

Author Spittle, Alicia J.
Brown, Nisha C.
Doyle, Lex W.
Boyd, Roslyn N.
Hunt, Rod W.
Bear, Merilyn
Inder, Terrie E.
Title Quality of general movements is related to white matter pathology in very preterm infants
Journal name Pediatrics   Check publisher's open access policy
ISSN 0031-4005
Publication date 2008-05
Sub-type Article (original research)
DOI 10.1542/peds.2007-1924
Volume 121
Issue 5
Start page e1184
End page e1189
Total pages 6
Place of publication Elk Grove Village, U.S.A.
Publisher American Academy of Pediatrics
Language eng
Subject 1103 Clinical Sciences
1114 Paediatrics and Reproductive Medicine
Formatted abstract
Objective: Preterm infants are at an increased risk for abnormalities of general movements, which predict subsequent poor neurodevelopmental outcome. The cerebral lesion that predisposes the preterm infant to abnormal general movements remains unknown. The objective of this study was to determine the association between MRI-defined cerebral abnormalities and general movements at 1 and 3 months' corrected age in infants who were born very preterm.

Methods: Eighty-six preterm infants (<30 weeks' gestation) were prospectively recruited and underwent brain MRI at term-equivalent age to investigate the relationship between qualitative white and gray matter pathology and abnormality of general movements. Standardized videotaped recordings of general movements were obtained at 1 and 3 months postterm (±1 week) and scored without knowledge of the MRI findings. At 1 month corrected age, general movements of a writhing character were classified as normal or abnormal (poor repertoire, cramped synchronized, or chaotic). At 3 months' corrected age, fidgety general movements were classified as present or absent.

Results:  At 1 month, 53 (62%) infants had abnormal general movements, 46 of whom had poor repertoire general movements and 7 of whom had cramped synchronized general movements. At 3 months, 23 (25%) infants had absent fidgety movements. At both 1 and 3 months of age, consistently abnormal general movement classifications were related to increasing white matter abnormality on MRI. In contrast, there were no significant relationships between general movement classifications and gray matter abnormalities, either individually or in total.

  The significant relationships between general movements at 1 and 3 months and cerebral white matter abnormalities on MRI in the very preterm infant support the concept that abnormal general movements reflect white matter injury.
Keyword Developmental follow-up
Magnetic resonance
Neuromotor outcome
Preterm infants
Cerebral Palsy
Q-Index Code C1
Q-Index Status Provisional Code

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Medicine Publications
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Created: Thu, 03 Sep 2009, 10:05:21 EST by Mr Andrew Martlew on behalf of Faculty Of Health Sciences