Neonatal Hypoxic-Ischaemic Encephalopathy: Motor Impairment beyond Cerebral Palsy

Article


Erdi-Krausz, G., Rocha, R., Brown, A., Myneni, A., Lennartsson, F., Romsauerova, A., Cianfaglione, R., Edmonds, C. and Vollmer, B. 2021. Neonatal Hypoxic-Ischaemic Encephalopathy: Motor Impairment beyond Cerebral Palsy. European Journal of Paediatric Neurology. 35, pp. 74-81. https://doi.org/10.1016/j.ejpn.2021.10.005
AuthorsErdi-Krausz, G., Rocha, R., Brown, A., Myneni, A., Lennartsson, F., Romsauerova, A., Cianfaglione, R., Edmonds, C. and Vollmer, B.
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 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.

JournalEuropean Journal of Paediatric Neurology
Journal citation35, pp. 74-81
ISSN1090-3798
Year2021
PublisherElsevier
Accepted author manuscript
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Anyone
Digital Object Identifier (DOI)https://doi.org/10.1016/j.ejpn.2021.10.005
Publication dates
Online14 Oct 2021
Publication process dates
Accepted09 Oct 2021
Deposited12 Oct 2021
Copyright holder© 2021 Elsevier
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