Associations Between Early Neonatal Neuroimaging, Hammersmith Infant Neurological Examination and General Movements
Condition: Cerebral Palsy; Infant, Premature, Diseases; Infant Development; Neurologic Disorder; Development Delay; Infant Asphyxia; Infant, Small for Gestational Age; Infant, Newborn, Disease; Infant, Very Low Birth Weight
MeSH terms: Cerebral Palsy; Nervous System Diseases; Infant, Premature, Diseases; Infant, Newborn, Diseases; Birth Weight; Asphyxia
Study type: Observational [Patient Registry]

Summary: 
      High risk infant is defined as infant with a negative history of environmental and biological
      factors, which can lead to neuromotor development problems. It is a heterogeneous group of
      premature infants born under thirty-seven weeks of age, with infants with low birth weight,
      term or developmental retardation for various reasons. Therefore, preterm infants with low
      birth weight can survive with a neurological sequelae such as cerebral palsy (CP), epilepsy,
      hearing and vision loss, mental retardation, speech and speech problems, and learning
      difficulties. The clinical diagnosis of CP, which can be observed in high-risk infants, is
      based on the combination of some neuroimaging and neurological examinations and assesments
      like neonatal imaging, general movements (GMs) and Hammersmith Infant Neurological
      Examination (HINE).
    

Detailed description: 
      High-risk infants may encounter many problems in terms of motor, cognitive, sensory, social,
      and academic development. Premature and LBW infants are at higher risk in terms of motor and
      cognitive development problems. Approximately 50% of these infants encounter
      neurodevelopmental problems. These problems are related to gestational age (GA), birth
      weight, brain damage occurring during the prenatal/perinatal period, and medical risk
      factors. Prematurity and low birth weight (LBW) are also among the most important causes of
      CP. Three methods with the best predictable validity that can determine CP before the
      adjusted age of 5-month is Magnetic Resonance Imaging (MRI), Prechtl's Assessment of General
      Movements (GMs), Hammersmith Infant Neurological Evaluation (HINE). In recent years, the
      diagnosis of high-risk of CP can be detected at 3 months with predictive validity and
      reliability by evaluating the quality of GMs. GMs are now considered the gold standard for
      early detection of CP because of its high sensitivity and specificity than MRI, cranial US
      and neurological evaluations. It was also found that cognitive or language skills may be
      inadequate in school age in patients with inadequate movement character and in the same
      postural patterns according to age, although GMs are normal. So new clinical care guidelines
      and new intervention research for infants with CP under the age of 2, needs to be shown. So
      this study aims to examine the associations between early neonatal neuroimaging, HINE and GMs
      assessment in a Cohort of High Risk of Infants with one year of follow up.
    

Intervention name(s): Measurements
Intervention type(s): Diagnostic Test
Intervention description(s): All infants wirth high risk of cp will be assessed by neuroimaging and Hammersmith Neonatal Neurological Examination (HNNE) at term age, Prechtl's General movements (GMs) assessments form birth up to 3-5 months, and will be assesed by Hammersmith Infant Neurological Examination (HINE) at 2,3,6,9 and 12th months, also BAYLEY-III Infant and Toddler Development Assessment Scale (BAYLEY-III) at the 3rd, 6th, and 12th months.
Other intervention name(s): Measurements of neurological development.
Observational model: Cohort
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        High risk of infants for cerebral palsy.
      
Keywords: Neonatal Neuroimaging; Hammersmith Infant Neurological Evaluation (HINE); General Movements (GMs); High Risk of Infants