The Predictive Accuracy of the General Movement Assessment for Cerebral Palsy: A Prospective, Observational Study of High-Risk Infants in a Clinical Follow-Up Setting

Journal of Clinical Medicine

Lynn Boswell¹  Annamarie Russow¹  Raye-Ann de Regnier¹  Randi Vågen²  GunnKristin Øberg³  Cathrine Labori³  Lars Adde⁴  Toril Fjørtoft⁴  Ragnhild Støen⁵  Espen Ihlen⁶  NilsThomas Songstad⁷  IngerElisabeth Silberg⁸  UnnInger Möinichen⁸  Marianne Loennecken⁸  Colleen Peyton⁹  Deborah Gaebler-Spira⁹  MichaelD. Schreiber^1,10  Michael Msall^1,11 

[1] Ann and Robert H Lurie Children’s Hospital of Chicago, Chicago, IL 60611, USA;Clinic of Clinical Services, St. Olavs hospital, Trondheim University Hospital, 7006 Trondheim, Norway;Department of Clinical Therapeutic Services, University Hospital of North Norway, 9038 Tromsø, Norway;Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, 7491 Trondheim, Norway;Department of Neonatology, St. Olavs hospital, Trondheim University Hospital, 7006 Trondheim, Norway;Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, 7491 Trondheim, Norway;Department of Pediatrics and Adolescent Medicine, University Hospital of North Norway, 9038 Tromsø, Norway;Department of Pediatrics, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, 0372 Oslo, Norway;Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA;University of Chicago Medicine, Comer Children’s Hospital, Department of Pediatrics, Chicago, IL 60637, USA;University of Chicago Medicine, Comer Children’s Hospital, Section of Developmental and Behavioral Pediatrics, Chicago, IL 60637, USA;

关键词: general movement assessment;    fidgety movements;    cerebral palsy;    early brain damage;    neuroimaging;   

DOI  :  10.3390/jcm8111790

来源: DOAJ

【 摘 要 】

Background: Early prediction of cerebral palsy (CP) using the General Movement Assessment (GMA) during the fidgety movements (FM) period has been recommended as standard of care in high-risk infants. The aim of this study was to determine the accuracy of GMA, alone or in combination with neonatal imaging, in predicting cerebral palsy (CP). Methods: Infants with increased risk of perinatal brain injury were prospectively enrolled from 2009−2014 in this multi-center, observational study. FM were classified by two certified GMA observers blinded to the clinical history. Abnormal GMA was defined as absent or sporadic FM. CP-status was determined by clinicians unaware of GMA results. Results: Of 450 infants enrolled, 405 had scorable video and follow-up data until at least 18−24 months. CP was confirmed in 42 (10.4%) children at mean age 3 years 1 month. Sensitivity, specificity, positive and negative predictive values, and accuracy of absent/sporadic FM for CP were 76.2, 82.4, 33.3, 96.8, and 81.7%, respectively. Only three (8.1%) of 37 infants with sporadic FM developed CP. The highest accuracy (95.3%) was achieved by a combination of absent FM and abnormal neonatal imaging. Conclusion: In infants with a broad range of neonatal risk factors, accuracy of early CP prediction was lower for GMA than previously reported but increased when combined with neonatal imaging. Sporadic FM did not predict CP in this study.

【 授权许可】

Unknown