Continuum of neurobehaviour and its associations with brain MRI in infants born preterm

Abbey Eeles, Jennifer M. Walsh, Joy E. Olsen, Rocco Cuzzilla, Deanne K Thompson, Peter J Anderson, Lex W. Doyle, Jeanie L Y Cheong, Alicia Jane Spittle

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background Infants born very preterm (VPT) and moderate-to-late preterm (MLPT) are at increased risk of long-term neurodevelopmental deficits, but how these deficits relate to early neurobehaviour in MLPT children is unclear. The aims of this study were to compare the neurobehavioural performance of infants born across three different gestational age groups: preterm <30 weeks’ gestational age (PT<30); MLPT (32–36 weeks’ gestational age) and term age (≥37 weeks’ gestational age), and explore the relationships between MRI brain abnormalities and neurobehaviour at term-equivalent age. Methods Neurobehaviour was assessed at term-equivalent age in 149 PT<30, 200 MLPT and 200 term-born infants using the Neonatal Intensive Care UnitNetwork Neurobehavioral Scale (NNNS), the Hammersmith Neonatal Neurological Examination (HNNE) and Prechtl’s Qualitative Assessment of General Movements (GMA). A subset of 110 PT<30 and 198 MLPT infants had concurrent brain MRI. Results Proportions with abnormal neurobehaviour on the NNNS and the HNNE, and abnormal GMA all increased with decreasing gestational age. Higher brain MRI abnormality scores in some regions were associated with suboptimal neurobehaviour on the NNNS and HNNE. The relationships between brain MRI abnormality scores and suboptimal neurobehaviour were similar in both PT<30 and MLPT infants. The relationship between brain MRI abnormality scores and abnormal GMA was stronger in PT<30 infants. Conclusions There was a continuum of neurobehaviour across gestational ages. The relationships between brain abnormality scores and suboptimal neurobehaviour provide evidence that neurobehavioural assessments offer insight into the integrity of the developing brain, and may be useful in earlier identification of the highest-risk infants.
Original languageEnglish
Article numbere000136
Number of pages8
JournalBMJ Paediatrics Open
Volume1
Issue number1
DOIs
Publication statusPublished - 5 Oct 2017

Cite this

Eeles, A., Walsh, J. M., Olsen, J. E., Cuzzilla, R., Thompson, D. K., Anderson, P. J., ... Spittle, A. J. (2017). Continuum of neurobehaviour and its associations with brain MRI in infants born preterm. BMJ Paediatrics Open, 1(1), [e000136]. https://doi.org/10.1136/bmjpo-2017-000136
Eeles, Abbey ; Walsh, Jennifer M. ; Olsen, Joy E. ; Cuzzilla, Rocco ; Thompson, Deanne K ; Anderson, Peter J ; Doyle, Lex W. ; Cheong, Jeanie L Y ; Spittle, Alicia Jane. / Continuum of neurobehaviour and its associations with brain MRI in infants born preterm. In: BMJ Paediatrics Open. 2017 ; Vol. 1, No. 1.
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abstract = "Background Infants born very preterm (VPT) and moderate-to-late preterm (MLPT) are at increased risk of long-term neurodevelopmental deficits, but how these deficits relate to early neurobehaviour in MLPT children is unclear. The aims of this study were to compare the neurobehavioural performance of infants born across three different gestational age groups: preterm <30 weeks’ gestational age (PT<30); MLPT (32–36 weeks’ gestational age) and term age (≥37 weeks’ gestational age), and explore the relationships between MRI brain abnormalities and neurobehaviour at term-equivalent age. Methods Neurobehaviour was assessed at term-equivalent age in 149 PT<30, 200 MLPT and 200 term-born infants using the Neonatal Intensive Care UnitNetwork Neurobehavioral Scale (NNNS), the Hammersmith Neonatal Neurological Examination (HNNE) and Prechtl’s Qualitative Assessment of General Movements (GMA). A subset of 110 PT<30 and 198 MLPT infants had concurrent brain MRI. Results Proportions with abnormal neurobehaviour on the NNNS and the HNNE, and abnormal GMA all increased with decreasing gestational age. Higher brain MRI abnormality scores in some regions were associated with suboptimal neurobehaviour on the NNNS and HNNE. The relationships between brain MRI abnormality scores and suboptimal neurobehaviour were similar in both PT<30 and MLPT infants. The relationship between brain MRI abnormality scores and abnormal GMA was stronger in PT<30 infants. Conclusions There was a continuum of neurobehaviour across gestational ages. The relationships between brain abnormality scores and suboptimal neurobehaviour provide evidence that neurobehavioural assessments offer insight into the integrity of the developing brain, and may be useful in earlier identification of the highest-risk infants.",
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Eeles, A, Walsh, JM, Olsen, JE, Cuzzilla, R, Thompson, DK, Anderson, PJ, Doyle, LW, Cheong, JLY & Spittle, AJ 2017, 'Continuum of neurobehaviour and its associations with brain MRI in infants born preterm', BMJ Paediatrics Open, vol. 1, no. 1, e000136. https://doi.org/10.1136/bmjpo-2017-000136

Continuum of neurobehaviour and its associations with brain MRI in infants born preterm. / Eeles, Abbey; Walsh, Jennifer M.; Olsen, Joy E.; Cuzzilla, Rocco; Thompson, Deanne K; Anderson, Peter J; Doyle, Lex W.; Cheong, Jeanie L Y; Spittle, Alicia Jane.

In: BMJ Paediatrics Open, Vol. 1, No. 1, e000136, 05.10.2017.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Continuum of neurobehaviour and its associations with brain MRI in infants born preterm

AU - Eeles, Abbey

AU - Walsh, Jennifer M.

AU - Olsen, Joy E.

AU - Cuzzilla, Rocco

AU - Thompson, Deanne K

AU - Anderson, Peter J

AU - Doyle, Lex W.

AU - Cheong, Jeanie L Y

AU - Spittle, Alicia Jane

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N2 - Background Infants born very preterm (VPT) and moderate-to-late preterm (MLPT) are at increased risk of long-term neurodevelopmental deficits, but how these deficits relate to early neurobehaviour in MLPT children is unclear. The aims of this study were to compare the neurobehavioural performance of infants born across three different gestational age groups: preterm <30 weeks’ gestational age (PT<30); MLPT (32–36 weeks’ gestational age) and term age (≥37 weeks’ gestational age), and explore the relationships between MRI brain abnormalities and neurobehaviour at term-equivalent age. Methods Neurobehaviour was assessed at term-equivalent age in 149 PT<30, 200 MLPT and 200 term-born infants using the Neonatal Intensive Care UnitNetwork Neurobehavioral Scale (NNNS), the Hammersmith Neonatal Neurological Examination (HNNE) and Prechtl’s Qualitative Assessment of General Movements (GMA). A subset of 110 PT<30 and 198 MLPT infants had concurrent brain MRI. Results Proportions with abnormal neurobehaviour on the NNNS and the HNNE, and abnormal GMA all increased with decreasing gestational age. Higher brain MRI abnormality scores in some regions were associated with suboptimal neurobehaviour on the NNNS and HNNE. The relationships between brain MRI abnormality scores and suboptimal neurobehaviour were similar in both PT<30 and MLPT infants. The relationship between brain MRI abnormality scores and abnormal GMA was stronger in PT<30 infants. Conclusions There was a continuum of neurobehaviour across gestational ages. The relationships between brain abnormality scores and suboptimal neurobehaviour provide evidence that neurobehavioural assessments offer insight into the integrity of the developing brain, and may be useful in earlier identification of the highest-risk infants.

AB - Background Infants born very preterm (VPT) and moderate-to-late preterm (MLPT) are at increased risk of long-term neurodevelopmental deficits, but how these deficits relate to early neurobehaviour in MLPT children is unclear. The aims of this study were to compare the neurobehavioural performance of infants born across three different gestational age groups: preterm <30 weeks’ gestational age (PT<30); MLPT (32–36 weeks’ gestational age) and term age (≥37 weeks’ gestational age), and explore the relationships between MRI brain abnormalities and neurobehaviour at term-equivalent age. Methods Neurobehaviour was assessed at term-equivalent age in 149 PT<30, 200 MLPT and 200 term-born infants using the Neonatal Intensive Care UnitNetwork Neurobehavioral Scale (NNNS), the Hammersmith Neonatal Neurological Examination (HNNE) and Prechtl’s Qualitative Assessment of General Movements (GMA). A subset of 110 PT<30 and 198 MLPT infants had concurrent brain MRI. Results Proportions with abnormal neurobehaviour on the NNNS and the HNNE, and abnormal GMA all increased with decreasing gestational age. Higher brain MRI abnormality scores in some regions were associated with suboptimal neurobehaviour on the NNNS and HNNE. The relationships between brain MRI abnormality scores and suboptimal neurobehaviour were similar in both PT<30 and MLPT infants. The relationship between brain MRI abnormality scores and abnormal GMA was stronger in PT<30 infants. Conclusions There was a continuum of neurobehaviour across gestational ages. The relationships between brain abnormality scores and suboptimal neurobehaviour provide evidence that neurobehavioural assessments offer insight into the integrity of the developing brain, and may be useful in earlier identification of the highest-risk infants.

U2 - 10.1136/bmjpo-2017-000136

DO - 10.1136/bmjpo-2017-000136

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