Early prediction of unilateral cerebral palsy in infants with asymmetric perinatal brain injury – Model development and internal validation

Autor: Ann-Christin Eliasson, Ulrike C. Ryll, Nienke Wagenaar, Mats Blennow, Linda S. de Vries, Cornelia H. Verhage
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
Pediatrics
Neurology
Clinical assessment
Brain Injuries/diagnosis
Birth Injuries/complications
Pregnancy
Neuroimaging/methods
Hand asymmetry
Netherlands
medicine.diagnostic_test
Area under the curve
Gestational age
General Medicine
Early diagnosis
Perinatology
Magnetic Resonance Imaging
and Child Health
Unilateral cerebral palsy
Female
medicine.medical_specialty
Clinical Neurology
Neuroimaging
Brain imaging
Gestational Age
Cerebral palsy
Birth Injuries
medicine
Journal Article
Humans
Hand function
Pediatrics
Perinatology
and Child Health
Validation Studies
Sweden
Cerebral Palsy/diagnosis
business.industry
Cerebral Palsy
Infant
Newborn
Infant
Magnetic resonance imaging
Nomogram
medicine.disease
Newborn
Nomograms
Brain Injuries
Pediatrics
Perinatology and Child Health
Corticospinal tract
Neurology (clinical)
business
Zdroj: European Journal of Paediatric Neurology, 23(4), 621. W.B. Saunders Ltd
ISSN: 1090-3798
Popis: Background Early diagnosis of unilateral cerebral palsy is important after asymmetric perinatal brain injury (APBI). Our objective is to estimate the risk of unilateral cerebral palsy (UCP) in infants with APBI during the first months of life using neuroimaging and clinical assessment. Patients and methods Prognostic multivariable prediction modeling study including 52 infants (27 males), median gestational age 39.3 weeks with APBI from Sweden (n = 33) and the Netherlands (n = 19). Inclusion criteria: (1) neonatal MRI within one month after term equivalent age (TEA), (2) Hand Assessment for Infants (HAI) between 3.5 and 4.5 months of (corrected) age. UCP was diagnosed ≥24 months of age. Firth regression with cross-validation was used to construct and internally validate the model to estimate the risk for UCP based on the predictors corticospinal tract (CST) and basal ganglia/thalamus (BGT) involvement, contralesional HAI Each hand sum score (EaHS), gestational age and sex. Results UCP was diagnosed in 18 infants (35%). Infants who developed UCP more often had involvement of the CST and BGT on neonatal MRI and had lower contralesional HAI EaHS compared to those who did not develop UCP. The final model showed excellent accuracy for UCP prediction between 3.5 and 4.5 months (area under the curve, AUC = 0.980; 95% CI 0.95–1.00). Conclusions Combining neonatal MRI, the HAI, gestational age and sex accurately identify the prognostic risk of UCP at 3.5–4.5 months in infants with APBI.
Databáze: OpenAIRE
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