Kinematic measurement of 12-week head control correlates with 12-month neurodevelopment in preterm infants

Abstract

Background: Although new interventions treating neonatal brain injury show great promise, our current ability to predict clinical functional outcomes is poor. Quantitative biomarkers of long-term neurodevelopmental outcome are critically needed to gauge treatment efficacy. Kinematic measures derived from commonly used developmental tasks may serve as early objective markers of future motor outcomes.

Aim: To develop reliable kinematic markers of head control at 12week corrected gestational age (CGA) from two motor tasks: head lifting in prone and pull-to-sit.

Study design and subjects: Prospective observational study of 22 preterm infants born between 24 and 34weeks of gestation.

Outcome measures: Bayley Scales of Infant Development III (Bayley) motor scores.

Results: Intrarater and interrater reliability of prone head lift angles and pull-to-sit head angles were excellent. Prone head lift angles at 12week CGA correlated with white matter NAA/Cho, concurrent Test of Infant Motor Performance (TIMP) scores, and 12-month Bayley motor scores. Head angles during pull-to-sit at 12-week CGA correlated with TIMP scores.

Conclusions: Poor ability to lift the head in prone and an inability to align the head with the trunk during the pull-to-sit task were associated with poorer future motor outcome scores. Kinematic measurements of head control in early infancy may serve as reliable objective quantitative markers of future motor impairment and neurodevelopmental outcome.

Keywords: Kinematics; Motor delay; Preterm infants.

Conflict of interest statement

Conflict of Interest: The authors report no declarations of interest.

Published by Elsevier Ireland Ltd.

Figures

Figure 1. Kinematic analysis of prone head lift and pull-to-sit tasks using Dartfish®. Anatomical markers: I = posterior iliac crest, II = tragus, III = temporal window, IV = acromion process, V = anterior superior iliac crest

1A. Maximum prone head lift angle measured with Dartfish® Analyzer tracking tool. An embedded Dartfish® Analyzer data table is shown. 1B. Head angle at a 90° trunk angle during pull-to-sit measured with Dartfish® Analyzer tracking tool. 1C. Head angle at a 90° trunk angle during pull-to-sit measured with Dartfish® Analyzer tracking tool. Anatom

Figure 2

A15 mm3 voxel box was placed in the basal ganglia (BG) and frontal white matter (WM) for magnetic resonance spectroscopy data acquisition.

Figure 3

Relationships between average prone head lift angle and motor developmental tests. Average prone head lift angle was associated with TIMP at term and 12 weeks CGA (A) and Bayley gross motor scores at 12 months CGA (B).

Figure 4

Average (A) and maximum (B) prone head lift angles by 12-month dichotomized motor Bayley outcomes.