Minor neurological dysfunction and associations with motor function, general cognitive abilities, and behaviour in children born extremely preterm

Broström, Lina; Vollmer, Brigitte; Bolk, Jenny; Eklöf, Eva; Ådén, Ulrika

doi:10.1111/dmcn.13738

Cited by 32 publications

(33 citation statements)

References 29 publications

(62 reference statements)

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“…This has been described mainly for school age cohorts. Broström et al (2018) 15 in accordance with other studies that looked at slightly more mature cohorts, for example, the EPIPAGE cohort assessed at the age of 5 years, 16 did show a higher prevalence of minor neurological dysfunction (assessed with a simplified version of the Touwen examination) at school age for a regional cohort of extremely preterm (<27 wGA) born children compared with the term born controls. In addition, a meta-analysis by de Kieviet et al (2009) 17 did show persisting poorer neuromotor function throughout childhood and into adolescence in very low BW and very preterm children compared with term born children.…”

Section: Neuromotor Function and Development Of Neuromotor Function Isupporting

confidence: 72%

Young Adult Motor, Sensory, and Cognitive Outcomes and Longitudinal Development after Very and Extremely Preterm Birth

Vollmer

Stålnacke

2019

Neuropediatrics

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In this narrative review, we report on adult outcomes after very (before 32 weeks of gestation [wGA]) and extremely (before 28 wGA) preterm birth, with a focus on neuromotor function, neurosensory impairment, general cognitive abilities, executive function, and attentional abilities, all of which are important for academic progress, peer relationships, and participation. Longitudinal development from childhood to adulthood is described. Preterm born individuals have a higher risk for impairment of general cognitive abilities, executive function, attention, and neuromotor abilities well into adulthood, with, however, considerable variability in outcomes. Differences between individuals born preterm and their term born peers persist. Long-term outcomes of general cognitive ability can be predicted with some degree of certainty from childhood assessments: those who perform poor on early childhood age assessments very likely will not catch up, whereas those who perform within the normal range on early assessments sometimes accelerate their development relative to term born peers. This appears similar for executive function and attention, although data on trajectories for these functions are somewhat inconsistent. In adulthood, some studies describe poorer educational outcomes, employment, independent living, and/or economic situation compared with term born individuals; however, large proportion of those born preterm report similar self-perceived quality of life.

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Section: Neuromotor Function and Development Of Neuromotor Function Isupporting

confidence: 72%

Young Adult Motor, Sensory, and Cognitive Outcomes and Longitudinal Development after Very and Extremely Preterm Birth

Vollmer

Stålnacke

2019

Neuropediatrics

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“…21 Neonatal insults, such as hypoxia or inflammation, result in permanent dysfunction of cortical architecture and physiology. [22][23][24] Deleterious effects are particularly exerted on the GABAergic circuits, resulting in disordered cortical excitatory/inhibitory balance, which is crucial for normal brain functioning. 25 While epidemiologic studies have not as yet linked neonatal insults with ALS, well-established conditions such as autism spectrum disorder, schizophrenia, and depression are associated with perinatal insults.…”

Section: Pathophysiologic Mechanisms Underlying Alsmentioning

confidence: 99%

ALS is a multistep process in South Korean, Japanese, and Australian patients

Vucic¹,

Higashihara²,

Sobue³

et al. 2020

Neurology

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ObjectiveTo establish whether amyotrophic lateral sclerosis (ALS) is a multistep process in South Korean and Japanese populations when compared to Australian cohorts.MethodsWe generated incident data by age and sex for Japanese (collected between April 2009 and March 2010) and South Korean patients with ALS (collected between January 2011 and December 2015). Mortality rates were provided for Australian patients with ALS (collected between 2007 and 2016). We regressed the log of age-specific incidence against the log of age with least squares regression for each ALS population.ResultsWe identified 11,834 cases of ALS from the 3 populations, including 6,524 Australian, 2,264 Japanese, and 3,049 South Korean ALS cases. We established a linear relation between the log incidence and log age in the 3 populations: Australia r2 = 0.99, Japan r2 = 0.99, South Korea r2 = 0.99. The estimate slopes were similar across the 3 populations, being 5.4 (95% confidence interval [CI], 4.8–5.5) in Japanese, 5.4 (95% CI, 5.2–5.7) in Australian, and 4.4 (95% CI, 4.2–4.8) in South Korean patients.ConclusionsThe linear relationship between log age and log incidence is consistent with a multistage model of disease, with slope estimated suggesting that 6 steps were required in Japanese and Australian patients with ALS while 5 steps were needed in South Korean patients. Identification of these steps could identify novel therapeutic strategies.

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“…22 Although neurological dysfunction has been associated with preterm birth, at present there are no data that link ALS with specific early-life CNS disorders. 23 There are indirect epidemiological data that have been interpreted as suggesting a link to neonatal infectious diseases, 24 although this area has not been explored in depth.…”

Section: Neuronal Susceptibility To Neonatal Insultsmentioning

confidence: 99%

Amyotrophic lateral sclerosis: Origins traced to impaired balance between neural excitation and inhibition in the neonatal period

2019

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Amyotrophic lateral sclerosis (ALS) is an adult onset disease but with an increasingly recognized preclinical prodrome. A wide spectrum of investigative approaches has identified loss of inhibitory function at the heart of ALS. In developing an explanation for the onset of ALS, it remains a consideration that ALS has its origins in neonatal derangement of the γ‐aminobutyric acid (GABA)‐ergic system, with delayed conversion from excitatory to mature inhibitory GABA and impaired excitation/inhibition balance. If this is so, the resulting chronic excitotoxicity could marginalize cortical network functioning very early in life, laying the path for neurodegeneration. The possibility that adult‐onset neurodegenerative conditions might have their roots in early developmental derangements is worthy of consideration, particularly in relation to current models of disease pathogenesis. Unraveling the very early molecular events will be crucial in developing a better understanding of ALS and other adult neurodegenerative disorders. Muscle Nerve, 2019

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Minor neurological dysfunction and associations with motor function, general cognitive abilities, and behaviour in children born extremely preterm

Abstract: Extremely preterm birth carries a risk of minor neurological dysfunction (MND). MND in children born extremely preterm is associated with impaired motor function and cognitive abilities, and behavioural problems. Male sex is associated with MND in children born extremely preterm.

Cited by 32 publications

References 29 publications

Young Adult Motor, Sensory, and Cognitive Outcomes and Longitudinal Development after Very and Extremely Preterm Birth

Young Adult Motor, Sensory, and Cognitive Outcomes and Longitudinal Development after Very and Extremely Preterm Birth

ALS is a multistep process in South Korean, Japanese, and Australian patients

Amyotrophic lateral sclerosis: Origins traced to impaired balance between neural excitation and inhibition in the neonatal period

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