Neonatal Diagnostics: Toward Dynamic Growth Charts of Neuromotor Control

Abstract

The current rise of neurodevelopmental disorders poses a critical need to detect risk early in order to rapidly intervene. One of the tools pediatricians use to track development is the standard growth chart. The growth charts are somewhat limited in predicting possible neurodevelopmental issues. They rely on linear models and assumptions of normality for physical growth data – obscuring key statistical information about possible neurodevelopmental risk in growth data that actually has accelerated, non-linear rates-of-change and variability encompassing skewed distributions. Here, we use new analytics to profile growth data from 36 newborn babies that were tracked longitudinally for 5 months. By switching to incremental (velocity-based) growth charts and combining these dynamic changes with underlying fluctuations in motor performance – as the transition from spontaneous random noise to a systematic signal – we demonstrate a method to detect very early stunting in the development of voluntary neuromotor control and to flag risk of neurodevelopmental derail.

Stochastic Signatures of Involuntary Head Micro-movements Can Be Used to Classify Females of ABIDE into Different Subtypes of Neurodevelopmental Disorders

“…It is our proposition that perhaps to detect risk for a neurodevelopmental disorder earlier in life, we could begin to combine the types of neuro-motor control related biometrics explained here with patterns of physical growth that are already tracked by pediatricians in the newborn -as we did in a small cohort of 36 babies, some at risk of stunting in neurodevelopment (Torres et al, 2016b). Indeed, female newborn babies are already separable from the male newborn babies according to their patterns of physical growth.…”

“…This should be particularly important in the nascent nervous systems of the newborn baby, or the rapidly developing nervous system of a young infant. During the pre-cognitive state of the neonate, accelerated rates of change in physical growth are accompanied by rapid neurodevelopment of motor control when typical development is in place (Torres et al, 2016b). Indeed failing to follow this coupled rate of change trajectory reveals stunting in neurodevelopment rather early.…”

“…Neurodevelopment is, indeed, non-uniform and highly non-linear in its early stages (Torres et al, 2016b), with the statistical properties of biorhythms from the developing nervous systems changing dramatically with age (Figure 1) (Torres et al, 2013a, 2016a). In particular, the degree to which spontaneous involuntary fluctuations in the nascent nervous systems can be dampened on command is in itself a sign of maturity (Torres et al, 2013a), as the nervous systems transition into more stable states.…”

“…Rather, the probability density functions empirically derived from actual physical data are skewed; shift skewness with aging and the rates of change of the shifts in skewness change within different age groups. For example, early in neonatal stages the female and male phenotypes separate according to the generalized coefficient of variation (CV) of their rates of growth, which is reflected as well in their rate of change of motion stochastic signatures (Torres et al, 2016b) [Data obtained from 26,985 babies per summary point (13,623 girls, 13,362 boys) publicly available from the methods to build the WHO-CDC Growth Charts]. Babies were longitudinally tracked for 24 months upon which cross-sectional data was used to build the charts up to 5 years of age (Kuczmarski et al, 2002; de Onis and Onyango, 2003).…”

“…Given the pervasive noisy and random somatic motor micro-movements signal in ASD across sex and ages (Torres et al, 2013b), severity (Torres and Denisova, 2016) and levels of motor control (voluntary, Torres et al, 2013a; automatic, Torres et al, 2016c), autonomic (Torres and Lande, 2015; Kalampratsidou and Torres, 2016; Torres et al, 2016b), the present work aimed to investigate if involuntary micro-movements of head motion recorded within the scanner had a statistically different rate of noise accumulation in ASD females in relation to TD control females. Further, this was examined in light of male-specific ASD-TD differential patterns to consider the impact of gender.…”