Development of muscle tone impairments in high-risk infants: Associations with cerebral palsy and cystic periventricular leukomalacia

Elisabeth J M Straathof, Elisa G Hamer, Kilian J Hensens, Sacha La Bastide-van Gemert, Kirsten R Heineman, Mijna Hadders-Algra*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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AIM: To assess the prevalence and development of muscle tone impairments in infants at high risk of developmental disorders, and their associations with cerebral palsy (CP) and cystic periventricular leukomalacia (cPVL).

METHOD: Longitudinal exploration of muscle tone in 39 infants at high risk of CP (LEARN2MOVE 0-2 project) mostly due to an early lesion of the brain. Muscle tone was assessed ≥4 times between 0 and 21 months corrected age (CA) with the Touwen Infant Neurological Examination. Diagnosis of CP was determined at 21 months CA. Neonatal neuro-imaging was available. Developmental trajectories were calculated using generalized linear mixed effect models.

RESULTS: Infants showed atypical muscle tone in three or four body parts in 93% (172/185) of the assessments. The most prevalent muscle tone pattern was hypotonia of neck and trunk with hypertonia of the limbs (28%). From 7 months CA onwards hypertonia of the arms was associated with CP. Asymmetric arm tone during infancy was associated with unilateral CP. At 18-21 months CA ankle hypertonia was associated with CP at 21 months; leg hypertonia in infancy was not associated with CP. Leg hypertonia was associated with cPVL, regardless of age.

INTERPRETATION: High-risk infants due to an early lesion of the brain often present with muscle tone impairment. In these infants, hypertonia and asymmetric muscle tone of the arms were from 7 months onwards associated with the diagnosis of CP at 21 months; hypertonia of the legs was not.

Original languageEnglish
Pages (from-to)12-18
Number of pages7
JournalEuropean Journal of Paediatric Neurology
Early online date1-Jan-2022
Publication statusPublished - Mar-2022

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