Movement analysis in neonates with spina bifida aperta

D A Sival; O F Brouwer; J L M Bruggink; J S H Vles; A L Staal-Schreinemachers; K M Sollie; P J J Sauer; A F Bos

doi:10.1016/j.earlhumdev.2005.09.002

Movement analysis in neonates with spina bifida aperta

D A Sival, O F Brouwer, J L M Bruggink, J S H Vles, A L Staal-Schreinemachers, K M Sollie, P J J Sauer, A F Bos

Research output: Contribution to journal › Article › Academic › peer-review

26 Citations (Scopus)

Abstract

INTRODUCTION: In neonates with spina bifida aperta (SBA), leg movements by myotomes caudal to the meningomyelocele (MMC) are transiently observed. It is unclear whether these leg movements relate to functional neural conduction through the MMC. For optimal therapeutical intervention, pathophysiological insight in these transient leg movements seems relevant. If leg movements by myotomes caudal to the MMC concur with the execution of general movements (GMs), functional neural conduction through the MMC is implicated.

OBJECTIVE: In neonates with SBA, we aimed to determine whether the transiently present leg movements caudal to the MMC indicate functional neural conduction through the MMC.

METHODS: During the perinatal period, fetuses and neonates with SBA (n = 7 and n = 13, respectively) were longitudinally analysed for concurrency between leg movements caudal to the MMC and GMs. To address the integrity of the reflex arc in spinal segments (at, or) caudal to the MMC, tendon leg reflexes were assessed during the first postnatal week.

RESULTS: At postnatal day 1, leg movements caudal to the MMC concurred with GMs in 12 of 13 infants. Isolated leg movements were observed in only 3 of these 12 infants (isolated vs. concurrent; p < 0.005). Leg movements concurring with GMs lasted longer than isolated leg movements (median duration = 11 s vs. 2 s; p < 0.05). Between days 1 and 7, tendon leg reflexes (at, or) caudal to the MMC had disappeared in all but 1 neonate. However, leg movements caudal to the MMC remained concurrently present with GMs in all five neonates available for follow-up after day 7. Comparing these leg movements between days 1 and 7 indicated a decreased duration (-44%, p < 0.05).

CONCLUSIONS: In neonates with SBA, leg movements caudal to the MMC concur with GMs, indicative of functional neural conduction through the MMC. The disappearance of these leg movements is caused by lower motor neuron dysfunction at the reflex arc, whereas neural conduction through the MMC is still functional.

Original language	English
Pages (from-to)	227-234
Number of pages	8
Journal	Early Human Development
Volume	82
Issue number	4
DOIs	https://doi.org/10.1016/j.earlhumdev.2005.09.002
Publication status	Published - Apr-2006

Keywords

spina bifida
motor behaviour
meningomyelocele
interneurons
central pattern generators
lower motor neuron damage
INTRAUTERINE GROWTH-RETARDATION
FULL-TERM INFANTS
GENERAL MOVEMENTS
FETAL SURGERY
MOTOR BEHAVIOR
HUMAN FETUSES
CORTICOSPINAL PROJECTIONS
QUALITATIVE ASSESSMENT
SPONTANEOUS MOTILITY
PRETERM INFANTS

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@article{110d44e60f1d44dfb954a69e1d40ee6e,

title = "Movement analysis in neonates with spina bifida aperta",

abstract = "INTRODUCTION: In neonates with spina bifida aperta (SBA), leg movements by myotomes caudal to the meningomyelocele (MMC) are transiently observed. It is unclear whether these leg movements relate to functional neural conduction through the MMC. For optimal therapeutical intervention, pathophysiological insight in these transient leg movements seems relevant. If leg movements by myotomes caudal to the MMC concur with the execution of general movements (GMs), functional neural conduction through the MMC is implicated.OBJECTIVE: In neonates with SBA, we aimed to determine whether the transiently present leg movements caudal to the MMC indicate functional neural conduction through the MMC.METHODS: During the perinatal period, fetuses and neonates with SBA (n = 7 and n = 13, respectively) were longitudinally analysed for concurrency between leg movements caudal to the MMC and GMs. To address the integrity of the reflex arc in spinal segments (at, or) caudal to the MMC, tendon leg reflexes were assessed during the first postnatal week.RESULTS: At postnatal day 1, leg movements caudal to the MMC concurred with GMs in 12 of 13 infants. Isolated leg movements were observed in only 3 of these 12 infants (isolated vs. concurrent; p < 0.005). Leg movements concurring with GMs lasted longer than isolated leg movements (median duration = 11 s vs. 2 s; p < 0.05). Between days 1 and 7, tendon leg reflexes (at, or) caudal to the MMC had disappeared in all but 1 neonate. However, leg movements caudal to the MMC remained concurrently present with GMs in all five neonates available for follow-up after day 7. Comparing these leg movements between days 1 and 7 indicated a decreased duration (-44%, p < 0.05).CONCLUSIONS: In neonates with SBA, leg movements caudal to the MMC concur with GMs, indicative of functional neural conduction through the MMC. The disappearance of these leg movements is caused by lower motor neuron dysfunction at the reflex arc, whereas neural conduction through the MMC is still functional.",

keywords = "spina bifida, motor behaviour, meningomyelocele, interneurons, central pattern generators, lower motor neuron damage, INTRAUTERINE GROWTH-RETARDATION, FULL-TERM INFANTS, GENERAL MOVEMENTS, FETAL SURGERY, MOTOR BEHAVIOR, HUMAN FETUSES, CORTICOSPINAL PROJECTIONS, QUALITATIVE ASSESSMENT, SPONTANEOUS MOTILITY, PRETERM INFANTS",

author = "Sival, {D A} and Brouwer, {O F} and Bruggink, {J L M} and Vles, {J S H} and Staal-Schreinemachers, {A L} and Sollie, {K M} and Sauer, {P J J} and Bos, {A F}",

year = "2006",

month = apr,

doi = "10.1016/j.earlhumdev.2005.09.002",

language = "English",

volume = "82",

pages = "227--234",

journal = "Early Human Development",

issn = "0378-3782",

publisher = "ELSEVIER IRELAND LTD",

number = "4",

}

TY - JOUR

T1 - Movement analysis in neonates with spina bifida aperta

AU - Sival, D A

AU - Brouwer, O F

AU - Bruggink, J L M

AU - Vles, J S H

AU - Staal-Schreinemachers, A L

AU - Sollie, K M

AU - Sauer, P J J

AU - Bos, A F

PY - 2006/4

Y1 - 2006/4

N2 - INTRODUCTION: In neonates with spina bifida aperta (SBA), leg movements by myotomes caudal to the meningomyelocele (MMC) are transiently observed. It is unclear whether these leg movements relate to functional neural conduction through the MMC. For optimal therapeutical intervention, pathophysiological insight in these transient leg movements seems relevant. If leg movements by myotomes caudal to the MMC concur with the execution of general movements (GMs), functional neural conduction through the MMC is implicated.OBJECTIVE: In neonates with SBA, we aimed to determine whether the transiently present leg movements caudal to the MMC indicate functional neural conduction through the MMC.METHODS: During the perinatal period, fetuses and neonates with SBA (n = 7 and n = 13, respectively) were longitudinally analysed for concurrency between leg movements caudal to the MMC and GMs. To address the integrity of the reflex arc in spinal segments (at, or) caudal to the MMC, tendon leg reflexes were assessed during the first postnatal week.RESULTS: At postnatal day 1, leg movements caudal to the MMC concurred with GMs in 12 of 13 infants. Isolated leg movements were observed in only 3 of these 12 infants (isolated vs. concurrent; p < 0.005). Leg movements concurring with GMs lasted longer than isolated leg movements (median duration = 11 s vs. 2 s; p < 0.05). Between days 1 and 7, tendon leg reflexes (at, or) caudal to the MMC had disappeared in all but 1 neonate. However, leg movements caudal to the MMC remained concurrently present with GMs in all five neonates available for follow-up after day 7. Comparing these leg movements between days 1 and 7 indicated a decreased duration (-44%, p < 0.05).CONCLUSIONS: In neonates with SBA, leg movements caudal to the MMC concur with GMs, indicative of functional neural conduction through the MMC. The disappearance of these leg movements is caused by lower motor neuron dysfunction at the reflex arc, whereas neural conduction through the MMC is still functional.

AB - INTRODUCTION: In neonates with spina bifida aperta (SBA), leg movements by myotomes caudal to the meningomyelocele (MMC) are transiently observed. It is unclear whether these leg movements relate to functional neural conduction through the MMC. For optimal therapeutical intervention, pathophysiological insight in these transient leg movements seems relevant. If leg movements by myotomes caudal to the MMC concur with the execution of general movements (GMs), functional neural conduction through the MMC is implicated.OBJECTIVE: In neonates with SBA, we aimed to determine whether the transiently present leg movements caudal to the MMC indicate functional neural conduction through the MMC.METHODS: During the perinatal period, fetuses and neonates with SBA (n = 7 and n = 13, respectively) were longitudinally analysed for concurrency between leg movements caudal to the MMC and GMs. To address the integrity of the reflex arc in spinal segments (at, or) caudal to the MMC, tendon leg reflexes were assessed during the first postnatal week.RESULTS: At postnatal day 1, leg movements caudal to the MMC concurred with GMs in 12 of 13 infants. Isolated leg movements were observed in only 3 of these 12 infants (isolated vs. concurrent; p < 0.005). Leg movements concurring with GMs lasted longer than isolated leg movements (median duration = 11 s vs. 2 s; p < 0.05). Between days 1 and 7, tendon leg reflexes (at, or) caudal to the MMC had disappeared in all but 1 neonate. However, leg movements caudal to the MMC remained concurrently present with GMs in all five neonates available for follow-up after day 7. Comparing these leg movements between days 1 and 7 indicated a decreased duration (-44%, p < 0.05).CONCLUSIONS: In neonates with SBA, leg movements caudal to the MMC concur with GMs, indicative of functional neural conduction through the MMC. The disappearance of these leg movements is caused by lower motor neuron dysfunction at the reflex arc, whereas neural conduction through the MMC is still functional.

KW - spina bifida

KW - motor behaviour

KW - meningomyelocele

KW - interneurons

KW - central pattern generators

KW - lower motor neuron damage

KW - INTRAUTERINE GROWTH-RETARDATION

KW - FULL-TERM INFANTS

KW - GENERAL MOVEMENTS

KW - FETAL SURGERY

KW - MOTOR BEHAVIOR

KW - HUMAN FETUSES

KW - CORTICOSPINAL PROJECTIONS

KW - QUALITATIVE ASSESSMENT

KW - SPONTANEOUS MOTILITY

KW - PRETERM INFANTS

U2 - 10.1016/j.earlhumdev.2005.09.002

DO - 10.1016/j.earlhumdev.2005.09.002

M3 - Article

C2 - 16256280

SN - 0378-3782

VL - 82

SP - 227

EP - 234

JO - Early Human Development

JF - Early Human Development

IS - 4

ER -

Movement analysis in neonates with spina bifida aperta

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