早产儿轻度运动发育迟缓的评定与干预模式研究

目的 分析早产儿轻度运动发育迟缓的评定及早期干预模式,为早产儿随访及干预提供新模式。方法 选取2018年3月1日-2019年3月31日在南方医科大学附属小榄医院儿童保健科建卡并常规随访的早产儿100例。研究对象用0～1岁20项神经运动检查(20项)检查,并被分为干预组33例、对照组31例、正常组32例及转诊的早产儿4例。比较干预组与对照组早产儿干预后的Alberta婴儿运动量表(AIMS)得分及12月龄时3组早产儿发育商(DQ)。结果 1)干预后,干预组AIMS得分高于对照组,差异有统计学意义(t=2.06,P＜0.05)。2)干预组、正常组与对照组12月龄时的大运动DQ、言语DQ、社交行为DQ比较,差异有统计学意义(F=9.49、9.02、4.53,P＜0.05)。两两比较结果显示,对照组与正常组、对照组与干预组间的大运动DQ差异均有统计学意义(P＜0.05);干预组与正常组、对照组与正常组间的言语DQ比较,差异均有统计学意义(P＜0.05);对照组与正常组间的社交行为DQ比较,差异有统计学意义(P＜0.05);其余组间两两比较差异无统计学意义(P＞0.05)。3)转诊早产儿4例,无视、听异常婴儿。结论 以20项为随访基础、以AIMS为早期干预指导基础及以Bobath运动疗法为主的早期综合干预模式在轻度运动发育迟缓早产儿随访中具有可行性。     

Forearm EMG response activity during motor performance in individuals prone to increased stress reactivity

BACKGROUND: Work-related Upper Extremity Disorders (WRUEDs) are conceived of as a multifactorial syndrome caused by the effects of excessive repetitive motions, sustained static postures, and muscular stiffness. Our aim is to test an etiological model derived from a theory by Van Galen and Van Huygevoort [2000] Biol Psychol 51:151-171. The theory holds that physical, emotional, and psychosocial stressors enhance muscular stiffness as a compensatory filtering of impoverished signal-to-noise ratios in the motor system. High individual levels of arousal, as measured by Spielberger et al. [1970], State and Trait Anxiety Test would further enhance a subject's predisposition to react with stiffness responses in conditions of stress. METHODS: Ten participants with a high- and 10 with a low trait-anxiety score performed a computer task involving series of fast but well-dosed accelerations of the forearm along the surface of a digitizer. To induce cognitive stress a tone had to be remembered simultaneously with the aiming task. Pen-tip displacements and surface electromyographic (EMG) signals were recorded from four forearm muscles. RESULTS: Memory load did not affect error rates but produced shorter reaction times and prolonged movement times. EMG data show that under stress overall levels of neuromotor activation were enhanced. High-anxious participants exhibited higher cocontraction levels than low-anxious participants. CONCLUSIONS: The findings support the view that stress and muscular tension are closely related and may provide a clue to the origin of WRUEDs.     

Effect of pyridoxine deficiency on the exploratory behavior of rats

Malnutrition early in life impairs the development of brain as well as behavior. In the present study the behavioral effects of preweaning pyridoxine deficiency in rats, as reflected by their exploratory score, have been investigated. The results clearly indicated that the body weight of pyridoxine-deficient rats was significantly less when compared to the control rats. Besides this, the sign of maturation of sensory perceptual mechanisms like the first day of eye opening and signs of maturation of neuromotor coordination like the day of supported standing are delayed in vitamin-deficient rats. The open-field activity reflected by the exploratory score was observed to be significantly less in vitamin-deficient rats. In short, considerable effects of prenatal pyridoxine deficiency were observed in the neonatal pups as stunting of growth and in the delayed onset of neuromotor coordination as well as a low level of open-field activity. The importance of maternal pyridoxine supplementation during pregnancy has been emphasized.     

Sleep difficulties in infants at risk for developmental delays: a longitudinal study

Objectives We compared the sleep of infants at risk forneuromotor delays to that of infants without such risks, andexamined the predictive validity of risk indicators to the developmentof sleep problems. Methods Conveniently recruitedinfants (n = 142) were assessed for neuromotor achievementsand sleep behaviors at 4–6 months and 10–12 monthsof age. Assessment tools were the Harris Infant Neuromotor Testand Morrell's Infant Sleep Questionnaire. Based on a cumulativerisk index, three groups were defined: higher risk (n = 28),lower risk (n = 42), and no risk (n = 72). Results Atboth ages, the sleep scores were similar among the groups. Inthe no risk and lower risk group, sleep difficulties decreasedwith age, while for infants in the higher risk group, more difficultieswere reported over time. Overall, the neuromotor attainmentswere not related to sleep fragmentation or settling difficulties. Conclusions Ina diverse sample of infants, with and without risks for developmentaldelays, overall, sleep patterns were similar. It appears thatthe neuromotor achievements are not associated with sleep-wakeregulation, as measured by caregivers’ report.     

早产儿早期神经运动发育纵向随访

目的 探讨早产对婴幼儿智力、运动发育及视觉认知能力的影响,为开展早产儿早期干预提供依据。方法 采用纵向随访方法,选取曾在本院新生儿科住院的55例早产儿(其中:极早产儿 25例,中晚期早产儿30例)作为研究组,40例正常足月儿作为对照组,应用Bayley-Ⅱ婴幼儿发育量表在12月龄、18月龄、24月龄和36月龄时进行评估,用智力发育指数(Mental Developmental Index,MDI)、运动发育指数(Psychomotor Developmental Index,PDI)和视觉项目通过率表示。结果 极早产儿各校正月龄MDI、PDI均较正常足月儿落后(P＜0.05);中晚期早产儿仅在校正12月龄和24月龄MDI得分与对照组存在显著性差异(P＜0.05),各校正月龄PDI得分与对照组无显著性差异(P＞0.05)。极早产儿组视觉项目通过率为46.3%,中晚期早产儿为61.5%,对照组为74.4%。 结论 早产对婴幼儿的智力、运动及视觉认知发育存在显著负面影响,在极早产儿中尤为明显,应尽早实施早期干预,促进早产儿发育。     

Peripheral neuromotor status in convalescents after tick-borne encephalitis

Complex electromyographic examinations of 57 patients with different forms of tick-borne encephalitis were carried out during acute and delayed periods. Abnormalities of the peripheral neuromotor system were detected in patients with all forms of the disease; the most characteristic were pronounced electrogenesis disorders in the proximal part of motor nerve axons, particularly in the upper limbs, and of the spinal anterior horn motoneurons at the level of the cervical intumescence. Translated from Byulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 146, No. 8, pp. 154–156, August, 2008     

Evaluation of neuromotor deficits in children with autism and children with a specific speech and language disorder

Several studies have described problems in motor functions in children with autism and children with a specific speech and language disorder. The purpose of this study was to identify neuromotor deficits in these neurodevelopmentally impaired children. A standardised neurological examination was performed in 11 children with childhood autism, 11 children with an expressive language disorder, 11 children with a receptive language disorder and 11 control children. The children were matched for age and non-verbal IQ, not for gender. All children had a non-verbal IQ above 85. The neurological examination procedure allowed for a qualitative and quantitative assessment of five specific neurological subsystems: fine and gross motor functions, balance, coordination and oral motor functions. The high-functioning children with autism and the children with a specific language disorder (expressive or receptive) had more motor problems than the control children on most neurological subsystems. There were few statistically significant differences between the three groups of developmentally impaired children. The frequent co-occurrence of verbal and non-verbal, in particular neuromotor, deficits in developmentally impaired children put an additional burden on the development of these children and should be diagnosed as early as possible. Accepted: 8 May 2002 The research was funded by grant AM 63/4–2 of the Deutsche Forschungsgemeinschaft. Correspondence to Dr. M. Noterdaeme     

应用弥散张量成像研究脑梗死后皮质脊髓束Wallerian变性与运动功能缺损的相关性

目的:应用弥散张量成像(DTI)研究脑梗死后皮质脊髓束Wallerian变性与神经运动功能缺损的相关性。方法:对11例单侧大脑中动脉供血区脑梗死的患儿进行了DTI研究。通过放置兴趣区(ROI)的方式获得定量部分各向异性(FA)和平均弥散量(MD)。ROI放置的部位包括:脑梗死区、脑梗死同侧内囊后支前部和大脑脚,以及上述部位对侧相应区域。根据手的运动情况将运动功能缺损分为轻、中和重3级。应用Mann-Whitney U检验确定差异有无显著性;应用Spearman相关检验确定皮质脊髓束DTI改变与神经运动功能缺损之间的相关性。结果:脑梗死同侧皮质脊髓束FA较对侧明显下降(P<0.05),但MD改变与对侧无明显差异(P>0.05)。FA下降与神经运动功能缺损之间存在明显相关性(r=-0.638,P=0.035)。结论:应用FA值的变化,DTI可以检测并定量分析儿童脑梗死后皮质脊髓束Wallerian变性,并可作为预测脑梗死后运动功能缺损的工具。