Associação entre a resposta hemodinâmica cortical e o desenvolvimento motor de crianças nascidas pré-termo aos seis e 12 meses de idade corrigida

Abstract

Motor impairments are among the most common comorbidities associated with preterm birth, and in some cases, they may be accompanied by neuroanatomical and neurophysiological changes throughout childhood. Moreover, it appears that even preterm children without identifiable brain injury, using neuroimaging, have poor development compared to their full-term peers. Thus, early monitoring of the psychomotor development of preterm infants has gained clinical relevance and research since identifying and acting on possible changes can help improve prognosis of these children. However, the currently available assessment tools have shown weaknesses. In this context Functional Near-Infrared Spectroscopy - fNIRS) has been identified as a promising tool for child development studies, including motor development. This study aimed to assess cortical hemodynamic activity in response to motor stimulation, measured by fNIRS, and its association with motor development assessed by Bayley-III in pre and full term infants at six and 12 months of age. Seventy-three children were included in this study. At six months, fNIRS data were obtained from 51 infants, and at 12 months, were obtained 35 fNIRS data. A 22 children subgroup completed all assessments at both ages and a descriptive analysis of this subgroup is presented. The cortical hemodynamic activity was different between pre and full term infants at six and 12 months. However, the groups were similar in motor development at both ages. At six months of age, motor development was positively correlated to sensorimotor cortex activation (the region corresponding to FC3-C3 CP3). At the same age, motor development was also positively correlated with deoxyhemoglobin response (HbR), which in this study was called integrated deoxyhemoglobin response (IR_HbR) and corresponds to the area under the curve HbR. At 12 months of age, we did not observe any significant association between motor scores and fNIRS measures. The results highlight the adequacy of fNIRS to assess differences in motor cortical activity between groups of children, being potentially suitable for use in children with a history of prematurity. The knowledge of motor development in this population may impact the design of better assessment and intervention strategies for the first year of life.