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Ana K, Iris ŽI, Nina P, Marina R, Tomislav Ć, Snježana S, Andrea B, Milan R, Ivica K. Linking integrity of visual pathways trajectories to visual behavior deficit in very preterm infants. Infant Behav Dev 2022; 67:101697. [DOI: 10.1016/j.infbeh.2022.101697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/23/2022] [Accepted: 01/25/2022] [Indexed: 11/05/2022]
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Buonsenso D, Costa S, Giordano L, Priolo F, Colonna AT, Morini S, Sbarbati M, Pata D, Acampora A, Conti G, Crudo F, Cantiani A, Martina BM, Amorelli GM, Orazi L, Petrianni M, Ricci D, Lanzone A, Sanguinetti M, Cattani P, Sali M, Romeo D, Zampino G, Vento G, Valentini P. Short- and mid-term multidisciplinary outcomes of newborns exposed to SARS-CoV-2 in utero or during the perinatal period: preliminary findings. Eur J Pediatr 2022; 181:1507-1520. [PMID: 35013811 PMCID: PMC8747884 DOI: 10.1007/s00431-021-04319-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 11/11/2021] [Accepted: 11/12/2021] [Indexed: 12/17/2022]
Abstract
UNLABELLED The long-term outcomes of newborns exposed to SARS-CoV-2 infection in utero or during the first hours of life are still unknown. We performed a single-center, prospective, observational study of newborns born from mothers with microbiologically confirmed SARS-CoV-2 infection in pregnancy or at time of delivery. Infants were offered a multidisciplinary follow-up consisting of nasopharyngeal Polymerase Chain Reaction test at birth and at 48-72 h of life, auxological growth and neurological development, serologic testing, and audiological and ophthalmological assessments. One-hundred ninety-eight mothers and 199 newborns were enrolled. Of the 199 newborns, 171 underwent nasopharyngeal swab, four (2.3%) and two (1.15%) children tested positive at birth and 48-72 h of life, respectively. None had SARS-CoV-2 related symptoms. Auxologic and neurologic development were normal in all children during follow-up. Nine out of 59 infants had SARS-CoV-2 IgG at 3 months of life, which was associated with a positive nasopharyngeal swab at birth (P = 0.04). Twenty seven out of 143 (18.8%) newborns had pathologic transitory evoked otoacoustic emissions at birth, although 14/27 repeated after 1 month were normal. Audiological evaluation was completed with Auditory Brainstem Response between the third and sixth month of life in 34 children, showing in all normal hearing threshold. The ophthalmological evaluation found retinal vascular anomalies in 3/20 (15%) children, immature visual acuity in 5/20 (25%) children, and reduced distance attention in 6/20 cases (30%). CONCLUSIONS Our study showed that the neonatal and mid-term multidisciplinary outcomes of newborns exposed to SARS-CoV-2 infection in utero or during the first hours of life are mostly positive, with the exception of ophthalmologic findings which, in a preliminary cohort, were abnormal in about 15% of cases. Further prospective, longitudinal studies are needed to better understand the clinical outcomes of children exposed to SARS-CoV-2 in utero and in the early postnatal life. WHAT IS KNOWN • In utero mother-to-child transmission of SARS-CoV-2 has been documented by several independent studies. • Neonatal COVID-19 is a systemic disease that can be severe, although rarely. WHAT IS NEW • Newborns exposed in utero to SARS-CoV-2 have mostly a normal auxological, audiological, and neurological development during the first months of life. • Fundus fluorescein angiography revealed that up to 5% of newborns exposed in utero to SARS-CoV2 can show retinal and choroidal abnormalities, including peripheral hypofluorescence of the choroid and increased vascular tortuosity.
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Affiliation(s)
- Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy. .,Global Health Research Institute, Istituto di Igiene, Università Cattolica del Sacro Cuore, Rome, Italy. .,Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Sezione di Microbiologia, Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Simonetta Costa
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Lucia Giordano
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Francessca Priolo
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Arianna Turriziani Colonna
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Sofia Morini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Martina Sbarbati
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Davide Pata
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Anna Acampora
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Guido Conti
- Institute of Otorhinolaryngology, Università Cattolica del Sacro Cuore, Fondazione Policlinico “A Gemelli,” IRCCS, Rome, Italy
| | - Fabrizio Crudo
- Institute of Otorhinolaryngology, Università Cattolica del Sacro Cuore, Fondazione Policlinico “A Gemelli,” IRCCS, Rome, Italy
| | - Alessandro Cantiani
- Institute of Otorhinolaryngology, Università Cattolica del Sacro Cuore, Fondazione Policlinico “A Gemelli,” IRCCS, Rome, Italy
| | - Bianca Maria Martina
- Institute of Otorhinolaryngology, Università Cattolica del Sacro Cuore, Fondazione Policlinico “A Gemelli,” IRCCS, Rome, Italy
| | - Giulia Maria Amorelli
- Department of Ophthalmology, Gemelli Foundation IRCSS, Catholic University of the Sacred Heart, Rome, Italy ,National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of Low Vision Patients, IAPB Italia Onlus- Fondazione Policlinico Agostino Gemelli IRCCS, Rome, Italy
| | - Lorenzo Orazi
- National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of Low Vision Patients, IAPB Italia Onlus- Fondazione Policlinico Agostino Gemelli IRCCS, Rome, Italy
| | - Maria Petrianni
- National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of Low Vision Patients, IAPB Italia Onlus- Fondazione Policlinico Agostino Gemelli IRCCS, Rome, Italy
| | - Daniela Ricci
- National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of Low Vision Patients, IAPB Italia Onlus- Fondazione Policlinico Agostino Gemelli IRCCS, Rome, Italy
| | - Antonio Lanzone
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Maurizio Sanguinetti
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Sezione di Microbiologia, Università Cattolica del Sacro Cuore, Rome, Italy ,Dipartimento di Scienze di Laboratorio E Infettivologiche, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Paola Cattani
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Sezione di Microbiologia, Università Cattolica del Sacro Cuore, Rome, Italy ,Dipartimento di Scienze di Laboratorio E Infettivologiche, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Michela Sali
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Sezione di Microbiologia, Università Cattolica del Sacro Cuore, Rome, Italy ,Dipartimento di Scienze di Laboratorio E Infettivologiche, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Domenico Romeo
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Giuseppe Zampino
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Giovanni Vento
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
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Signorini S, Luparia A, Cappagli G, Perotto E, Antonini M, Morelli F, Aprile G, Ballante E, Figini S, Borgatti R. Visual Function Score: A New Clinical Tool to Assess Visual Function and Detect Visual Disorders in Children. Front Pediatr 2022; 10:868974. [PMID: 35558364 PMCID: PMC9087345 DOI: 10.3389/fped.2022.868974] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 03/16/2022] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION A comprehensive assessment of visual functioning at an early age is important not only for identifying and defining visual impairment but also for planning personalized rehabilitation programs based on the visual diagnosis. Since existing tools to evaluate visual functioning present some important limitations (e.g., they are based on qualitative reports, they do not take into account environmental adaptations of visual testing or they have not been formally validated as clinical instruments), the present work has the main aim to propose a new clinical tool (Visual Function Score, VFS) to detect and define visual disorders at an early age. METHODS The Visual Function Score was administered to one hundred visually impaired children (age range 4 months to 17.75 years old) in the form of a professional-reported protocol for a total of 51 items, each of which is assigned a score from 1 to 9 (or from 0 to 9 in some specific cases). The VFS produces three sub-scores and a global score (from 0 to 100), resulting in a quantitative evaluation of visual functioning. RESULTS The VFS can detect the well-known differences between different types of visual impairment (cerebral, oculomotor, and peripheral or grouped as central and peripheral) and takes into account different environments in the definition of a quantitative score of visual functioning. DISCUSSION Overall, the use of a quantitative tool to evaluate visual functions and functional vision such as the VFS would be fundamental to monitor the progresses of patients over time in response to rehabilitation interventions.
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Affiliation(s)
- Sabrina Signorini
- Developmental Neuro-ophthalmology Unit, IRCCS Mondino Foundation, Pavia, Italy.,Child Neuropsychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Antonella Luparia
- Developmental Neuro-ophthalmology Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Giulia Cappagli
- Developmental Neuro-ophthalmology Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Eleonora Perotto
- Developmental Neuro-ophthalmology Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Mauro Antonini
- Developmental Neuro-ophthalmology Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Federica Morelli
- Developmental Neuro-ophthalmology Unit, IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - Giorgia Aprile
- Developmental Neuro-ophthalmology Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Elena Ballante
- BioData Science Center, IRCCS Mondino Foundation, Pavia, Italy.,Department of Political and Social Sciences, University of Pavia, Pavia, Italy
| | - Silvia Figini
- BioData Science Center, IRCCS Mondino Foundation, Pavia, Italy.,Department of Political and Social Sciences, University of Pavia, Pavia, Italy
| | - Renato Borgatti
- Child Neuropsychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
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Pascoali Rodovanski G, Bêz Reus BA, Cechinel Damiani AV, Franco Mattos K, Moreira RS, Neves Dos Santos A. Home-based early stimulation program targeting visual and motor functions for preterm infants with delayed tracking: Feasibility of a Randomized Clinical Trial. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 116:104037. [PMID: 34293634 DOI: 10.1016/j.ridd.2021.104037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 06/17/2021] [Accepted: 07/13/2021] [Indexed: 06/13/2023]
Abstract
AIMS To verify the feasibility of a home-based early stimulation program targeting visual and motor functions in preterm infants with delayed visual tracking. METHOD We applied a randomized controlled trial. We included thirty low-risk preterm infants, from both genders, with delayed visual tracking, gestational between 28-37 weeks, and age at entrance between 1-2 months of corrected age, and absence of visual impairments. Infants were divided into two groups as follows: a) standard care group (SC) that received general orientation about sensory and motor development (16 infants); b) experimental group, that received a four-week home-based early stimulation program targeting visual and motor functions (ESPVM) applied by the caregivers (14 infants). The feasibility outcomes were retention and loss rates, adherence, adverse events, and stress signals. We obtained preliminary data by comparing visual tracking, motor development, and sensory behavior between groups at the end of the intervention. RESULTS Retention rate was high, 90 % of the caregivers provided ESPVM at least 22 days, and 70 % provided SC at least 17 days. No adverse events were reported. At the end of intervention, the ESPVM group presented higher frequencies of complete visual tracking for cards 7 (ESPVM = 57.3 %, SC = 6.3 %, p = 0.006) and 8 (ESPVM = 64.3 %, SC = 12.2 %, p = 0.013), and lower scores for total sensory profile (ESPVM: median = 58, range = 46-69; SC: median = 71, range = 54-90; p = 0.016). The groups were similar for motor development. CONCLUSIONS The protocol was feasible, and the results encourage a larger randomized controlled trial.
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Affiliation(s)
| | | | | | - Karina Franco Mattos
- Department of Health Science, Federal University of Santa Catarina, Araranguá, SC, Brazil
| | - Rafaela Silva Moreira
- Department of Health Science, Federal University of Santa Catarina, Araranguá, SC, Brazil
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Ross-Sheehy S, Reynolds E, Eschman B. Evidence for Attentional Phenotypes in Infancy and Their Role in Visual Cognitive Performance. Brain Sci 2020; 10:brainsci10090605. [PMID: 32899198 PMCID: PMC7565433 DOI: 10.3390/brainsci10090605] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 08/28/2020] [Accepted: 08/31/2020] [Indexed: 11/16/2022] Open
Abstract
Infant visual attention rapidly develops during the first year of life, playing a pivotal role in the way infants process, learn, and respond to their visual world. It is possible that individual differences in eye movement patterns shape early experience and thus subsequent cognitive development. If this is the case, then it may be possible to identify sub-optimal attentional behaviors in infancy, before the emergence of cognitive deficit. In Experiment 1, a latent profile analysis was conducted on scores derived from the Infant Orienting with Attention (IOWA) task, a cued-attention task that measures individual differences in spatial attention and orienting proficiency. This analysis identified three profiles that varied substantially in terms of attentional efficiency. The largest of these profiles (“high flexible”, 55%) demonstrated functionally optimal patterns of attentional functioning with relatively rapid, selective, and adaptive orienting responses. The next largest group (“low reactive”, 39.6%) demonstrated low attentional sensitivity with slow, insensitive orienting responses. The smallest group (“high reactive”, 5.4%) demonstrated attentional over-sensitivity, with rapid, unselective and inaccurate orienting responses. A linear mixed effect model and growth curve analysis conducted on 5- to 11-month-old eye tracking data revealed significant stable differences in growth trajectory for each phenotype group. Results from Experiment 2 demonstrated the ability of attentional phenotypes to explain individual differences in general cognitive functioning, revealing significant between-phenotype group differences in performance on a visual short-term memory task. Taken together, results presented here demonstrate that attentional phenotypes are present early in life and predict unique patterns of growth from 5 to 11 months, and may be useful in understanding the origin of individual differences in general visuo-cognitive functioning.
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Affiliation(s)
- Shannon Ross-Sheehy
- Department of Psychology, University of Tennessee, Knoxville, TN 37996, USA;
- Correspondence:
| | - Esther Reynolds
- Department of Psychology, University of Tennessee, Knoxville, TN 37996, USA;
| | - Bret Eschman
- Department of Psychology, Florida International University, Miami, FL 33199, USA;
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Ricci D, Lucibello S, Orazi L, Gallini F, Staccioli S, Serrao F, Olivieri G, Quintiliani M, Sivo S, Rossi V, Leone D, Ferrantini G, Romeo DM, Frezza S, Amorelli GM, Molle F, Vento G, Lepore D, Mercuri E. Early visual and neuro-development in preterm infants with and without retinopathy. Early Hum Dev 2020; 148:105134. [PMID: 32688300 DOI: 10.1016/j.earlhumdev.2020.105134] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/06/2020] [Accepted: 07/07/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Retinopathy of prematurity (ROP) is often associated with visual impairment and multiple developmental disabilities. AIMS As most of the previous studies include infants with brain lesions, that can determine visual impairment per se, a cohort of low neurological risk preterm infants without ROP and with various degree of severity of ROP was assessed in order to establish visual and neurodevelopmental outcome. STUDY DESIGN Preterm infants born at <31 weeks gestation, without major brain lesions, underwent visual function assessment at 1 year corrected age and neurodevelopmental assessment at 2 years corrected age. SUBJECTS One hundred and five infants were included in the study: 42 infants did not develop ROP, 7 reached stage 1 in zone 2 ROP, 37 reached prethreshold (untreated) type 2 ROP. The remaining 19 infants were classified as type 1 ROP. OUTCOME MEASURES Visual function (including fixing, tracking, visual acuity, visual field, attention at distance and nystagmus) were assessed at 12 months corrected age and Griffiths Scales at 2 years corrected age. RESULTS The severity of ROP was strongly correlated (p < 0.001) with both visual function at 1 year and neurodevelopment at 2 years. Similarly, the presence of nystagmus was also strongly correlated with visual and neurodevelopmental sequelae. CONCLUSIONS Infants with no or milder retinopathy showed normal visual function at 1 year and neurodevelopment at 2 years. Infants who underwent treatment more frequently showed abnormal results on several aspects of visual function. Presence of nystagmus appeared to increase the risk for abnormal visual function and neurodevelopmental outcome.
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Affiliation(s)
- Daniela Ricci
- Paediatric Neurology and Psychiatry, Catholic University, Largo A. Gemelli 8, Rome, Italy; National Centre of Services and Research for Prevention of Blindness and Rehabilitation of Visually Impaired, Fondazione Policlinico A. Gemelli IRCCS, Largo A. Gemelli 8, Rome, Italy
| | - Simona Lucibello
- Paediatric Neurology and Psychiatry, Catholic University, Largo A. Gemelli 8, Rome, Italy
| | - Lorenzo Orazi
- National Centre of Services and Research for Prevention of Blindness and Rehabilitation of Visually Impaired, Fondazione Policlinico A. Gemelli IRCCS, Largo A. Gemelli 8, Rome, Italy; Institute of Ophthalmology, Catholic University, Fondazione Policlinico A. Gemelli, Largo A. Gemelli 8, Rome, Italy
| | - Francesca Gallini
- Division of Neonatology, Catholic University, Largo A. Gemelli, 8, 00168 Rome, Italy
| | - Susanna Staccioli
- Paediatric Neurology and Psychiatry, Catholic University, Largo A. Gemelli 8, Rome, Italy; Child Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS Via Torre di Palidoro, Rome, Italy
| | - Francesca Serrao
- Division of Neonatology, Catholic University, Largo A. Gemelli, 8, 00168 Rome, Italy
| | - Giorgia Olivieri
- Paediatric Neurology and Psychiatry, Catholic University, Largo A. Gemelli 8, Rome, Italy
| | - Michela Quintiliani
- Paediatric Neurology and Psychiatry, Catholic University, Largo A. Gemelli 8, Rome, Italy
| | - Serena Sivo
- Paediatric Neurology and Psychiatry, Catholic University, Largo A. Gemelli 8, Rome, Italy
| | - Valeria Rossi
- Paediatric Neurology and Psychiatry, Catholic University, Largo A. Gemelli 8, Rome, Italy
| | - Daniela Leone
- Paediatric Neurology and Psychiatry, Catholic University, Largo A. Gemelli 8, Rome, Italy
| | - Gloria Ferrantini
- Paediatric Neurology and Psychiatry, Catholic University, Largo A. Gemelli 8, Rome, Italy
| | - Domenico M Romeo
- Paediatric Neurology and Psychiatry, Catholic University, Largo A. Gemelli 8, Rome, Italy
| | - Simonetta Frezza
- Division of Neonatology, Catholic University, Largo A. Gemelli, 8, 00168 Rome, Italy
| | - Giulia Maria Amorelli
- Institute of Ophthalmology, Catholic University, Fondazione Policlinico A. Gemelli, Largo A. Gemelli 8, Rome, Italy
| | - Fernando Molle
- Institute of Ophthalmology, Catholic University, Fondazione Policlinico A. Gemelli, Largo A. Gemelli 8, Rome, Italy; Institute of Ophthalmology, Fondazione Policlinico A. Gemelli IRCCS, Largo A. Gemelli 8, Rome, Italy
| | - Giovanni Vento
- Division of Neonatology, Catholic University, Largo A. Gemelli, 8, 00168 Rome, Italy
| | - Domenico Lepore
- Institute of Ophthalmology, Catholic University, Fondazione Policlinico A. Gemelli, Largo A. Gemelli 8, Rome, Italy; Institute of Ophthalmology, Fondazione Policlinico A. Gemelli IRCCS, Largo A. Gemelli 8, Rome, Italy
| | - Eugenio Mercuri
- Paediatric Neurology and Psychiatry, Catholic University, Largo A. Gemelli 8, Rome, Italy; Pediatric Neurology Unit, Fondazione Policlinico A. Gemelli IRCCS, Largo A. Gemelli 8, Rome, Italy.
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Kulke L, Atkinson J, Braddick O. Relation Between Event-Related Potential Latency and Saccade Latency in Overt Shifts of Attention. Perception 2020; 49:468-483. [DOI: 10.1177/0301006620911869] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Controlled shifts of attention between competing stimuli are crucial for effective everyday visual behaviour. While these typically involve overt shifts of fixation, many past studies used covert attention shifts in which fixation is unchanged, meaning that some response components may result from the inhibition of eye movements. In this study, the neural events in the human brain when making overt shifts of attention are studied through the combination of event-related potential recording with simultaneous eye tracking. Fixation shifts under competition (central target remains visible when a peripheral target appears) were compared with noncompetition (central target disappears). A longer latency for competition compared with noncompetition, which is found in the saccadic response, is already present in the early occipital positivity when a single target is presented for the fixation shift. These results indicate that the requirement to disengage from a current target affects the time course of neural processing at an early level. However, the relation is more complex when the participant is required to choose which of two targets to fixate.
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Affiliation(s)
- Louisa Kulke
- Affective Neuroscience and Psychophysiology Laboratory, Göttingen University, Göttingen, Germany; Division of Psychology and Language Sciences, Faculty of Brain Sciences, University College London, London, UK
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Janette Atkinson
- Division of Psychology and Language Sciences, Faculty of Brain Sciences, University College London, London, UK; Department of Experimental Psychology, University of Oxford, Oxford, UK
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Oliver Braddick
- Department of Experimental Psychology, University of Oxford, Oxford, UK
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Wallois F, Routier L, Bourel-Ponchel E. Impact of prematurity on neurodevelopment. HANDBOOK OF CLINICAL NEUROLOGY 2020; 173:341-375. [PMID: 32958184 DOI: 10.1016/b978-0-444-64150-2.00026-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The consequences of prematurity on brain functional development are numerous and diverse, and impact all brain functions at different levels. Prematurity occurs between 22 and 36 weeks of gestation. This period is marked by extreme dynamics in the physiologic maturation, structural, and functional processes. These different processes appear sequentially or simultaneously. They are dependent on genetic and/or environmental factors. Disturbance of these processes or of the fine-tuning between them, when caring for premature children, is likely to induce disturbances in the structural and functional development of the immature neural networks. These will appear as impairments in learning skills progress and are likely to have a lasting impact on the development of children born prematurely. The level of severity depends on the initial alteration, whether structural or functional. In this chapter, after having briefly reviewed the neurodevelopmental, structural, and functional processes, we describe, in a nonexhaustive manner, the impact of prematurity on the different brain, motor, sensory, and cognitive functions.
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Affiliation(s)
- Fabrice Wallois
- Research Group on Multimodal Analysis of Brain Function, Jules Verne Picardie University, Amiens, France; Department of Pediatric Functional Exploration of the Nervous System, University Hospital, Picardie, Amiens, France.
| | - Laura Routier
- Research Group on Multimodal Analysis of Brain Function, Jules Verne Picardie University, Amiens, France; Department of Pediatric Functional Exploration of the Nervous System, University Hospital, Picardie, Amiens, France
| | - Emilie Bourel-Ponchel
- Research Group on Multimodal Analysis of Brain Function, Jules Verne Picardie University, Amiens, France; Department of Pediatric Functional Exploration of the Nervous System, University Hospital, Picardie, Amiens, France
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9
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Kooiker MJG, Swarte RMC, Smit LS, Reiss IKM. Perinatal risk factors for visuospatial attention and processing dysfunctions at 1 year of age in children born between 26 and 32 weeks. Early Hum Dev 2019; 130:71-79. [PMID: 30703620 DOI: 10.1016/j.earlhumdev.2019.01.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 12/03/2018] [Accepted: 01/19/2019] [Indexed: 01/13/2023]
Abstract
BACKGROUND Children born preterm are at risk of visuospatial attention orienting and processing dysfunctions, which can be quantified early in life using visually-guided eye movement responses. AIMS To identify the prevalence and perinatal risk factors for visuospatial attention orienting and processing dysfunctions in children born preterm of 1 year of corrected age (CA). STUDY DESIGN 123 children born between 26 and 33 weeks of gestation underwent a nonverbal visuospatial test at 1y CA, using an eye tracking-based paradigm. For the detected high-salient (cartoon and contrast), intermediate-salient (form and motion) and low-salient (color) stimuli, we quantified the reaction time to fixation (RTF). RTFs were compared to normative references from an age-matched control group (N = 38). The prevalence of perinatal risk factors (gestational age and weight, indices of neurological damage, overal sickness, respiratory failure, and retinopathy) was compared between the groups with normal and delayed RTFs. RESULTS At 1y CA, the preterm group had 7-20% less detected stimuli than the control group, particularly for intermediate and low-salient stimuli. Compared to normative RTFs, modest delays were found for high-salient cartoon (in 19% of preterm children) and contrast (8%), intermediate-salient motion (23%) and form (21%), and low-salient color stimuli (8%). These children had a significantly higher prevalence of perinatal risk factors for respiratory failure and intraventricular hemorrhages. CONCLUSIONS Children born between 26 and 32 weeks have a modest risk (8-23%) of visuospatial attention and processing dysfunction. This warrants early monitoring and support of general visual development in preterm children at risk of respiratory distress and disrupted cerebral blood flow.
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Affiliation(s)
- M J G Kooiker
- Vestibular and Oculomotor Research Group, Department of Neuroscience, Erasmus MC, PO Box 2040, 3000 CA Rotterdam, the Netherlands.
| | - R M C Swarte
- Department of Pediatrics, Division of Neonatology, Erasmus MC - Sophia Children's Hospital, PO Box 2060, 3000 CB Rotterdam, the Netherlands
| | - L S Smit
- Department of Pediatrics, Division of Neonatology, Erasmus MC - Sophia Children's Hospital, PO Box 2060, 3000 CB Rotterdam, the Netherlands; Department of Neurology, Division of Pediatric Neurology, Erasmus MC - Sophia Children's Hospital, PO Box 2060, 3000 CB Rotterdam, the Netherlands
| | - I K M Reiss
- Department of Pediatrics, Division of Neonatology, Erasmus MC - Sophia Children's Hospital, PO Box 2060, 3000 CB Rotterdam, the Netherlands
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Petkovic M, Rat-Fischer L, Fagard J. The Emergence of Tool Use in Preterm Infants. Front Psychol 2016; 7:1104. [PMID: 27486429 PMCID: PMC4949218 DOI: 10.3389/fpsyg.2016.01104] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 07/08/2016] [Indexed: 11/13/2022] Open
Abstract
Preterm born children without neurological impairments have been shown to present some visual-manual coordination deficits, more or less depending on their tonicity and the degree of prematurity. In this paper, we compare the development of tool use in 15-23-month-old preterm infants born after 33-36 weeks of gestation without neurological complications with that of full-term infants according to corrected age. Understanding the affordance of a tool is an important cognitive milestone in early sensorimotor period. Using a tool to bring within reach an out-of-reach object, for instance, has been shown to develop during the 2nd year in full-term infants. Here we presented preterm infants with an attractive toy out of reach and with a rake-like tool within reach in five conditions of spatial relationships between the toy and the tool. Like full-terms, preterm infants used the tool with success in conditions of spatial contiguity around 15-17 months. In conditions of a spatial gap between tool and toy, i.e., the only conditions which shows without ambiguity that the infant understands the affordance of the tool, preterm infants as a group showed no delay for tool use: the frequency of spontaneous successes started to increase after 18 months, and demonstration became effective after that age. However, further analyses showed that only the preterm infants without hypotonia and born after 36 weeks of pregnancy developed tool use without delay. Hypotonic preterm infants were still largely unsuccessful in the conditions of spatial gap, even at the end of the study. The degree of prematurity also influenced the performance at tool use. These results, following the observation of a delay in the development of bimanual coordination and of handedness in the same infants at 10-12 months in a previous study, show that low risk preterm infants can still be impaired for the development of new manual skills beyond the 1st year. Thus, hypotonic preterm infants and infants born before 36 weeks of pregnancy should be followed and might benefit from early intervention programs.
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Affiliation(s)
- Maja Petkovic
- Laboratoire Psychologie de la Perception, Centre Biomédical des Saints-Pères, CNRS UMR 8158, Université Paris Descartes Paris, France
| | - Lauriane Rat-Fischer
- Laboratoire Psychologie de la Perception, Centre Biomédical des Saints-Pères, CNRS UMR 8158, Université Paris Descartes Paris, France
| | - Jacqueline Fagard
- Laboratoire Psychologie de la Perception, Centre Biomédical des Saints-Pères, CNRS UMR 8158, Université Paris Descartes Paris, France
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Petkovic M, Chokron S, Fagard J. Visuo-manual coordination in preterm infants without neurological impairments. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 51-52:76-88. [PMID: 26812594 DOI: 10.1016/j.ridd.2016.01.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 01/14/2016] [Accepted: 01/14/2016] [Indexed: 06/05/2023]
Abstract
The extent of and reasons for visuo-manual coordination deficits in moderate and late preterm born infants without neurological impairments are not well known. This paper presents a longitudinal study on the visuo-manual development of twelve preterm infants, born after 33-36 weeks of gestation without neurological complications, between the ages of 6 and 12 months. Visuo-manual integration and grasping were assessed using the Peabody Developmental Motor Scales, along with bimanual coordination and handedness tests. Visual function was examined once prior to the beginning of the study. Gross motor development was also evaluated every month. Preterm infants were compared to a control group of ten full-term infants according to corrected age. Compared to full-terms, the visual perception of preterm infants was close to normal, with only a measure of visual fixation lower than in full-terms. In contrast, preterm infants had delayed development of visuo-manual integration, grasping, bimanual coordination, and handedness even when compared using corrected age. Tonicity and gestational age at birth were the main variables associated to the delays. These results are discussed in terms of the possible factors underlying such delays. They need to be confirmed on a larger sample of preterm born children, and to be correlated with later development. This would allow developing markers of future neuropsychological impairments during childhood.
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Affiliation(s)
- Maja Petkovic
- Djecji vrtic Sopot, V.Kovacica 18c, Zagreb, 10000, Zagreb Croatia; Laboratoire Psychologie de la Perception, Université Paris Descartes, CNRS UMR 8158, Centre Biomédical des Saints-Pères, 75006, Paris France.
| | - Sylvie Chokron
- Laboratoire Psychologie de la Perception, Université Paris Descartes, CNRS UMR 8158, Centre Biomédical des Saints-Pères, 75006, Paris France; Unité Vision & Cognition, Fondation Ophtalmologique Rothschild, 25 rue Manin, 75019, Paris France
| | - Jacqueline Fagard
- Laboratoire Psychologie de la Perception, Université Paris Descartes, CNRS UMR 8158, Centre Biomédical des Saints-Pères, 75006, Paris France
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12
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Developmental synergy between thalamic structure and interhemispheric connectivity in the visual system of preterm infants. NEUROIMAGE-CLINICAL 2015; 8:462-72. [PMID: 26106571 PMCID: PMC4474422 DOI: 10.1016/j.nicl.2015.05.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 05/26/2015] [Accepted: 05/27/2015] [Indexed: 11/22/2022]
Abstract
Thalamic structural co-variation with cortical regions has been demonstrated in preterm infants, but its relationship to cortical function and severity of non-cystic white matter injury (non-cystic WMI) is unclear. The relationship between thalamic morphology and both cortical network synchronization and cortical structural connectivity has not been established. We tested the hypothesis that in preterm neonates, thalamic volume would correlate with primary cortical visual function and microstructural integrity of cortico-cortical visual association pathways. A total of 80 term-equivalent preterm and 44 term-born infants underwent high-resolution structural imaging coupled with visual functional magnetic resonance imaging or diffusion tensor imaging. There was a strong correlation between thalamic volume and primary visual cortical activation in preterms with non-cystic WMI (r = 0.81, p-value = 0.001). Thalamic volume also correlated strongly with interhemispheric cortico-cortical connectivity (splenium) in preterm neonates with a relatively higher severity of non-cystic WMI (p-value < 0.001). In contrast, there was lower correlation between thalamic volume and intrahemispheric cortico-cortical connectivity, including the inferior longitudinal fasciculus and inferior frontal orbital fasciculus. This study shows distinct temporal overlap in the disruption of thalamo-cortical and interhemispheric cortico-cortical connectivity in preterm infants suggesting developmental synergy between thalamic morphology and the emergence of cortical networks in the last trimester.
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13
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Cerebral visual dysfunction in prematurely born children attending mainstream school. Doc Ophthalmol 2013; 127:89-102. [DOI: 10.1007/s10633-013-9405-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Accepted: 08/21/2013] [Indexed: 01/05/2023]
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Chau V, Taylor MJ, Miller SP. Visual function in preterm infants: visualizing the brain to improve prognosis. Doc Ophthalmol 2013; 127:41-55. [PMID: 23761036 DOI: 10.1007/s10633-013-9397-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Accepted: 06/05/2013] [Indexed: 11/28/2022]
Abstract
Considerable development of the visual system occurs in the third trimester of life, a time when very preterm-born infants are in a neonatal intensive care unit (NICU). Their very early birth during a period of rapid and marked neurodevelopment and their clinical course makes them a very high-risk population. A range of different events impacts brain development and the visual system, leading to significant long-term visual dysfunction. Improved neuroimaging techniques provide an important window on the early brain and visual system development of these vulnerable infants. Greater understanding of the etiology of visual impairment subsequent to preterm birth and the timing of critical processes will allow early recognition and the earlier implementations of interventions. In the longer term, this will help clinicians optimize NICU practice to reduce the incidence of visual dysfunction in these children.
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Affiliation(s)
- Vann Chau
- Department of Pediatrics (Neurology), University of British Columbia, Vancouver, Canada
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15
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Sansavini A, Guarini A, Caselli MC. Preterm birth: neuropsychological profiles and atypical developmental pathways. ACTA ACUST UNITED AC 2013; 17:102-13. [PMID: 23362030 DOI: 10.1002/ddrr.1105] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2012] [Accepted: 05/10/2012] [Indexed: 11/08/2022]
Abstract
Preterm birth is characterized by multiple interacting atypical constraints affecting different aspects of neuropsychological development. In the first years of life, perceptual, motor, and communicative-linguistic abilities, as well as attention, processing speed, and memory are affected by preterm birth resulting in cascading effects on later development. From school age to adolescence, a catch-up of simpler competencies (i.e., receptive lexicon) along with a more selective effect on more complex competencies (i.e., complex linguistic functions, math, motor, and executive functions) are observed, as well as a relevant incidence of behavioral outcomes. A wide heterogeneity in preterm children's neuropsychological profiles is described depending on the interaction among the degree of neonatal immaturity, medical complications, neurological damages/alterations, environmental and social factors. Severe neuromotor and sensory damages are not frequent, while low severity impairments are common among preterm children. It is argued that developmental pathways of preterm children are atypical, and not merely delayed, and are characterized by different developmental patterns and relationships among competencies.
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Filippi L, Fiorini P, Daniotti M, Catarzi S, Savelli S, Fonda C, Bartalena L, Boldrini A, Giampietri M, Scaramuzzo R, Papoff P, Del Balzo F, Spalice A, la Marca G, Malvagia S, Della Bona ML, Donzelli G, Tinelli F, Cioni G, Pisano T, Falchi M, Guerrini R. Safety and efficacy of topiramate in neonates with hypoxic ischemic encephalopathy treated with hypothermia (NeoNATI). BMC Pediatr 2012; 12:144. [PMID: 22950861 PMCID: PMC3478965 DOI: 10.1186/1471-2431-12-144] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Accepted: 08/31/2012] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Despite progresses in neonatal care, the mortality and the incidence of neuro-motor disability after perinatal asphyxia have failed to show substantial improvements. In countries with a high level of perinatal care, the incidence of asphyxia responsible for moderate or severe encephalopathy is still 2-3 per 1000 term newborns. Recent trials have demonstrated that moderate hypothermia, started within 6 hours after birth and protracted for 72 hours, can significantly improve survival and reduce neurologic impairment in neonates with hypoxic-ischemic encephalopathy. It is not currently known whether neuroprotective drugs can further improve the beneficial effects of hypothermia. Topiramate has been proven to reduce brain injury in animal models of neonatal hypoxic ischemic encephalopathy. However, the association of mild hypothermia and topiramate treatment has never been studied in human newborns. The objective of this research project is to evaluate, through a multicenter randomized controlled trial, whether the efficacy of moderate hypothermia can be increased by concomitant topiramate treatment. METHODS/DESIGN Term newborns (gestational age ≥ 36 weeks and birth weight ≥ 1800 g) with precocious metabolic, clinical and electroencephalographic (EEG) signs of hypoxic-ischemic encephalopathy will be randomized, according to their EEG pattern, to receive topiramate added to standard treatment with moderate hypothermia or standard treatment alone. Topiramate will be administered at 10 mg/kg once a day for the first 3 days of life. Topiramate concentrations will be measured on serial dried blood spots. 64 participants will be recruited in the study. To evaluate the safety of topiramate administration, cardiac and respiratory parameters will be continuously monitored. Blood samplings will be performed to check renal, liver and metabolic balance. To evaluate the efficacy of topiramate, the neurologic outcome of enrolled newborns will be evaluated by serial neurologic and neuroradiologic examinations. Visual function will be evaluated by means of behavioural standardized tests. DISCUSSION This pilot study will explore the possible therapeutic role of topiramate in combination with moderate hypothermia. Any favourable results of this research might open new perspectives about the reduction of cerebral damage in asphyxiated newborns.
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Affiliation(s)
- Luca Filippi
- Neonatal Intensive Care Unit, Medical Surgical Feto-Neonatal Department, A. Meyer University Children's Hospital, Viale Pieraccini, 24, I-50139, Florence, Italy.
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Leonhardt M, Forns M, Calderón C, Reinoso M, Gargallo E. Visual performance in preterm infants with brain injuries compared with low-risk preterm infants. Early Hum Dev 2012; 88:669-75. [PMID: 22381046 DOI: 10.1016/j.earlhumdev.2012.02.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2011] [Revised: 11/04/2011] [Accepted: 02/06/2012] [Indexed: 01/09/2023]
Abstract
BACKGROUND Neonatal brain injuries are the main cause of visual deficit produced by damage to posterior visual pathways. While there are several studies of visual function in low-risk preterm infants or older children with brain injuries, research in children of early age is lacking. AIM To assess several aspects of visual function in preterm infants with brain injuries and to compare them with another group of low-risk preterm infants of the same age. STUDY DESIGN AND SUBJECTS Forty-eight preterm infants with brain injuries and 56 low-risk preterm infants. OUTCOME MEASURES The ML Leonhardt Battery of Optotypes was used to assess visual functions. This test was previously validated at a post-menstrual age of 40 weeks in newborns and at 30-plus weeks in preterm infants. RESULTS The group of preterm infants with brain lesions showed a delayed pattern of visual functions in alertness, fixation, visual attention and tracking behavior compared to infants in the healthy preterm group. The differences between both groups, in the visual behaviors analyzed were around 30%. These visual functions could be identified from the first weeks of life. CONCLUSION Our results confirm the importance of using a straightforward screening test with preterm infants in order to assess altered visual function, especially in infants with brain injuries. The findings also highlight the need to provide visual stimulation very early on in life.
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Affiliation(s)
- Merçè Leonhardt
- NICU, Hospital Sant Joan de Déu, Passeig Sant Joan de Déu 2, Esplugues, Barcelona, Spain.
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Hou C, Norcia AM, Madan A, Tith S, Agarwal R, Good WV. Visual cortical function in very low birth weight infants without retinal or cerebral pathology. Invest Ophthalmol Vis Sci 2011; 52:9091-8. [PMID: 22025567 DOI: 10.1167/iovs.11-7458] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Preterm infants are at high risk of visual and neural developmental deficits. However, the development of visual cortical function in preterm infants with no retinal or neurologic morbidity has not been well defined. To determine whether premature birth itself alters visual cortical function, swept parameter visual evoked potential (sVEP) responses of healthy preterm infants were compared with those of term infants. METHODS Fifty-two term infants and 58 very low birth weight (VLBW) infants without significant retinopathy of prematurity or neurologic morbidities were enrolled. Recruited VLBW infants were between 26 and 33 weeks of gestational age, with birth weights of less than 1500 g. Spatial frequency, contrast, and vernier offset sweep VEP tuning functions were measured at 5 to 7 months' corrected age. Acuity and contrast thresholds were derived by extrapolating the tuning functions to 0 amplitude. These thresholds and suprathreshold response amplitudes were compared between groups. RESULTS Preterm infants showed increased thresholds (indicating decreased sensitivity to visual stimuli) and reductions in amplitudes for all three measures. These changes in cortical responsiveness were larger in the <30 weeks ' gestational age subgroup than in the ≥30 weeks' gestational age subgroup. CONCLUSIONS Preterm infants with VLBW had measurable and significant changes in cortical responsiveness that were correlated with gestational age. These results suggest that premature birth in the absence of identifiable retinal or neurologic abnormalities has a significant effect on visual cortical sensitivity at 5 to 7 months' of corrected age and that gestational age is an important factor in visual development.
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Affiliation(s)
- Chuan Hou
- The Smith-Kettlewell Eye Research Institute, 2318 Fillmore Street, San Francisco, CA, USA
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Romeo DM, Ricci D, Baranello G, Pagliano E, Brogna C, Olivieri G, Contaldo I, Mazzone D, Quintiliani M, Torrioli MG, Romeo MG, Mercuri E. The forward parachute reaction and independent walking in infants with brain lesions. Dev Med Child Neurol 2011; 53:636-40. [PMID: 21418202 DOI: 10.1111/j.1469-8749.2011.03940.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM The aim of this study was to assess the onset of forward parachute reaction (FPR) in infants with brain lesions and its correlation with age of walking. METHOD FPR was assessed at 6, 9, and 12 months in 140 infants with brain lesions (78 males, 62 females; mean gestational age 31 wks; SD 3.6 wks; mean birthweight 1450 g, SD 252 g). On cranial ultrasound 62 infants had mild and 78 had major abnormalities; 86 developed cerebral palsy. All were followed for 5 years, and the age at which each child achieved independent walking was recorded. Infants who had been born small for gestational age (weight <10th centile) were excluded, as were those who had major congenital malformations, severe postnatal infectious diseases, or metabolic or haematological complications. RESULTS A complete FPR was present in eight infants at 6 months, in 42 at 9 months, and in 71 at 12 months. At 12 months, 29 infants presented incomplete FPR and 40 presented absent FPR. Seventy-three infants were able to walk independently between the ages of 11 months and 60 months (67 with complete FPR and six with incomplete FPR at 12 mo). A complete FPR at 12 months was a good predictor of independent walking. The age at onset of complete FPR was also a good predictor of age of walking. INTERPRETATION The late acquisition of a complete FPR appears to be an early sign of a more general delayed maturation of functional abilities.
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Grönqvist H, Brodd KS, Rosander K. Development of smooth pursuit eye movements in very prematurely born infants: 2. The low-risk subgroup. Acta Paediatr 2011; 100:e5-11. [PMID: 21362038 DOI: 10.1111/j.1651-2227.2011.02247.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To investigate the impact of premature birth on visual tracking in a group of 37 infants, born before the 32nd gestational weeks (mean 29 + 6 weeks) and diagnosed as being without major neonatal complications. This paper is a part of the LOVIS study (Strand Brodd, Ewald, Grönqvist, Holmström, Strömberg, Von Hofsten, et al. Acta Pediatrica, 2011). METHODS At 2 and 4 months corrected age, eye and head movements were measured when the infant tracked a moving object. The eye movements were analysed in terms of smooth pursuit and saccades (Vision Res, 37, 1997, 1799; Exp Brain Res, 146, 2002, 257). Accuracy of gaze, proportion of smooth pursuit, head movements and saccades were calculated. RESULTS Between 2 and 4 months of age, all infants improved their ability to smoothly pursue a moving object. However, at both occasions, the preterm infants had less proportion smooth pursuit than the full-term infants. The groups did not differ with respect to gaze and head movements, but the saccade frequency was higher for the very preterms in some of the conditions. CONCLUSION The development of smooth pursuit in the low-risk preterm infant group was strongly delayed compared to typically developed infants. Thus, the 2 months or more extra visual experience did not have a distinguishable positive effect on visuo-motor development as expressed in smooth pursuit.
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Ricci D, Romeo DM, Gallini F, Groppo M, Cesarini L, Pisoni S, Serrao F, Papacci P, Contaldo I, Perrino F, Brogna C, Bianco F, Baranello G, Sacco A, Quintiliani M, Ometto A, Cilauro S, Mosca F, Romagnoli C, Romeo MG, Cowan F, Cioni G, Ramenghi L, Mercuri E. Early visual assessment in preterm infants with and without brain lesions: correlation with visual and neurodevelopmental outcome at 12 months. Early Hum Dev 2011; 87:177-82. [PMID: 21237588 DOI: 10.1016/j.earlhumdev.2010.12.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2010] [Revised: 12/07/2010] [Accepted: 12/11/2010] [Indexed: 11/17/2022]
Abstract
BACKGROUND Several studies have reported the development of various aspects of visual function in infancy and early childhood in both preterm and term-born infants, but only a few studies have focused on the predictive power of neonatal visual findings in infants with brain lesions. AIMS To explore visual findings at term age, and at 3 and 12 months corrected age in preterm infants (gestational age <33 weeks) with and without brain lesions; to compare the assessment at term age and at 12 months; and to assess the relationship between visual findings and neurodevelopmental outcome at 12 months. STUDY DESIGN Cranial ultrasound scans (US) were classified in normal, mild or major abnormalities. One-hundred and forty-five infants were assessed with age specific tests for visual function at term age, and at 3 and 12 months. Neurodevelopmental assessment (Griffiths' Scales) was performed at 12 months. RESULTS A good correlation was found between early and late visual assessment and neurodevelopment outcome. Of the 121 infants with normal neonatal visual assessment, 119 were also normal at 12 months and 116 had normal developmental quotient. Of the 24 infants with abnormal neonatal visual assessment, 12 were also abnormal at 12 months. All the false positives had normalised by 3 months. Of the 35 infants with major US abnormalities, 20 had normal and 15 abnormal scores on the neonatal assessment. At 1 year 17 had normal and 18 abnormal scores. CONCLUSION A normal visual assessment at term age is a good predictor of normal visual and neurodevelopmental outcome at 12 months. An abnormal visual examination in the neonatal period was a less reliable prognostic indicator, infant should be reassessed at 3 months.
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Affiliation(s)
- Daniela Ricci
- Paediatric Neurology Unit, Catholic University, Rome, Italy
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Filippi L, Cavallaro G, Fiorini P, Daniotti M, Benedetti V, Cristofori G, Araimo G, Ramenghi L, La Torre A, Fortunato P, Pollazzi L, la Marca G, Malvagia S, Bagnoli P, Ristori C, Dal Monte M, Bilia AR, Isacchi B, Furlanetto S, Tinelli F, Cioni G, Donzelli G, Osnaghi S, Mosca F. Study protocol: safety and efficacy of propranolol in newborns with Retinopathy of Prematurity (PROP-ROP): ISRCTN18523491. BMC Pediatr 2010; 10:83. [PMID: 21087499 PMCID: PMC2993687 DOI: 10.1186/1471-2431-10-83] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2010] [Accepted: 11/18/2010] [Indexed: 02/07/2023] Open
Abstract
Background Despite new therapeutic approaches have improved the prognosis of newborns with retinopathy of prematurity (ROP), an unfavourable structural and functional outcome still remains high. There is high pressure to develop new drugs to prevent and treat ROP. There is increasing enthusiasm for anti-VEGF drugs, but angiogenic inhibitors selective for abnormal blood vessels would be considered as an optimal treatment. In an animal experimental model of proliferative retinopathy, we have recently demonstrated that the pharmacological blockade of beta-adrenoreceptors improves retinal neovascularization and blood retinal barrier breakdown consequent to hypoxia. The purpose of this study is to evaluate the propranolol administration in preterm newborns suffering from a precocious phase of ROP in terms of safety and efficacy in counteracting the progression of retinopathy. Methods/Design Preterm newborns (gestational age at birth lower than 32 weeks) with stage 2 ROP (zone II-III without plus) will be randomized, according to their gestational age, to receive propranolol added to standard treatment (treatment adopted by the ETROP Cooperative Group) or standard treatment alone. Propranolol will be administered until retinal vascularization will be completely developed, but not more than 90 days. Forty-four participants will be recruited into the study. To evaluate the safety of propranolol administration, cardiac and respiratory parameters will be continuously monitored. Blood samplings will be performed to check renal, liver and metabolic balance. To evaluate the efficacy of propranolol, the progression of the disease, the number of laser treatments or vitrectomies, the incidence of retinal detachment or blindness, will be evaluated by serial ophthalmologic examinations. Visual function will be evaluated by means of behavioural standardized tests. Discussion This pilot study is the first research that explores the possible therapeutic role of beta blockers in ROP. The objective of this research is highly ambitious: to find a treatment simple, inexpensive, well tolerated and with few adverse effects, able to counteract one of the major complications of the prematurity. Any favourable results of this research could open new perspectives and original scenarios about the treatment or the prevention of this and other proliferative retinopathies. Trial Registration Current Controlled Trials ISRCTN18523491; ClinicalTrials.gov Identifier NCT01079715; EudraCT Number 2010-018737-21
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Affiliation(s)
- Luca Filippi
- Neonatal Intensive Care Unit, Department of Perinatal Medicine, A, Meyer University Children's Hospital, Florence, Italy.
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