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Biomedical subjects

M Jongmans

Publications and source records attributed to M Jongmans.

11 recordsLinked to original sources

Congenital hemiplegia in children at school age: assessment of hand function in the non-hemiplegic hand and correlation with MRI.

The aim of this study was to evaluate whether children with congenital hemiplegia show abnormal hand function on the non-hemiplegic side and whether this, if present, can be related to the type and extent of brain lesions on MRI. Twenty-two children with congenital hemiplegia of age ranging between 4.8 and 12.3 years, were assessed with a clinical and MRI assessment. Clinical assessment included a structured neurological examination, assessment of hand grips and the Movement Assessment Battery for Children which also includes one item assessing speed and accuracy in each hand. The results showed that 64% of the children studied showed some degree of functional impairment of the non-hemiplegic hand. Manual dexterity 1 from the Movement ABC was, in our experience, a more sensitive tool to detect minor functional abnormalities than the evaluation of hand grips. The severity of the impairment on the non-hemiplegic side was not significantly related to the severity of impairment in the hemiplegic hand (p > 0.05). In contrast, a significant association was found with the site of lesions as hand function in the non-hemiplegic hand was always normal in children with unilateral lesion and abnormal in the ones with bilateral parenchymal lesions (p < 0.05). Children with predominantly unilateral lesions but with bilateral ventricular dilatation or periventricular changes showed more variable results.

Brain↗

Minor neurological signs and perceptual-motor difficulties in prematurely born children.

AIM: To examine the spectrum of neurological dysfunction and perceptual-motor difficulties at school age in a cohort of prematurely born children, and the relation of these measures to neonatal brain lesions, intelligence quotient, and behavioural adjustment. METHOD: One hundred and eighty three children were tested at the age of 6 years using Touwen's Examination of the Child with Minor Neurological Dysfunction, the Movement Assessment Battery for Children (Movement ABC), the Developmental Test of Visual-Motor Integration (VMI), British Ability Scales, and Rutter Scales. RESULTS: Twenty six children had definite cerebral palsy and one was blind. Of the remaining 156, the proportions falling below the 15th centile point were 31% on Touwen's Examination, 44% on the Movement ABC, and 17% on the VMI. Forty two passed all three tests. No child with a normal ultrasound scan developed cerebral palsy, whereas nearly all those with major lesions did. Minor lesions, however, were not generally predictive of later outcome. Correlations between the tests were generally low. CONCLUSIONS: These findings stress the need to assess neurological and perceptual motor functioning separately at school age and to monitor relationships with other aspects of development.

Analysis of Variance↗

Visual function of prematurely born children with and without perceptual-motor difficulties.

The relationship between visual and perceptual-motor abilities at 6 years of age was investigated in a cohort of 141 prematurely born children without cerebral palsy. Visual acuity was assessed using the Sonksen-Silver Acuity System and stereopsis with the Titmus stereo test. Perceptual motor abilities were evaluated using the Movement Assessment Battery for Children and the Developmental Test of Visual-Motor Integration. The results showed a higher incidence of abnormalities both of linear acuity and stereopsis in the study group when compared to a group of reference children. Whereas abnormalities of linear acuity were not associated with perceptual-motor difficulties, abnormal stereopsis was significantly associated with poor performance on both perceptual-motor tests. Our results suggest that infants born preterm, even in the absence of other major neurological signs, are at risk for abnormal visual function and perceptual-motor difficulties. As these could interfere with everyday life and school performance, a longitudinal assessment of both areas of competencies is recommended so that diagnosis and possible intervention can take place as early as possible.

Brain Diseases↗

Evaluation of the corpus callosum in clumsy children born prematurely: a functional and morphological study.

The aim of this study was to evaluate the incidence of functional and neuroradiological abnormalities of the corpus callosum in a group of 21 prematurely born children (GA < 34 weeks) who were found to be "clumsy" on the Movement Assessment Battery for Children at 6 years of age. All children underwent functional and morphological assessment of the corpus callosum. The functional assessment included tests of somesthesis, diadochokinesis and repetitive finger tapping. The morphology of the corpus callosum was evaluated on midsagittal MRI. Thirteen of the 21 clumsy children showed morphological abnormalities which were significantly associated with functional abnormalities. Morphological changes of the corpus callosum were also significantly associated with lesions on both neonatal ultrasound and late MRI. Our results support the view that morphological abnormalities of the corpus callosum are frequent in children born prematurely. The association between these abnormalities and lesions on US or MRI suggests that they are likely to be secondary to pre- or perinatal lesions.

Agenesis of Corpus Callosum↗

Effect of cerebral lesions on continuous performance test responses of school age children born prematurely.

Examined attention skills, as measured by the Continuous Performance Test (CPT), in a group of 64 children born premature and 40 full-term children, ages 6 to 8 years. Premature children were classified by neonatal cerebral lesions into no lesion, mild lesion, and severe lesion groups. It was predicted that severity of lesion would be associated with CPT performance. While mean differences among the groups of prematures did not reach significance, children with severe lesions made significantly more errors of omission and commission than the full-term comparison group. Children with mild lesions were poorer than full terms in errors of commission. Children with no lesions also made more errors of omission and commission than full terms, suggesting attention deficits secondary to prematurity even in the absence of identified brain lesion. With increasing severity of lesion, increasing percentages of each group were found to perform more than 2 SD below the mean in errors of commission. Results suggest that premature children, with and without identified lesions, are at risk for attention deficits.

Attention↗

How local is the impact of a specific learning difficulty on premature children's evaluation of their own competence?

The aim of this study was to determine whether children's perceptions of their own competence levels reflected their actual strengths and weaknesses (Specificity Hypothesis) or transcended these (Generality Hypothesis). Harter and Pike's measure of self-perception was administered to 163 prematurely born 6-year-olds with or without motor co-ordination and/or reading problems. Associations between children's self-perceptions and their scores on standardised tests of motor co-ordination and reading were assessed in three distinct ways. These analyses produced converging results: self-perceptions of physical competence were associated specifically with performance on the Movement ABC Test, and self-perceptions of cognitive competence were associated specifically with performance on the BAS Word Reading Scale. Our results support the Specificity Hypothesis.

Achievement↗

Minor neurological and perceptuo-motor deficits in children with congenital muscular dystrophy: correlation with brain MRI changes.

Diffuse white matter changes on magnetic resonance imaging (MRI) have been a consistent feature in some children with the "pure" form of congenital muscular dystrophy (CMD) in which there are no structural changes in the brain or severe mental retardation. The aim of this study was to assess fine motor and perceptuo-motor abilities in children with CMD with and without MRI changes. Twenty-two children with "pure" CMD were investigated with a standard neurological examination and a battery of tests (Manual dexterity from the Movement ABC, test of visual-motor integration, Zurich Neuromotor test) which have already been used to detect minor neurological signs related to white matter changes. The cohort was then divided in two groups for analysis depending on the presence or the absence of diffuse white matter changes. A significant difference was found for all the tests between the group of the CMD children with normal MRI and the group with diffuse white matter changes. The manual dexterity and the Zurich Neuromotor tests showed a greater sensitivity than the test of visual-motor integration, which had some false negatives. It is of interest that in the group with diffuse white matter changes the presence of contractures or weakness did not seem to affect the quality of the performance; all these children scored abnormally on the test, irrespective of the severity or the extent of contractures and weakness. In contrast, in children with normal MRI severe contractures and weakness did affect the performances. Our results demonstrate that perceptuo-motor difficulties and minor neurological soft signs are a consistent feature in CMD children with diffuse MRI changes but not with normal MRI.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Duration of periventricular densities in preterm infants and neurological outcome at 6 years of age.

Parenchymal echogenicities that break down into extensive cystic lesions are generally followed by severe motor deficit. However, the effect of echodensities in the periventricular white matter, so called 'flares', on later development is less well documented. The aim of the present study was to investigate the impact of neonatal flares in preterm infants on neurological status and motor competence at 6 years of age and to see to what extent outcome was related to duration of flares. Forty four children with flares, subdivided into three groups according to the duration of flares, and 62 children with normal scans were assessed on Touwen's neurological examination, the Movement ABC, and the British Ability Scales. No differences in cognitive abilities were found between the groups. The results of the motor assessments showed that performance decreased significantly with increasing duration of flares. In addition, there was a suggestion that this trend was stronger in measures assessing lower limb function than those of upper limb. Teachers were also able to identify differences between the groups of children on the basis of their motor performance in school.

Activities of Daily Living↗

Clumsiness in children--do they grow out of it? A 10-year follow-up study.

The question of whether problems of motor co-ordination in early childhood recede with age has rarely been addressed. This paper reports the findings from a follow-up study of 17 children, identified by their teachers as having poor motor co-ordination at age six. Now age 16, these children and their matched controls completed a battery of assessments. The results suggest that the majority of children still have difficulties with motor co-ordination, have poor self-concept and are experiencing problems of various kinds in school. However, there are individual differences in the extent to which the children have learned to cope with their continuing difficulties over the years.

Achievement↗

Antiperinuclear factor: indicator of more severe disease in seronegative rheumatoid arthritis.

The specificity of antiperinuclear factor (APF) for patients with rheumatoid arthritis (RA) is well documented. It is unknown whether detection of these antibodies adds information to the detection of rheumatoid factor (RF). In a group of 132 patients with RA, 94 were RF positive. Of the 38 patients persistently negative for RF, 14 (37%) were positive for APF. These 14 proved to have a disease course similar to that of RF positive patients. This similarity was shown most impressively by radiological progression of the disease, and to a lesser extent, by the medication needed to control the disease and the number of extraarticular manifestations. No significant correlation was shown between APF and antinuclear antibodies. Among the RF positive patients with their generally poorer prognosis, APF identified the worst affected. Our study suggests that APF in serum of patients with RA is associated with a poor disease outcome, especially in RF negative patients.

Adult↗