Visual function in term infants with hypoxic-ischaemic insults: correlation with neurodevelopment at 2 years of age

Abstract

Aims-To determine if there is any association between the findings of visual assessment performed at the age of 5 months and neurodevelopmental outcome at the age of 2 years in children who have sustained hypoxic-ischaemic insults. Methods-Twenty nine term infants with hypoxic-ischaemic encephalopathy and/or brain lesions on neonatal magnetic resonance imaging (MRI) were prospectively evaluated. At 5 months of age all the infants had their visual function assessed using the Atkinson Battery of Child Development for Examining Functional Vision, which includes the assessments of optokinetic nystagmus (OKN), acuity, visual fields, fixation shift and phase and orientation reversal visual evoked potentials. At 2 years of age the children had a structured neurological evaluation and a GriYths developmental assessment. Results-There was good correlation between the extent of the early detected visual impairment and both neuromotor and global development. Children with more than three out of five abnormal visual tests at 5 months of age tended to have abnormal neurological examination results and abnormal developmental quotients. Children with three or fewer abnormalities tended to have developmental quotients in the normal range; the level of their performance, however, was still related to the number of visual tests passed. Conclusions-Individual visual tests can provide important prognostic information. While abnormal OKN and acuity were always associated with abnormal outcome, normal results on visual evoked potentials and fixation shift tended to be associated with normal outcome. (Arch Dis Child Fetal Neonatal Ed 1999;80:F99-F104)

A prospective longitudinal study on visuo-cognitive development in Dravet syndrome: Is there a “dorsal stream vulnerability”?

“…These findings appeared to suggest a possible predictive value of the impaired visual function towards cognitive decline, and different causative factors other than seizures. This is in keeping with previous studies also showing that the assessment of visual function in the first months of life, providing an evaluation of precognitive skills can predict subsequent cognitive development (Weisglas-Kuperus et al, 1993;Mercuri et al, 1999;Atkinson and Braddick, 2007;Guzzetta et al, 2008).…”

Frontal Cortex Functioning in Infancy

“…Gap task performance seemed to tap into more general mechanisms of cognitive function, at least when assessed at 4 months of age. This is consistent with studies showing disengagement problems in children with developmental disorders (Landry & Bryson, 2004;Lasker et al, 2007;Zwaigenbaum et al, 2005) as well as in infants with early neurological damage associated with later cognitive deficits (Atkinson & Braddick, 2007;Mercuri et al, 1999). However, as discussed above, the Gap task did show some association with another frontal cortex task administered at the same age (the Anticipation task).…”

“…The association between performance on the Gap task and developmental delay has generally been observed in older infants and young children (Landry & Bryson, 2004;Lasker et al, 2007;Zwaigenbaum et al, 2005) and in longitudinal studies of paediatric populations (Atkinson & Braddick, 2007;Mercuri et al, 1999). The current study adds to this evidence by suggesting that performance on the Gap task at the age where the ability to disengage attention has just developed (Hood & Atkinson, 1993;Johnson et al, 1991) predicts cognitive ability later in the first year of life in typically developing infants.…”

“…These disorders are often associated with developmental delay and other cognitive deficits. Furthermore, very premature infants, who often suffer varying degrees of neurological damage, and infants with neonatal brain damage perform poorly on Atkinson et al's (1992) fixation shift task (Atkinson & Braddick, 2007;Mercuri et al, 1997aMercuri et al, , 1997bMercuri et al, 1996), and this impairment is associated with more general cognitive deficits later in childhood (Atkinson & Braddick, 2007;Mercuri et al, 1999). However, disengagement difficulty is not always linked to developmental problems since children with Down syndrome have better performance on the Overlap condition of the Gap task than normal controls (Landry & Bryson, 2004).…”

The relationship between brain structure and function of very preterm infants, and the ability to predict neurodevelopmental outcomes

“…The battery is easy to perform, does not require long training, and can be performed reliably from 32 weeks PMA 156 . It has been demonstrated to contribute to prediction of neurodevelopmental outcome in preterm babies [157][158][159] . The overall sensitivity and specificity of Neonatal Visual Assessment to predict 12 month CA visual scores were 90% and 63% respectively in 121 preterm infants 158 .…”