BACKGROUND Neonatal therapeutic hypothermia (TH) can ameliorate or prevent the development of dyskinetic cerebral palsy (CP) after hypoxic-ischemic encephalopathy (HIE). The Dyskinesia Impairment Scale (DIS) was recently launched to quantify dyskinetic (dystonic and choreatic) motor features in patients with CP. In TH treated children, who are at risk of developing dyskinetic CP, we aimed to determine DIS-scores at pre-school age. METHOD In 21 Dutch pre-school children (3-6 years of age) who had received TH according to the Dutch-Flemish treatment protocol, we determined DIS-scores. We associated DIS-scores with 1. age-matched control values (Kuiper et al., 2018) [1], and 2. previously reported DIS-score range in dyskinetic CP (Monbaliu E et al., 2015). RESULTS The motor phenotype was determined as: normal (n = 18/21), mildly impaired (reduced coordination (n = 2/21)) and abnormal (dyskinetic CP; n = 1/21). In absence of CP (n = 20/21), DIS-scores were lower (more favorable) than in dyskinetic CP, without any overlapping group scores (mean difference: 71 points; p < .05). However, the obtained DIS-scores were still higher than previously reported in healthy age-matched controls (mean difference: 14 points; p < .05). There was an association between DIS-scores and retrospective neonatal MRI (basal ganglia and thalamus injury on diffusion weighted imaging (DWI)) and (a)EEG parameters (p < .05). CONCLUSION In the vast majority (95%) of Dutch TH-HIE treated pre-school children, the phenotypic motor outcome was favorable. However, DIS-scores were moderately increased compared with healthy age-matched controls. Future studies may elucidate the significance of moderately increased DIS-scores should to further extent.

中文翻译：

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荷兰学龄前儿童新生儿低温治疗后运动障碍障碍量表评分

背景新生儿治疗性低温（TH）可以改善或预防缺氧缺血性脑病（HIE）后运动障碍性脑瘫（CP）的发展。最近推出了运动障碍障碍量表 (DIS)，以量化 CP 患者的运动障碍（肌张力障碍和舞蹈病）运动特征。对于有发生运动障碍 CP 风险的 TH 治疗儿童，我们旨在确定学龄前儿童的 DIS 分数。方法 在根据荷兰-佛兰芒治疗方案接受 TH 的 21 名荷兰学龄前儿童（3-6 岁）中，我们确定了 DIS 分数。我们将 DIS 分数与 1. 年龄匹配的对照值（Kuiper 等人，2018 年）[1] 和 2. 先前报告的运动障碍 CP 的 DIS 分数范围相关联（Monbaliu E 等人，2015 年）。结果 运动表型确定为：正常（n = 18/21），轻度受损（协调性降低（n = 2/21））和异常（运动障碍 CP；n = 1/21）。在没有 CP (n = 20/21) 的情况下，DIS 分数低于（更有利）运动障碍 CP，没有任何重叠的组分数（平均差异：71 分；p < .05）。然而，获得的 DIS 分数仍高于先前在健康年龄匹配的对照中报告的分数（平均差异：14 分；p < .05）。DIS 评分与回顾性新生儿 MRI（弥散加权成像 (DWI) 上的基底神经节和丘脑损伤）和 (a) EEG 参数（p < .05）之间存在关联。结论 在绝大多数 (95%) 荷兰 TH-HIE 治疗的学龄前儿童中，表型运动结果是有利的。然而，与年龄匹配的健康对照相比，DIS 分数适度增加。