Peripheral nervous system maturation in preterm infants: longitudinal motor and sensory nerve conduction studies

  • S. Lori
  • Giovanna Bertini
  • M. Bastianelli
  • S. Gabbanini
  • D. Gualandi
  • E. Molesti
  • C. Dani
Original Paper
  • 31 Downloads

Abstract

Objective

To study the evolution of sensory-motor nerves in the upper and lower limbs in neurologically healthy preterm infants and to use sensory-motor studies to compare the rate of maturation in preterm infants at term age and full-term healthy neonates.

Methods

The study comprised 26 neurologically normal preterm infants born at 23–33 weeks of gestational age, who underwent sensory nerve conduction and motor nerve conduction studies from plantar medial and median nerves and from tibial and ulnar nerves, respectively. We repeated the same neurophysiological studies in 19 of the preterm infants every 2 weeks until postnatal term age. The data from the preterm infants at term was matched with a group of ten full-term babies a few days after birth.

Results

The motor nerve conduction velocity of the tibial and ulnar nerves showed progressive increases in values in relation to gestational age, but there was a decrease of values in distal latencies and F wave latencies. Similarly, there was a gradual increase of sensory nerve conduction velocity values of the medial plantar and median nerves and decreases in latencies in relation to gestational age. At term age, the preterm infants showed significantly lower values of conduction velocities and distal latencies than the full-term neonates. These results were probably because the preterm infants had significantly lower weights, total length and, in particular, distal segments of the limbs at term age.

Conclusion

The sensory-motor conduction parameters were clearly related to gestational age, but extrauterine life did not affect the maturation of the peripheral nervous system in the very preterm babies who were neurologically healthy.

Keywords

Myelination Nerve conduction Preterm infants Peripheral nervous system 

Abbreviations

cMAP

Compound muscle action potential

CNS

Central nervous system

GA

Gestational age

M-NCV

Motor nerve conduction velocity

PNS

Peripheral nervous system

SAP

Sensory action potential

S-NCV

Sensory nerve conduction velocity

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Bertini G (2009) The extremely preterm births in Florence. Arch Dis Child Fetal Neonatal Ed 94:231–232Google Scholar
  2. 2.
    Zeitlin J, Manktelow BN, Piedvache A, Cuttini M, Boyle E, van Heijst A et al (2016) Use of evidence based practices to improve survival without severe morbidity for very preterm infants: results from the EPICE population based cohort. BMJ i2976:354Google Scholar
  3. 3.
    Draper ES, Zeitlin J, Fenton AC, Weber T, Gerrits J, Martens G, Misselwitz B (2009) Breart G; MOSAIC research group. Investigating the variations in survival rates for very preterm infants in 10 European regions: the MOSAIC birth cohort. Arch Dis Child Fetal Neonatal Ed 94(3):F158–F163CrossRefPubMedGoogle Scholar
  4. 4.
    Marlow N, Wolke D, Bracewell MA, Samara M (2005) Neurologic and developmental disability at six years of age after extremely preterm birth. NEJM 352(1):9–19CrossRefPubMedGoogle Scholar
  5. 5.
    Salt A, Redshaw M (2006) Neurodevelopmental follow up after preterm birth: follow up after two years. Early Hum Dev 83:185–197CrossRefGoogle Scholar
  6. 6.
    Tranier S, Bougle D, Pottier M, Venezia R (1989) Maturation of peripheral nerves in preterm infants: proprioceptive and motor nerve conductions of tibial nerve. Brain and Development 11(4):215–220CrossRefPubMedGoogle Scholar
  7. 7.
    Bhatia BD, Prakash U (1993) Electrophysiological studies in preterm and growth retarded low birth weight babies. Electromyogr Clin Neurophysiol 33(8):507–509PubMedGoogle Scholar
  8. 8.
    De Vries LS, Heckmatt JZ, Burrin JM, Dubowitz LMS, Dubowitz V (1986) Low serum thyroxine concentrations and neural maturation in preterm infants. Arch Dis Child 61:862–866CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Bhatia BD, Prakash U, Singh MN, Gupta SK, Satya K (1991) Electrophysiological studies in newborns with reference to gestation and anthropometry. Electromyogr Clin Neurophysiol 31(1):55–59PubMedGoogle Scholar
  10. 10.
    Prakash U, Bhatia BD, Kumar M, Singh OP (1994) Electrophysiological studies (MNCV and H-RL) in twin babies. Electromyogr Clin Neurophysiol 34(6):351–354PubMedGoogle Scholar
  11. 11.
    Smit BJ, Kok JH, De Vries LS, Dekker FW, Ongerboer de Visser BW (1999) Motor nerve conduction velocity in very preterm infants. Muscle Nerve 22(3):372–377CrossRefPubMedGoogle Scholar
  12. 12.
    Parano E, Uncini A, De Vivo DC, Lovelace RE (1993) Electrophysiologic correlates of peripheral nervous system maturation in infancy and child. J Child Neurol 8:336–338CrossRefPubMedGoogle Scholar
  13. 13.
    Fangcheng C, Zhang J (1997) Study of nerve conduction and late responses in normal chinese infants, children and adults. J Chil Neurol 12:13–18CrossRefGoogle Scholar
  14. 14.
    Lien RJ, Naidich TP, Delman BN (2004) Embryogenesis of the peripheral nervous system. Neuroimaging Clin N Am 14:1–42CrossRefPubMedGoogle Scholar
  15. 15.
    Sarnat HB, Flores-Sarnat L (2005) Embryology of the neural crest: its inductive role in the neurocutaneous syndrome. J Child Neurol 20(8):637–643CrossRefPubMedGoogle Scholar
  16. 16.
    Mirsky R, Jessen KR, Brennan A, Parkinson D, Dong Z, Meier C, Parmantier E, Lawson D (2002) Schwann cells as regulators of nerve development. J Physiol Paris 96(1–2):17–24CrossRefPubMedGoogle Scholar
  17. 17.
    Volpe JJ (2001) Neurology of the newborns. Neuronal proliferation, migration, organization, and myelination 45–88Google Scholar
  18. 18.
    Garcia A, Calleja J, Antolin FM, Berciano J (2000) Peripheral motor and sensory nerve conduction study in normal infants and children. Clin Neurophysiol 111:513–520CrossRefPubMedGoogle Scholar
  19. 19.
    Garcia-Garcia A, Calleja-Fernandez J (2004) Neurophysiology of the development and maturation of the peripheral nervous system. Rev Neurol 38(1):79–83PubMedGoogle Scholar
  20. 20.
    Tombini M, Pasqualetti P, Rizzo C et al (2009) Extrauterine maturation of somatosensory pathways in preterm infants: a somatosensory evoked potential study. Clin Neurophysiol 120:783–789CrossRefPubMedGoogle Scholar
  21. 21.
    Cheng HL, Sullivan KA, Feldman EL (1996) Immunohistochemical localization of insulin-like growth factor binding protein-5 in the developing rat nervous system. Brain Res Dev Brain Res 92(2):211–218CrossRefPubMedGoogle Scholar
  22. 22.
    Pellitteri R, Zicca A, Mancardi GL, Savio T, Cadoni A (2001) Schwann cell-derived factors support serotoninergic neuron survival and promoteneurite outgrowth. Eur J Histochem 45(4):367–376CrossRefPubMedGoogle Scholar
  23. 23.
    Hellström A, Ley D, Hansen-Pupp I, Hallberg B, Löfqvist C, van Marter L, van Weissenbruch M, Ramenghi LA, Beardsall K, Dunger D, Hård AL, Smith LE (2016) Insulin-like growth factor 1 has multisystem effects on foetal and preterm infant development. Acta Paediatr 105(6):576–586CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Neurophysiology Unit, Neuro-Musculo-Skeletal DepartmentCareggi University HospitalFlorenceItaly
  2. 2.Department of Neurosciences, Psychology, Drug Research and Children’s HealthUniversity of FlorenceFlorenceItaly

Personalised recommendations