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Entwicklungsneurologie – vernetzte Medizin und neue Perspektiven

Developmental neurology – networked medicine and new perspectives

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Zusammenfassung

Die Entwicklungsneurologie ist einer der großen Bereiche der Kinderneurologie. Sie hat u. a. die (gesetzliche) Aufgabe, mithilfe standardisierter Nachsorgeuntersuchungen die motorische, kognitive und psychosoziale Entwicklung von Frühgeborenen vor der 32. Schwangerschaftswoche (unter 1500 g Geburtsgewicht), ebenso aber auch aller anderen Risikokinder engmaschig und standardisiert zu begleiten. Abweichungen von der „normalen“ altersentsprechenden Entwicklung sollen durch eine frühestmögliche Diagnosestellung zu einer frühen Therapieeinleitung („early intervention“) führen und die Langzeitprognose der Patienten positiv beeinflussen. Die hierfür zu Verfügung stehenden Methoden mit Schwerpunkt auf aktuellen Neuentwicklungen werden beleuchtet. Mit einem Fokus auf Früherkennung wird besonders auf den prädiktiven Wert der „general movements“ (GMs) eingegangen. Dabei wird die fortschreitende Entwicklung der automatisierten, markerlosen Bewegungsanalyse beispielhalft an drei Patienten (gesund vs. genetisches Syndrom vs. Zerebralparese) im Alter von 12 Wochen mithilfe herkömmlicher Tiefenbildkameras veranschaulicht und diskutiert.

Abstract

Developmental neurology is one of the major areas of neuropediatrics and is among other things (legally) responsible for monitoring the motor, cognitive and psychosocial development of all infants using standardized monitoring investigations. The special focus is on infants born at risk and/or due to premature birth before 32 weeks of gestation or a birth weight less than 1500 g. Early diagnosis of deviations from normal, age-related development is a prerequisite for early interventions, which may positively influence development and the long-term biopsychosocial prognosis of the patients. This article illustrates the available methods in developmental neurology with a focus on recent developments. Particular attention is paid to the predictive value of general movements (GM). The current development of markerless automated detection of spontaneous movements using conventional depth imaging cameras is demonstrated. Differences in spontaneous movements in infants at the age of 12 weeks are illustrated and discussed exemplified by three patients (healthy versus genetic syndrome versus cerebral palsy).

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Authors and Affiliations

  1. Abteilung für Neuropädiatrie und Entwicklung, Universitäts-Kinderspital beider Basel (UKBB), Spitalstraße 33, Postfach, 4031, Basel, Schweiz

    U. Tacke

  2. Abteilung für Pädiatrische Neurologie und Entwicklungsneurologie LMU Zentrum – iSPZ Hauner, Kinderklinik und Kinderpoliklinik, Dr. von Haunersches Kinderspital der Universität München, München, Deutschland

    H. Weigand-Brunnhölzl, A. Hilgendorff, R. M. Giese, H. König, B. Warken-Madelung & A. S. Schroeder

  3. Institut für Lungenbiologie Comprehensive Pneumology Center (CPC), Helmholz-Zentrum München, Deutsches Forschungszentrum für Gesundheit und Umwelt, München, Deutschland

    A. Hilgendorff

  4. Neonatologie der Kinderklinik am Perinatalzentrum, Klinikum der LMU-München, Campus Großhadern, München, Deutschland

    A. W. Flemmer

  5. Fraunhofer Institut für Optronik, Systemtechnik und Bildauswertung (IOSB), Ettlingen, Deutschland

    M. Arens & N. Hesse

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  1. U. Tacke
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  9. N. Hesse
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  10. A. S. Schroeder
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Correspondence to U. Tacke.

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Interessenkonflikt

U. Tacke, H. Weigand-Brunnhölzl, A. Hilgendorff, R. M. Giese, A. W. Flemmer, H. König, B. Warken-Madelung, M. Arens, N. Hesse und A.S. Schroeder geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

Additional information

Dieser Artikel ist dem Nestor der Entwicklungsneurologie in Deutschland, Richard Michaelis aus Tübingen (1934–2017), gewidmet.

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Tacke, U., Weigand-Brunnhölzl, H., Hilgendorff, A. et al. Entwicklungsneurologie – vernetzte Medizin und neue Perspektiven. Nervenarzt 88, 1395–1401 (2017). https://doi.org/10.1007/s00115-017-0436-6

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