Papers by Christa Einspieler
Klinische Neurophysiologie, 2011
Theoretical Medicine and Bioethics, Sep 30, 1986
Risk is the probability that within a certain time some expected negative event will take place. ... more Risk is the probability that within a certain time some expected negative event will take place. In medicine risk can be related to a decision or to some intrinsic factors wh ich are associated with the probability of the occurrence of a disease. Decisions can be necessary in the individual life with respect to the question of visiting a physician or performing a certain diagnostic or therapeutic procedure. The introductio n of new pharmaceutical o r technical products into medical use are another set of deci sio ns which can ge nerate certain risks. Intrinsic or inherent ri sk factors are a set of variab les o r signs and symptoms which indicate the presence of a certain probability that some disease or event, e.g., arteriosclerosis or sudden infant death syndrome, may occur. Risk is always related to judgement. In a decision process cost, effectiveness and profit can be used to estimate the magn itude of the risk to be taken. In a similar way the problems in con nection with an inherent risk are primarily rel ated to th e recognition of the magnitude of risk and to the possibility of prophylactic measures.
Develop Med Child Neurol, 2007
... Arend F Bos* MD PhD, Neonatologist, Department of Pediatrics, Beatrix Children's Hos... more ... Arend F Bos* MD PhD, Neonatologist, Department of Pediatrics, Beatrix Children's Hospital, University Hospital, Groningen, The Netherlands; Christa Einspieler PhD, Associate Professor of ... born N=88 McCarthy motor scores, groups Wechsler Intelligence Scale for Children ...
Journal of Child Psychology and Psychiatry and Allied Disciplines, May 1, 2009
Background: The quality of very preterm infants' spontaneous movements at 11 to 16 weeks post-ter... more Background: The quality of very preterm infants' spontaneous movements at 11 to 16 weeks post-term age is a powerful predictor of their later neurological status. This study investigated whether early spontaneous movements also have predictive value for the intellectual and behavioural problems that children born very preterm often experience. Methods: Spontaneous movement quality was assessed, using Prechtl's method, at 11 to 16 weeks post-term in 65 infants born at £ 33 weeks of gestation in a single centre. Intelligence and behaviour were assessed with standardised tests at 7 to 11 years of age. Neurological status was assessed with Touwen's test. Multiple regression was used to determine the predictive value of movement quality for intelligence and behavioural problems. The Sobel test was used to determine if neurological status mediated associations found between early movement quality and outcome. Results: Spontaneous movement quality at 11 to 16 weeks post-term was significantly, positively associated with later intelligence. The number of normal postural patterns displayed contributed most strongly to the association, which was not mediated by neurological status. Fidgety movements, strong predictors of later neurological dysfunction, were not associated with intelligence. Spontaneous movement quality was not associated with internalising or externalising problems but showed a trend to an association with attention problems. Conclusion: These findings suggest that, in children born preterm, early spontaneous movement quality has clear prognostic value for neurological and intellectual outcome, and to a lesser extent, for attentional outcome. However, cognitive outcome was associated with the presence of specific, age-appropriate postural patterns, while neurological outcome has been associated with the presence of global movement abnormalities. The presence of specific, age-appropriate postural patterns may reflect the integrity of areas of the brain involved in cognitive processing and the regulation of attention later in childhood. Alternately, it may facilitate cognitive and attentional development.
Developmental medicine and child neurology, Jan 14, 2015
To explore the appropriateness of applying a detailed assessment of general movements and charact... more To explore the appropriateness of applying a detailed assessment of general movements and characterize the relationship between global and detailed assessment. The analysis was based on 783 video recordings of 233 infants (154 males, 79 females) who had been videoed from 27 to 45 weeks postmenstrual age. Apart from assessing the global general movement categories (normal, poor repertoire, cramped-synchronized, or chaotic general movements), we scored the amplitude, speed, spatial range, proximal and distal rotations, onset and offset, tremulous and cramped components of the upper and lower extremities. Applying the optimality concept, the maximum general movement optimality score of 42 indicates the optimal performance. General movement optimality scores (GMOS) differentiated between normal general movements (median 39 [25-75th centile 37-41]), poor repertoire general movements (median 25 [22-29]), and cramped-synchronized general movements (median 12 [10-14]; p<0.01). The optima...
Research in Developmental Disabilities, 2015
This study compared early markers of social reciprocity in children with typical Rett syndrome (R... more This study compared early markers of social reciprocity in children with typical Rett syndrome (RTT) and in those with the preserved speech variant (PSV) of RTT. Retrospective video analysis of 10 toddlers with typical RTT and five with PSV investigated participants&amp;amp;amp;amp;amp;amp;amp;amp;#39; orientation to their name being called between the ages of 5 and 24 months, prior to their diagnosis. From analysis of the recordings two distinct profiles were apparent. Although response rate was higher in girls with typical RTT than PSV at 5 to 8 months this noticeably reversed from 9 to 12 months onwards. By two years of age there was a markedly higher rate and range of responses from girls with PSV. This study contributes to the delineation of different profiles for the variants of RTT.
International Journal of Developmental Neuroscience, 2008
Cadherins and their essential adaptor proteins, catenins, are widely expressed in neurons. These ... more Cadherins and their essential adaptor proteins, catenins, are widely expressed in neurons. These complex proteins bridge the extracellular and intracellular environment, interact with several signalling pathways, and regulate a variety of developmental processes in the nervous system. The p120 catenin has been demonstrated to mediate important postsynaptic roles such as regulating dendritic spine and synapse development in vitro and in vivo (Elia et al., 2006). In the present work, we examine the presynaptic role of p120 by investigating functional consequences of p120 loss in hippocampal neurons. We find that p120 deletion leads to a large reduction in the frequency of spontaneous excitatory synaptic miniature events compared to control wildtype (WT) neurons. In addition, using dual-neuron patch-clamp recordings we measured a dramatic switch in the paired-pulse ratio in p120 deleted compared to WT neurons. Our evoked EPSC results further show an increase in the coefficient of variation of EPSC size in p120 deleted neurons, but do not detect any significant alterations on the ratio of AMPA receptor-mediated currents and NMDA receptor-mediated currents. These results together indicate a presynaptic role of p120. Such presynaptic regulation by the cadherin-catenin pathway may contribute to the stability and plasticity of synaptic transmission, and reveals a critical role for p120 catenin in the normal presynaptic function of CNS neurons.
International Journal of Human-computer Studies / International Journal of Man-machine Studies, 2009
The Lancet, 1997
In normal awake infants, fidgety movements are seen from the age of 6 weeks to 20 weeks. The aim ... more In normal awake infants, fidgety movements are seen from the age of 6 weeks to 20 weeks. The aim of the study was to test the predictive value of absent or abnormal spontaneous movements in young infants for the later development of neurological deficits. In a collaborative study involving five hospitals we collected data on the normal and abnormal quality of fidgety movements of 130 infants and compared it with assessments of neurological development done longitudinally until the age of 2 years. On the basis of ultrasound scans infants were classified as at low-risk or at high-risk of neurological deficits. Infants were videoed for 1 h every week from birth to discharge and then for 15 min every 3 to 4 weeks; quality of general movements was assessed. Repeated neurological assessments were also done until 24 months of corrected age. 67 (96%) of 70 infants with normal fidgety movements had a normal neurological outcome. Abnormal quality or total absence of fidgety movements was followed by neurological abnormalities in 57 (95%) of the 60 infants (49 had cerebral palsy and eight had developmental retardation or minor neurological signs). Specificity and sensitivity of fidgety movement assessment were higher (96% and 95%, respectively) than of ultrasound imaging of the infants&amp;amp;#39; brain (83% and 80%, respectively). Our technique of assessing spontaneous motor activity can identify and distinguish between those infants who require early intervention for neurological abnormalities and those who do not. Our technique is simple, non-intrusive, reliable, quick, and can be done on very young infants.
Background: The quality of very preterm infants' spontaneous movements at 11 to 16 weeks post-ter... more Background: The quality of very preterm infants' spontaneous movements at 11 to 16 weeks post-term age is a powerful predictor of their later neurological status. This study investigated whether early spontaneous movements also have predictive value for the intellectual and behavioural problems that children born very preterm often experience. Methods: Spontaneous movement quality was assessed, using Prechtl's method, at 11 to 16 weeks post-term in 65 infants born at £ 33 weeks of gestation in a single centre. Intelligence and behaviour were assessed with standardised tests at 7 to 11 years of age. Neurological status was assessed with Touwen's test. Multiple regression was used to determine the predictive value of movement quality for intelligence and behavioural problems. The Sobel test was used to determine if neurological status mediated associations found between early movement quality and outcome. Results: Spontaneous movement quality at 11 to 16 weeks post-term was significantly, positively associated with later intelligence. The number of normal postural patterns displayed contributed most strongly to the association, which was not mediated by neurological status. Fidgety movements, strong predictors of later neurological dysfunction, were not associated with intelligence. Spontaneous movement quality was not associated with internalising or externalising problems but showed a trend to an association with attention problems. Conclusion: These findings suggest that, in children born preterm, early spontaneous movement quality has clear prognostic value for neurological and intellectual outcome, and to a lesser extent, for attentional outcome. However, cognitive outcome was associated with the presence of specific, age-appropriate postural patterns, while neurological outcome has been associated with the presence of global movement abnormalities. The presence of specific, age-appropriate postural patterns may reflect the integrity of areas of the brain involved in cognitive processing and the regulation of attention later in childhood. Alternately, it may facilitate cognitive and attentional development.
Klin. Neurophysiol., 2013
Wiener Klinische Wochenschrift, 2003
Research in Developmental Disabilities, 2014
We investigated the early socio-communicative development of individuals with fragile X syndrome ... more We investigated the early socio-communicative development of individuals with fragile X syndrome (FXS) by undertaking a retrospective analysis of family videos. Videos were analyzed to identify existing communicative forms and functions. Analyses were undertaken on seven children who were later diagnosed with FXS. The children were filmed when they were 9-12 months old and before being diagnosed. Fourteen different communicative forms and six different communicative functions were observed. All participants were observed to express the functions of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;Attention to self&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;Answering&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;, but none indicated &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;Requesting action&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;, &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;Requesting information&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;, &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;Choice making&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;, or &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;Imitating&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;. Results suggest that children with FXS may have a limited range of communicative forms and functions when they are from 9 to 12 months of age. However, further research is necessary to gain a specific developmental profile of socio-communicative forms and functions in FXS.
Pediatric Research, 2005
An apparently normal early development was one of the initial criteria for classical Rett syndrom... more An apparently normal early development was one of the initial criteria for classical Rett syndrome. However, several investigators considered Rett syndrome to be a developmental disorder manifesting very soon after birth. Videos of 22 Rett cases were assessed carefully for movements, posture, and behavior during the first 6 mo of life. All signs that deviated from the normal standard were recorded meticulously. Special attention was paid to the face, the hands, and body movements. A detailed analysis clearly demonstrated an abnormal quality of general movements (100%), tongue protrusion (62%), postural stiffness (58%), asymmetric eye opening and closing (56%), abnormal finger movements (52%), hand stereotypies (42%), bursts of abnormal facial expressions (42%), bizarre smile (32%), tremor (28%), and stereotyped body movements (15%). Our study is the first to apply specific standardized measures of early spontaneous movements to Rett infants, proving conclusively that the disorder is manifested within the first months of life. Although not necessarily specific, the signs that we have observed will be of value in alerting clinicians to the possibility of the diagnosis at an early stage, when intervention is likely to be most effective.
Neuropediatrics, 2002
Qualitative abnormalities of spontaneous motor activity in newborns and young infants are early p... more Qualitative abnormalities of spontaneous motor activity in newborns and young infants are early predictive markers for later spastic cerebral palsy. Aim of this research was to identify which motor patterns may be specific for later dyskinetic cerebral palsy. In a large, prospectively performed longitudinal study involving four European hospitals we identified twelve cases with the relatively rare condition of dyskinetic cerebral palsy and compared their early motor development with twelve spastic cerebral palsy cases and twelve controls. From birth to the fifth month post-term, all infants were repeatedly videoed and their spontaneous motor patterns, including general movements, were assessed. Until the second month post-term, the infants that later became dyskinetic displayed a poor repertoire of general movements, ªarm movements in circlesº and finger spreading. Abnormal arm and finger movements remained until at least five months and were then concurrent with a lack of arm and leg movements towards the midline. Later dyskinetic infants share with later spastic infants the absence of fidgety movements, a spontaneous movement pattern that is normally present from three to five months. Qualitative assessment of spontaneous motor patterns enabled us to identify infants at high risk for dyskinetic cerebral palsy early in life. Additionally, we were able to discriminate them from those infants at high risk for later spastic cerebral palsy. This is a matter of significant clinical relevance because the two types of cerebral palsy ask for different management and early intervention.
Neonatology, 2008
Background: The qualitative assessment of general movements (GMs) proved to be a highly sensitive... more Background: The qualitative assessment of general movements (GMs) proved to be a highly sensitive and specific diagnostic tool for the assessment of the integrity of the young nervous system. It is essential that the quality of GMs remains consistent in an individual during a given recording at a certain date. Objectives: The aim of the study was to investigate the intra-individual consistency of the quality of GMs during one recording. Methods: 39 preterm infants were recorded at least twice; some were recorded three times. In all, 88 recordings were available but three recordings were excluded due to frequent crying, seizures or hypokinesia. Three scorers assessed 2-3 sequences of these 85 GM recordings. Results: The inter-scorer agreement was high ( 0.85-0.94). Intra-individual consistency revealed a of 0.90 with a 95% CI (0.51, 1.00) for preterm GMs, 0.96 with a 95% CI (0.57, 1.00) for writhing GMs, and 0.92 with a 95% CI (0.53, 1.00) for fidgety GMs. Conclusions: The individual quality of GMs remains consistent for a neonate or young infant at a certain date.
Laterality: Asymmetries of Body, Brain and Cognition, 2007
The aim of the study was to describe a developmental trend of hand use for picking up and stackin... more The aim of the study was to describe a developmental trend of hand use for picking up and stacking blocks from the age of 18 months to 7 years. A second aim was to determine whether there is a relationship between right-hand use while building a tower and manual laterality at school age. A total of 28 children were asked to build a tower at five longitudinal assessments. The use of the right hand fluctuated considerably with age (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;.05), but no age-related increase was observed. Right-hand use was rather prominent at 18 months, decreased significantly at 26 months, increased at age 4;7, decreased again at 5;7, and finally increased again at age 7. From age 4;7 onwards, the percentage of right-hand use for stacking the blocks was significantly (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;.05) related to the laterality quotient at school age.
Uploads
Papers by Christa Einspieler