OC163: Functional studies of fetal CNS

Abstract

Congenital abnormalities resulting in abnormal motor activities are rare. Can assessment of motor activity, one of the functional aspects of the CNS, play an additional role in the prenatal diagnosis? A literature search on sonographically found motor anomalies in fetuses with congenital abnormalities afflicting the neuro-moto-skeletal development has been performed. Each case was examined for age-related differentiations into specific movement patterns and quality in performance of the general movement: variance in speed and distance, participation of all body parts in a not beforehand known order (complexity), fluency, coming and going activity. Until now 90 cases have been reported. Those authors who examined specific movement patterns found a reduced differentiation and reduced variability in performance. The latter could either be reduced speed, distance and complexity such as not all body parts participating or augmented speed and distance with reduced complexity concerning always all body parts active; abruptness and burst-pause patterns. Various reports on fetal hypokinesia sequence illustrate the early but various (first-second trimester) onset of the disease in reduced speed and distance of either upper or lower extremities. This retrospective evaluation of quality assessment of specific movement patterns reveals the possibilities of prenatal diagnosis for those neuro-musculo-skeletal diseases in which diagnosis through other imaging techniques or invasive techniques are still lacking. Moreover, the repeated assessments during pregnancies provided new insights in the ongoing destructive process of neuro-musculo-skeletal diseases. Future research focuses on the systematic approach of motor assessment in fetuses at risk for these diseases.