Cerebral Palsy: Early Markers of Clinical Phenotype and Functional Outcome

Einspieler, C., Bos, A. F., Krieber-Tomantschger, M., Alvarado, E., Barbosa, V. M., Bertoncelli, N., Burger, M., Chorna, O., Del Secco, S., Deregnier, R-A., Huening, B., Ko, J., Lucaccioni, L., Maeda, T., Marchi, V., Martin, E., Morgan, C., Mutlu, A., Nogolova, A., Pansy, J., Peyton, C., Pokorny, F. B., Prinsloo, L. R., Ricci, E., Saini, L., Scheuchenegger, A., Silva, C. R. D., Soloveichick, M., Spittle, A. J., Toldo, M., Utsch, F., van Zyl, J., Vinals, C., Wang, J., Yang, H., Yardimci-Lokmanoglu, B. N., Cioni, G., Ferrari, F., Guzzetta, A. & Marschik, P. B., 4-Oct-2019, In : Journal of Clinical Medicine. 8, 10, 27 p., 1616.

Research output: Contribution to journalArticleAcademicpeer-review

  • Christa Einspieler
  • Arend F. Bos
  • Magdalena Krieber-Tomantschger
  • Elsa Alvarado
  • Vanessa M. Barbosa
  • Natascia Bertoncelli
  • Marlette Burger
  • Olena Chorna
  • Sabrina Del Secco
  • Raye-Ann Deregnier
  • Britta Huening
  • Jooyeon Ko
  • Laura Lucaccioni
  • Tomoki Maeda
  • Viviana Marchi
  • Erika Martin
  • Catherine Morgan
  • Akmer Mutlu
  • Alice Nogolova
  • Jasmin Pansy
  • Colleen Peyton
  • Florian B. Pokorny
  • Lucia R. Prinsloo
  • Eileen Ricci
  • Lokesh Saini
  • Anna Scheuchenegger
  • Cinthia R. D. Silva
  • Marina Soloveichick
  • Alicia J. Spittle
  • Moreno Toldo
  • Fabiana Utsch
  • Jeanetta van Zyl
  • Carlos Vinals
  • Jun Wang
  • Hong Yang
  • Bilge N. Yardimci-Lokmanoglu
  • Giovanni Cioni
  • Fabrizio Ferrari
  • Andrea Guzzetta
  • Peter B. Marschik

The Prechtl General Movement Assessment (GMA) has become a cornerstone assessment in early identification of cerebral palsy (CP), particularly during the fidgety movement period at 3-5 months of age. Additionally, assessment of motor repertoire, such as antigravity movements and postural patterns, which form the Motor Optimality Score (MOS), may provide insight into an infant's later motor function. This study aimed to identify early specific markers for ambulation, gross motor function (using the Gross Motor Function Classification System, GMFCS), topography (unilateral, bilateral), and type (spastic, dyskinetic, ataxic, and hypotonic) of CP in a large worldwide cohort of 468 infants. We found that 95% of children with CP did not have fidgety movements, with 100% having non-optimal MOS. GMFCS level was strongly correlated to MOS. An MOS > 14 was most likely associated with GMFCS outcomes I or II, whereas GMFCS outcomes IV or V were hardly ever associated with an MOS > 8. A number of different movement patterns were associated with more severe functional impairment (GMFCS III-V), including atypical arching and persistent cramped-synchronized movements. Asymmetrical segmental movements were strongly associated with unilateral CP. Circular arm movements were associated with dyskinetic CP. This study demonstrated that use of the MOS contributes to understanding later CP prognosis, including early markers for type and severity.

Original languageEnglish
Article number1616
Number of pages27
JournalJournal of Clinical Medicine
Issue number10
Publication statusPublished - 4-Oct-2019


  • cerebral palsy, dyskinesia, fidgety movements, general movements, GMFCS, hemiplegia, hypotonia, identification, motor optimality score, segmental movements, LOW-BIRTH-WEIGHT, GENERAL MOVEMENT ASSESSMENT, WHITE-MATTER PATHOLOGY, EARLY MOTOR REPERTOIRE, PRETERM-INFANTS, FULL-TERM, FIDGETY MOVEMENTS, SOCIOECONOMIC-STATUS, BABY-CIMT, CHILDREN

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