title: Neurological assessment of Chinese infants with positional plagiocephaly using a Chinese version of the Infant Neurological International Battery (INFANIB).
abstract: OBJECTIVE
  Positional plagiocephaly (PP) is the most common subtype of asymmetric deformity in the infant skull. Cumulative evidence has demonstrated that PP is associated with abnormal neuromotor development; however, neurological assessment scores of infants with PP have not been well established, and PP has not attracted sufficient attention in China. This study used a Chinese version of the Infant Neurological International Battery (INFANIB) to identify neurological abnormalities among infants with PP and to determine the differences between infants with different (mild, moderate, and severe) degrees of PP.
  
  
  METHODS
  We compared the neurological evaluation scores between 393 infants with different degrees of PP and 390 healthy infants from 0 to 18 months of age using a Chinese version of the INFANIB.
  
  
  RESULTS
  The infants with PP aged 0-7.9 months had lower scores on the spasticity, head and trunk, leg, and French angle subscales and lower total scores than the normal infants. Additionally, the infants with PP aged 9-18 months showed statistically significantly lower scores on the spasticity, head and trunk, vestibular function, leg, and French angle subscales and total scores than the normal infants. Among the PP subgroups, the infants with mild PP had the highest scores, followed by the infants with moderate PP and the infants with severe PP. Compared with the normal infants, the infants with PP had abnormal neurological assessment scores, and the degree of neurological abnormality was associated with the severity of PP.
  
  
  CONCLUSIONS
  The INFANIB revealed neurological abnormalities, including asymmetric movements and abnormal muscle tone, postures, and reflexes, in infants with PP, especially those with moderate or severe PP. These abnormalities were similar to those of infants with cerebral palsy. Therefore, PP may serve as a marker of neurodevelopmental risk and should receive considerable attention. Whether moderate or severe PP is related to cerebral palsy remains to be confirmed in long-term follow-up studies and other future studies.
authors.affiliation: Department of Pediatrics, Xinqiao Hospital, Third Military Medical University, 2-V Xinqiao Street, Chongqing, 400037, China.
authors.forename: Xue-Qing
authors.initials: XQ
authors.lastname: Zhao
authors.affiliation: Department of Pediatrics, Xinqiao Hospital, Third Military Medical University, 2-V Xinqiao Street, Chongqing, 400037, China.
authors.forename: Li-Yan
authors.initials: LY
authors.lastname: Wang
authors.affiliation: Department of Pediatrics, Xinqiao Hospital, Third Military Medical University, 2-V Xinqiao Street, Chongqing, 400037, China.
authors.forename: Cong-Min
authors.initials: CM
authors.lastname: Zhao
authors.affiliation: Department of Pediatrics, Xinqiao Hospital, Third Military Medical University, 2-V Xinqiao Street, Chongqing, 400037, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Men
authors.affiliation: Department of Pediatrics, Xinqiao Hospital, Third Military Medical University, 2-V Xinqiao Street, Chongqing, 400037, China.
authors.forename: Zhi-Feng
authors.initials: ZF
authors.lastname: Wu
authors.affiliation: Department of Pediatrics, Xinqiao Hospital, Third Military Medical University, 2-V Xinqiao Street, Chongqing, 400037, China. yupingzhangtmmu@gmail.com.
authors.forename: Yu-Ping
authors.initials: YP
authors.lastname: Zhang
mesh_terms: D000367:Age Factors; D002681:China; D002658:Developmental Disabilities / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009460:Neurologic Examination / Q000379:methods*; D049068:Plagiocephaly, Nonsynostotic / Q000175:diagnosis*; D012189:Retrospective Studies; D014175:Translating
keywords: Cerebral palsy; Infant Neurological International Battery (INFANIB); Neurological abnormality; Positional plagiocephaly (PP)