Finger movements and fingers postures in pre-term infants are not a good indicator of brain damage.

The aim of the study was to analyse, with a more detailed classification the occurrence of movements and postures of the fingers in normal and brain damaged pre-term infants. To this end the same videorecordings of normal subjects of the study described by Cioni and Prechtl and those with defined brain lesions from the investigation by Ferrari et al. have been reanalysed. In three general movements, selected randomly from each infant, we assessed the finger movement. There was no systematic trend with age and the repertoire of finger patterns per observation varied between different individuals. Only one or two finger(s) move (pattern B) and synchronized finger opening-closing (pattern D) and the complex and variable movement of three or more fingers (pattern E) are all more often or even only seen during arm movements. Fisting without arm movement (pattern A-) was only seen less frequently in the control cases, in the infants with flares and one-sided lesions. On the other hand, the two latter groups had more often pattern C+ (opening of all fingers with arm movement) while B+ (only one or two fingers move with arm movement) and E+ (three or more fingers move variably with arm movement) was less frequent in the severely damaged infants. Albeit significant differences, the plotted data immediately show the large overlap of the findings between the groups. There was no difference in the fisting between low-risk and neurologically abnormal pre-term infants. These findings corroborate the conclusions that abnormal movements and postures are not useful in the diagnosis of pre-term infants with confirmed brain lesions because of the wide overlap between the values for normal and brain damaged infants.