Developmental Medicine and Child Neurology最新文献

{"title":"Wearable sensors in paediatric neurology.","authors":"Camila González Barral, Laurent Servais","doi":"10.1111/dmcn.16239","DOIUrl":"https://doi.org/10.1111/dmcn.16239","url":null,"abstract":"<p><p>Wearable sensors have the potential to transform diagnosis, monitoring, and management of children who have neurological conditions. Traditional methods for assessing neurological disorders rely on clinical scales and subjective measures. The snapshot of the disease progression at a particular time point, lack of cooperation by the children during assessments, and susceptibility to bias limit the utility of these measures. Wearable sensors, which capture data continuously in natural settings, offer a non-invasive and objective alternative to traditional methods. This review examines the role of wearable sensors in various paediatric neurological conditions, including cerebral palsy, epilepsy, autism spectrum disorder, attention-deficit/hyperactivity disorder, as well as Rett syndrome, Down syndrome, Angelman syndrome, Prader-Willi syndrome, neuromuscular disorders such as Duchenne muscular dystrophy and spinal muscular atrophy, ataxia, Gaucher disease, headaches, and sleep disorders. The review highlights their application in tracking motor function, seizure activity, and daily movement patterns to gain insights into disease progression and therapeutic response. Although challenges related to population size, compliance, ethics, and regulatory approval remain, wearable technology promises to improve clinical trials and outcomes for patients in paediatric neurology.</p>","PeriodicalId":50587,"journal":{"name":"Developmental Medicine and Child Neurology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143071159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Historia natural de la distonía mioclónica asociada a variantes de SGCE en niños y adolescentes.","authors":"Valeria De Francesch, Ana Cazurro-Gutiérrez, Elze R Timmers, Gemma Español-Martín, Julia Ferrero-Turrión, David Gómez-Andrés, Anna Marcé-Grau, Lucía Dougherty-de Miguel, Victoria González, Antonio Moreno-Galdó, Marina A J Tijssen, Belén Pérez-Dueñas","doi":"10.1111/dmcn.16215","DOIUrl":"https://doi.org/10.1111/dmcn.16215","url":null,"abstract":"<p><p>Children and adolescents with SGCE-myoclonus dystonia showed a progression of motor symptoms during a mean follow-up of 4 years. Patients developed a significant increase in the severity of axial and limb myoclonus, as well as dystonia during writing. Consequently, patients reported a marked decline in their speech, writing, and walking abilities. Up to 74% of patients had a psychiatric diagnosis, most commonly anxiety, obsessive-compulsive disorders, and attention-deficit/hyperactivity disorder.</p>","PeriodicalId":50587,"journal":{"name":"Developmental Medicine and Child Neurology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143071156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral palsy and perinatal mortality in children born in Norway to immigrant mothers.","authors":"Maria Wiedswang Sigholt, Guro L Andersen, Stian Lydersen, Liv Cecilie Vestrheim Thomsen, Torstein Vik, Sandra Julsen Hollung","doi":"10.1111/dmcn.16253","DOIUrl":"https://doi.org/10.1111/dmcn.16253","url":null,"abstract":"<p><strong>Aim: </strong>To compare the prevalence and clinical characteristics of cerebral palsy (CP), and perinatal mortality, in children born to non-immigrant mothers with children born to immigrant mothers.</p><p><strong>Method: </strong>This was a registry-based cross-sectional study. Data on children born from 2000 to 2016 were extracted from the Medical Birth Registry of Norway and linked to the Norwegian Quality and Surveillance Registry for Cerebral Palsy. The mother's country of birth was categorized into three groups: non-immigrant (born in Norway); immigrant from high-income countries (HICs); and immigrant from low- and middle-income countries (LMICs) (born abroad giving birth in Norway). Birth prevalence of CP and prevalence of perinatal mortality per 1000 live births were calculated. Odds ratios (ORs) for CP among live-born children of non-immigrant mothers compared to mothers from HICs and LMICs were calculated using logistic regression, both unadjusted and adjusted for each risk factor for CP. Pearson χ² tests were used to compare the proportions of clinical characteristics.</p><p><strong>Results: </strong>The prevalence of CP among non-immigrant mothers was 2.11 per 1000 live births, 1.44 among mothers from HICs, and 1.71 among mothers from LMICs. The OR for CP in mothers from HICs was 0.68 and 0.81 in mothers from LMICs. Despite mothers from LMICs having higher proportions of consanguinity and lower folate intake, and their children having lower Apgar scores, the ORs for CP were unchanged after adjusting for these. Yet, children born to mothers from LMICs had higher perinatal mortality; their children with CP had higher proportions of intellectual disability.</p><p><strong>Interpretation: </strong>The lower birth prevalence of CP among children born to mothers from LMICs was unexpected. Yet, children born to mothers from LMICs had higher perinatal mortality, which could impact the number of live-born children with CP.</p>","PeriodicalId":50587,"journal":{"name":"Developmental Medicine and Child Neurology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consciousness trajectories and functional independence after acute brain injury in children with prolonged disorder of consciousness.","authors":"Ningning Chen, Helin Zheng, Ying Feng, Congjie Chen, Li Xie, Duan Wang, Xiaoling Duan, Ting Zhang, Nong Xiao, Tingsong Li","doi":"10.1111/dmcn.16244","DOIUrl":"https://doi.org/10.1111/dmcn.16244","url":null,"abstract":"<p><strong>Aim: </strong>To explore the trajectories of consciousness recovery and prognosis-associated predictors in children with prolonged disorder of consciousness (pDoC).</p><p><strong>Method: </strong>This single-centre, retrospective, observational cohort involved 134 (87 males, 47 females) children diagnosed with pDoC and hospitalized at the Department of Rehabilitation at the Children's Hospital of Chongqing Medical University in China. The median onset age was 30 (interquartile range [IQR] 18-54) months, with onset ages ranging from 3 to 164 months. Least absolute shrinkage and selection operator (LASSO) regression and logistic regression analyses were performed to identify the independent predictors of consciousness recovery at 1 year after brain injury. Discrimination and calibration were assessed using 1000 bootstrap resamples. The potential predictors of resultant living independence were also explored.</p><p><strong>Results: </strong>The predictors for consciousness recovery at 1-year postinjury were: traumatic brain injury (odds ratio [OR]: 3.26, 95% confidence interval [95% CI]: 1.21-9.46), electroencephalogram (EEG) grade IV or below based on Young's classification (OR: 3.41, 95% CI: 1.38-8.70), and no bilateral impairments in the basal ganglia (OR: 3.75, 95% CI: 1.50-9.91) or posterior cingulate (OR: 5.61, 95% CI: 2.20-15.54). A nomogram was constructed with the area under the curve of 0.845 (95% CI: 0.780-0.911). Additionally, EEG grade IV or below, and the absence of bilateral impairments in the frontal lobes and occipital lobes were associated with favorable functional outcomes.</p><p><strong>Interpretation: </strong>These findings underscore the importance of comprehensive early-stage assessments in evaluating consciousness and function, assisting clinicians and families in making clinical decisions.</p>","PeriodicalId":50587,"journal":{"name":"Developmental Medicine and Child Neurology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polymicrogyria in infants with symptomatic congenital cytomegalovirus at birth is associated with epilepsy: A retrospective, descriptive cohort study.","authors":"George Lawson, Alexander Sheeka, Pritika Gaur, Styliani Alifieraki, Nigel Basheer, Wajanat Jan, Carolina Kachramanoglou, Hermione Lyall","doi":"10.1111/dmcn.16250","DOIUrl":"https://doi.org/10.1111/dmcn.16250","url":null,"abstract":"<p><strong>Aim: </strong>To identify neonatal magnetic resonance imaging (MRI) features that predict the likelihood of children with congenital cytomegalovirus (cCMV) developing epilepsy, together with clinical features and a validated MRI scoring system.</p><p><strong>Method: </strong>This was a retrospective descriptive cohort study of infants with cCMV referred to a paediatric infectious disease centre between April 2012 and March 2022, and followed up for at least 2 years. MRI was performed before 4 months of age and assessed by two paediatric neuroradiologists.</p><p><strong>Results: </strong>Ninety children with cCMV were included, 46 were female and 44 were male. The median age at MRI was 20 days, (standard deviation = 34, range = 1-200). Seventy-two of 90 children were symptomatic at birth and 7 of 72 developed epilepsy (9.7% of symptomatic infants, 7.8% of total). None of 18 asymptomatic children developed epilepsy. Those with epilepsy were more likely to be symptomatic at birth (100% vs. 76%, p = 0.14) and to have cortical malformations (86% vs. 15%, p < 0.001). Infants with polymicrogyria (PMG) were more likely to develop epilepsy (odds ratio = 35 [3.9-317.1], p < 0.001). A 1-year remission was achieved in three of seven children; four required multiple antiseizure medications without remission.</p><p><strong>Interpretation: </strong>The strongest correlate of epilepsy development was PMG. Infants with symptomatic cCMV at birth and PMG were more likely to develop epilepsy, and were likely to require one or more antiseizure medications. Parents of infants with cCMV and cortical malformations should be counselled regarding this risk. Including PMG severity in cCMV MRI scoring could improve epilepsy risk prediction.</p>","PeriodicalId":50587,"journal":{"name":"Developmental Medicine and Child Neurology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Involving people with lived experience when setting cerebral palsy research priorities: A scoping review.","authors":"Evonne Younan, Sarah McIntyre, Natasha Garrity, Tasneem Karim, Mark Wallace, Paul Gross, Shona Goldsmith","doi":"10.1111/dmcn.16219","DOIUrl":"https://doi.org/10.1111/dmcn.16219","url":null,"abstract":"<p><strong>Aim: </strong>To describe research priority-setting activities for cerebral palsy (CP) that have been conducted worldwide involving people with lived experience, focusing on participant characteristics, methods employed, identified research priorities, and collaboration as research partners.</p><p><strong>Method: </strong>The JBI scoping review approach was followed. Six electronic databases and grey literature were searched for all publications up to February 2024. We extracted study and participant characteristics, methods, and research priorities. Priorities were then categorized into prevention and cure, quality of life and community engagement, and service provision and intervention.</p><p><strong>Results: </strong>Five studies from North America and Australia met the inclusion criteria. Participants with lived experience were most often parents/caregivers (n = 135, proportion 12-80%), with 54 (proportion 12-25%) people with CP participating in the priority-setting exercises. The studies' methods were varied, with surveys and workshops being the most common. The most reported category of research priorities was optimal intervention. People with lived experience collaborated as research partners (e.g. in aspects of study development/analysis/reporting) in four studies.</p><p><strong>Interpretation: </strong>This review, the first to examine CP research priority-setting efforts on a global scale, identified five activities conducted to date. The small overall number of participants with lived experience of CP, originating only from North America and Australia, highlights the need for increased representation to better reflect the diverse CP community worldwide. Future projects need to address these gaps, using rigorous methodologies, and continued collaboration with research partners to ensure their perspectives shape and enhance the research agenda.</p>","PeriodicalId":50587,"journal":{"name":"Developmental Medicine and Child Neurology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Making visible disability the new normal in health professionals.","authors":"Peter Rosenbaum, Julia Hanes","doi":"10.1111/dmcn.16245","DOIUrl":"https://doi.org/10.1111/dmcn.16245","url":null,"abstract":"","PeriodicalId":50587,"journal":{"name":"Developmental Medicine and Child Neurology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic accuracy of early neonatal MRI in predicting adverse motor outcomes in children born preterm: Systematic review and meta-analysis","authors":"","doi":"10.1111/dmcn.16248","DOIUrl":"10.1111/dmcn.16248","url":null,"abstract":"<p>Each year, around 15 million infants are born preterm worldwide (before 37 weeks of pregnancy). Infants born preterm are more likely to have motor difficulties such as cerebral palsy (CP) or developmental coordination disorder (DCD). Identifying infants who are at-risk of these adverse outcomes is important so they can receive early intervention.</p><p>Magnetic resonance imaging (MRI) of the brain is a promising tool to identify early signs of injury among at-risk infants. Most research focuses on MRI performed once the infant reaches term age (approximately 40 weeks); however, infants born preterm are usually discharged from hospital before they reach term age.</p><p>We performed a systematic review of the literature to see if MRI performed before 36 weeks since conception could be used to identify these at-risk infants. This included 27 studies published up to October 2023 that evaluated the effectiveness of Early MRI to predict an outcome of CP and poorer motor outcomes in childhood among infants born preterm.</p><p>We found that brain injury in newborn infants observed on Early MRI reported by eight studies was able to predict children with CP by the age of 2 or older with a high accuracy. Four additional studies found these Early MRIs were also accurate at identifying children who would have age-appropriate motor ability by 3 years or older, but may miss children who develop mild or moderate motor difficulties.</p>","PeriodicalId":50587,"journal":{"name":"Developmental Medicine and Child Neurology","volume":"67 3","pages":"e78"},"PeriodicalIF":3.8,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dmcn.16248","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of and risk factors for osteoporosis and fragility fracture in adults with cerebral palsy: A systematic review","authors":"","doi":"10.1111/dmcn.16249","DOIUrl":"10.1111/dmcn.16249","url":null,"abstract":"<p>Individuals with cerebral palsy (CP) are living longer and experience new complications of their CP associated with ageing. Even those with the most severe impairments are living to young adulthood. If they survive to age 25 years, their remaining life expectancy is another 30 years. Several epidemiological studies have identified two main disease processes highly prevalent in adults with CP, namely bone fragility and cardiometabolic disease. This study reviews how common weak bones and fractures are in adults with CP, and what factors increase the risk of these conditions.</p><p>Researchers searched multiple medical databases for studies on adults with CP. They looked for studies that reported on the prevalence (how common) and incidence (new cases) of these bone conditions, as well as risk factors.</p><p>Out of 303 studies, 17 were relevant for prevalence and incidence, and 16 out of 663 for risk factors. Osteoporosis was found in 5% of the general adult CP population, but this increased to 43% in those attending clinics. Those attending clinics had poorer mobility and more complex medical issues. Fragility fractures were found in 5.5% of adults overall, but up to 38% in clinic patients. Key risk factors included limited mobility, poor nutrition, and use of anticonvulsant medications.</p>","PeriodicalId":50587,"journal":{"name":"Developmental Medicine and Child Neurology","volume":"67 3","pages":"e79"},"PeriodicalIF":3.8,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dmcn.16249","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"‘A Fence or an Ambulance’ for disabled children","authors":"Catherine Tuffrey","doi":"10.1111/dmcn.16243","DOIUrl":"10.1111/dmcn.16243","url":null,"abstract":"&lt;p&gt;In 1895, the English author Joseph Malins wrote the poem ‘A Fence or an Ambulance’ (https://allpoetry.com/poem/13223676-A-Fence-or-an-Ambulance-by-Joseph-Malins). The poem describes the idea that people find it more attractive to pay for the cure than the prevention – the ambulance at the bottom of the cliff rather than the fence stopping people falling off the top.&lt;/p&gt;&lt;p&gt;130 years on, we have yet to move to the more rational position in many of our health services. Evidence for the efficacy of early therapy intervention for children with conditions such as cerebral palsy (CP) is now accepted. But what about other aspects of preventative input? How are we doing and how best can we support families and communities to improve the health of disabled children? How can we better address the additional socioeconomic challenges to health that many of these families face including poor quality damp housing, noise and air pollution, fuel poverty, and so on?&lt;/p&gt;&lt;p&gt;We know that disabled children often have challenges in eating and sleeping, as well as physical activity. These are the cornerstones of a healthy life and yet, are we doing enough to teach and enable parents to understand and promote healthy behaviours from the beginning? How many children are diagnosed with attention-deficit/hyperactivity disorder, where good sleep hygiene and a healthy diet would reduce impairment? Adults with CP have higher rates of cardiovascular disease, but how often are we making sure that as children, they are accessing enough physical exercise and healthy food to mitigate this risk? Many neuro-disabling conditions affect sleep, and rigorous attention to sleep hygiene early on can avoid the behavioural elements that we so commonly see, but instead vainly attempt to treat later with medications, when behaviours are entrenched.&lt;/p&gt;&lt;p&gt;How can we promote healthy weight when we are not even able to accurately measure disabled children? The British Academy of Child Health ‘weight and height To Go’ project stemmed from this finding of the 2018 NCEPOD inquiry ‘Each and Every Need’ (https://www.ncepod.org.uk/2018cn.html). Subsequent audits show that UK health services are still struggling to achieve the basics in this area (https://www.bacdis.org.uk/pages/weigh_to_go). How can we improve this?&lt;/p&gt;&lt;p&gt;Nearly 25 years ago, we showed that immunization rates of children in UK special schools were lower than in mainstream controls.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Studies continue to show lower vaccination rates for vaccinations such as human papillomavirus (HPV) in neuro-disabled children.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Many of my patients were invited to book COVID vaccination in 2024 but venues were often miles away, making access difficult or impossible. We need to do better.&lt;/p&gt;&lt;p&gt;Disabled adults face further disadvantage in accessing preventative healthcare. The UK primary care annual Adult Health Checks for those with learning disability are still not universally offered.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;","PeriodicalId":50587,"journal":{"name":"Developmental Medicine and Child Neurology","volume":"67 5","pages":"556"},"PeriodicalIF":3.8,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dmcn.16243","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}