Developmental Medicine and Child Neurology最新文献

{"title":"Early developmental trajectories of the impaired hand in infants with unilateral cerebral palsy.","authors":"Leanne Sakzewski, Susan Greaves, Ann-Christin Eliasson, Margaret Wallen, Iona Novak, Robert S Ware, Jill Heathcock, Nathalie Maitre, Roslyn N Boyd","doi":"10.1111/dmcn.16240","DOIUrl":"https://doi.org/10.1111/dmcn.16240","url":null,"abstract":"<p><strong>Aim: </strong>To identify developmental trajectories of impaired hand function in infants aged 3 to 15 months with unilateral cerebral palsy (CP).</p><p><strong>Method: </strong>Sixty-three infants (37 male; median gestational age 37 weeks [interquartile range 30-39.1 weeks]) recruited as part of a randomized trial with a confirmed diagnosis of unilateral CP were included. All infants received early upper limb therapy. The Hand Assessment for Infants (HAI) was completed at baseline and until 12 to 15 months corrected age. Group-based trajectory modelling identified groups with similar trajectories of development of impaired hand function. Multinomial logistic regression determined associations between demographic variables and trajectory membership.</p><p><strong>Results: </strong>The three-group trajectory model comprised 'low' 29%, 'moderate' 35%, and 'high' 36% functioning groups. The relative risk ratio of being in the low or moderate relative to high group increased by 16% (95% confidence interval [CI] 1.02-1.32) and 14% (95% CI 1.01-1.29) respectively for each 1 week increase in gestational age. Males were more likely to be in the low relative to high group (relative risk ratio 7.22; 95% CI 1.6-32.5).</p><p><strong>Interpretation: </strong>Three distinct trajectories of development of the impaired hand were identified. Males and infants born closer to term age were at higher risk of being in a low group with little improvement over time, despite receiving early intervention.</p>","PeriodicalId":50587,"journal":{"name":"Developmental Medicine and Child Neurology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015606","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":"Prevalence of and risk factors for osteoporosis and fragility fracture in adults with cerebral palsy: A systematic review","authors":"Anne Trinh,&nbsp;Ellen Fremion,&nbsp;Shayan Bhathena,&nbsp;Craig F. Munns,&nbsp;Prue Morgan,&nbsp;Daniel G. Whitney,&nbsp;Bernadette Gillick,&nbsp;Margaret Zacharin,&nbsp;Darcy Fehlings,&nbsp;Amanda J. Vincent,&nbsp;Frances Milat","doi":"10.1111/dmcn.16234","DOIUrl":"10.1111/dmcn.16234","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To systematically review the prevalence and incidence of osteoporosis, osteopenia, low bone mass, and fragility fracture in adults with cerebral palsy (CP), and identify the risk factors for osteoporosis and fracture.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A systematic literature search was performed in the MEDLINE, PubMed, CINAHL, AMED, Cochrane Reviews, EMBASE, and EBM database reviews from inception until May 2024. Search terms covered a combination of keywords for CP, fracture, osteoporosis, incidence and prevalence, and risk factors. Participants were adults with CP aged 18 years and older. JBI critical appraisal instruments were used to assess quality and risk of bias.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventeen of 303 studies met the eligibility criteria to assess the prevalence and incidence of osteoporosis and fracture, and 16 of 663 studies to assess risk factors. Osteoporosis prevalence was 5% in a general adult population with CP, increasing to 43% in those attending outpatient clinics. Osteoporosis incidence reported in one study was 2.85 per 1000 person years. Prevalence of fragility fracture was 5.5% overall but up to 38% in outpatient settings. Risk factors for osteoporosis and fracture included mobility status, nutritional status, and anticonvulsant use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Interpretation</h3>\u0000 \u0000 <p>Low bone density and fracture is common in adults with CP with reduced mobility. The main risk factors for poor bone health are related to reduced mobility, nutrition, and anticonvulsant use.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50587,"journal":{"name":"Developmental Medicine and Child Neurology","volume":"67 5","pages":"563-571"},"PeriodicalIF":3.8,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015612","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":"Multi-system resilience for disabled children and their families during crisis and emergency","authors":"Tali-Noy Hindi","doi":"10.1111/dmcn.16158","DOIUrl":"10.1111/dmcn.16158","url":null,"abstract":"&lt;p&gt;Emergency management is complex, requiring different layers of actions taken by diverse actors. Emergency activities such as evacuations, assistance, and casualty management issues are undertaken by government agencies, civil society organizations, and private-sector companies that can be used to finance, build, operate projects, and provide emergency services. Merrick et al.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; have established agreement on specific policies and practices for services supporting disabled children during emergencies. The authors revised these solutions into draft recommendations focused on localized decision-making in three key areas: (1) prioritizing care for high-risk health issues; (2) organizing and delivering care; and (3) communicating changes in care provision during future emergencies. This article is fundamental since it underscores the fact that acute crises no longer have a geographically localized impact; their influence expands to far-reaching locations due to globalization. Hence, it is vital to prepare for acute crises that will almost certainly occur in the future.&lt;/p&gt;&lt;p&gt;Moreover, different governmental ministries, regional and local authorities, and service providers are responsible for preparing services, to operate in routine and emergency situations, and enhancing their resilience. The recommendations in the Merrick et al. study include cross-service and sector provision such as the ‘Every Contact Counts’ approach. However, research shows that devolution of power to local governments in crisis is only partially effective. During an ongoing acute crisis, budget cuts and reallocation should be expected, thus forcing local authorities to reduce services provided routinely to residents. This reduction would inevitably be even higher in weaker local authorities.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Most recommendations emphasize the prevalent approach in rehabilitation psychology studies that describes the effects of crisis and distress on the individual. However, a disabled child's low level of functioning has far-reaching consequences for family members, just as a low level of family functioning affects the health and well-being of the disabled child. Therefore, current policy studies refer to family resilience as the reactivity of the family to complex challenges such as the effects of climate change, epidemics, or war.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;The impact of crises on families with disabled children is multidimensional. Families face many challenges that are exacerbated by the complex circumstances of caring for disabled children. Intersecting factors that endanger or promote family resilience describe how marginalized groups face multiple layers of risk that interact with low-resource intensity.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;The concept of coping with multiple stressors arising from disruptions and threats across various systems is referred to as multisystemic resilience, where the resilience of one system can influenc","PeriodicalId":50587,"journal":{"name":"Developmental Medicine and Child Neurology","volume":"67 5","pages":"561-562"},"PeriodicalIF":3.8,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dmcn.16158","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973045","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":"Morbidities and comorbidities associated with optic nerve hypoplasia and septo-optic-pituitary dysplasia.","authors":"Michael S Salman, Chelsea A Ruth, Marina S Yogendran, Lisa M Lix","doi":"10.1111/dmcn.16235","DOIUrl":"https://doi.org/10.1111/dmcn.16235","url":null,"abstract":"<p><strong>Aim: </strong>To quantify optic nerve hypoplasia (ONH) and septo-optic-pituitary dysplasia (SOD) morbidities and comorbidities.</p><p><strong>Method: </strong>A retrospective population-based study with a case-control design was undertaken using administrative health data from Manitoba, Canada. Cases were 124 patients with ONH or SOD (70 males, 54 females; age range 6 months-36 years 8 months [mean 13 years, SD 7 years 2 months]) diagnosed from 1990 to 2019, matched to 620 unrelated population-based controls (350 males, 270 females; age range 0-36 years 8 months [mean 12 years 5 months, SD 7 years 2 months]) on birth year, sex, and area of residence. Additionally, 76 cases with ONH or SOD (46 males, 30 females; age range 2 years 5 months-36 years 8 months [mean 13 years 11 months, SD 7 years 3 months]) were matched one-to-one with sibling controls (40 males, 36 females; age range 7 months-33 years 1 month [mean 11 years 8 months, SD 7 years 3 months]). We used χ² or Fisher's exact tests to test for differences in prevalence in morbidities and comorbidities between cases and controls; odds ratios (ORs) with 95% confidence intervals (CIs) were estimated. Cox proportional hazards models were used to test for differences in subgroups of cases; hazard ratios and 95% CIs were estimated.</p><p><strong>Results: </strong>Visual impairment and visual impairment with hypopituitarism were core morbidities associated with ONH and SOD cases respectively compared to unrelated controls (OR = 58.6, 95% CI = 22.5-152.5; OR = 243.4, 95% CI = 32.9-1799.0 respectively). Developmental delay or intellectual disability (OR = 6.9, 95% CI = 3.3-14.4), autism spectrum disorder (OR = 4.0, 95% CI = 2.0-8.3), epilepsy (OR = 14.9, 95% CI = 6.1-36.5), cerebral palsy (OR = 40.9, 95% CI = 14.0-119.6), and mood or anxiety disorders (OR = 1.7, 95% CI = 1.0-2.8) were the comorbidities more common among cases with ONH and SOD. Cases matched to siblings showed similar results except for mood and anxiety disorders.</p><p><strong>Interpretation: </strong>Visual impairment and visual impairment with hypopituitarism are the main morbidities in patients with ONH and SOD respectively, while developmental delay or intellectual disability, autism spectrum disorder, epilepsy, cerebral palsy, and mood or anxiety disorders are important comorbidities.</p>","PeriodicalId":50587,"journal":{"name":"Developmental Medicine and Child Neurology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980596","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":"Prediction of cerebral palsy and cognitive delay among high-risk children in a developing nation: A successful early detection programme","authors":"","doi":"10.1111/dmcn.16236","DOIUrl":"10.1111/dmcn.16236","url":null,"abstract":"<p>Therapy for children with cerebral palsy (CP) and other developmental disabilities is most effective if started early in life. Targeting therapy early requires detection programs that are appropriate for the resources that are available. In high-income, predominantly western countries, it is recommended that brain MRI and serial examinations be used to predict CP. However, in low- and middle-income countries (LMICs), there is often limited access to MRI, and repeating developmental assessments over time is difficult. With the majority of children with CP and other developmental disabilities living in LMICs, it is important to perform early detection research in LMICs to provide practical recommendations, useful in various clinical settings.</p><p>We integrated the General Movements Assessment (GMA) and Hammersmith Infant Neurological Examination (HINE) in the routine follow-up of 201 Sri Lankan infants at risk for CP. In a busy neurology clinic, the GMA was done twice, at approximately term to assess for writhing movements and at 3 to 4 months to assess fidgety movements. The HINE was done at approximately 5 to 6 months. At 2 years of age, a neurological examination was done to determine whether the child had CP. In addition, the Bayley Scales of Infant and Toddler Development was also done at 2 to 3½ years of age to detect non-CP developmental disorders.</p>","PeriodicalId":50587,"journal":{"name":"Developmental Medicine and Child Neurology","volume":"67 3","pages":"e75"},"PeriodicalIF":3.8,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dmcn.16236","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967349","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":"Reverse transcriptase inhibitors in Aicardi-Goutières syndrome: Design and regulatory challenges in clinical trials for rare disease.","authors":"Russell C Dale","doi":"10.1111/dmcn.16237","DOIUrl":"https://doi.org/10.1111/dmcn.16237","url":null,"abstract":"","PeriodicalId":50587,"journal":{"name":"Developmental Medicine and Child Neurology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967393","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":"Forewords","authors":"","doi":"10.1111/dmcn.16178","DOIUrl":"10.1111/dmcn.16178","url":null,"abstract":"<p>Welcome to the British Paediatric Neurology Association (BPNA) Annual Conference. As always, the quality of the programme remains exceptionally high, complemented by a large number of abstract submissions.</p><p>The 2025 conference is hosted by the Oxford team, and while the programme reflects local interests, it also provides a broad perspective on current issues in paediatric neurology. We have actively encouraged the involvement of patients and carers in the programme, with several stands and video clips from patient organizations featured for the first time.</p><p>Building on the success of last year's research workshops, we are once again hosting sessions to address key research questions in the field and promote collaboration. These interactive workshops are open to all, aiming to bring together leading experts to advance research, discuss patient pathways, and identify clinical and research gaps. We also invite and welcome patient groups to attend these sessions.</p><p>The Oxford team will showcase some of the outstanding work being done in neuroinflammation. Presentations from world-leading experts and researchers will highlight the latest treatment interventions and breakthroughs in answering fundamental questions in this field. The programme reflects current developments and addresses challenges faced by all in paediatric neurology.</p><p>We will also feature the ever-popular video session, designed to help attendees learn from expert panel discussions on how to approach paediatric neurological disorders, phenomenology, differential diagnosis, and investigations through case presentations and video analysis.</p><p>During the conference, we will present the prestigious Ronnie Mac Keith Prize, as well as the Developmental Medicine and Child Neurology (DMCN) Best Article by a BPNA Trainee Prize. Additional prizes will be awarded for the best oral presentation, oral poster, e-poster, and medical student presentation.</p><p>Given the recent attention on epileptic encephalopathies, we will host a debate on Lennox–Gastaut syndrome and its relevance.</p><p>Recent advances in genetic testing and gene therapies have introduced new complexities to our specialty, and we will explore whether applying genomics can enhance diagnosis, neurobiology, and treatment for neurodevelopmental disorders.</p><p>The hosting team will also be delighted to share some of Oxford's rich history with those attending the conference in person.</p><p>Delegates are warmly invited to the reception event at the medieval Divinity School, and we hope you enjoy dinner and a Cèilidh while visiting the Museum of Natural History. We trust that this year's BPNA conference will inspire ambition, foster innovation, promote collaboration, and showcase achievements.</p><p>Sam Amin</p><p>Chair of Research</p>","PeriodicalId":50587,"journal":{"name":"Developmental Medicine and Child Neurology","volume":"67 S1","pages":"3"},"PeriodicalIF":3.8,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dmcn.16178","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933488","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":"Forewords","authors":"Bernard Dan","doi":"10.1111/dmcn.16179","DOIUrl":"10.1111/dmcn.16179","url":null,"abstract":"<p>It is a great pleasure to publish and archive the abstracts of the presentation that will be made at the 2025 Annual Conference of the British Paediatric Neurology Association (BPNA) in Oxford. These abstracts cover a very wide range of timely topics in paediatric neurology in terms of clinical presentations, diagnostics, and management, often with clear implications for clinical practice. Interestingly, most of the themes identified by the recent BPNA effort in conjunction with the National Institute for Health and Care Research and the James Lind Alliance, as research priorities regarding the effectiveness of interventions for the benefit of children with neurological conditions, are represented, including early intervention, sleep, emotional well-being, psychological interventions for functional neurological disorders, pharmacological treatment of hypertonia, and non-medical interventions for motor disorders.<span>¹</span> Several abstracts involve interesting use of technologies such as machine learning or telemedicine. Many have a direct educational value in addition to scientific quality; a few address quality improvement of service or training. A proportion of the presented works result from international collaboration.</p><p>Readers of this <i>Developmental Medicine &amp; Child Neurology</i> supplement must bear in mind that although each of the abstracts was carefully selected by the BPNA for presentation at the Annual Conference, the submitted material did not go through the review and editorial process that is applied to full papers received at the Journal. The abstracts serve as a base for the actual presentation and discussion during and around the meeting, which is also a form of peer review and constructive interaction. I hope that a number of these presentations will eventually be written up as research articles and duly submitted.</p><p>Bernard Dan</p><p>Editor in Chief</p><p>Email: <span>[email protected]</span></p>","PeriodicalId":50587,"journal":{"name":"Developmental Medicine and Child Neurology","volume":"67 S1","pages":"4"},"PeriodicalIF":3.8,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dmcn.16179","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933491","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":"Poster Presentations","authors":"","doi":"10.1111/dmcn.16181","DOIUrl":"10.1111/dmcn.16181","url":null,"abstract":"","PeriodicalId":50587,"journal":{"name":"Developmental Medicine and Child Neurology","volume":"67 S1","pages":"23-136"},"PeriodicalIF":3.8,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dmcn.16181","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933496","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":"The MacKeith Prize for BPNA 2025 has been awarded to Dr. Elizabeth Radford","authors":"","doi":"10.1111/dmcn.16210","DOIUrl":"10.1111/dmcn.16210","url":null,"abstract":"","PeriodicalId":50587,"journal":{"name":"Developmental Medicine and Child Neurology","volume":"67 S1","pages":"5"},"PeriodicalIF":3.8,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dmcn.16210","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933498","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}