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Lee H, Kim H, Lee S, Lee GJ. Establishing Reference Values for a New Computerized Cognitive Function Test Program for Children. Ann Rehabil Med 2024; 48:135-145. [PMID: 38644639 PMCID: PMC11058362 DOI: 10.5535/arm.230014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/23/2024] [Accepted: 01/29/2024] [Indexed: 04/23/2024] Open
Abstract
OBJECTIVE To establish reference values for the computerized cognitive test and evaluate cognitive function improvements across different age groups, we introduce the computerized Cognitive Function Test program (eCFT), specifically designed for children. We aimed to establish eCFT reference values and assess cognitive function improvements across different age groups. METHODS We included children aged 3-6 years with confirmed normal cognition based on the Korean Developmental Screening Test for Infants and Children and Kaufman Assessment Battery for Children-II. The eCFT consists of 8 subtests for visual perception, attention, memory, and executive function. RESULTS A total of 66 participants (36 males and 30 females) with an average age of 4.4 years participated. The age 6 group consistently outperformed both age group 3 and 4 in terms of correct responses. With regard to the completed stage, the "selective auditory stimulus" test findings were 2.0 and 3.9 for the age 3 and age 6 groups, respectively (p<0.05). The "trail-making" test findings were 1.7, 2.1, 2.6, and 2.8, respectively (between ages 3 and 6, p<0.01; between ages 4 and 6, p<0.05); moreover, the age 5 group surpassed the age 3 group (2.6 and 1.7, respectively, p<0.05). CONCLUSION The eCFT is an easily accessible tool to evaluate cognitive function in young children. We introduce reference values with a cutoff range for preschool-aged children, enabling early intervention for those with cognitive impairment. Given its accessibility and relatively short evaluation time, the eCFT has potential for clinical use.
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Affiliation(s)
- Hyunji Lee
- Department of Rehabilitation Medicine, National Traffic Injury Rehabilitation Hospital, Yangpyeong, Korea
| | - Hajeong Kim
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Korea
| | - Suan Lee
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Korea
| | - Goo Joo Lee
- Department of Rehabilitation Medicine, National Traffic Injury Rehabilitation Hospital, Yangpyeong, Korea
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Korea
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Pellegrini C, Caraceni AT, Massimino M, De Vivo A, Blandini MG, Simoncini B, Chisari M, Bedodi LIE, Sensi R, Brunelli C. Development and field testing of a neuro psychomotor multidimensional grid for the assessment of children with cns tumor. Pediatr Hematol Oncol 2022; 39:108-120. [PMID: 34289789 DOI: 10.1080/08880018.2021.1948648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Central Nervous System (CNS) tumors are the most common pediatric solid tumor and development neuro psychomotor (DNPM) therapy can contribute to the rehabilitation of these children. This paper describes the development of a DNPM multidimensional assessment grid for children with CNS tumor (DNPM-CNS grid).The development process included 4 phases: (P1) literature review and grid development (Version 1.0), (P2) two rounds consultations with experts (Version 1.1 and 2.0), (P3) field testing, (P4) final revision (Version 3.0).(P1) The DNPM-CNS grid was developed based on previous tools and manuals and on clinical experience with this patient population. (P2) A total of 52 questionnaires were filled in by experts about relevance of assessment areas, pertinence, comprehensibility and feasibility of the grid. Average scores ranged from 7.6 to 10. (P3) At case level, good inter-rater agreement scores (78%) and limited non-evaluability rates (18%) emerged. At item level, 27% of items reached high disagreement and 26% high not-evaluability rates. The qualitative assessment was judged clinically useful for planning the neuro-oncology rehabilitation treatment and a good feasibility of the DNPM-CNS grid emerged both for preschool and school-age children. (P4) The final version of the grid consists of 8 assessment areas with 133 items.The DNPM-CNS grid is a comprehensive tool that can guide the overall DNPM assessment in a limited amount of time. It can be used as a screening tool to customize more specific assessments. Further research is needed to better characterize grid psychometric properties.Supplemental data for this article is available online at https://doi.org/10.1080/08880018.2021.1948648 .
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Affiliation(s)
- Chiara Pellegrini
- Palliative care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.,Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Augusto T Caraceni
- Palliative care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Maura Massimino
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Annarita De Vivo
- Palliative care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Maria Grazia Blandini
- Palliative care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Beatrice Simoncini
- Palliative care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Marco Chisari
- Palliative care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Livia I E Bedodi
- Palliative care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Raffaella Sensi
- Palliative care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Cinzia Brunelli
- Palliative care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
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Chevignard M, Câmara-Costa H, Dellatolas G. Pediatric traumatic brain injury and abusive head trauma. HANDBOOK OF CLINICAL NEUROLOGY 2020; 173:451-484. [PMID: 32958191 DOI: 10.1016/b978-0-444-64150-2.00032-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Childhood traumatic brain injury (TBI) commonly occurs during brain development and can have direct, immediately observable neurologic, cognitive, and behavioral consequences. However, it can also disrupt subsequent brain development, and long-term outcomes are a combination of preinjury development and abilities, consequences of brain injury, as well as delayed impaired development of skills that were immature at the time of injury. There is a growing number of studies on mild TBI/sport-related concussions, describing initial symptoms and their evolution over time and providing guidelines for effective management of symptoms and return to activity/school/sports. Mild TBI usually does not lead to long-term cognitive or academic consequences, despite reports of behavioral/psychologic issues postinjury. Regarding moderate to severe TBI, injury to the brain is more severe, with evidence of a number of detrimental consequences in various domains. Patients can display neurologic impairments (e.g., motor deficits, signs of cerebellar disorder, posttraumatic epilepsy), medical problems (e.g., endocrine pituitary deficits, sleep-wake abnormalities), or sensory deficits (e.g., visual, olfactory deficits). The most commonly reported deficits are in the cognitive-behavioral field, which tend to be significantly disabling in the long-term, impacting the development of autonomy, socialization and academic achievement, participation, quality of life, and later, independence and ability to enter the workforce (e.g., intellectual deficits, slow processing speed, attention, memory, executive functions deficits, impulsivity, intolerance to frustration). A number of factors influence outcomes following pediatric TBI, including preinjury stage of development and abilities, brain injury severity, age at injury (with younger age at injury most often associated with worse outcomes), and a number of family/environment factors (e.g., parental education and occupation, family functioning, parenting style, warmth and responsiveness, access to rehabilitation and care). Interventions should identify and target these specific factors, given their major role in postinjury outcomes. Abusive head trauma (AHT) occurs in very young children (most often <6 months) and is a form of severe TBI, usually associated with delay before appropriate care is sought. Outcomes are systematically worse following AHT than following accidental TBI, even when controlling for age at injury and injury severity. Children with moderate to severe TBI and AHT usually require specific, coordinated, multidisciplinary, and long-term rehabilitation interventions and school adaptations, until transition to adult services. Interventions should be patient- and family-centered, focusing on specific goals, comprising education about TBI, and promoting optimal parenting, communication, and collaborative problem-solving.
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Affiliation(s)
- Mathilde Chevignard
- Rehabilitation Department for Children with Acquired Neurological Injury and Outreach Team for Children and Adolescents with Acquired Brain Injury, Saint Maurice Hospitals, Saint Maurice, France; Laboratoire d'Imagerie Biomédicale, Sorbonne Université, Paris, France; GRC 24, Handicap Moteur et Cognitif et Réadaptation, Sorbonne Université, Paris, France.
| | - Hugo Câmara-Costa
- GRC 24, Handicap Moteur et Cognitif et Réadaptation, Sorbonne Université, Paris, France; Centre d'Etudes en Santé des Populations, INSERM U1018, Paris, France
| | - Georges Dellatolas
- GRC 24, Handicap Moteur et Cognitif et Réadaptation, Sorbonne Université, Paris, France
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Pellegrini C, Caraceni AT, Bedodi LI, Sensi R, Breggiè S, Gariboldi FA, Brunelli C. Tools for the assessment of neuropsychomotor profile in the rehabilitation of children with central nervous system tumor: a systematic review. TUMORI JOURNAL 2019; 106:12-24. [DOI: 10.1177/0300891619868011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: This study reviews the scientific literature to identify and describe which assessment tools (ATs) are used in pediatric oncology and neuro-oncology rehabilitation and which development neuropsychomotor (DNPM) ATs were built for children with central nervous system (CNS) tumors. Methods: A systematic review was performed searching PubMed, CINAHL, PEDro, Science Direct, and Catalog of National Institute of Tumors databases and specialized journals. The search covered 7 years (2010–2017) and used relevant keywords in different combinations. A further search was carried out on DNPM rehabilitation manuals and academic thesis. Results: The review retrieved 35 eligible articles containing 63 ATs. The most common ATs were the Behavioral Rating Inventory of Executive Function (BRIEF) and the Wechsler Intelligence Scale for Children (WISC). Most of the ATs covered a single area of child development among behavioral/psychological, cognitive, and motor areas. A total of 159 ATs were found in manuals and thesis, and only 17 of them were already identified in the journal search. None of the ATs identified in both searches had been specifically developed for children with CNS tumor. Conclusion: The results highlight the need to develop and validate a global multidimensional AT for children with CNS tumor, overcoming the fragmentation of the assessment procedures and promoting standardized rehabilitation protocols.
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Affiliation(s)
- Chiara Pellegrini
- Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Augusto T. Caraceni
- Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
- European Palliative Care Research Centre (PRC), Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Livia I.E. Bedodi
- Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Raffaella Sensi
- Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Simona Breggiè
- Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Fulvia A. Gariboldi
- Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Cinzia Brunelli
- Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
- European Palliative Care Research Centre (PRC), Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Kieffer V, Chevignard MP, Dellatolas G, Puget S, Dhermain F, Grill J, Valteau-Couanet D, Dufour C. Intellectual, educational, and situation-based social outcome in adult survivors of childhood medulloblastoma. Dev Neurorehabil 2019; 22:19-26. [PMID: 29336639 DOI: 10.1080/17518423.2018.1424262] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To investigate intellectual and situation-based social outcome and educational achievement in adult survivors of childhood medulloblastoma and analyse factors influencing outcome Methods: We collected demographic, medical and cognitive data, and social and educational outcome at a mean time since the end of treatments of 14.9 years in 58 adults, aged 19-35 years, consecutively treated in a single cancer center between 1989 and 2005. RESULTS Ten survivors had severe intellectual disability, 12 were still studying, 23 had a regular employment and 13 were unemployed. Full Scale Intellectual Quotient, assessed 6.6 years after the end of treatments, ranged from 46 to 131. It was strongly associated with educational achievement and significantly lower in patients who experienced postoperative cerebellar mutism, and when parental education level was low. CONCLUSION These factors should be systematically considered at diagnosis in order to offer adequate and timely assessments and interventions.
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Affiliation(s)
- Virginie Kieffer
- a Rehabilitation Department for children with acquired neurological injury , Saint Maurice Hospitals , Saint Maurice , France
| | - Mathilde P Chevignard
- a Rehabilitation Department for children with acquired neurological injury , Saint Maurice Hospitals , Saint Maurice , France
| | | | - Stephanie Puget
- c Department of neurosurgery , Necker-Enfants Malades Hospital , Paris , France
| | - Frederic Dhermain
- d Département de radiothérapie , Gustave Roussy , Villejuif , France
| | - Jacques Grill
- e Département de Cancérologie de l'Enfant et de l'Adolescent , Gustave Roussy , Villejuif , France
| | | | - Christelle Dufour
- e Département de Cancérologie de l'Enfant et de l'Adolescent , Gustave Roussy , Villejuif , France
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Labrell F, Câmara-Costa H, Dufour C, Grill J, Dellatolas G, Chevignard M. Parental stress and paediatric acquired brain injury. Brain Inj 2018; 32:1780-1786. [DOI: 10.1080/02699052.2018.1524931] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Florence Labrell
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
- INSHEA, Suresnes, France
| | - Hugo Câmara-Costa
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
| | - Christelle Dufour
- Department of Pediatric and Adolescent Oncology, Gustave Roussy, Villejuif, France
| | - Jacques Grill
- Department of Pediatric and Adolescent Oncology, Gustave Roussy, Villejuif, France
| | - Georges Dellatolas
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
| | - Mathilde Chevignard
- Rehabilitation Department for children with acquired neurological injury, and Outreach Team for children and adolescents with acquired brain injury, Saint Maurice Hospitals, Saint Maurice, France
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Corti C, Poggi G, Romaniello R, Strazzer S, Urgesi C, Borgatti R, Bardoni A. Feasibility of a home-based computerized cognitive training for pediatric patients with congenital or acquired brain damage: An explorative study. PLoS One 2018; 13:e0199001. [PMID: 29924823 PMCID: PMC6010294 DOI: 10.1371/journal.pone.0199001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 03/27/2018] [Indexed: 11/28/2022] Open
Abstract
Objectives Pediatric brain damage is associated with various cognitive deficits. Cognitive rehabilitation may prevent and reduce cognitive impairment. In recent years, home-based computerized cognitive training (CCT) has been introduced in clinical practice to increase treatment opportunities for patients (telerehabilitation). However, limited research has been conducted thus far on investigating the effects of remote CCT for the juvenile population in contexts other than English-speaking countries. The aim of the present study was to investigate the feasibility of a home-based CCT in a group of Italian adolescents with brain damage. A commercially available CCT (Lumosity) developed in the English language was used due to the lack of telerehabilitation programs in the Italian language that allow stimulation of multiple cognitive domains and, at the same time, remote automatic collection of data. Thus, this investigation provides information on the possibility of introducing CCT programs available in foreign languages in countries with limited investment in the telerehabilitation field. Methods 32 adolescents aged 11–16 with a diagnosis of congenital or acquired (either traumatic or non-traumatic) brain damage participated in the study. They received 40 training sessions (5 days/week for 8 weeks). Before starting the training program, they received face-to-face demonstration of training exercises and written instructions in their mother tongue. The feasibility of both training and study design and procedures was assessed through 9 criteria taken from extant literature. Results All 9 feasibility criteria were met. 31 out of the 32 participants demonstrated adherence to the training program. 94.2% of training sessions were completed in the recommended timeframe. No significant technical issue was found. Conclusions Telerehabilitation seems to be a feasible practice for adolescents with brain damage. A training program developed in a foreign language can be used to counter the unavailability of programs in patients’ mother tongue. Trial registration The trial is registered with the ISRCTN registry with study ID ISRCTN59250807
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Affiliation(s)
- Claudia Corti
- Neuro-oncological and Neuropsychological Rehabilitation Unit, Scientific Institute IRCCS Eugenio Medea, Bosisio Parini, Lecco, Italy
- * E-mail:
| | - Geraldina Poggi
- Neuro-oncological and Neuropsychological Rehabilitation Unit, Scientific Institute IRCCS Eugenio Medea, Bosisio Parini, Lecco, Italy
| | - Romina Romaniello
- Neuropsychiatry and Neurorehabilitation Unit, Scientific Institute IRCCS Eugenio Medea, Bosisio Parini, Lecco, Italy
| | - Sandra Strazzer
- Acquired Brain Injury Unit, Scientific Institute IRCCS Eugenio Medea, Bosisio Parini, Lecco, Italy
| | - Cosimo Urgesi
- Neuropsychiatry and Neurorehabilitation Unit, Scientific Institute IRCCS Eugenio Medea, Bosisio Parini, Lecco, Italy
- Laboratory of Cognitive Neuroscience, Department of Languages and Literatures, Communication, Education and Society, University of Udine, Udine, Italy
| | - Renato Borgatti
- Neuropsychiatry and Neurorehabilitation Unit, Scientific Institute IRCCS Eugenio Medea, Bosisio Parini, Lecco, Italy
| | - Alessandra Bardoni
- Neuro-oncological and Neuropsychological Rehabilitation Unit, Scientific Institute IRCCS Eugenio Medea, Bosisio Parini, Lecco, Italy
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Câmara-Costa H, Bull KS, Kennedy C, Wiener A, Calaminus G, Resch A, Kieffer V, Lalande C, Poggi G, von Hoff K, Grill J, Doz F, Rutkowski S, Massimino M, Kortmann RD, Lannering B, Dellatolas G, Chevignard M. Quality of survival and cognitive performance in children treated for medulloblastoma in the PNET 4 randomized controlled trial. Neurooncol Pract 2017; 4:161-170. [PMID: 31385949 DOI: 10.1093/nop/npw028] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background The relationship between direct assessments of cognitive performance and questionnaires assessing quality of survival (QoS) is reported to be weak-to-nonexistent. Conversely, the associations between questionnaires evaluating distinct domains of QoS tend to be strong. This pattern remains understudied. Methods In the HIT-SIOP PNET4 randomized controlled trial, cognitive assessments, including Full Scale, Verbal and Performance IQ, Working Memory, and Processing Speed, were undertaken in 137 survivors of standard-risk medulloblastoma from 4 European countries. QoS questionnaires, including self-reports and/or parent reports of the Behavior Rating Inventory of Executive Function (BRIEF), the Health Utilities Index, the Strengths and Difficulties Questionnaire, and the Pediatric Quality of Life Inventory, were completed for 151 survivors. Correlations among direct cognitive assessments, QoS questionnaires, and clinical data were examined in participants with both assessments available (n = 86). Results Correlations between direct measures of cognitive performance and QoS questionnaires were weak, except for moderate correlations between the BRIEF Metacognition Index (parent report) and working memory (r = .32) and between health status (self-report) and cognitive outcomes (r = .35-.44). Correlations among QoS questionnaires were moderate to strong both for parent and self-report (r = .39-.76). Principal Component Analysis demonstrated that questionnaires and cognitive assessments loaded on 2 separate factors. Conclusions We hypothesize that the strong correlations among QoS questionnaires is partially attributable to the positive/negative polarity of all questions on the questionnaires, coupled with the relative absence of disease-specific questions. These factors may be influenced by respondents' personality and emotional characteristics, unlike direct assessments of cognitive functioning, and should be taken into account in clinical trials.
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Affiliation(s)
- Hugo Câmara-Costa
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France (H.C.C., G.D.)
| | - Kim S Bull
- University of Southampton, Faculty of Medicine, Southampton, SO16 6YD, UK (K.S.B., C.K.)
| | - Colin Kennedy
- University of Southampton, Faculty of Medicine, Southampton, SO16 6YD, UK (K.S.B., C.K.)
| | - Andreas Wiener
- University of Bonn, Paediatric Oncology, Bonn and University Hospital Muenster, Paediatric Oncology, Münster, Germany (A.W., G.C.)
| | - Gabriele Calaminus
- University of Bonn, Paediatric Oncology, Bonn and University Hospital Muenster, Paediatric Oncology, Münster, Germany (A.W., G.C.)
| | - Anika Resch
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany (A.R., K.V.H., S.R.)
| | - Virginie Kieffer
- Hôpitaux de Saint Maurice, Saint Maurice; Groupe de Recherche Clinique Handicap Cognitif et Réadaptation; UPMC Paris 6, France (V.K.)
| | | | - Geraldina Poggi
- Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Lecco, Italy (G.P.)
| | - Katja von Hoff
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany (A.R., K.V.H., S.R.)
| | - Jacques Grill
- Gustave Roussy, Villejuif 94805, France (C.L., J.G.).,Université Paris Saclay, Villejuif 94805, France (J.G.)
| | - François Doz
- Institut Curie and University Paris Descartes, Sorbonne Paris Cité, Paris, France (F.D.)
| | - Stefan Rutkowski
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany (A.R., K.V.H., S.R.)
| | - Maura Massimino
- Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy (M.M.)
| | - Rolf-Dieter Kortmann
- University of Leipzig, Department of Radiation Therapy, Leipzig, Germany (R.D.K.)
| | - Birgitta Lannering
- University of Gothenburg, Department of Paediatric Oncology, Gothenburg, Sweden (B.L.)
| | - Georges Dellatolas
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France (H.C.C., G.D.)
| | - Mathilde Chevignard
- Saint Maurice Hospitals, Rehabilitation Department for children with acquired neurological injury; F-94410 Saint Maurice, France; Sorbonne Universités, UPMC Université Paris 06, INSERM, CNRS, LIB, F-7013 Paris, France (M.C.)
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