1
|
Stewart K, Lewis J, Wallen M, Bear N, Harvey A. The Dyskinetic Cerebral Palsy Functional Impact Scale: development and validation of a new tool. Dev Med Child Neurol 2021; 63:1469-1475. [PMID: 34145577 DOI: 10.1111/dmcn.14960] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/19/2021] [Indexed: 12/26/2022]
Abstract
AIM To outline the development and examine the content and construct validity of a new tool, the Dyskinetic Cerebral Palsy Functional Impact Scale (D-FIS), which measures the impact of dyskinesia on everyday activities in children with cerebral palsy (CP). METHOD D-FIS content was informed by a systematic review of dyskinesia outcome measures, in collaboration with children with dyskinetic CP, parents, caregivers, and expert clinicians. The D-FIS uses parent proxy to rate impact of dyskinesia on everyday activities. Construct validity was determined by examining internal consistency; known groups validity with the Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), Communication Function Classification System (CFCS), and Eating and Drinking Ability Classification System (EDACS); and convergent validity with the Barry-Albright Dystonia Scale (BADS). RESULTS Fifty-seven parents of children (29 males, 28 females, mean [SD] age 11y 8mo [4y 4mo], range 2y 6mo-18y) completed the D-FIS. Correlation between D-FIS and GMFCS was r=0.86 (95% confidence interval [CI]: 0.77-0.91, p<0.001); MACS r=0.84 (95% CI: 0.73-0.90, p<0.001); CFCS r=0.80 (95% CI: 0.67-0.88, p<0.001); and EDACS r=0.78 (95% CI: 0.66-0.87). Correlation between D-FIS and BADS was r=0.77 (95% CI: 0.64-0.86, p<0.001). Cronbach's alpha was 0.96. INTERPRETATION The D-FIS demonstrates good construct validity and high internal consistency. The D-FIS will be useful for identifying priorities for intervention. It adds to the measurement tool kit for children with dyskinetic CP by addressing functional impact of dyskinetic movements and postures. What this paper adds The Dyskinetic Cerebral Palsy Functional Impact Scale (D-FIS) assesses the perceived impact of dyskinesia on daily activities in children with cerebral palsy (CP). The D-FIS demonstrates good construct validity and high internal consistency. The D-FIS is a clinically feasible, family-centred tool that fills a current gap in the dyskinetic CP assessment toolkit.
Collapse
Affiliation(s)
- Kirsty Stewart
- Kids Rehab, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,School of Allied Health, Australian Catholic University, North Sydney, New South Wales, Australia
| | - Jennifer Lewis
- Kids Rehab, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Margaret Wallen
- School of Allied Health, Australian Catholic University, North Sydney, New South Wales, Australia
| | - Natasha Bear
- Institute of Health Research, University of Notre Dame, Freemantle, Western Australia, Australia
| | - Adrienne Harvey
- Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| |
Collapse
|
2
|
Barcala L, Politti F, Artilheiro MC, Speciali DS, Garbelotti SA, Correa JCF, Lucareli PRG. Adult dyskinetic cerebral palsy: Upper limb movement and muscle function. Acta Neurol Scand 2019; 139:505-511. [PMID: 30810219 DOI: 10.1111/ane.13083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Revised: 02/06/2019] [Accepted: 02/20/2019] [Indexed: 02/01/2023]
Abstract
AIM The aim of this study was to characterize upper limb motor function during a comparative analysis of electromyographic and upper limb movement analysis during drinking between healthy adults and individuals with DCP. METHOD Fifteen healthy individuals (CG) and fifteen individuals with DCP (DG) participated in the study. Upper limb function was analyzed during drinking and consisted of a task divided into three phases: the going, the adjustment, and the return. RESULTS Electromyographic analysis revealed a lower activity of the anterior deltoid, posterior deltoid, and biceps brachii muscles in the DG. When comparing the interactions between groups and phases, only biceps brachii shower lower muscle activity during going and adjustment phases. The DG presented a smaller range of motion (ROM) for the shoulder, elbow, forearm and wrist movements. An interaction between groups and phases showed smaller ROM for the flexion and internal rotation of the shoulder, elbow flexion, forearm pronation, and ulnar deviation in the return phase compared to CG. INTERPRETATION The results may contribute positively to the quantification of the level of motor impairment and may be used as a reference for the development of therapeutic interventions for patients with DCP.
Collapse
Affiliation(s)
- Luciana Barcala
- Human Motion Analysis Laboratory, Department of Rehabilitation Science Universidade Nove de Julho São Paulo Brazil
| | - Fabiano Politti
- Human Motion Analysis Laboratory, Department of Rehabilitation Science Universidade Nove de Julho São Paulo Brazil
| | - Mariana C. Artilheiro
- Human Motion Analysis Laboratory, Department of Rehabilitation Science Universidade Nove de Julho São Paulo Brazil
| | - Danielli S. Speciali
- Human Motion Analysis Laboratory, Department of Rehabilitation Science Universidade Nove de Julho São Paulo Brazil
- Human Movement Analysis Laboratory Albert Einstein Hospital São Paulo Brazil
| | - Silvio A. Garbelotti
- Department of Physical Therapy Universidade Cidade de São Paulo São Paulo Brazil
| | - João C. F. Correa
- Human Motion Analysis Laboratory, Department of Rehabilitation Science Universidade Nove de Julho São Paulo Brazil
| | - Paulo R. G. Lucareli
- Human Motion Analysis Laboratory, Department of Rehabilitation Science Universidade Nove de Julho São Paulo Brazil
| |
Collapse
|
3
|
Functional Connectivity Alterations in Children with Spastic and Dyskinetic Cerebral Palsy. Neural Plast 2018; 2018:7058953. [PMID: 30186320 PMCID: PMC6114065 DOI: 10.1155/2018/7058953] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 06/01/2018] [Accepted: 06/06/2018] [Indexed: 01/28/2023] Open
Abstract
Cerebral palsy (CP) has long been investigated to be associated with a range of motor and cognitive dysfunction. As the two most common CP subtypes, spastic cerebral palsy (SCP) and dyskinetic cerebral palsy (DCP) may share common and distinct elements in their pathophysiology. However, the common and distinct dysfunctional characteristics between SCP and DCP on the brain network level are less known. This study aims to detect the alteration of brain functional connectivity in children with SCP and DCP based on resting-state functional MRI (fMRI). Resting-state networks (RSNs) were established based on the independent component analysis (ICA), and the functional network connectivity (FNC) was performed on the fMRI data from 16 DCP, 18 bilateral SCP, and 18 healthy children. Compared with healthy controls, altered functional connectivity within the cerebellum network, sensorimotor network (SMN), left frontoparietal network (LFPN), and salience network (SN) were found in DCP and SCP groups. Furthermore, the disconnections of the FNC consistently focused on the visual pathway; covariance of the default mode network (DMN) with other networks was observed both in DCP and SCP groups, while the DCP group had a distinct connectivity abnormality in motor pathway and self-referential processing-related connections. Correlations between the functional disconnection and the motor-related clinical measurement in children with CP were also found. These findings indicate functional connectivity impairment and altered integration widely exist in children with CP, suggesting that the abnormal functional connectivity is a pathophysiological mechanism of motor and cognitive dysfunction of CP.
Collapse
|
4
|
Ballester-Plané J, Schmidt R, Laporta-Hoyos O, Junqué C, Vázquez É, Delgado I, Zubiaurre-Elorza L, Macaya A, Póo P, Toro E, de Reus MA, van den Heuvel MP, Pueyo R. Whole-brain structural connectivity in dyskinetic cerebral palsy and its association with motor and cognitive function. Hum Brain Mapp 2017; 38:4594-4612. [PMID: 28608616 DOI: 10.1002/hbm.23686] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 06/01/2017] [Indexed: 12/31/2022] Open
Abstract
Dyskinetic cerebral palsy (CP) has long been associated with basal ganglia and thalamus lesions. Recent evidence further points at white matter (WM) damage. This study aims to identify altered WM pathways in dyskinetic CP from a standardized, connectome-based approach, and to assess structure-function relationship in WM pathways for clinical outcomes. Individual connectome maps of 25 subjects with dyskinetic CP and 24 healthy controls were obtained combining a structural parcellation scheme with whole-brain deterministic tractography. Graph theoretical metrics and the network-based statistic were applied to compare groups and to correlate WM state with motor and cognitive performance. Results showed a widespread reduction of WM volume in CP subjects compared to controls and a more localized decrease in degree (number of links per node) and fractional anisotropy (FA), comprising parieto-occipital regions and the hippocampus. However, supramarginal gyrus showed a significantly higher degree. At the network level, CP subjects showed a bilateral pathway with reduced FA, comprising sensorimotor, intraparietal and fronto-parietal connections. Gross and fine motor functions correlated with FA in a pathway comprising the sensorimotor system, but gross motor also correlated with prefrontal, temporal and occipital connections. Intelligence correlated with FA in a network with fronto-striatal and parieto-frontal connections, and visuoperception was related to right occipital connections. These findings demonstrate a disruption in structural brain connectivity in dyskinetic CP, revealing general involvement of posterior brain regions with relative preservation of prefrontal areas. We identified pathways in which WM integrity is related to clinical features, including but not limited to the sensorimotor system. Hum Brain Mapp 38:4594-4612, 2017. © 2017 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Júlia Ballester-Plané
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Barcelona, Spain.,Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain.,Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain
| | - Ruben Schmidt
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Olga Laporta-Hoyos
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Barcelona, Spain.,Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain.,Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain
| | - Carme Junqué
- Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain.,Departament de Medicina, Universitat de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Élida Vázquez
- Servei de Radiologia Pediàtrica, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Ignacio Delgado
- Servei de Radiologia Pediàtrica, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Leire Zubiaurre-Elorza
- Departamento de Fundamentos y Métodos de la Psicología, Facultad de Psicología y Educación, Universidad de Deusto, Bilbo-Bizkaia, Spain
| | - Alfons Macaya
- Grup de Recerca en Neurologia Pediàtrica, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Pilar Póo
- Servei de Neurologia, Hospital Universitari Sant Joan de Déu, Barcelona, Spain
| | - Esther Toro
- Servei de Rehabilitació i Medicina Física, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Marcel A de Reus
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Martijn P van den Heuvel
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Roser Pueyo
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Barcelona, Spain.,Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain.,Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain
| |
Collapse
|