Elegast Monbaliu1, Paul de Cock2, Els Ortibus3, Lieve Heyrman1, Katrijn Klingels1, Hilde Feys1. 1. Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium. 2. Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium. 3. Department of Development and Regeneration, KU Leuven, Leuven, Belgium.
Abstract
AIM: The aim of the study was to map clinical patterns of dystonia and choreoathetosis and to assess the relation between functional classifications and basal ganglia and thalamus lesions in participants with dyskinetic cerebral palsy (CP). METHODS: In this cross-sectional study, 55 participants with dyskinetic CP (mean age 14y 6mo, SD 4y 1mo; range 6-22y) were assessed with the Dyskinesia Impairment Scale and classified with the Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), and Communication Function Classification System (CFCS). RESULTS: Dystonia and choreoathetosis are simultaneously present. Median levels of dystonia (70.2%) were significantly higher than levels of choreoathetosis (26.7%) and both were significantly higher during activity than at rest (both p<0.01). High correlations were found between dystonia levels and GMFCS level (Spearman's rank correlation coefficient, rS =0.70; 95% confidence interval [CI] 0.53-0.81; p<0.01) and MACS (rS =0.65; 95% CI 0.47-0.81; p<0.01), and fair correlation with CFCS (rs =0.36; 95% CI=0.11-0.57; p<0.05). No significant correlation was found between choreoathetosis levels and motor classifications. Finally, higher choreoathetosis levels were found in participants with pure thalamus and basal ganglia lesions (p=0.03) than mixed lesions, but not for dystonia (p=0.41). INTERPRETATION: Dystonia and choreoathetosis increase during activity. However, dystonia predominates and seems to have a larger impact on functional abilities. Our findings further suggest that choreoathetosis seems to be more linked to pure thalamus and basal ganglia lesions than dystonia.
AIM: The aim of the study was to map clinical patterns of dystonia and choreoathetosis and to assess the relation between functional classifications and basal ganglia and thalamus lesions in participants with dyskinetic cerebral palsy (CP). METHODS: In this cross-sectional study, 55 participants with dyskinetic CP (mean age 14y 6mo, SD 4y 1mo; range 6-22y) were assessed with the Dyskinesia Impairment Scale and classified with the Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), and Communication Function Classification System (CFCS). RESULTS:Dystonia and choreoathetosis are simultaneously present. Median levels of dystonia (70.2%) were significantly higher than levels of choreoathetosis (26.7%) and both were significantly higher during activity than at rest (both p<0.01). High correlations were found between dystonia levels and GMFCS level (Spearman's rank correlation coefficient, rS =0.70; 95% confidence interval [CI] 0.53-0.81; p<0.01) and MACS (rS =0.65; 95% CI 0.47-0.81; p<0.01), and fair correlation with CFCS (rs =0.36; 95% CI=0.11-0.57; p<0.05). No significant correlation was found between choreoathetosis levels and motor classifications. Finally, higher choreoathetosis levels were found in participants with pure thalamus and basal ganglia lesions (p=0.03) than mixed lesions, but not for dystonia (p=0.41). INTERPRETATION:Dystonia and choreoathetosis increase during activity. However, dystonia predominates and seems to have a larger impact on functional abilities. Our findings further suggest that choreoathetosis seems to be more linked to pure thalamus and basal ganglia lesions than dystonia.
Authors: Dylan den Hartog; Marjolein M van der Krogt; Sven van der Burg; Ignazio Aleo; Johannes Gijsbers; Laura A Bonouvrié; Jaap Harlaar; Annemieke I Buizer; Helga Haberfehlner Journal: Sensors (Basel) Date: 2022-06-09 Impact factor: 3.847
Authors: Roslyn N Boyd; Peter Sw Davies; Jenny Ziviani; Stewart Trost; Lee Barber; Robert Ware; Stephen Rose; Koa Whittingham; Leanne Sakzewski; Kristie Bell; Christopher Carty; Steven Obst; Katherine Benfer; Sarah Reedman; Priya Edwards; Megan Kentish; Lisa Copeland; Kelly Weir; Camilla Davenport; Denise Brooks; Alan Coulthard; Rebecca Pelekanos; Andrea Guzzetta; Simona Fiori; Meredith Wynter; Christine Finn; Andrea Burgess; Kym Morris; John Walsh; Owen Lloyd; Jennifer A Whitty; Paul A Scuffham Journal: BMJ Open Date: 2017-07-12 Impact factor: 2.692
Authors: Bhooma R Aravamuthan; Michael Shevell; Young-Min Kim; Jenny L Wilson; Jennifer A O'Malley; Toni S Pearson; Michael C Kruer; Michael Fahey; Jeff L Waugh; Barry Russman; Bruce Shapiro; Ann Tilton Journal: Neurology Date: 2020-10-12 Impact factor: 9.910
Authors: Laura A Bonouvrié; Jules G Becher; Johan S H Vles; R Jeroen Vermeulen; Annemieke I Buizer Journal: Ann Neurol Date: 2019-05-21 Impact factor: 10.422