학술논문
Gross Motor Function in Children with Congenital Zika Syndrome.
Document Type
Academic Journal
Author
Takahasi EHM; Sarah Network of Neurorehabilitation Hospitals, São Luís, Maranhão, Brazil.; Public Health Department, Federal University of Maranhão, São Luís, Maranhão, Brazil.; Alves MTSSB; Public Health Department, Federal University of Maranhão, São Luís, Maranhão, Brazil.; Ribeiro MRC; Public Health Department, Federal University of Maranhão, São Luís, Maranhão, Brazil.; Souza VFP; Reference Center on Neurodevelopment, Assistance and Rehabilitation of Children - NINAR, State Department of Health of the State of Maranhão, São Luís, Maranhão, Brazil.; Simões VMF; Public Health Department, Federal University of Maranhão, São Luís, Maranhão, Brazil.; Borges MCR; Diagnostic Imaging Department, Federal University of São Paulo, São Paulo, São Paulo, Brazil.; Amaral GA; Sarah Network of Neurorehabilitation Hospitals, São Luís, Maranhão, Brazil.; Gomes LN; Laboratory of Immunology Human, Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, São Paulo, Brazil.; Khouri R; Laboratory of Vector-Borne Infectious Diseases, Gonçalo Moniz Institute, Salvador, Bahia, Brazil.; Department of Pathology and Legal Medicine, Faculty of Medicine, Federal University of Bahia, Salvador, Bahia, Brazil.; da Silva Sousa P; Reference Center on Neurodevelopment, Assistance and Rehabilitation of Children - NINAR, State Department of Health of the State of Maranhão, São Luís, Maranhão, Brazil.; Silva AAMD; Public Health Department, Federal University of Maranhão, São Luís, Maranhão, Brazil.
Source
Publisher: Hippokrates Verlag Country of Publication: Germany NLM ID: 8101187 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1439-1899 (Electronic) Linking ISSN: 0174304X NLM ISO Abbreviation: Neuropediatrics Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Little information on gross motor function of congenital Zika syndrome (CZS) children is available.
Objectives: To evaluate gross motor function in CZS children aged up to 3 years, and its associated factors and changes in a minimum interval of 6 months.
Methods: One hundred children with CZS and cerebral palsy (36 with confirmed and 64 with presumed CZS) were evaluated with the Gross Motor Function Classification System (GMFCS) and Gross Motor Function Measure (GMFM-88/GMFM-66). Forty-six were reevaluated. Wilcoxon tests, Wilcoxon tests for paired samples, percentile scores, and score changes were performed.
Results: Clinical and socioeconomic characteristics (except maternal age), GMFM scores and GMFCS classification of confirmed and probable cases, which were analyzed together, were similar. The mean age was 25.6 months (±5.5); the median GMFM-88 score was 8.0 (5.4-10.8); and the median GMFM-66 score was 20.5 (14.8-23.1); 89% were classified as GMFCS level V. Low economic class, microcephaly at birth, epilepsy, and brain parenchymal volume loss were associated with low GMFM-66 scores. The median GMFM-66 percentile score was 40 (20-55). On the second assessment, the GMFM-66 scores in two GMFCS level I children and one GMFCS level IV child improved significantly. In one GMFCS level III child, one GMFCS level IV child, and the group of GMFCS level V children, no significant changes were observed.
Conclusions: Almost all CZS children had severe cerebral palsy; in the third year of life, most presented no improvement in gross motor function and were likely approaching their maximal gross motor function potential.
Competing Interests: Dr. Souza reports grants from Brazilian National Council for Scientific and Technological Development (CNPq), State Funding Agency of Maranhao (FAPEMA), Ministry of Health Department of Science and Technology (DECIT), and the Ministry of Education Coordination for the Improvement of Higher Education (CAPES), during the conduct of the study.Dr. Simoes reports grants from Brazilian National Council for Scientific and Technological Development (CNPq), State Funding Agency of Maranhao (FAPEMA), Ministry of Health Department of Science and Technology (DECIT), and the Ministry of Education Coordination for the Improvement of Higher Education (CAPES), during the conduct of the study.Dr. Gomes reports grants from Brazilian National Council for Scientific and Technological Development (CNPq), State Funding Agency of Maranhao (FAPEMA), Ministry of Health Department of Science and Technology (DECIT), and the Ministry of Education Coordination for the Improvement of Higher Education (CAPES), during the conduct of the study.Dr. Ribeiro reports grants from Brazilian National Council for Scientific and Technological Development (CNPq), State Funding Agency of Maranhao (FAPEMA), Ministry of Health Department of Science and Technology (DECIT), and the Ministry of Education Coordination for the Improvement of Higher Education (CAPES), during the conduct of the study.Dr. Amaral reports grants from Brazilian National Council for Scientific and Technological Development (CNPq), State Funding Agency of Maranhao (FAPEMA), Ministry of Health Department of Science and Technology (DECIT), and the Ministry of Education Coordination for the Improvement of Higher Education (CAPES), during the conduct of the study.Dr. Sousa reports grants from Brazilian National Council for Scientific and Technological Development (CNPq), State Funding Agency of Maranhao (FAPEMA), Ministry of Health Department of Science and Technology (DECIT), and the Ministry of Education Coordination for the Improvement of Higher Education (CAPES), during the conduct of the study.Dr. Takahasi reports grants from Brazilian National Council for Scientific and Technological Development (CNPq), State Funding Agency of Maranhao (FAPEMA), Ministry of Health Department of Science and Technology (DECIT), and the Ministry of Education Coordination for the Improvement of Higher Education (CAPES), during the conduct of the study.Dr. Borges reports grants from Brazilian National Council for Scientific and Technological Development (CNPq), State Funding Agency of Maranhao (FAPEMA), Ministry of Health Department of Science and Technology (DECIT), and the Ministry of Education Coordination for the Improvement of Higher Education (CAPES), during the conduct of the study.Dr. Alves reports grants from Brazilian National Council for Scientific and Technological Development (CNPq), State Funding Agency of Maranhao (FAPEMA), Ministry of Health Department of Science and Technology (DECIT), and the Ministry of Education Coordination for the Improvement of Higher Education (CAPES), during the conduct of the study.Dr. Khouri reports grants from Brazilian National Council for Scientific and Technological Development (CNPq), State Funding Agency of Maranhao (FAPEMA), Ministry of Health Department of Science and Technology (DECIT), and the Ministry of Education Coordination for the Improvement of Higher Education (CAPES), during the conduct of the study.Dr. Silva reports grants from Brazilian National Council for Scientific and Technological Development (CNPq), State Funding Agency of Maranhao (FAPEMA), Ministry of Health Department of Science and Technology (DECIT), and the Ministry of Education Coordination for the Improvement of Higher Education (CAPES), during the conduct of the study.
(Thieme. All rights reserved.)
Objectives: To evaluate gross motor function in CZS children aged up to 3 years, and its associated factors and changes in a minimum interval of 6 months.
Methods: One hundred children with CZS and cerebral palsy (36 with confirmed and 64 with presumed CZS) were evaluated with the Gross Motor Function Classification System (GMFCS) and Gross Motor Function Measure (GMFM-88/GMFM-66). Forty-six were reevaluated. Wilcoxon tests, Wilcoxon tests for paired samples, percentile scores, and score changes were performed.
Results: Clinical and socioeconomic characteristics (except maternal age), GMFM scores and GMFCS classification of confirmed and probable cases, which were analyzed together, were similar. The mean age was 25.6 months (±5.5); the median GMFM-88 score was 8.0 (5.4-10.8); and the median GMFM-66 score was 20.5 (14.8-23.1); 89% were classified as GMFCS level V. Low economic class, microcephaly at birth, epilepsy, and brain parenchymal volume loss were associated with low GMFM-66 scores. The median GMFM-66 percentile score was 40 (20-55). On the second assessment, the GMFM-66 scores in two GMFCS level I children and one GMFCS level IV child improved significantly. In one GMFCS level III child, one GMFCS level IV child, and the group of GMFCS level V children, no significant changes were observed.
Conclusions: Almost all CZS children had severe cerebral palsy; in the third year of life, most presented no improvement in gross motor function and were likely approaching their maximal gross motor function potential.
Competing Interests: Dr. Souza reports grants from Brazilian National Council for Scientific and Technological Development (CNPq), State Funding Agency of Maranhao (FAPEMA), Ministry of Health Department of Science and Technology (DECIT), and the Ministry of Education Coordination for the Improvement of Higher Education (CAPES), during the conduct of the study.Dr. Simoes reports grants from Brazilian National Council for Scientific and Technological Development (CNPq), State Funding Agency of Maranhao (FAPEMA), Ministry of Health Department of Science and Technology (DECIT), and the Ministry of Education Coordination for the Improvement of Higher Education (CAPES), during the conduct of the study.Dr. Gomes reports grants from Brazilian National Council for Scientific and Technological Development (CNPq), State Funding Agency of Maranhao (FAPEMA), Ministry of Health Department of Science and Technology (DECIT), and the Ministry of Education Coordination for the Improvement of Higher Education (CAPES), during the conduct of the study.Dr. Ribeiro reports grants from Brazilian National Council for Scientific and Technological Development (CNPq), State Funding Agency of Maranhao (FAPEMA), Ministry of Health Department of Science and Technology (DECIT), and the Ministry of Education Coordination for the Improvement of Higher Education (CAPES), during the conduct of the study.Dr. Amaral reports grants from Brazilian National Council for Scientific and Technological Development (CNPq), State Funding Agency of Maranhao (FAPEMA), Ministry of Health Department of Science and Technology (DECIT), and the Ministry of Education Coordination for the Improvement of Higher Education (CAPES), during the conduct of the study.Dr. Sousa reports grants from Brazilian National Council for Scientific and Technological Development (CNPq), State Funding Agency of Maranhao (FAPEMA), Ministry of Health Department of Science and Technology (DECIT), and the Ministry of Education Coordination for the Improvement of Higher Education (CAPES), during the conduct of the study.Dr. Takahasi reports grants from Brazilian National Council for Scientific and Technological Development (CNPq), State Funding Agency of Maranhao (FAPEMA), Ministry of Health Department of Science and Technology (DECIT), and the Ministry of Education Coordination for the Improvement of Higher Education (CAPES), during the conduct of the study.Dr. Borges reports grants from Brazilian National Council for Scientific and Technological Development (CNPq), State Funding Agency of Maranhao (FAPEMA), Ministry of Health Department of Science and Technology (DECIT), and the Ministry of Education Coordination for the Improvement of Higher Education (CAPES), during the conduct of the study.Dr. Alves reports grants from Brazilian National Council for Scientific and Technological Development (CNPq), State Funding Agency of Maranhao (FAPEMA), Ministry of Health Department of Science and Technology (DECIT), and the Ministry of Education Coordination for the Improvement of Higher Education (CAPES), during the conduct of the study.Dr. Khouri reports grants from Brazilian National Council for Scientific and Technological Development (CNPq), State Funding Agency of Maranhao (FAPEMA), Ministry of Health Department of Science and Technology (DECIT), and the Ministry of Education Coordination for the Improvement of Higher Education (CAPES), during the conduct of the study.Dr. Silva reports grants from Brazilian National Council for Scientific and Technological Development (CNPq), State Funding Agency of Maranhao (FAPEMA), Ministry of Health Department of Science and Technology (DECIT), and the Ministry of Education Coordination for the Improvement of Higher Education (CAPES), during the conduct of the study.
(Thieme. All rights reserved.)