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Studying Brain Function in Children Using Magnetoencephalography
Published on: April 8, 2019
Quality of Life in Children With Sturge-Weber Syndrome
Kelly A Harmon1, Alyssa M Day1, Adrienne M Hammill2
1Department of Neurology, Kennedy Krieger Institute, Baltimore, Maryland.
Insights
Pediatric patients with Sturge-Weber syndrome experience lower cognitive function quality of life. Early seizure onset and male gender are linked to poorer outcomes in this rare neurovascular disorder.
Area of Science:
- Neurology
- Pediatrics
- Quality of Life Research
Background:
- Sturge-Weber syndrome is a rare neurovascular disorder affecting pediatric patients.
- It often leads to neurological impairments including seizures, brain atrophy, and calcification.
- Assessing quality of life is crucial for understanding the comprehensive impact of the syndrome.
Purpose of the Study:
- To evaluate the utilization of the National Institutes of Health Quality of Life in Neurological Disorders (Neuro-QoL) in pediatric patients with Sturge-Weber syndrome.
- To identify factors associated with quality of life in this population.
- To compare Neuro-QoL scores with a referenced control population.
Main Methods:
- Utilized the Pediatric Neuro-QoL instrument for 22 pediatric patients diagnosed with Sturge-Weber syndrome.
- Converted Neuro-QoL subscores to T-scores for comparison with control subjects.
- Collected additional clinical and demographic data using the Brain Vascular Malformation Consortium Database Questionnaire for 21 participants.
Main Results:
- Pediatric patients with Sturge-Weber syndrome showed significantly lower cognitive function quality of life compared to controls (P < 0.001).
- Male gender (P = 0.02), greater extent of skin and ocular port-wine birthmarks, and overall disease severity were negatively correlated with cognitive function Neuro-QoL.
- Younger age at seizure onset (HR = 0.90, P = 0.004) and antidepressant use (P = 0.005) were also associated with lower cognitive function scores.
Conclusions:
- Cognitive function quality of life should be a target in treatment trials for Sturge-Weber syndrome.
- Early seizure onset is a significant prognostic indicator for cognitive function.
- Further research is warranted to explore sex-related differences in quality of life outcomes.
Aim:
We assessed the utilization of the National Institutes of Health Quality of Life in Neurological Disorders (Neuro-QoL) in pediatric patients with Sturge-Weber syndrome, a rare neurovascular disorder which frequently results in seizures, brain atrophy, calcification, and a range of neurological impairments.
Methods:
Subjects were seen clinically and consented for research. All 22 patients filled out the Pediatric Neuro-QoL. The Neuro-QoL subscores were converted to T-scores to compare with the referenced control population. Twenty-one participants also filled out the Brain Vascular Malformation Consortium Database Questionnaire containing data pertaining to Sturge-Weber syndrome-related medical history, medications, comorbidities, and family history. All data were analyzed with a significance threshold of P < 0.05.
Results:
Cognitive function quality of life was significantly lower (P < 0.001) in pediatric patients with Sturge-Weber syndrome compared with referenced control subjects. Male gender (P = 0.02) was associated with lower cognitive function Neuro-QoL. The extent of skin (R = -0.46, P = 0.04), total eyelid port-wine birthmark (R = -0.56, P = 0.007), eye (R = -0.58, P = 0.005), and total Sturge-Weber syndrome involvement (R = -0.63, P = 0.002) were negatively correlated with cognitive function Neuro-QoL. A younger age at seizure onset was associated with lower cognitive function Neuro-QoL (hazard ratio = 0.90, P = 0.004) even after controlling for extent of brain, skin, or eye involvement. Antidepressant use was associated with lower cognitive function Neuro-QoL (P = 0.005), and cognitive function Neuro-QoL was negatively correlated with depression Neuro-QoL; however, after adjusting for depression this relationship was no longer significant.
Conclusions:
The results suggest targeting cognitive function Neuro-QoL in treatment trials and reiterate the prognostic value of early seizure onset. In addition, sex-related differences were noted, which should be further studied.
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