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Vestibulo-Oculomotor Reflex Dysfunction in Children with Cerebral Palsy Correlates with Gross Motor Function
Laura Casagrande Conti1, Nicola Ferri2, Leonardo Manzari3
1Santa Lucia Foundation, Scientific Institute for Research and Health Care, 00179 Rome, Italy.
Insights
Vestibular impairments are common in children with cerebral palsy (CP). The video Head Impulse Test (vHIT) is a feasible method to assess angular vestibulo-ocular reflex (aVOR) function, correlating with motor ability.
Area of Science:
- Neuroscience
- Pediatrics
- Vestibular System Research
Background:
- Cerebral palsy (CP) often involves complex motor and cognitive impairments.
- Vestibular system dysfunction is increasingly recognized in children with CP.
- Accurate assessment of vestibular function is crucial for understanding and managing CP-related challenges.
Purpose of the Study:
- To evaluate the feasibility of assessing angular vestibulo-ocular reflex (aVOR) in children with CP using the video Head Impulse Test (vHIT).
- To investigate the correlation between vestibular impairments (aVOR gain) and functional motor ability in children with CP.
- To explore the utility of vHIT in a pediatric CP population.
Main Methods:
- Cross-sectional study involving children diagnosed with CP undergoing vHIT assessment.
- Descriptive statistics and subgroup analysis based on clinical presentation (e.g., ataxia).
- Correlation analysis between aVOR gain and the Gross Motor Function Classification System (GMFCS).
Main Results:
- Six of thirteen children exhibited at least one dysfunctional horizontal semicircular canal via vHIT.
- All children with ataxia showed dysfunctional aVOR gain.
- A significant negative correlation was found between aVOR gain and GMFCS scores (r = -0.73 and -0.68 for left and right horizontal canals, p < 0.05).
Conclusions:
- Vestibular dysfunctions are prevalent in children with CP and significantly correlate with motor function.
- Instrumental vestibular assessment using vHIT, particularly for horizontal canals and the HIMP paradigm, is feasible in children with CP.
- These findings support the use of vHIT for better characterization of function and tailored management strategies for balance and motor impairments in CP.
Background/Objectives:
This study aims to evaluate the feasibility of the angular vestibulo-ocular reflex (aVOR) function assessment in children with cerebral palsy (CP) using the video Head Impulse Test (vHIT) and to investigate how vestibular impairments correlate with functional motor ability.
Methods:
This cross-sectional study included children diagnosed with CP who attempted a vestibular function assessment with the vHIT. Descriptive statistics and a subgroup analysis based on clinical expression were performed. Finally, the correlation between aVOR gain and functional motor ability was investigated.
Results:
Thirteen children underwent assessments of the horizontal semicircular canals. Six out of thirteen children presented at least one dysfunctional canal; overall, eight out of twenty-six horizontal semicircular canals were dysfunctional in the HIMP paradigm. A subgroup analysis revealed a dysfunctional aVOR gain in all the children presenting ataxia. The correlation analysis demonstrated a strong negative association between aVOR gain and the Gross Motor Function Classification System (-0.73 and -0.68 for the left and right horizontal canal, respectively; p < 0.05).
Conclusions:
Vestibular dysfunctions are prevalent in children with CP and strongly correlate with motor function. An instrumental vestibular assessment in children with cognitive-motor disability seems feasible, in particular for horizontal canals and the HIMP paradigm. This could be important for better framing a child's function and enhancing the management of balance and motor impairments with more specific strategies for children with CP.
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