Nonmotor Symptom Scales in Children With Movement Disorders: A Scoping Review

Area of Science:

• Pediatric Neurology
• Movement Disorders
• Nonmotor Symptoms Assessment

Background:

• Nonmotor symptoms (NMSs) significantly impact children with movement disorders like tics, dystonia, and cerebral palsy (CP).
• These symptoms are frequently overlooked, affecting daily functioning and quality of life.
• Understanding current assessment practices is crucial for future research and tool development.

Purpose of the Study:

• To identify scales and tools used in routine practice and research for assessing NMSs in pediatric movement disorders.
• To inform the development of standardized and potentially disorder-specific NMS assessment instruments.

Main Methods:

• A comprehensive literature search was conducted across MEDLINE, Embase, and PsycINFO (1990-2023).
• Studies evaluating NMSs using scales in children (0-18 years) with tic disorders, dystonia, or CP were included.

Main Results:

• 382 studies were analyzed, primarily cross-sectional, cohort, and case-control designs.
• Cognitive impairment, mental health, behavioral issues, and pain were most frequently assessed.
• Self-esteem, communication, sleep disturbance, fatigue, and GI/urinary symptoms were rarely evaluated, with potential overrepresentation of CP assessments.

Conclusions:

• Significant gaps exist in evaluating NMSs in pediatric movement disorders, especially for pain, sleep, and GI symptoms.
• Standardization is needed, but the preference for general vs. disorder-specific tools remains unclear.
• Integrating NMS assessment into routine care and cross-cultural validation are essential for early identification and management.