Article (Scientific journals)
Scoping Review on the Diagnosis, Prognosis, and Treatment of Pediatric Disorders of Consciousness.
Molteni, Erika; Santos S Canas, Liane; Briand, Marie-Michèle et al.
2023In Neurology, p. 10.1212/WNL.0000000000207473
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Keywords :
Pediatric disorders of consciousness; adolescents; children; diagnosis; minimally conscious state; prognosis; treatment; unresponsive wakefulness syndrome/ vegetative state; Neurology (clinical)
Abstract :
[en] [en] BACKGROUND AND OBJECTIVES: Comprehensive guidelines for diagnosis, prognosis, and treatments of disorders of consciousness (DoCs) in pediatric patients have not yet been released. We aim to summarize available evidence for DoCs with >14 days duration, to support the future development of guidelines for children aged 6 months to 18 years. METHODS: This scoping review was reported based on PRISMA-ScR guidelines. A systematic search identified records from 4 databases: PubMed, Embase, Cochrane Library, and Web of Science. Abstracts received 3-blind reviews. Corresponding full-text articles rated as "in-scope" and reporting data not published in any other retained article (i.e., no double reporting) were identified and assigned to 5 thematic evaluating teams. Full-text articles were reviewed using a double-blind standardized form. Level of evidence was graded, and summative statements were generated. RESULTS: On November 9, 2022, 2167 documents had been identified; 132 articles were retained, of which 33 (25%) were published over the last 5 years. Overall, 2161 individuals met the inclusion criteria; female patients were 527 of 1554 (33.9%) cases included, whose sex was identifiable. Of 132 articles, 57 (43.2%) were single case reports, and only 5 (3.8%) clinical trials; the level of evidence was prevalently low (80/132; 60.6%). Most studies included neurobehavioral measures (84/127; 66.1%), and neuroimaging (81/127; 63.8%); 59 (46.5%) were mainly related to diagnosis, 56 (44.1%) to prognosis, and 44 (34.6%) to treatment. Most frequently used neurobehavioral tools included the Coma Recovery Scale-Revised, Coma/Near Coma Scale, Level of Cognitive Functioning Assessment Scale and Post-Acute Level of Consciousness scale. Electroencephalography, event related potentials, structural computerized tomography and Magnetic Resonance Imaging were the most frequently used instrumental techniques. In 29/53 (54.7%) cases DoC improvement was observed, which was associated to treatment with amantadine. DISCUSSION: The literature on pediatric DoCs is mainly observational, and clinical details are either inconsistently presented or absent. Conclusions drawn from many studies convey insubstantial evidence, and have limited validity, and low potential for translation in clinical practice. Despite these limitations, our work summarizes the extant literature and constitutes a base for future guidelines related to diagnosis, prognosis and treatment of pediatric DoCs.
Disciplines :
Neurosciences & behavior
Author, co-author :
Molteni, Erika ;  School of Biomedical Engineering & Imaging Sciences, Faculty of Life Science & Medicine, King's College London, London, UK erika.molteni@gmail.com
Santos S Canas, Liane ;  School of Biomedical Engineering & Imaging Sciences, Faculty of Life Science & Medicine, King's College London, London, UK
Briand, Marie-Michèle ;  Université de Liège - ULiège > GIGA ; Department of Physical Medicine and Rehabilitation, Hôpital du Sacré-Coeur de Montréal, Montréal, Canada
Estraneo, Anna ;  IRCCS Fondazione Don Gnocchi, Florence, Sant'Angelo dei Lombardi, Italy
Font, Carolina Colomer ;  NEURORHB - Neuro Rehab Human Brain. Fundación Hospitales Vithas, Valencia, Spain
Formisano, Rita ;  IRCCS Santa Lucia Foundation, Rome, Italy
Fufaeva, Ekaterina ;  Clinical and Research Institute of Emergency Pediatric Surgery and Trauma (CRIEPST), Moscow, Russian Federation
Gosseries, Olivia  ;  Université de Liège - ULiège > GIGA > GIGA Consciousness - Coma Science Group
Howarth, Robyn A ;  Department of Neuropsychology, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
Lanteri, Paola ;  Neurophysiology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
Licandro, Gimena Inès;  Centro de Rehabilitación Infantil CRI CETNA, Fleni, Buenos Aires, Argentina
Magee, Wendy L ;  Boyer College of Music and Dance, Temple University, Philadelphia, USA
Veeramuthu, Vigneswaran ;  Division of Clinical Neuropsychology, Subang Jaya Medical Center, Selangor, Division of Clinical Neuropsychology, Thompson Hospital Kota Damanasara, Selangor, Malaysia
Wilson, Pamela ;  Department of Physical Medicine and Rehabilitation, University of Colorado, Children's Hospital Colorado, Aurora Colorado, USA
Yamaki, Tomohiro ;  Division of Neurosurgery, Rehabilitation Center for Traumatic Apallics Chiba, National Agency for Automotive Safety and Victims' Aid, Chiba, Japan
Slomine, Beth S ;  Department of Neuropsychology, Kennedy Krieger Institute, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, School of Medicine, Baltimore, Maryland, USA
for Special Interest Group on DoC of the International Brain Injury Association (IBIA-DoC SIG)
More authors (7 more) Less
Language :
English
Title :
Scoping Review on the Diagnosis, Prognosis, and Treatment of Pediatric Disorders of Consciousness.
Publication date :
12 June 2023
Journal title :
Neurology
ISSN :
0028-3878
eISSN :
1526-632X
Publisher :
Ovid Technologies (Wolters Kluwer Health), United States
Pages :
10.1212/WNL.0000000000207473
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 22 June 2023

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