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Gielis M, Dirix V, Vanderhenst E, Uyttebroeck A, Feys H, Sleurs C, Jacobs S. Better detection of reduced motor functioning in brain tumor survivors based on objective motor assessments: an incentive for improved standardized follow-up. Eur J Pediatr 2022; 181:2731-2740. [PMID: 35476292 PMCID: PMC9192471 DOI: 10.1007/s00431-022-04472-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 03/15/2022] [Accepted: 04/09/2022] [Indexed: 11/03/2022]
Abstract
Long-term sequelae are well-known in childhood brain tumor survivors, but motor functioning remains poorly described. This cross-sectional study aimed to assess objective motor functioning, patient-specific risk factors, and parental perceptions. Fifty-two childhood brain tumor patients (pilocytic astrocytoma, medulloblastoma, and other types) who were at least 6 months out of treatment were evaluated. Mean age at testing was 11.7 years. Objective motor functioning was assessed with the Movement Assessment Battery for Children (MABC-2-NL) and/or Bruininks-Oseretsky test of motor proficiency (BOT-2). Functional walking capacity was assessed with the 6-min walk test (6MWT). Parent-reported motor functioning was addressed using the ABILHAND-Kids, ABILOCO-Kids questionnaires, and a standardized anamnesis. Patients showed impaired motor functioning in all domains (p < 0.001). Regarding risk factors, younger age at diagnosis (< 5 year) was significantly associated with lower scores on body coordination (p = 0.006). Adjuvant treatment resulted in lower scores for fine manual control of the BOT-2 (p = 0.024) and balance of MABC-2-NL (p = 0.036). Finally, questionnaires revealed an underestimation of motor problems as perceived by the parents. In conclusion, many children who are in follow-up for a brain tumor show impaired motor functioning on multiple aspects, with younger age at diagnosis and adjuvant treatment as specific risk factors. Based on the questionnaires and anamnesis, motor problems appear to be underestimated by the parents. Conclusion: These findings point to the need for timely prospective screening of motor functioning. Based on a screening assessment, adequate rehabilitation programs can be applied in childhood brain tumor survivors, aiming to reduce the adverse impact on their daily lives, both for functional activities and cardiovascular fitness. What is Known: • A pediatric brain tumor and its treatment are associated with potential long-term motor sequelae. • Test assessments could enable us to objectify motor functioning of these patients. What is New: • Pediatric brain tumors survivors show lower motor performance compared to the norm, which is often underestimated by parents. • Younger age at diagnosis and adjuvant treatment could be specific risk factors.
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Affiliation(s)
- Marjoke Gielis
- grid.410569.f0000 0004 0626 3338Department of Pediatrics, Pediatric Hemato-Oncology, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
| | - Veerle Dirix
- grid.410569.f0000 0004 0626 3338Department of Pediatrics, Pediatric Hemato-Oncology, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
| | - Ellen Vanderhenst
- grid.410569.f0000 0004 0626 3338Department of Pediatrics, Pediatric Hemato-Oncology, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
| | - Anne Uyttebroeck
- grid.410569.f0000 0004 0626 3338Department of Pediatrics, Pediatric Hemato-Oncology, University Hospitals Leuven, Herestraat 49, Leuven, Belgium ,grid.5596.f0000 0001 0668 7884Department of Oncology, KU Leuven, Leuven, Belgium
| | - Hilde Feys
- grid.5596.f0000 0001 0668 7884Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Charlotte Sleurs
- grid.5596.f0000 0001 0668 7884Department of Oncology, KU Leuven, Leuven, Belgium
| | - Sandra Jacobs
- Department of Pediatrics, Pediatric Hemato-Oncology, University Hospitals Leuven, Herestraat 49, Leuven, Belgium. .,Department of Oncology, KU Leuven, Leuven, Belgium.
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Gielis M, Dirix V, Vanderhenst E, Uyttebroeck A, Feys H, Sleurs C, Jacobs S. Correction to: Better detection of reduced motor functioning in brain tumor survivors based on objective motor assessments: an incentive for improved standardized follow-up. Eur J Pediatr 2022; 181:3993. [PMID: 36074271 PMCID: PMC9546958 DOI: 10.1007/s00431-022-04605-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Marjoke Gielis
- Department of Pediatrics, Pediatric Hemato-Oncology, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
| | - Veerle Dirix
- Department of Pediatrics, Pediatric Hemato-Oncology, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
| | - Ellen Vanderhenst
- Department of Pediatrics, Pediatric Hemato-Oncology, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
| | - Anne Uyttebroeck
- Department of Pediatrics, Pediatric Hemato-Oncology, University Hospitals Leuven, Herestraat 49, Leuven, Belgium ,Department of Oncology, KU Leuven, Leuven, Belgium
| | - Hilde Feys
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | | | - Sandra Jacobs
- Department of Pediatrics, Pediatric Hemato-Oncology, University Hospitals Leuven, Herestraat 49, Leuven, Belgium. .,Department of Oncology, KU Leuven, Leuven, Belgium.
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Schepers K, Dirix V, Mouchet F, Verscheure V, Lecher S, Locht C, Mascart F. Early cellular immune response to a new candidate mycobacterial vaccine antigen in childhood tuberculosis. Vaccine 2015; 33:1077-83. [PMID: 25583385 DOI: 10.1016/j.vaccine.2014.12.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 09/18/2014] [Accepted: 12/03/2014] [Indexed: 01/02/2023]
Abstract
The search for novel vaccines against tuberculosis (TB) would benefit from in-depths knowledge of the human immune responses to Mycobacterium tuberculosis (Mtb) infection. Here, we characterised in a low TB incidence country, the immune responses to a new candidate vaccine antigen against TB, the heparin-binding haemagglutinin (HBHA), in young children in contact with an active TB case (aTB). Children with no history of BCG vaccination were compared to those vaccinated at birth to compare the initial immune responses to HBHA with secondary immune responses. Fifty-eight children with aTB and 76 with latent TB infection (LTBI) were included and they were compared to 90 non-infected children. Whereas Mtb-infected children globally secreted more interferon-gamma (IFN-γ) in response to HBHA compared to the non-infected children, these IFN-γ concentrations were higher in previously BCG-vaccinated compared to non-vaccinated children. The IFN-γ concentrations were similar in LTBI and aTB children, but appeared to differ qualitatively. Whereas the IFN-γ secretion induced by native methylated and recombinant non-methylated HBHA were well correlated for aTB, this was not the case for LTBI children. Thus, Mtb-infected young children develop IFN-γ responses to HBHA that are enhanced by prior BCG vaccination, indicating BCG-induced priming, thereby supporting a prime-boost strategy for HBHA-based vaccines. The qualitative differences between aTB and LTBI in their HBHA-induced IFN-γ responses may perhaps be exploited for diagnostic purposes.
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Affiliation(s)
- K Schepers
- Laboratory of Vaccinology and Mucosal Immunity, Université Libre de Bruxelles (U.L.B.), Brussels, Belgium; Immunodeficiency Unit, Hôpital Erasme, Université libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - V Dirix
- Laboratory of Vaccinology and Mucosal Immunity, Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - F Mouchet
- Department of Pediatrics, CHU Saint-Pierre, Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - V Verscheure
- Laboratory of Vaccinology and Mucosal Immunity, Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - S Lecher
- INSERM U 1019, Lille, France; CNRS, UMR8204, Lille, France; Université de Lille Nord de France, Lille, France; Institut Pasteur de Lille, Center for Infection and Immunity of Lille, Lille, France
| | - C Locht
- INSERM U 1019, Lille, France; CNRS, UMR8204, Lille, France; Université de Lille Nord de France, Lille, France; Institut Pasteur de Lille, Center for Infection and Immunity of Lille, Lille, France
| | - F Mascart
- Laboratory of Vaccinology and Mucosal Immunity, Université Libre de Bruxelles (U.L.B.), Brussels, Belgium; Immunobiology Clinic, Hôpital Erasme, Université Libre de Bruxelles (U.L.B.), Brussels, Belgium.
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Dirix V, Verscheure V, Goetghebuer T, Hainaut M, Debrie A, Locht C, Mascart F. Cytokine and antibody profiles in 1-year-old children vaccinated with either acellular or whole-cell pertussis vaccine during infancy. Vaccine 2009; 27:6042-7. [DOI: 10.1016/j.vaccine.2009.07.075] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2009] [Revised: 07/02/2009] [Accepted: 07/22/2009] [Indexed: 11/16/2022]
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