Gimeno Hortensia, Lin Jean-Pierre
Complex Motor Disorders Service, Evelina London Children's Hospital, Guy's & St Thomas' NHS Foundation Trust, London, UK; Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK.
Complex Motor Disorders Service, Evelina London Children's Hospital, Guy's & St Thomas' NHS Foundation Trust, London, UK.
Eur J Paediatr Neurol. 2017 Jan;21(1):147-167. doi: 10.1016/j.ejpn.2016.08.016. Epub 2016 Sep 8.
The multidisciplinary team (MDT) approach illustrates how motor classification systems, assessments and outcome measures currently available have been applied to a national cohort of children and young people with dystonia and other hyperkinetic movement disorders (HMD) particularly with a focus on dyskinetic cerebral palsy (CP). The paper is divided in 3 sections. Firstly, we describe the service model adopted by the Complex Motor Disorders Service (CMDS) at Evelina London Children's Hospital and King's College Hospital (ELCH-KCH) for deep brain stimulation. We describe lessons learnt from available dystonia studies and discuss/propose ways to measure DBS and other dystonia-related intervention outcomes. We aim to report on current available functional outcome measures as well as some impairment-based assessments that can encourage and generate discussion among movement disorders specialists of different backgrounds regarding choice of the most important areas to be measured after DBS and other interventions for dystonia management. Finally, some recommendations for multi-centre collaboration in regards to functional clinical outcomes and research methodologies for dystonia-related interventions are proposed.
多学科团队(MDT)方法展示了当前可用的运动分类系统、评估方法和结局指标是如何应用于一个全国性的患有肌张力障碍及其他运动亢进性疾病(HMD)的儿童和青少年队列的,尤其聚焦于运动障碍型脑性瘫痪(CP)。本文分为三个部分。首先,我们描述了伦敦伊夫林儿童医院和国王学院医院(ELCH-KCH)的复杂运动障碍服务(CMDS)所采用的用于深部脑刺激的服务模式。我们阐述了从现有肌张力障碍研究中吸取的经验教训,并讨论/提出了测量深部脑刺激及其他与肌张力障碍相关干预结局的方法。我们旨在报告当前可用的功能结局指标以及一些基于损伤的评估方法,这些指标和方法能够促进不同背景的运动障碍专家之间就深部脑刺激及其他治疗肌张力障碍的干预措施后最重要的测量领域的选择展开讨论并引发思考。最后,针对肌张力障碍相关干预措施的功能临床结局和研究方法,提出了一些关于多中心合作的建议。