Department of Paediatrics, University Hospitals Leuven, Leuven, Belgium.
Department of Development and Regeneration, KU Leuven, Leuven, Belgium.
J Neuromuscul Dis. 2024;11(4):791-799. doi: 10.3233/JND-230251.
Emerging evidence underscores the high prevalence of neurobehavioral difficulties like ADHD, ASD and OCD, in patients with Duchenne muscular dystrophy (DMD). The substantial impact of these complex behavioral challenges in addition to motor function decline on the well-being of affected individuals and their families is increasingly evident. However, a uniform approach for effective screening, assessment and management of the neurobehavioral symptoms remains elusive.
We explored strategies used by healthcare professionals with clinical expertise in DMD to address neurobehavioral symptoms, in order to uncover diverse practices and to identify potential directions for clinical approaches in managing DMD neurobehavioral symptoms.
Twenty-eight respondents from 16 different countries completed an online survey. Only 35% of the centers systematically screened for neurobehavioral difficulties in their DMD population. Predominant screening methods included history taking and clinical observation. Common neurobehavioral difficulties encompassed learning challenges, dependency from adults, anxiety, concentration difficulties, and social deficits. The participating centers frequently employed parental counseling and liaison with psychosocial healthcare professionals for psychosocial intervention.
This study underscores the complex behavioral landscape in DMD, highlighting the need for validated screening, assessment and management strategies and collaborative efforts in implementing these. We advocate for international consensus recommendations for screening, assessment and management of neurobehavioral difficulties in DMD to enhance patient care and communication across healthcare settings.
越来越多的证据表明,杜氏肌营养不良症(DMD)患者中存在注意力缺陷多动障碍(ADHD)、自闭症谱系障碍(ASD)和强迫症(OCD)等神经行为障碍的高发率。这些复杂的行为挑战以及运动功能下降对患者及其家庭的幸福感的重大影响越来越明显。然而,对于神经行为症状的有效筛查、评估和管理,仍然缺乏统一的方法。
我们探讨了具有 DMD 临床专业知识的医疗保健专业人员用于解决神经行为症状的策略,以揭示不同的实践,并确定管理 DMD 神经行为症状的临床方法的潜在方向。
来自 16 个不同国家的 28 名受访者完成了在线调查。只有 35%的中心对其 DMD 人群进行了系统性的神经行为困难筛查。主要的筛查方法包括病史采集和临床观察。常见的神经行为困难包括学习挑战、对成人的依赖、焦虑、注意力困难和社交缺陷。参与的中心经常为家长提供咨询,并与心理社会保健专业人员联系,以进行心理社会干预。
本研究强调了 DMD 中复杂的行为状况,突出了需要验证的筛查、评估和管理策略,并需要合作努力来实施这些策略。我们主张制定 DMD 神经行为困难筛查、评估和管理的国际共识建议,以加强跨医疗保健环境的患者护理和沟通。