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Quality of Life in Children With Sturge-Weber Syndrome
- Harmon, Kelly A;
- Day, Alyssa M;
- Hammill, Adrienne M;
- Pinto, Anna L;
- McCulloch, Charles E;
- Comi, Anne M;
- Group, Institutes of Health Rare Disease Clinical Research Consortium Brain and Vascular Malformation Consortium SWS Investigator;
- Ball, Karen L;
- Fisher, Brian J;
- Juhász, Csaba;
- Kim, Helen;
- Koenig, Jim;
- Lawton, Michael T;
- Lo, Warren D;
- Marchuk, Douglas A;
- Miles, Daniel K;
- Moses, Marsha A;
- Pevsner, Jonathan;
- Roach, E Steve;
- Wilfong, Angus A
Published Web Location
https://doi.org/10.1016/j.pediatrneurol.2019.04.004Abstract
AIM: We assessed the utilization of the National Institutes of Health Quality of Life in Neurological Disorders (Neuro-QoL) in pediatric patients with Sturge-Weber syndrome, a rare neurovascular disorder which frequently results in seizures, brain atrophy, calcification, and a range of neurological impairments. METHODS: Subjects were seen clinically and consented for research. All 22 patients filled out the Pediatric Neuro-QoL. The Neuro-QoL subscores were converted to T-scores to compare with the referenced control population. Twenty-one participants also filled out the Brain Vascular Malformation Consortium Database Questionnaire containing data pertaining to Sturge-Weber syndrome-related medical history, medications, comorbidities, and family history. All data were analyzed with a significance threshold of P < 0.05. RESULTS: Cognitive function quality of life was significantly lower (P < 0.001) in pediatric patients with Sturge-Weber syndrome compared with referenced control subjects. Male gender (P = 0.02) was associated with lower cognitive function Neuro-QoL. The extent of skin (R = -0.46, P = 0.04), total eyelid port-wine birthmark (R = -0.56, P = 0.007), eye (R = -0.58, P = 0.005), and total Sturge-Weber syndrome involvement (R = -0.63, P = 0.002) were negatively correlated with cognitive function Neuro-QoL. A younger age at seizure onset was associated with lower cognitive function Neuro-QoL (hazard ratio = 0.90, P = 0.004) even after controlling for extent of brain, skin, or eye involvement. Antidepressant use was associated with lower cognitive function Neuro-QoL (P = 0.005), and cognitive function Neuro-QoL was negatively correlated with depression Neuro-QoL; however, after adjusting for depression this relationship was no longer significant. CONCLUSIONS: The results suggest targeting cognitive function Neuro-QoL in treatment trials and reiterate the prognostic value of early seizure onset. In addition, sex-related differences were noted, which should be further studied.
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