TY - JOUR
T1 - Left-handedness should not be overrated as a risk factor for postoperative speech impairment in children after posterior fossa tumour surgery
T2 - a prospective European multicentre study
AU - Grønbæk, Jonathan Kjær
AU - Laustsen, Aske Foldbjerg
AU - Toescu, Sebastian
AU - Pizer, Barry
AU - Mallucci, Conor
AU - Aquilina, Kristian
AU - Molinari, Emanuela
AU - Hjort, Magnus Aasved
AU - Gumbeleviciene, Lingvita
AU - Hauser, Peter
AU - Pálmafy, Beatrix
AU - van Baarsen, Kirsten
AU - Hoving, Eelco
AU - Zipfel, Julian
AU - Ehrstedt, Christoffer
AU - Grillner, Pernilla
AU - Callesen, Michael Thude
AU - Frič, Radek
AU - Wibroe, Morten
AU - Nysom, Karsten
AU - Schmiegelow, Kjeld
AU - Sehested, Astrid
AU - Mathiasen, René
AU - Juhler, Marianne
AU - Grønbæk, Jonathan Kjær
AU - Møller, Lisbeth Nørgaard
AU - Gustavsson, Bengt
AU - Westerholm-Ormio, Mia
AU - Kiudeliene, Rosita
AU - Mudra, Katalin
AU - van Baarsen, Kirsten
AU - Kjærsgaard, Mimi
AU - Bøgeskov, Lars
AU - Skjøth-Rasmussen, Jane
AU - Hauerberg Tamm, John
AU - Poulsgaard, Lars
AU - Gudrunardottir, Thora
AU - Grønbæk, Sylvester Klöcker
AU - Blichfeldt, Alberte
AU - Raben-Levetzau, Felix Nicolai
AU - Thude Callesen, Michael
AU - Rathe, Mathias
AU - Klokker, Rikke Bassø
AU - von Oettingen, Gorm
AU - Mikkelsen, Torben
AU - Henriksen, Louise Tram
AU - Cortnum, Søren
AU - Tofting-Olesen, Kamilla
AU - Karppinen, Atte
AU - Thomassen, Harald
AU - On behalf of The CMS study group
N1 - Funding Information:
This study was funded by The Danish Childhood Cancer Foundation, The Swedish Childhood Cancer Foundation, The Brain Tumour Charity (UK), The Danish Cancer Society, King Christian IX and Queen Louise’s anniversary grant, The Danish Capitol Regions Research Fund, Dagmar Marshall Foundation and Rigshospitalet’s Research Fund in support of oncology purposes and Braintrust (SCOT). All research at Great Ormond Street Hospital NHS Foundation Trust and UCL Great Ormond Street Institute of Child Health is made possible by the NIHR Great Ormond Street Hospital Biomedical Research Centre. This work is part of Childhood Oncology Network Targeting Research, Organization & Life expectancy (CONTROL) and supported by Danish Cancer Society and the Danish Childhood Cancer Foundation. The funding bodies had no role in the design of the study, analyses, interpretation of the data or decision to submit results.
Funding Information:
KS reports personal fees from Jazz Pharmaceuticals, Servier, Amgen, and Medscape, and personal fees and grants from Servier, outside the submitted work. KN reports personal fees from Bayer, EUSA Pharma and Y-mAbs, all outside the submitted work. All other authors declare no competing interests.
PY - 2022
Y1 - 2022
N2 - Purpose: Cerebellar mutism syndrome (CMS) is a severe neurological complication of posterior fossa tumour surgery in children, and postoperative speech impairment (POSI) is the main component. Left-handedness was previously suggested as a strong risk factor for POSI. The aim of this study was to investigate the relationship between handedness and the risk of POSI. Methods: We prospectively included children (aged < 18 years) undergoing surgery for posterior fossa tumours in 26 European centres. Handedness was assessed pre-operatively and postoperative speech status was categorised as either POSI (mutism or reduced speech) or habitual speech, based on the postoperative clinical assessment. Logistic regression was used in the risk factor analysis of POSI as a dichotomous outcome. Results: Of the 500 children included, 37 (7%) were excluded from the present analysis due to enrolment at a reoperation; another 213 (43%) due to missing data about surgery (n = 37) and/or handedness (n = 146) and/or postoperative speech status (n = 53). Out of the remaining 250 (50%) patients, 20 (8%) were left-handed and 230 (92%) were right-handed. POSI was observed equally frequently regardless of handedness (5/20 [25%] in left-handed, 61/230 [27%] in right-handed, OR: 1.08 [95% CI: 0.40–3.44], p = 0.882), also when adjusted for tumour histology, location and age. Conclusion: We found no difference in the risk of POSI associated with handedness. Our data do not support the hypothesis that handedness should be of clinical relevance in the risk assessment of CMS.
AB - Purpose: Cerebellar mutism syndrome (CMS) is a severe neurological complication of posterior fossa tumour surgery in children, and postoperative speech impairment (POSI) is the main component. Left-handedness was previously suggested as a strong risk factor for POSI. The aim of this study was to investigate the relationship between handedness and the risk of POSI. Methods: We prospectively included children (aged < 18 years) undergoing surgery for posterior fossa tumours in 26 European centres. Handedness was assessed pre-operatively and postoperative speech status was categorised as either POSI (mutism or reduced speech) or habitual speech, based on the postoperative clinical assessment. Logistic regression was used in the risk factor analysis of POSI as a dichotomous outcome. Results: Of the 500 children included, 37 (7%) were excluded from the present analysis due to enrolment at a reoperation; another 213 (43%) due to missing data about surgery (n = 37) and/or handedness (n = 146) and/or postoperative speech status (n = 53). Out of the remaining 250 (50%) patients, 20 (8%) were left-handed and 230 (92%) were right-handed. POSI was observed equally frequently regardless of handedness (5/20 [25%] in left-handed, 61/230 [27%] in right-handed, OR: 1.08 [95% CI: 0.40–3.44], p = 0.882), also when adjusted for tumour histology, location and age. Conclusion: We found no difference in the risk of POSI associated with handedness. Our data do not support the hypothesis that handedness should be of clinical relevance in the risk assessment of CMS.
KW - Cerebellar mutism syndrome
KW - Handedness
KW - Posterior fossa syndrome
U2 - 10.1007/s00381-022-05567-8
DO - 10.1007/s00381-022-05567-8
M3 - Journal article
C2 - 35759029
AN - SCOPUS:85135051641
VL - 38
SP - 1479
EP - 1485
JO - Child's Nervous System
JF - Child's Nervous System
SN - 0256-7040
IS - 8
ER -