Prediction Model for Identifying Computational Phenotypes of Children with Cerebral Palsy Needing Neurotoxin Treatments

Bertoncelli, Carlo M.; Latalski, M; Bertoncelli, Domenico; Bagui, Sikha; Gautier, Dechelle; Solla, Federico

doi:10.3390/toxins15010020

Cited by 4 publications

(2 citation statements)

References 49 publications

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“…While a dystonic pattern within a syndrome characterized by spasticity may not always be easy to recognize [2,8], it can be decisive in the therapeutic approach to the patient. A recent study highlighted that recognizing dystonia within CP can impact diagnostic and therapeutic workup and that the presence of concomitant dystonia is a positive predictor of response to BT treatment [26].…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review of Botulinum Toxin Injection in Pediatric Dystonia

Rasera,

Squintani,

Cerruto

2024

Toxins

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Botulinum toxin (BT), a first-line treatment for focal dystonias in adults, has gained USA Food and Drug Administration approval for pediatric upper and lower extremity spasticity and sialorrhea, though its use in children younger than 2 years old is still considered off-label treatment for all pathologies. Dosing, treatment strategies and outcome measures lack international consensus, and they are often extrapolated from adult or spasticity guidelines. This review aims to evaluate the best available evidence on the efficacy and safety of BT therapy in pediatric dystonia (age under 21 years old), isolated or associated with other medical conditions. A comprehensive search in PubMed, Scopus and Web of Science was conducted, including only articles in English. Although no randomized controlled trials are still present, 12 articles were included with an overall of 57 patients. All the papers demonstrate that BT can improve motor function, decrease pain and ameliorate quality of life, with minimal adverse effects in pediatric patients affected by pure or mixed dystonic motor disorders. Despite the low level of evidence, our review shows that BT could be an efficacious treatment for these pediatric patients. The frequent generalized involvement, together with the heterogeneous nature of childhood dystonic forms, sometimes intermingled with spasticity, prompts further multicenter clinical trials or prospective studies with a higher level of evidence to shed light on the efficacy and safety profile of BT in pediatric dystonia.

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Section: Discussionmentioning

confidence: 99%

A Systematic Review of Botulinum Toxin Injection in Pediatric Dystonia

Rasera,

Squintani,

Cerruto

2024

Toxins

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“…The next article is concerned with human studies combining the effect of BoNTs and the aid of electronic devices. Bertoncelli et al [ 11 ] explained the use of a statistical machine learning algorithm, named BTX-PredictMed. The algorithm is based on a model that identifies clinical phenotypes for the prognosis of cerebral palsy in children that can benefit from an injection of BoNTs.…”

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confidence: 99%

Introduction to the Toxins Special Issue on Botulinum Toxins: New Uses in the Treatment of Diseases

Luvisetto

2023

Toxins

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Accuracy of Machine Learning in Detecting Pediatric Epileptic Seizures: Systematic Review and Meta-Analysis

Zou,

Chen,

Xiao

et al. 2024

J Med Internet Res

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Background Real-time monitoring of pediatric epileptic seizures poses a significant challenge in clinical practice. In recent years, machine learning (ML) has attracted substantial attention from researchers for diagnosing and treating neurological diseases, leading to its application for detecting pediatric epileptic seizures. However, systematic evidence substantiating its feasibility remains limited. Objective This systematic review aimed to consolidate the existing evidence regarding the effectiveness of ML in monitoring pediatric epileptic seizures with an effort to provide an evidence-based foundation for the development and enhancement of intelligent tools in the future. Methods We conducted a systematic search of the PubMed, Cochrane, Embase, and Web of Science databases for original studies focused on the detection of pediatric epileptic seizures using ML, with a cutoff date of August 27, 2023. The risk of bias in eligible studies was assessed using the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies–2). Meta-analyses were performed to evaluate the C-index and the diagnostic 4-grid table, using a bivariate mixed-effects model for the latter. We also examined publication bias for the C-index by using funnel plots and the Egger test. Results This systematic review included 28 original studies, with 15 studies on ML and 13 on deep learning (DL). All these models were based on electroencephalography data of children. The pooled C-index, sensitivity, specificity, and accuracy of ML in the training set were 0.76 (95% CI 0.69-0.82), 0.77 (95% CI 0.73-0.80), 0.74 (95% CI 0.70-0.77), and 0.75 (95% CI 0.72-0.77), respectively. In the validation set, the pooled C-index, sensitivity, specificity, and accuracy of ML were 0.73 (95% CI 0.67-0.79), 0.88 (95% CI 0.83-0.91), 0.83 (95% CI 0.71-0.90), and 0.78 (95% CI 0.73-0.82), respectively. Meanwhile, the pooled C-index of DL in the validation set was 0.91 (95% CI 0.88-0.94), with sensitivity, specificity, and accuracy being 0.89 (95% CI 0.85-0.91), 0.91 (95% CI 0.88-0.93), and 0.89 (95% CI 0.86-0.92), respectively. Conclusions Our systematic review demonstrates promising accuracy of artificial intelligence methods in epilepsy detection. DL appears to offer higher detection accuracy than ML. These findings support the development of DL-based early-warning tools in future research. Trial Registration PROSPERO CRD42023467260; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023467260

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Prediction Model for Identifying Computational Phenotypes of Children with Cerebral Palsy Needing Neurotoxin Treatments

Cited by 4 publications

References 49 publications

A Systematic Review of Botulinum Toxin Injection in Pediatric Dystonia

A Systematic Review of Botulinum Toxin Injection in Pediatric Dystonia

Introduction to the Toxins Special Issue on Botulinum Toxins: New Uses in the Treatment of Diseases

Accuracy of Machine Learning in Detecting Pediatric Epileptic Seizures: Systematic Review and Meta-Analysis

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