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Article ; Online: Prognostic value of cranial ultrasonography in comparison with magnetic resonance imaging in children with cerebral palsy: a population-based study.

Delin, Sanja / Bošnjak Nađ, Katarina / Martinec, Sunčica / Čokolić Petrović, Dunja / Šimic Klarić, Andrea / Mejaški Bošnjak, Vlatka

Acta clinica Croatica

2021 Volume 59, Issue 2, Page(s) 260–269

Abstract: The aim of this population-based study was to evaluate the characteristics of cerebral palsy (CP) in relation to the predominant pattern of the Magnetic Resonance Imaging Classification System (MRICS) that was analogously applied to the neonatal/early ... ...

Abstract	The aim of this population-based study was to evaluate the characteristics of cerebral palsy (CP) in relation to the predominant pattern of the Magnetic Resonance Imaging Classification System (MRICS) that was analogously applied to the neonatal/early infant cranial ultrasound (CUS). The study included children born during the 2004-2007 period from the Croatian part (C28 RCP-HR) of the Surveillance of Cerebral Palsy in Europe (SCPE) CP register. Motor functions, accompanying impairments and brain MRI were evaluated in 227 children, 185 of which also had CUS. Concerning CP types, 56% of children had bilateral spastic, 34% unilateral spastic, 9% dyskinetic and 1% ataxic CP type. Gross Motor Function Classification System (GMFCS) revealed that 62.05% had mild (GMFCS I-III) and 37.85% had severe motor impairment (GMFCS IV-V). CUS showed white matter injury in 60%, gray matter injury in 12%, maldevelopments in 8%, miscellaneous changes in 14%, while 6% were normal; MRI showed significant agreement (κ=0.675, p<0.001). Neuroimaging findings of maldevelopments and predominant gray matter injury were associated with more severe CP, but 7% of children with CP had normal MRI. As we found very good agreement between CUS and MRI findings, CUS is recommended in children at an increased risk of CP if MRI is not available.
MeSH term(s)	Cerebral Palsy/complications ; Cerebral Palsy/diagnostic imaging ; Cerebral Palsy/epidemiology ; Child ; Europe ; Humans ; Magnetic Resonance Imaging ; Prognosis ; Severity of Illness Index ; Ultrasonography
Language	English
Publishing date	2021-01-12
Publishing country	Croatia
Document type	Journal Article
ZDB-ID	1478635-7
ISSN	1333-9451 ; 0353-9466
ISSN (online)	1333-9451
ISSN	0353-9466
DOI	10.20471/acc.2020.59.02.09
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Article ; Online: FUNCTIONAL CLASSIFICATION OF CHILDREN WITH CEREBRAL PALSY IN KRAPINA-ZAGORJE COUNTY.

Martinec, Sunčica / Cesarec, Gordana / Tomečak Krilić, Ana Marija / Radošević, Tomislav / Bakran, Žarko / Mejaški Bošnjak, Vlatka

Acta clinica Croatica

2021 Volume 60, Issue 2, Page(s) 282–289

Abstract: The aim was to study functional abilities and to create functional classification of children with cerebral palsy (CP) in Krapina-Zagorje County, based on the classification of gross and fine motor skills and associated impairments. Classification was ... ...

Abstract	The aim was to study functional abilities and to create functional classification of children with cerebral palsy (CP) in Krapina-Zagorje County, based on the classification of gross and fine motor skills and associated impairments. Classification was performed according to the SCPE (Surveillance of Cerebral Palsy in Europe) criteria. We used standardized and complementary functional classification systems for cerebral palsy to create a functional profile. Research included 44 children with CP in the age range of 4 to 18 years. The results showed that the majority of children had bilateral spastic CP (63.6%), followed by unilateral spastic (22.7%) while the representation of dyskinetic CP was 9.09% and ataxic CP 4.55%. Based on the classification of gross and fine motor skills, 43.2% of children had the ability to walk, 11% of children could walk with assistive mobility devices, while 45.4% of children had a low functional level. The study also analyzed the associated impairments where higher classification score of motor impairment correlated with the severity of impairment. The results showed that children with dyskinetic CP and severe motor impairment could have mild cognitive impairment. We systematically present the neuropsychological and functional profile according to the CP type.
MeSH term(s)	Adolescent ; Ataxia ; Cerebral Palsy/complications ; Cerebral Palsy/epidemiology ; Child ; Child, Preschool ; Europe ; Genetic Diseases, Inborn ; Humans ; Motor Skills ; Severity of Illness Index ; Walking
Language	English
Publishing date	2021-11-03
Publishing country	Croatia
Document type	Journal Article
ZDB-ID	1478635-7
ISSN	1333-9451 ; 0353-9466
ISSN (online)	1333-9451
ISSN	0353-9466
DOI	10.20471/acc.2021.60.02.15
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Article: Congenital CMV infection: a common cause of childhood disability.

Mejaski-Bosnjak, Vlatka

Developmental medicine and child neurology

2008 Volume 50, Issue 6, Page(s) 403

MeSH term(s)	Brain/abnormalities ; Brain/virology ; Child ; Cytomegalovirus Infections/congenital ; Cytomegalovirus Infections/epidemiology ; Cytomegalovirus Infections/genetics ; DNA, Viral/genetics ; Disabled Children/statistics & numerical data ; Echoencephalography ; Humans ; Infant, Newborn ; Magnetic Resonance Imaging
Chemical Substances	DNA, Viral
Language	English
Publishing date	2008-06
Publishing country	England
Document type	Editorial
ZDB-ID	80369-8
ISSN	1469-8749 ; 0012-1622
ISSN (online)	1469-8749
ISSN	0012-1622
DOI	10.1111/j.1469-8749.2008.00403.x
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Article: Stimulation of functional vision in children with perinatal brain damage.

Alimović, Sonja / Mejaski-Bosnjak, Vlatka

Collegium antropologicum

2011 Volume 35 Suppl 1, Page(s) 3–9

Abstract: Cerebral visual impairment (CVI) is one of the most common causes of bilateral visual loss, which frequently occurs due to perinatal brain injury. Vision in early life has great impact on acquisition of basic comprehensions which are fundamental for ... ...

Abstract	Cerebral visual impairment (CVI) is one of the most common causes of bilateral visual loss, which frequently occurs due to perinatal brain injury. Vision in early life has great impact on acquisition of basic comprehensions which are fundamental for further development. Therefore, early detection of visual problems and early intervention is necessary. The aim of the present study is to determine specific visual functioning of children with perinatal brain damage and the influence of visual stimulation on development of functional vision at early age of life. We initially assessed 30 children with perinatal brain damage up to 3 years of age, who were reffered to our pediatric low vision cabinet in "Little house" from child neurologists, ophthalmologists Type and degree of visual impairment was determined according to functional vision assessment of each child. On the bases of those assessments different kind of visual stimulations were carried out with children who have been identified to have a certain visual impairment. Through visual stimulation program some of the children were stimulated with light stimulus, some with different materials under the ultraviolet (UV) light, and some with bright color and high contrast materials. Children were also involved in program of early stimulation of overall sensory motor development. Goals and methods of therapy were determined individually, based on observation of child's possibilities and need. After one year of program, reassessment was done. Results for visual functions and functional vision were compared to evaluate the improvement of the vision development. These results have shown that there was significant improvement in functional vision, especially in visual attention and visual communication.
MeSH term(s)	Brain Injuries/physiopathology ; Brain Injuries/therapy ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Photic Stimulation/methods ; Vision, Ocular/physiology ; Visual Acuity/physiology
Language	English
Publishing date	2011-01
Publishing country	Croatia
Document type	Journal Article
ZDB-ID	233430-6
ISSN	0350-6134 ; 0353-3735
ISSN	0350-6134 ; 0353-3735
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Article: Effects of vibrotactile stimulation on the control of muscle tone and movement facilitation in children with cerebral injury.

Katusić, Ana / Mejaski-Bosnjak, Vlatka

Collegium antropologicum

2011 Volume 35 Suppl 1, Page(s) 57–63

Abstract: Afferent signals from the muscle's proprioceptors play important role in the control of muscle tone and in the facilitation of movements. Peripheral afferent pathway enables the restoration of connections with supraspinal structures and so includes ... ...

Abstract	Afferent signals from the muscle's proprioceptors play important role in the control of muscle tone and in the facilitation of movements. Peripheral afferent pathway enables the restoration of connections with supraspinal structures and so includes mechanism of synaptic inhibition in the performance of normal movement. Different sensory stimuli, as vibrotactile stimulation, excite muscle's proprioceptors which then send sensorimotor information via spinal cord. In this way afferent signals promote cortical control and modulation of movements. The goal of this study is to evaluate the effects of vibrotactile stimulation on the spasticity and motor performance in children with cerebral injury. Subjects included in this study were 13 children who were developing the classification of spastic cerebral palsy. For all children perinatal brain damage was documented by medical reports and neonatal brain ultrasound scan. At the mean age of 3 years and 6 months subject underwent the assessment of motor development by Gross Motor Function Measurement (GMFM-88). Gross Motor Classification System (GMFCS) has been used to classify functions of lower extremities. Therapeutic intervention was conducted once a week during 3 months. All subjects were stimulated with vibrotactile stimuli of 40Hz in duration of 20 minutes in order to reduce spasticity. After the ending of the treatment subjects underwent second assessment of motor performance and the classification of lower extremities functions. The results have shown that there was a significant improvement in motor performance, what has been seen in the facilitation of rotations, better postural trunk stability and head control and in greater selectivity of movements. Further randomized, control trial investigations with bigger sample and included spasm scale are needed to gain better insight in the role of vibrotactile stimulation in the facilitation of normal movements.
MeSH term(s)	Cerebral Palsy/diagnostic imaging ; Cerebral Palsy/rehabilitation ; Child, Preschool ; Female ; Humans ; Leg ; Male ; Motor Skills/physiology ; Muscle Tonus/physiology ; Physical Stimulation/methods ; Ultrasonography ; Vibration/therapeutic use
Language	English
Publishing date	2011-01
Publishing country	Croatia
Document type	Clinical Trial ; Journal Article
ZDB-ID	233430-6
ISSN	0350-6134 ; 0353-3735
ISSN	0350-6134 ; 0353-3735
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Article ; Online: The effect of vibration therapy on spasticity and motor function in children with cerebral palsy: a randomized controlled trial.

Katusic, Ana / Alimovic, Sonja / Mejaski-Bosnjak, Vlatka

NeuroRehabilitation

2013 Volume 32, Issue 1, Page(s) 1–8

Abstract: As the motor system relies heavily on deep sensory stimulation, recent studies have investigated the effect of vibration stimuli. Although research suggests a positive influence of vibration on motor performance in individuals with neurological disorders, ...

Abstract	As the motor system relies heavily on deep sensory stimulation, recent studies have investigated the effect of vibration stimuli. Although research suggests a positive influence of vibration on motor performance in individuals with neurological disorders, there are very limited numbers of studies in children with cerebral palsy (CP). The objective of the present study was to evaluate the effects of sound wave vibration therapy on spasticity and motor function in children with CP. In this 3-month trial, 89 children with spastic CP were randomized to either continue their physiotherapy treatment (PT) or to receive vibration therapy twice a week in addition to their PT program. The randomization was stratified according to the Gross Motor Function Classification System (GMFCS) level to ensure similar functional ability. Children were assessed at baseline and after the 12-week intervention period. The outcomes measured were spasticity level as assessed by Modified Modified Ashworth Scale (MMAS) and gross motor function as assessed by Gross Motor Function Measurement (GMFM-88). Subgroup analysis was performed for the GMFCS. Significant differences between groups were detected for changes in spasticity level and gross motor function after the three months intervention. In conclusion, vibration therapy may decrease spasticity and improve motor performance in children with CP. The results of the present trial serve as valuable input for evidence-based treatments in paediatric neurorehabilitation.
MeSH term(s)	Activities of Daily Living ; Cerebral Palsy/physiopathology ; Cerebral Palsy/therapy ; Child ; Child, Preschool ; Female ; Humans ; Male ; Motor Activity/physiology ; Muscle Spasticity/physiopathology ; Muscle Spasticity/therapy ; Physical Therapy Modalities ; Treatment Outcome ; Vibration/therapeutic use
Language	English
Publishing date	2013
Publishing country	Netherlands
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	1087912-2
ISSN	1878-6448 ; 1053-8135
ISSN (online)	1878-6448
ISSN	1053-8135
DOI	10.3233/NRE-130817
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Article ; Online: Visual stimulations' critical period in infants with perinatal brain damage.

Alimović, Sonja / Katušić, Ana / Mejaški-Bošnjak, Vlatka

NeuroRehabilitation

2013 Volume 33, Issue 2, Page(s) 251–255

Abstract: Background: Children with perinatal brain damage have a high prevalence of visual impairment. Stimulation of vision at a critical period can encourage brain plasticity and the recovery of impaired function.: Objective: The aim of our study was to ... ...

Abstract	Background: Children with perinatal brain damage have a high prevalence of visual impairment. Stimulation of vision at a critical period can encourage brain plasticity and the recovery of impaired function. Objective: The aim of our study was to investigate when is the critical period for visual stimulation in children with perinatal brain damage. Methods: We compared 35 children within the first eight months of life (median age = 4 months) to 35 children aged between eight and thirty months (median age = 15 months), all with perinatal brain damage. All the children were attending an early intervention program at Mali dom, Zagreb, a rehabilitation centre for children with visual impairment. We compared the results from baseline and follow-up assessments of visual functions (grating acuity and contrast sensitivity). We also compared differences in change scores between the two groups. Results: Our results have shown that children who commence a visual stimulation program within the first eight months of life had more improvement in both visual functions. This improvement is statistically significant in visual acuity (p = 0.048). Conclusions: These results indicate the importance of starting a visual stimulation program within the first eight months after birth.
MeSH term(s)	Brain Injuries/physiopathology ; Brain Injuries/therapy ; Child, Preschool ; Critical Period (Psychology) ; Humans ; Infant ; Photic Stimulation/methods ; Visual Acuity/physiology
Language	English
Publishing date	2013
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1087912-2
ISSN	1878-6448 ; 1053-8135
ISSN (online)	1878-6448
ISSN	1053-8135
DOI	10.3233/NRE-130952
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Article ; Online: Epilepsy in patients with pineal gland cyst.

Bosnjak, Jelena / Butkovic, Silva Soldo / Miskov, Snjezana / Coric, Lejla / Jadrijevic-Tomas, Ana / Mejaski-Bosnjak, Vlatka

Clinical neurology and neurosurgery

2018 Volume 165, Page(s) 72–75

Abstract: Objective: The aim of the study is to describe types of epileptic seizures in patients with pineal gland cyst (PGC) and their outcome during follow up period (6-10 years). We wanted to determine whether patients with epilepsy differ in PGC volume and ... ...

Abstract	Objective: The aim of the study is to describe types of epileptic seizures in patients with pineal gland cyst (PGC) and their outcome during follow up period (6-10 years). We wanted to determine whether patients with epilepsy differ in PGC volume and compression of the PGC on surrounding brain structures compared to patients with PGC, without epilepsy. Patients and methods: We analyzed prospectivelly 92 patients with PGC detected on magnetic resonance (MR) of the brain due to various neurological symptoms during the period 2006-2010. Data on described compression of the PGC on surrounding brain structures and size of the PGC were collected. Results: 29 patients (16 women, 13 men), mean age 21.17 years had epilepsy and PGC (epilepsy group). 63 patients (44 women, 19 men), mean age 26.97 years had PGC without epilepsy (control group). Complex partial seizures were present in 8 patients, complex partial seizures with secondary generalization in 8 patients, generalized tonic clonic seizures (GTCS) in 10 and absance seizures in 3 patients. Mean PGC volume in epilepsy group was 855.93 mm Conclusions: In patients with PGC, epileptic seizures were classified as: complex partial seizures (with or without secondary generalization), GTCS and absance seizures. All patients were put on AET. During follow up period 79.31% patients were seizure free. There was no difference in PGC volume, nor in described compression of the PGC on surrounding brain structures between epilepsy and control group. Based on our findings, pathomechanism of epileptic seizures in patients with PGC cannot be attributable solely to PGC volume or described compression on surrounding brain structures based on MRI findings.
MeSH term(s)	Adolescent ; Adult ; Anticonvulsants/therapeutic use ; Central Nervous System Cysts/complications ; Central Nervous System Cysts/diagnostic imaging ; Child ; Epilepsy/diagnostic imaging ; Epilepsy/drug therapy ; Epilepsy/etiology ; Female ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Pinealoma/complications ; Pinealoma/diagnostic imaging ; Prospective Studies ; Seizures/diagnostic imaging ; Seizures/drug therapy ; Seizures/etiology ; Treatment Outcome ; Young Adult
Chemical Substances	Anticonvulsants
Language	English
Publishing date	2018-01-04
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	193107-6
ISSN	1872-6968 ; 0303-8467
ISSN (online)	1872-6968
ISSN	0303-8467
DOI	10.1016/j.clineuro.2017.12.025
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Article ; Online: MRI classification system (MRICS) for children with cerebral palsy: development, reliability, and recommendations.

Himmelmann, Kate / Horber, Veronka / De La Cruz, Javier / Horridge, Karen / Mejaski-Bosnjak, Vlatka / Hollody, Katalin / Krägeloh-Mann, Ingeborg

Developmental medicine and child neurology

2017 Volume 59, Issue 1, Page(s) 57–64

Abstract: Aim: To develop and evaluate a classification system for magnetic resonance imaging (MRI) findings of children with cerebral palsy (CP) that can be used in CP registers.: Method: The classification system was based on pathogenic patterns occurring in ...

Abstract	Aim: To develop and evaluate a classification system for magnetic resonance imaging (MRI) findings of children with cerebral palsy (CP) that can be used in CP registers. Method: The classification system was based on pathogenic patterns occurring in different periods of brain development. The MRI classification system (MRICS) consists of five main groups: maldevelopments, predominant white matter injury, predominant grey matter injury, miscellaneous, and normal findings. A detailed manual for the descriptions of these patterns was developed, including test cases (www.scpenetwork.eu/en/my-scpe/rtm/neuroimaging/cp-neuroimaging/). A literature review was performed and MRICS was compared with other classification systems. An exercise was carried out to check applicability and interrater reliability. Professionals working with children with CP or in CP registers were invited to participate in the exercise and chose to classify either 18 MRIs or MRI reports of children with CP. Results: Classification systems in the literature were compatible with MRICS and harmonization possible. Interrater reliability was found to be good overall (k=0.69; 0.54-0.82) among the 41 participants and very good (k=0.81; 0.74-0.92) using the classification based on imaging reports. Interpretation: Surveillance of Cerebral Palsy in Europe (SCPE) proposes the MRICS as a reliable tool. Together with its manual it is simple to apply for CP registers.
MeSH term(s)	Brain/diagnostic imaging ; Brain/embryology ; Brain/growth & development ; Cerebral Palsy/classification ; Cerebral Palsy/diagnostic imaging ; Cerebral Palsy/physiopathology ; Child ; Child, Preschool ; Databases, Bibliographic/statistics & numerical data ; Female ; Humans ; Image Processing, Computer-Assisted ; Magnetic Resonance Imaging/methods ; Male ; Registries ; Reproducibility of Results ; Severity of Illness Index
Language	English
Publishing date	2017-01
Publishing country	England
Document type	Journal Article
ZDB-ID	80369-8
ISSN	1469-8749 ; 0012-1622
ISSN (online)	1469-8749
ISSN	0012-1622
DOI	10.1111/dmcn.13166
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Article ; Online: Language development in preschool children born after asymmetrical intrauterine growth retardation.

Simić Klarić, Andrea / Kolundžić, Zdravko / Galić, Slavka / Mejaški Bošnjak, Vlatka

European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society

2012 Volume 16, Issue 2, Page(s) 132–137

Abstract: Background: After intrauterine growth retardation, many minor neurodevelopmental disorders may occur, especially in the motor skills domain, language and speech development, and cognitive functions.: Aim: The assessment of language development and ... ...

Abstract	Background: After intrauterine growth retardation, many minor neurodevelopmental disorders may occur, especially in the motor skills domain, language and speech development, and cognitive functions. Aim: The assessment of language development and impact of postnatal head growth in preschool children born with asymmetrical intrauterine growth retardation. Methods: Examinees were born at term with birth weight below the 10th percentile for gestational age, parity and gender. Mean age at the time of study was six years and four months. The control group was matched according to chronological and gestational age, gender and maternal education with mean age six years and five months. There were 50 children with intrauterine growth retardation and 50 controls, 28 girls and 22 boys in each group. For the assessment of language development Reynell Developmental Language Scale, the Naming test and Mottier test were performed. Results: There were statistically significant differences (p < 0.05) in language comprehension, total expressive language (vocabulary, structure, content), naming skills and non-words repetition. Statistically significant positive correlations were found between relative growth of the head [(Actual head circumference - head circumference at birth)/(Body weight - birth weight)] and language outcome. Children with neonatal complications had lower results (p < 0.05) in language comprehension and total expressive language. Conclusion: Intrauterine growth retardation has a negative impact on language development which is evident in preschool years. Slow postnatal head growth is correlated with poorer language outcome. Neonatal complications were negatively correlated with language comprehension and total expressive language.
MeSH term(s)	Birth Weight ; Body Height/physiology ; Body Weight ; Cerebral Cortex/anatomy & histology ; Cerebral Cortex/growth & development ; Child ; Child, Preschool ; Female ; Fetal Growth Retardation/psychology ; Head/growth & development ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Language Development ; Language Development Disorders/etiology ; Language Development Disorders/psychology ; Language Tests ; Male ; Neuropsychological Tests ; Vocabulary
Language	English
Publishing date	2012-03
Publishing country	England
Document type	Journal Article
ZDB-ID	1397146-3
ISSN	1532-2130 ; 1090-3798
ISSN (online)	1532-2130
ISSN	1090-3798
DOI	10.1016/j.ejpn.2011.06.003
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