Gross motor function in children with Congenital Zika Syndrome from Rio de Janeiro, Brazil

Abstract

Congenital Zika Syndrome (CZS) is characterized by many impairments especially in the central nervous system, potentially compromising neurodevelopment and causing significant morbidity in affected children. The aim was to assess gross motor function in children with CZS. This was a cross-sectional investigation nested within a prospective cohort study of children with CZS based in a Brazilian referral hospital in Rio de Janeiro. Between March/2017 and February/2018, we performed gross motor function assessments using the Gross Motor Function Classification (GMFCS) and the Gross Motor Function Measure (GMFM), estimating the mean and standard deviation of GMFM scores among GMFCS groups. The study sample included 72 children, with a median age of 13 months (7–25). Of these, 63 (87.5%) had severe motor impairment, 3 (4%) had moderate impairment, and 6 (8%) had mild impairment. The mean GMFM score for each group was respectively 11.6, 26.1, and 81.6, with statistically significant differences (p-value < 0.001). Severely affected children only achieved head control in the sitting posture when supported. Children with milder forms were able to develop walking skills.Conclusion: Most children with CZS have major motor disabilities and a poor prognosis. Better understanding of limitations and functionality in children with CZS can serve as a prognostic guide in their management. What is Known:• Severe motor impairment was present in 63 (87.5%) children with CZS.• The degree of neurological impairment was inversely associated with motor performance. What is New:• Microcephaly was more frequent among children with severe gross motor function impairment.• Children with CZS have major motor disabilities and a poor prognosis.

Disruption of myelin structure and oligodendrocyte maturation in a pigtail macaque model of congenital Zika infection

“…Neurotropic ZikV virus emerged to global importance as an etiologic agent of microcephaly and is now recognized to cause CZS, characterized by extensive motor and cognitive impairment in developing neonates 42,43 . Neurodevelopmental delay has become apparent for ZikV-exposed normocephalic infants born without microcephaly or other overt congenital anomalies [44][45][46][47] .…”

Longitudinal Follow-Up of Gross Motor Function in Children with Congenital Zika Virus Syndrome from a Cohort in Rio de Janeiro, Brazil

“…As children with CZS grow, it is essential to monitor their motor development using standardized assessment tools [2,12]. The Gross Motor Function Measure (GMFM) was developed to assess longitudinal changes in gross motor function in children with CZS [13]. When used in parallel with the Gross Motor Function Classification System (GMFCS), both measures can inform motor prognosis and guide clinical management [13].…”

“…We previously performed a cross-sectional analysis of gross motor function in children with CZS in Rio de Janeiro [13]. Building on this work, the present study describes the evolution of gross motor function in children with CZS who have been prospectively followed in our pediatric infectious diseases service at a referral hospital in Rio de Janeiro, Brazil.…”