Neurodevelopmental outcome in children with congenital cytomegalovirus infection: A prospective multicenter cohort study

Keymeulen, A.; Leenheer, E. De; Casaer, A.; Cossey, V.; Laroche, S.; Mahieu, L.; Oostra, A.; Mol, C. Van; Dhooge, I.; Smets, K.

doi:10.1016/j.earlhumdev.2023.105777

Cited by 8 publications

(5 citation statements)

References 24 publications

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“…Despite limited systematic investigation, prior studies also noted behavioral and/or social-emotional problems in children with cCMV, underscoring the need for continuous monitoring, particularly as these issues may not manifest until school age. 2,4,5 Children with symptomatic cCMV face a higher risk, and cCMV-related neurosensory impairments are likely to have a confounding or enhancing effect. 2…”

Section: Discussionmentioning

confidence: 99%

“…Congenital cytomegalovirus (cCMV) is a leading cause of childhood disability, yet there is limited understanding of the associated child behavior problems and the quality of life of affected individuals and families. 1–6 Our study aimed to investigate behavioral problems in children with cCMV and explore parental perceptions regarding the impact of cCMV and its long-term consequences on family life.…”

mentioning

confidence: 99%

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Behavioral Problems and Family Impact in Congenital Cytomegalovirus Infection

Rodríguez-Molino,

Alarcón,

Martínez-Biarge

et al. 2024

Pediatric Infectious Disease Journal

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We examined behavior (Child Behavior Checklist) and family functioning (Family Impact Questionnaire) in 65 children with congenital cytomegalovirus. Behavioral problems were present in 30.8%. Parents of children with moderate/severe outcomes reported strain on all areas of family functioning. Behavioral problems were associated with negative impact on parental feelings and marital/partnership relationship. Our findings inform planning support services.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Behavioral Problems and Family Impact in Congenital Cytomegalovirus Infection

Rodríguez-Molino,

Alarcón,

Martínez-Biarge

et al. 2024

Pediatric Infectious Disease Journal

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“…Notably, impairment occurred in both symptomatic and asymptomatic groups. The authors further reported that 46 percent of the children had hypotonia, although many of these underwent improvement, 10.4 percent had mild to severe cognitive impairment, and 17.2 percent had sensorineural hearing loss [16].…”

Section: Congenital Perinatal and Early-life Hcmv Infection And Child...mentioning

confidence: 95%

“…Worldwide, HCMV is the most common congenital infection [16]. Diagnosis can be difficult in that most babies with congenital HCMV are asymptomatic [17,18].…”

Section: Congenital Perinatal and Early-life Hcmv Infection And Child...mentioning

confidence: 99%

“…Areas requiring further study include better estimates of the number of children seropositive for HCMV who have deficits in brain function and the identification of factors associated with outcomes in children with congenital HCMV or early-life infection with HCMV. In addition, some studies indicate that improvement in neurological and neurocognitive outcomes can occur in children with congenital or early-childhood HCMV [16,28,30], underscoring the importance of identifying not only factors associated with HCMV but also with neurological and neurocognitive improvement in children infected with HCMV.…”

Section: Congenital Perinatal and Early-life Hcmv Infection And Child...mentioning

confidence: 99%

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Human Cytomegalovirus Infection and Neurocognitive and Neuropsychiatric Health

Gale,

Farrer,

Erbstoesser

et al. 2024

Pathogens

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A common infection, human cytomegalovirus (HCMV) has been associated with a variety of human diseases, including cardiovascular disease and possibly certain cancers. HCMV has also been associated with cognitive, psychiatric, and neurological conditions. Children with congenital or early-life HCMV are at risk for microcephaly, cerebral palsy, and sensorineural hearing loss, although in many cases sensorineural loss may resolve. In addition, HCMV can be associated with neurodevelopmental impairment, which may improve with time. In young, middle-aged, and older adults, HCMV has been adversely associated with cognitive function in some but not in all studies. Research has linked HCMV to Alzheimer’s and vascular dementia, but again not all findings consistently support these associations. In addition, HCMV has been associated with depressive disorder, bipolar disorder, anxiety, and autism-spectrum disorder, although the available findings are likewise inconsistent. Given associations between HCMV and a variety of neurocognitive and neuropsychiatric disorders, additional research investigating reasons for the considerable inconsistencies in the currently available findings is needed. Additional meta-analyses and more longitudinal studies are needed as well. Research into the effects of antiviral medication on cognitive and neurological outcomes and continued efforts in vaccine development have potential to lower the neurocognitive, neuropsychiatric, and neurological burden of HCMV infection.

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Apparent diffusion coefficient values of the white matter in magnetic resonance imaging of the neonatal brain may help predict outcome in congenital cytomegalovirus infection

Vande Walle,

Keymeulen,

Oostra

et al. 2024

Pediatr Radiol

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Background White matter change is a well-known abnormality in congenital cytomegalovirus (cCMV) infection, but grading remains challenging and clinical relevance unclear. Objective To investigate if quantitative measurement of white matter apparent diffusion coefficient (ADC) values in magnetic resonance imaging (MRI) of the neonatal brain can predict outcome in cCMV. Materials and methods A retrospective, single-center observational study, including patients with cCMV who had a neonatal brain MRI with diffusion-weighted imaging, was performed between 2007 and 2020. Regions of interest were systematically placed in the white matter on the ADC maps. Two pediatric radiologists independently scored additional brain abnormalities. Outcome measures were neonatal hearing and cognitive and motor development. Statistical analysis included simple and penalized elastic net regression. Results Neonatal brain MRI was evaluated in 255 patients (median age 21 days, 25–75 percentiles: 14–28 days, 121 male). Gyral abnormalities were noted in nine patients (3.5%), ventriculomegaly in 24 (9.4%), and subependymal cysts in 58 (22.7%). General white matter ADC was significantly higher in patients with neonatal hearing loss and cognitive and motor impairment (P< 0.05). For neonatal hearing loss, simple logistic regression using only general white matter was the best prediction model, with a receiver operating characteristic area under the curve (AUC)=0.76. For cognitive impairment, interacting elastic net regression, including other brain abnormalities and frontoparietal white matter ADC, performed best, with AUC=0.89. For motor impairment, interacting elastic net regression, including other brain abnormalities and deep anterior frontal white matter performed best, with AUC=0.73. Conclusion Neonatal white matter ADC was significantly higher in patients with clinical impairments. Quantitative ADC measurement may be a useful tool for predicting clinical outcome in cCMV. Graphical Abstract

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Neurodevelopmental outcome in children with congenital cytomegalovirus infection: A prospective multicenter cohort study

Cited by 8 publications

References 24 publications

Behavioral Problems and Family Impact in Congenital Cytomegalovirus Infection

Behavioral Problems and Family Impact in Congenital Cytomegalovirus Infection

Human Cytomegalovirus Infection and Neurocognitive and Neuropsychiatric Health

Apparent diffusion coefficient values of the white matter in magnetic resonance imaging of the neonatal brain may help predict outcome in congenital cytomegalovirus infection

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