Effective treatment of toddler development: A Synthesis of Findings from 24 Studies

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Original Abstract of the Article

Major Research Findings

Regarding the short-term effects of the SAFE early intervention approach in preterm infants, a study published in 13 suggests that the SAFE approach, which includes sensory strategies, activity-based motor training, family collaboration, and environmental enrichment, may have positive short-term effects on motor, cognitive, speech and language, and sensory development in preterm infants. However, a study in 11 found that preterm infants screened for retinopathy of prematurity (ROP) are at risk for various neurodevelopmental outcomes, making prediction difficult.

The impact of retinopathy of prematurity (ROP) severity and treatment on neurodevelopmental impairment in very-low-birth-weight infants (VLBWIs) in early childhood was investigated in 24 , which suggests that ROP severity and treatment may affect neurodevelopmental impairment in early childhood. Additionally, a study published in 21 evaluated the neurodevelopmental outcomes of preterm infants who received intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections to treat ROP and found that anti-VEGF injections may affect neurodevelopment.

To assess the neurodevelopmental outcomes in the first 5 years of life of children with transposition of the great arteries surgically corrected in the neonatal period, a systematic review and meta-analysis was conducted in 9 . The results suggest that corrective surgery may have positive effects on neurodevelopment in these children. Furthermore, a study in 10 investigated the relationship between perioperative electroencephalogram metrics and hemodynamic adverse events and neurodevelopmental outcomes in infants with congenital heart disease undergoing cardiac surgery. The findings suggest that these factors may be predictive of neurodevelopmental outcomes.

Regarding the efficacy and safety of stem cell therapy for cerebral palsy, a systematic review and meta-analysis in 20 suggests that stem cell therapy may be safe and effective for cerebral palsy. However, the study emphasizes the need for validation through high-quality randomized controlled trials (RCTs). On the other hand, a case report in 16 describes a rare case of traumatic cervical epidural hematoma in an infant, highlighting the importance of rapid diagnosis and treatment.

A study published in 18 explored the association between neonatal near miss and infant development at two years and suggested that near misses in the neonatal period may have an impact on infant development. Additionally, a study in 22 investigated the neurodevelopmental outcomes of children with neonatal opioid withdrawal syndrome (NOWS) at one year of age and found that NOWS may affect language development. However, a study in 19 examined the longitudinal developmental profile of newborns and toddlers treated for spinal muscular atrophy (SMA) and found that SMA primarily impacts motor function without affecting intellectual abilities.

Surgical and non-surgical interventions are used for the treatment of thoracic outlet syndrome (TOS). In 2 , TOS is described as one of the most controversial clinical entities in medicine. A study in 3 compared the outcomes of three surgical procedures for neurogenic TOS: transaxillary first rib excision (TAFRE), supraclavicular first rib excision with scalenectomy (SCFRE), and supraclavicular release leaving the first rib intact (SCR). The results suggest that TAFRE may be the most effective approach.

The necessity of first rib resection (FRR) for patients with neurogenic thoracic outlet syndrome (nTOS) is unclear, as stated in 6 . A randomized clinical trial (STOPNTOS Trial) published in 4 compared surgery and continued conservative treatment for nTOS, suggesting that surgery might be superior to conservative treatment. However, the European Association of Neurosurgical Societies' section of peripheral nerve surgery, in a consensus statement published in 5 , acknowledges a lack of level 1 evidence, particularly concerning nTOS management, and provides a consensus statement on nTOS treatment among experienced neurosurgeons.

The relationship between retinopathy of prematurity (ROP) and neurodevelopmental outcomes in preterm infants was investigated in 17 . The study highlights that ROP and abnormal brain development share similar risk factors and mechanisms. 14 investigated the 2-year neurodevelopmental outcomes of infants after neonatal cardiac surgery for tetralogy of Fallot or pulmonary atresia with a ventricular septal defect, suggesting that surgery may have positive effects on neurodevelopment.

The potential of musical and vocal interventions to improve neurodevelopmental outcomes for preterm infants was explored in 12 . The study suggests that music therapy may contribute to improving health outcomes, quality of life for preterm infants, and parental well-being. On the other hand, a study in 8 characterized Dravet Syndrome (DS) as a developmental and epileptic encephalopathy characterized by significant seizure burden, treatment-resistant epilepsy, and developmental stagnation. This study evaluated seizure burden and language/communication development in children with DS and found that communication deficits are a common challenge for these individuals.

A single-center experience reported in 15 aimed to assess the etiologies and adverse outcomes of infantile acquired hydrocephalus and predict prognosis, suggesting that further research is needed to investigate the causes and prognostic factors of hydrocephalus in infants.

Treatment Summary

The SAFE early intervention approach may promote motor, cognitive, speech, and language development in preterm infants. 13

Anti-VEGF injections for retinopathy of prematurity (ROP) may have an impact on neurodevelopment in preterm infants. 21

Corrective surgery for transposition of the great arteries may have positive effects on neurodevelopment in children who undergo surgery in the neonatal period. 9

Stem cell therapy may be a safe and effective treatment option for cerebral palsy. 20

Surgery might be superior to conservative treatment for neurogenic thoracic outlet syndrome (nTOS). 4

There is a lack of sufficient level 1 evidence regarding the management of neurogenic thoracic outlet syndrome (nTOS). 5

Music therapy may be beneficial for improving health outcomes and quality of life for preterm infants. 12

Benefits and Risks

Benefits Summary

The SAFE early intervention approach, anti-VEGF injections, corrective surgery for transposition of the great arteries, stem cell therapy for cerebral palsy, surgery for neurogenic thoracic outlet syndrome, and music therapy each have the potential to improve neurodevelopmental outcomes in specific conditions.

Risk Summary

The SAFE early intervention approach, anti-VEGF injections, corrective surgery for transposition of the great arteries, stem cell therapy for cerebral palsy, surgery for neurogenic thoracic outlet syndrome, and music therapy all carry their respective risks. Since these treatments have not been fully validated through clinical trials, it is essential to carefully consider the risks and benefits.

Comparison Across Studies

Commonalities

Many studies are exploring the effectiveness and safety of various therapeutic interventions aimed at improving neurodevelopmental outcomes.

Differences

Each study focuses on specific diseases, treatments, and evaluation methods.

Consistency and Inconsistencies in Findings

Research findings concerning the efficacy and safety of treatments for improving neurodevelopmental outcomes show both consistency and inconsistencies. Further research is needed to address these discrepancies.

Implications for Real-Life Application

When choosing a treatment aimed at improving neurodevelopment, it is crucial to consider the individual patient's condition and circumstances. Consult with a medical professional before making any treatment decisions.

Limitations of Current Research

Current research is limited by factors such as small sample sizes and the absence of long-term outcome assessments.

Future Research Directions

Future research should aim to evaluate the effectiveness and safety of treatments for improving neurodevelopmental outcomes using larger sample sizes and long-term outcome assessments.

Conclusion

Numerous treatment options exist for improving neurodevelopmental outcomes, each with associated risks and benefits. Further research is essential for a deeper understanding of the effectiveness and safety of these interventions. Consulting with a medical professional is vital to determine the optimal treatment plan for children with neurodevelopmental challenges and their families.

Treatment List

SAFE early intervention approach, anti-VEGF injections, corrective surgery for transposition of the great arteries, stem cell therapy for cerebral palsy, surgery for neurogenic thoracic outlet syndrome, music therapy, conservative treatment

Literature analysis of 24 papers
Positive Content
17
Neutral Content
0
Negative Content
7
Article Type
3
1
7
5
23
1.

Surgical treatment of thoracic outlet syndrome: a randomized trial comparing two operations.

Author: ShethRishi N, CampbellJames N

Improved thoracic outlet syndrome treatment
Thoracic outlet syndrome

This study compares the outcomes of two surgical approaches for thoracic outlet syndrome (TOS) in patients whose primary symptom is pain: supraclavicular neuroplasty of the brachial plexus (no rib removal) and transaxillary first rib resection.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

2.

Treatment for thoracic outlet syndrome.

Author: PovlsenBo, BelzbergAllan, HanssonThomas, DorsiMichael

Pain reduction
No adverse effects

Transaxillary first rib resection was shown to decrease pain more effectively than supraclavicular neuroplasty in patients with thoracic outlet syndrome (TOS). However, the evidence was of very low quality due to a lack of standardized diagnostic criteria and limited randomized trials.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

3.

Outcomes of Surgical Management of Neurogenic Thoracic Outlet Syndrome: A Systematic Review and Bayesian Perspective.

Author: YinZhong Gang, GongKe Tong, ZhangJian Bing

Improved TOS treatment

This review examines the outcomes of three surgical procedures for neurogenic thoracic outlet syndrome (TOS): transaxillary first rib excision (TAFRE), supraclavicular first rib excision with scalenectomy (SCFRE), and supraclavicular release leaving the first rib intact (SCR).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

4.

Surgery Versus Continued Conservative Treatment for Neurogenic Thoracic Outlet Syndrome: the First Randomised Clinical Trial (STOPNTOS Trial).

Author: GoeteynJens, PesserNiels, HoutermanSaskia, van SambeekMarc R H M, van NuenenBart F L, TeijinkJoep A W

NTOS treatment

Neurogenic thoracic outlet syndrome (NTOS) is a condition that affects nerves in the shoulder and neck, but it's not fully understood. While surgery has been shown to help some people, more research is needed. This study aims to objectively evaluate the effects of a procedure called thoracic outlet decompression (TOD).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

5.

Thoracic Outlet Syndrome Part II: Consensus on the Management of Neurogenic Thoracic Outlet Syndrome by the European Association of Neurosurgical Societies' Section of Peripheral Nerve Surgery.

Author: RochkindShimon, FerraresiStefano, DenisovaNatalia, GarozzoDebora, HeinenChristian, AlimehmetiRidvan, CaponeCrescenzo, BaroneDamiano G, ZdunczykAnna, PedroMaria T, AntoniadisGregor, KaiserRadek, DubuissonAnnie, PondaagWillem, KretschmerThomas, RasulicLukas, DenglerNora F

Thoracic outlet syndrome treatment

This consensus statement discussed the management of neurogenic thoracic outlet syndrome (nTOS), highlighting the lack of high-level evidence for treatment approaches.

Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

6.

Considerations for Surgical Treatment of Neurogenic Thoracic Outlet Syndrome: A Meta-Analysis of Patient-Reported Outcomes.

Author: BlondinMario, GarnerGarrett L, HonesKeegan M, NicholsDavid Spencer, CoxElizabeth A, ChimHarvey

Improved functional outcomes

This systematic review and meta-analysis compares patient-reported functional outcomes following different surgical approaches for neurogenic thoracic outlet syndrome (nTOS).

Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

7.

Thoracic outlet syndrome in females: A systematic review.

Author: CralleLauren E, HarrisLinda M, LumYing Wei, DeerySarah E, HumphriesMisty D

TOS treatment

Thoracic outlet syndrome (TOS) occurs when nerves, veins, or arteries are compressed in the area where the neck and shoulder meet. While TOS is thought to be more common in women, there's limited research on how the condition affects men and women differently. This study will examine how men and women experience different types of TOS, including the symptoms, treatment, and outcomes.

Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

8.

Severe Communication Delays Are Independent of Seizure Burden and Persist Despite Contemporary Treatments in SCN1A+ Dravet Syndrome: Insights from the ENVISION Natural History Study.

Author: PerryM Scott, SchefferIngrid E, SullivanJoseph, BrunklausAndreas, BoronatSusana, WhelessJames W, LauxLinda, PatelAnup D, RobertsColin M, DlugosDennis, HolderDeborah, KnuppKelly G, LallasMatt, PhillipsSteven, SegalEric, SmeyersPatricia, LalDennis, WirrellElaine, ZuberiSameer, BrüngerTobias, WojnaroskiMary, MaruBenit, O'DonnellPenrose, MortonMagda, JamesEmma, VilaMaria Candida, HuangNorman, GofshteynJacqueline S, RicoSalvador

DS communication deficits
DS seizure burden

This study examines the relationship between seizure burden and language/communication development in children with Dravet Syndrome (DS). DS is a severe form of epilepsy characterized by treatment-resistant seizures and developmental stagnation. Communication deficits are a significant concern for families of children with DS, and this research investigates the impact of seizures on language development in this population.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

9.

Neurodevelopment outcomes in the first 5 years of the life of children with transposition of the great arteries surgically corrected in the neonatal period: systematic review and meta-analysis.

Author: SoaresCatarina, VieiraRafael José, CostaSandra, MoitaRita, AndradeMariana, GuimarãesHercília

Improved neurodevelopment outcomes

This systematic review and meta-analysis explores the neurodevelopment outcomes of children who underwent corrective surgery for transposition of the great arteries in the neonatal period, providing insights into long-term outcomes, particularly in the first 5 years of life.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

10.

Can perioperative electroencephalogram and adverse hemodynamic events predict neurodevelopmental outcomes in infants with congenital heart disease?

Author: VaughanTiffany, HammoudMiza Salim, PandeAmol, ChuLee, CumminsKaleigh, McCloskeyOlivia, ParfyonovMaksim, DohChang Yoon, EdwardsAlyssa, SharewBetemariam, GreasonChristie, AbushanabElham, GuptaAjay, MarinoBradley, NajmHani K, KaramlouTara

Cognitive impairment
Neurologic injury

This study found that perioperative continuous electroencephalogram metrics and hemodynamic adverse events were associated with late-term neurologic injury in infants with congenital heart disease undergoing surgery. This suggests that continuous electroencephalogram metrics can be used as predictors of neurologic impairment.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

12.

Musical and vocal interventions to improve neurodevelopmental outcomes for preterm infants.

Author: HaslbeckFriederike B, MuellerKatharina, KarenTanja, LoewyJoanne, MeerpohlJoerg J, BasslerDirk

Music therapy
Preterm infant health
Brain maturation
Preterm birth

This study calls for a comprehensive and rigorous systematic review to evaluate the efficacy of music therapy for preterm infants. Prior systematic reviews with mixed methodological quality have shown ambiguous results, highlighting the need for a more thorough investigation to address controversies and conflicting findings.

Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

15.

Outcomes and prognostic factors of infantile acquired hydrocephalus: a single-center experience.

Author: ZhouFaliang, YangZhao, TangZezhong, ZhangYang, WangHongmei, SunGuoyu, ZhangRui, JiangYi, ZhouCongle, HouXinlin, LiuLili

Death
Neurodevelopmental impairment

Late surgical intervention time and severe ventricular dilation are associated with adverse outcomes in infants with acquired hydrocephalus. In a retrospective study of 129 infants, 48.7% experienced adverse outcomes. Post-hemorrhage was the most common etiology and had a favorable outcome compared to other etiologies.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

16.

An Unusual Case of Traumatic Cervical Epidural Hematoma in an Infant.

Author: HanMin Jeong, KimSun Jun, OhYoung Min

Improved developmental outcomes
Rapid diagnosis
Successful hematoma evacuation

This case report describes the rapid diagnosis and successful treatment of a traumatic cervical epidural hematoma in an infant. The case highlights the importance of prompt diagnosis and treatment for this rare condition, which can lead to serious neurological deficits if left untreated.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

18.

Association between neonatal near miss and infant development: the Ribeirão Preto and São Luís birth cohorts (BRISA).

Author: AristizábalLiliana Yanet Gómez, RochaPaulo Ricardo Higassiaraguti, ConfortinSusana Cararo, SimõesVanda Maria Ferreira, BettiolHeloisa, BarbieriMarco Antonio, da SilvaAntônio Augusto Moura

Developmental delays

Neonatal near miss was a risk factor for developmental delays at two years of age.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

21.

Neurodevelopmental Outcomes for Retinopathy of Prematurity: A Taiwan Premature Infant Follow-up Network Database Study.

Author: ChiangMing-Chou, ChenYen-Ting, KangEugene Yu-Chuan, ChenKuan-Jen, WangNan-Kai, LiuLaura, ChenYen-Po, HwangYih-Shiou, LaiChi-Chun, WuWei-Chi

No adverse neurodevelopment
Laser treatment risks

This retrospective cohort study evaluated the neurodevelopmental outcomes of premature infants who received intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections for retinopathy of prematurity (ROP). Anti-VEGF treatment was not associated with adverse neurodevelopmental outcomes. However, further studies are needed to determine the impact of general anesthesia or sedation used in laser treatment for ROP.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

23.

Impact of tight glycemic control and hypoglycemia after pediatric cardiac surgery on neurodevelopmental outcomes at three years of age: Findings from a randomized clinical trial.

Author: SadhwaniAnjali, AsaroLisa A, GoldbergCaren S, WareJanice, ButcherJennifer, GaiesMichael, SmithCynthia, AlexanderJamin L, WypijDavid, AgusMichael S D

Neurodevelopmental outcomes
Hypoglycemia

This study examines the relationship between tight glycemic control (TGC) and hypoglycemia in children undergoing cardiac surgery. It aims to clarify the potential impact of these factors on neurodevelopmental outcomes in this population.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

24.

Association Between Retinopathy of Prematurity in Very-Low-Birth-Weight Infants and Neurodevelopmental Impairment.

Author: HanGyule, LimDong Hui, KangDanbee, ChoJuhee, GuallarEliseo, ChangYun Sil, ChungTae-Young, KimSang Jin, ParkWon Soon

Neurodevelopmental impairment
ROP risks

Treatment-requiring retinopathy of prematurity (TR-ROP) was associated with an increased risk of neurodevelopmental impairment in very-low-birth-weight infants (VLBWIs) compared to those with no ROP. The type of ROP treatment (anti-VEGF or laser therapy) did not affect neurodevelopmental impairment in the TR-ROP group.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

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