Publicaciones científicas

Assessment and Diagnosis of Down Syndrome Regression Disorder: International Expert Consensus

15-jul-2022 | Revista: Frontiers in Neurology

Jonathan D Santoro  1   2 , Lina Patel  3 , Ryan Kammeyer  4 , Robyn A Filipink  5 , Grace Y Gombolay  6 , Kathleen M Cardinale  7 , Diego Real de Asua  8 , Shahid Zaman  9 , Stephanie L Santoro  10 , Sammer M Marzouk  10 , Mellad Khoshnood  1 , Benjamin N Vogel  2 , Runi Tanna  2 , Dania Pagarkar  2 , Sofia Dhanani  2 , Maria Del Carmen Ortega  11 , Rebecca Partridge  12 , Maria A Stanley  13 , Jessica S Sanders  14 , Alison Christy  15 , Elise M Sannar  3   16 , Ruth Brown  17 , Andrew A McCormick  5 , Heather Van Mater  18 , Cathy Franklin  19 , Gordon Worley  20 , Eileen A Quinn  21 , George T Capone  22   23 , Brian Chicoine  24 , Brian G Skotko  10   25 , Michael S Rafii  2   26

Objective: To develop standardization for nomenclature, diagnostic work up and diagnostic criteria for cases of neurocognitive regression in Down syndrome.

Background: There are no consensus criteria for the evaluation or diagnosis of neurocognitive regression in persons with Down syndrome. As such, previously published data on this condition is relegated to smaller case series with heterogenous data sets. Lack of standardized assessment tools has slowed research in this clinical area.

Methods: The authors performed a two-round traditional Delphi method survey of an international group of clinicians with experience in treating Down syndrome to develop a standardized approach to clinical care and research in this area. Thirty-eight potential panelists who had either previously published on neurocognitive regression in Down syndrome or were involved in national or international working groups on this condition were invited to participate. In total, 27 panelists (71%) represented nine medical specialties and six different countries reached agreement on preliminary standards in this disease area. Moderators developed a proposed nomenclature, diagnostic work up and diagnostic criteria based on previously published reports of regression in persons with Down syndrome.

Results: During the first round of survey, agreement on nomenclature for the condition was reached with 78% of panelists agreeing to use the term Down Syndrome Regression Disorder (DSRD). Agreement on diagnostic work up and diagnostic criteria was not reach on the first round due to low agreement amongst panelists with regards to the need for neurodiagnostic testing. Following incorporation of panelist feedback, diagnostic criteria were agreed upon (96% agreement on neuroimaging, 100% agreement on bloodwork, 88% agreement on lumbar puncture, 100% agreement on urine studies, and 96% agreement on "other" studies) as were diagnostic criteria (96% agreement).

Conclusions: The authors present international consensus agreement on the nomenclature, diagnostic work up, and diagnostic criteria for DSRD, providing an initial practical framework that can advance both research and clinical practices for this condition.

CITA DEL ARTÍCULO  Front Neurol. 2022 Jul 15;13:940175. doi: 10.3389/fneur.2022.940175