Applicability of quantitative oculomotor and SARA assessment in children. (November 2021)

• Record Type: Journal Article
• Authors: Vogelaar, Francien A.; Brandsma, Rick; Maurits, Natasha M.; Sival, Deborah A.
• Is Part Of: European journal of paediatric neurology. Volume 35(2021)
• Page Start: 56
• Page End: 60
• Publication Date: 2021-11
• Subjects: SARA -- ICARS -- Ataxia rating scale -- Child -- Oculomotor assessment -- Cerebellum; Pediatric neurology -- Periodicals; Nervous System Diseases -- Periodicals; Child -- Periodicals; Infant -- Periodicals; Neurologie pédiatrique -- Périodiques; Pediatric neurology; Electronic journals; Periodicals; Electronic journals; 618.928
• DOI: 10.1016/j.ejpn.2021.09.011
• Languages: English
• ISSNs: 1090-3798

Abstract

Abstract: Background: In clinical practice, eye movements can provide an early diagnostic marker for early onset ataxia (EOA). However, quantitative oculomotor assessment is not included in the most frequently used and age-validated ataxia rating scale in children, the Scale for the Assessment and Rating of Ataxia (SARA). We aimed to investigate the applicability of semi-quantitative eye movement assessment by the International Cooperative Ataxia Rating Scale (ICARSOCM ) and Ocular Motion Score (OMS7-10 ) complementary to SARA measurements in children. Methods: In 52 typically developing children (aged 4–16 years; n = 4 per year of age), three independent assessors scored saccadic eye movements and ocular pursuit according to the ICARSOCM and matching parameters from the OMS7-10 . For ICARSOCM, we determined 1) construct validity for coordinated eye movements by correlation with OMS7-10, ICARSEYE-HAND-COORDINATION and SARA subscale scores, 2) agreement percentage and inter-rater agreement (Fleiss Kappa) and 3) age-dependency. Results: Spearman's rank correlations of ICARSOCM with OMS7-10 and ICARS- and SARA subscales were moderate to fair (all p < .001). Inter-rater agreement of ICARS-OCM was 80.8%; (Fleiss Kappa: 0.411). ICARSOCM scores revealed a similar exponentially decreasing association with age as the other SARA (sub)scores, reaching a plateau at 10 years of age. Interpretation: ICARSOCM has a valid construct for the measurement of coordinated eye movement performance and is reliably assessable in children. ICARSOCM reveals a similar age-dependent relationship as the other ataxia subscales, reflecting the physiological maturation of the cerebellum. In children, these data may implicate that ICARSOCM can reliably contribute to coordination assessment, complementary to the SARA subscales. Highlights: Paediatric, semi-quantitative oculomotor parameters (ICARSOCM ): Reveal construct validity with coordinated eye movements as assessed by OMS. Reveal construct validity with coordinated limb movements, as assessed by ICARSEYE-HAND-COORDINATION and SARA. Are reliably assessable by paediatric neurologists and researchers. Are age-dependent until ≈10 years of age, analogous with other SARA-subscale scores.