Developmental Skills and Neurorehabilitation for Children With Batten Disease: A Retrospective Chart Review of a Comprehensive Batten Clinic

Pediatr Neurol. 2024 Mar:152:107-114. doi: 10.1016/j.pediatrneurol.2023.12.001. Epub 2023 Dec 5.

Abstract

Background: Batten disease is a rare, progressive neurogenetic disorder composed of 13 genotypes that often presents in childhood. Children present with seizures, vision loss, and developmental regression. Neurorehabilitation services (i.e., physical therapy, occupational therapy, and speech-language therapy) can help improve the quality of life for children and their families. Owing to the rarity of Batten disease, there are no standardized clinical recommendations or outcome assessments. To describe developmental profiles, current dose of neurorehabilitation, and outcome assessments used clinically for children diagnosed with Batten disease.

Methods: Electronic medical records of 70 children with Batten disease (subtypes n = 5 CLN1; n = 25 CLN2; n = 23 CLN3; n = 17 CLN6) were reviewed (7.0 ± 3.4 years). Descriptive statistics were used to describe clinical features, developmental skills, dose of neurorehabilitation, and outcome assessment use.

Results: Across CLN subtypes, most children experienced vision impairments (61%) and seizures (68%). Most children demonstrated delays in fine motor (65%), gross motor (80%), cognitive (63%), and language skills (83%). The most common frequency of neurorehabilitation was weekly (42% to 43%). Two standardized outcome assessments were used to track developmental outcomes: Peabody Developmental Motor Scales, second edition (30% of children completed this assessment) and Preschool Language Scales, fifth edition (27.4% of children completed this assessment).

Conclusions: Neurorehabilitation professionals should understand the clinical features and prognosis for children with Batten disease. The child's clinical features and family preferences should guide the rehabilitation plan of care. Future work needs to be completed to define dosing parameters and validate outcome assessments for neurorehabilitation services.

Keywords: Batten disease; Dosing; Neuronal ceroid lipofuscinosis; Neurorehabilitation.

MeSH terms

  • Child
  • Child, Preschool
  • Humans
  • Membrane Glycoproteins
  • Membrane Proteins
  • Molecular Chaperones
  • Neurological Rehabilitation*
  • Neuronal Ceroid-Lipofuscinoses* / genetics
  • Quality of Life
  • Retrospective Studies
  • Seizures

Substances

  • CLN3 protein, human
  • Membrane Glycoproteins
  • Molecular Chaperones
  • CLN6 protein, human
  • Membrane Proteins