Left-handedness should not be overrated as a risk factor for postoperative speech impairment in children after posterior fossa tumour surgery: a prospective European multicentre study

Jonathan Kjær Grønbæk; Aske Foldbjerg Laustsen; Sebastian Toescu; Barry Pizer; Conor Mallucci; Kristian Aquilina; Emanuela Molinari; Magnus Aasved Hjort; Lingvita Gumbeleviciene; Peter Hauser; Beatrix Pálmafy; Kirsten van Baarsen; Eelco Hoving; Julian Zipfel; Christoffer Ehrstedt; Pernilla Grillner; Michael Thude Callesen; Radek Frič; Morten Wibroe; Karsten Nysom; Kjeld Schmiegelow; Astrid Sehested; René Mathiasen; Marianne Juhler; On behalf of The CMS study group

doi:10.1007/s00381-022-05567-8

Left-handedness should not be overrated as a risk factor for postoperative speech impairment in children after posterior fossa tumour surgery: a prospective European multicentre study

Jonathan Kjær Grønbæk, Aske Foldbjerg Laustsen, Sebastian Toescu, Barry Pizer, Conor Mallucci, Kristian Aquilina, Emanuela Molinari, Magnus Aasved Hjort, Lingvita Gumbeleviciene, Peter Hauser, Beatrix Pálmafy, Kirsten van Baarsen, Eelco Hoving, Julian Zipfel, Christoffer Ehrstedt, Pernilla Grillner, Michael Thude Callesen, Radek Frič, Morten Wibroe, Karsten NysomKjeld Schmiegelow, Astrid Sehested, René Mathiasen, Marianne Juhler, On behalf of The CMS study group

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

6 Citations (Scopus)

Abstract

Purpose: Cerebellar mutism syndrome (CMS) is a severe neurological complication of posterior fossa tumour surgery in children, and postoperative speech impairment (POSI) is the main component. Left-handedness was previously suggested as a strong risk factor for POSI. The aim of this study was to investigate the relationship between handedness and the risk of POSI. Methods: We prospectively included children (aged < 18 years) undergoing surgery for posterior fossa tumours in 26 European centres. Handedness was assessed pre-operatively and postoperative speech status was categorised as either POSI (mutism or reduced speech) or habitual speech, based on the postoperative clinical assessment. Logistic regression was used in the risk factor analysis of POSI as a dichotomous outcome. Results: Of the 500 children included, 37 (7%) were excluded from the present analysis due to enrolment at a reoperation; another 213 (43%) due to missing data about surgery (n = 37) and/or handedness (n = 146) and/or postoperative speech status (n = 53). Out of the remaining 250 (50%) patients, 20 (8%) were left-handed and 230 (92%) were right-handed. POSI was observed equally frequently regardless of handedness (5/20 [25%] in left-handed, 61/230 [27%] in right-handed, OR: 1.08 [95% CI: 0.40–3.44], p = 0.882), also when adjusted for tumour histology, location and age. Conclusion: We found no difference in the risk of POSI associated with handedness. Our data do not support the hypothesis that handedness should be of clinical relevance in the risk assessment of CMS.

Original language	English
Journal	Child's Nervous System
Volume	38
Issue	8
Pages (from-to)	1479-1485
Number of pages	7
ISSN	0256-7040
DOIs	https://doi.org/10.1007/s00381-022-05567-8
Publication status	Published - Aug 2022

Keywords

Cerebellar mutism syndrome
Handedness
Posterior fossa syndrome
Prospective Studies
Humans
Risk Factors
Cerebellar Diseases/complications
Functional Laterality
Mutism/complications
Infratentorial Neoplasms/complications
Postoperative Complications/epidemiology
Speech
Cerebellar Neoplasms/surgery
Child

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10.1007/s00381-022-05567-8

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Grønbæk, J. K., Laustsen, A. F., Toescu, S., Pizer, B., Mallucci, C., Aquilina, K., Molinari, E., Hjort, M. A., Gumbeleviciene, L., Hauser, P., Pálmafy, B., van Baarsen, K., Hoving, E., Zipfel, J., Ehrstedt, C., Grillner, P., Callesen, M. T., Frič, R., Wibroe, M., ... On behalf of The CMS study group (2022). Left-handedness should not be overrated as a risk factor for postoperative speech impairment in children after posterior fossa tumour surgery: a prospective European multicentre study. Child's Nervous System, 38(8), 1479-1485. https://doi.org/10.1007/s00381-022-05567-8

@article{4650f25ff04b488dbffdcee4522a0ad9,

title = "Left-handedness should not be overrated as a risk factor for postoperative speech impairment in children after posterior fossa tumour surgery: a prospective European multicentre study",

abstract = "Purpose: Cerebellar mutism syndrome (CMS) is a severe neurological complication of posterior fossa tumour surgery in children, and postoperative speech impairment (POSI) is the main component. Left-handedness was previously suggested as a strong risk factor for POSI. The aim of this study was to investigate the relationship between handedness and the risk of POSI. Methods: We prospectively included children (aged < 18 years) undergoing surgery for posterior fossa tumours in 26 European centres. Handedness was assessed pre-operatively and postoperative speech status was categorised as either POSI (mutism or reduced speech) or habitual speech, based on the postoperative clinical assessment. Logistic regression was used in the risk factor analysis of POSI as a dichotomous outcome. Results: Of the 500 children included, 37 (7%) were excluded from the present analysis due to enrolment at a reoperation; another 213 (43%) due to missing data about surgery (n = 37) and/or handedness (n = 146) and/or postoperative speech status (n = 53). Out of the remaining 250 (50%) patients, 20 (8%) were left-handed and 230 (92%) were right-handed. POSI was observed equally frequently regardless of handedness (5/20 [25%] in left-handed, 61/230 [27%] in right-handed, OR: 1.08 [95% CI: 0.40–3.44], p = 0.882), also when adjusted for tumour histology, location and age. Conclusion: We found no difference in the risk of POSI associated with handedness. Our data do not support the hypothesis that handedness should be of clinical relevance in the risk assessment of CMS.",

keywords = "Cerebellar mutism syndrome, Handedness, Posterior fossa syndrome, Prospective Studies, Humans, Risk Factors, Cerebellar Diseases/complications, Functional Laterality, Mutism/complications, Infratentorial Neoplasms/complications, Postoperative Complications/epidemiology, Speech, Cerebellar Neoplasms/surgery, Child",

author = "Gr{\o}nb{\ae}k, {Jonathan Kj{\ae}r} and Laustsen, {Aske Foldbjerg} and Sebastian Toescu and Barry Pizer and Conor Mallucci and Kristian Aquilina and Emanuela Molinari and Hjort, {Magnus Aasved} and Lingvita Gumbeleviciene and Peter Hauser and Beatrix P{\'a}lmafy and {van Baarsen}, Kirsten and Eelco Hoving and Julian Zipfel and Christoffer Ehrstedt and Pernilla Grillner and Callesen, {Michael Thude} and Radek Fri{\v c} and Morten Wibroe and Karsten Nysom and Kjeld Schmiegelow and Astrid Sehested and Ren{\'e} Mathiasen and Marianne Juhler and Gr{\o}nb{\ae}k, {Jonathan Kj{\ae}r} and M{\o}ller, {Lisbeth N{\o}rgaard} and Bengt Gustavsson and Mia Westerholm-Ormio and Rosita Kiudeliene and Katalin Mudra and {van Baarsen}, Kirsten and Mimi Kj{\ae}rsgaard and Lars B{\o}geskov and Jane Skj{\o}th-Rasmussen and {Hauerberg Tamm}, John and Lars Poulsgaard and Thora Gudrunardottir and Gr{\o}nb{\ae}k, {Sylvester Kl{\"o}cker} and Alberte Blichfeldt and Raben-Levetzau, {Felix Nicolai} and {Thude Callesen}, Michael and Mathias Rathe and Klokker, {Rikke Bass{\o}} and {von Oettingen}, Gorm and Henriksen, {Louise Tram} and S{\o}ren Cortnum and Kamilla Tofting-Olesen and Atte Karppinen and Niels Clausen and {On behalf of The CMS study group}",

note = "Publisher Copyright: {\textcopyright} 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.",

year = "2022",

month = aug,

doi = "10.1007/s00381-022-05567-8",

language = "English",

volume = "38",

pages = "1479--1485",

journal = "Child's Nervous System",

issn = "0256-7040",

publisher = "Springer",

number = "8",

}

Grønbæk, JK, Laustsen, AF, Toescu, S, Pizer, B, Mallucci, C, Aquilina, K, Molinari, E, Hjort, MA, Gumbeleviciene, L, Hauser, P, Pálmafy, B, van Baarsen, K, Hoving, E, Zipfel, J, Ehrstedt, C, Grillner, P, Callesen, MT, Frič, R, Wibroe, M, Nysom, K, Schmiegelow, K, Sehested, A, Mathiasen, R, Juhler, M & On behalf of The CMS study group 2022, 'Left-handedness should not be overrated as a risk factor for postoperative speech impairment in children after posterior fossa tumour surgery: a prospective European multicentre study', Child's Nervous System, vol. 38, no. 8, pp. 1479-1485. https://doi.org/10.1007/s00381-022-05567-8

Left-handedness should not be overrated as a risk factor for postoperative speech impairment in children after posterior fossa tumour surgery: a prospective European multicentre study. / Grønbæk, Jonathan Kjær; Laustsen, Aske Foldbjerg; Toescu, Sebastian et al.
In: Child's Nervous System, Vol. 38, No. 8, 08.2022, p. 1479-1485.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Left-handedness should not be overrated as a risk factor for postoperative speech impairment in children after posterior fossa tumour surgery

T2 - a prospective European multicentre study

AU - Grønbæk, Jonathan Kjær

AU - Laustsen, Aske Foldbjerg

AU - Toescu, Sebastian

AU - Pizer, Barry

AU - Mallucci, Conor

AU - Aquilina, Kristian

AU - Molinari, Emanuela

AU - Hjort, Magnus Aasved

AU - Gumbeleviciene, Lingvita

AU - Hauser, Peter

AU - Pálmafy, Beatrix

AU - van Baarsen, Kirsten

AU - Hoving, Eelco

AU - Zipfel, Julian

AU - Ehrstedt, Christoffer

AU - Grillner, Pernilla

AU - Callesen, Michael Thude

AU - Frič, Radek

AU - Wibroe, Morten

AU - Nysom, Karsten

AU - Schmiegelow, Kjeld

AU - Sehested, Astrid

AU - Mathiasen, René

AU - Juhler, Marianne

AU - Grønbæk, Jonathan Kjær

AU - Møller, Lisbeth Nørgaard

AU - Gustavsson, Bengt

AU - Westerholm-Ormio, Mia

AU - Kiudeliene, Rosita

AU - Mudra, Katalin

AU - van Baarsen, Kirsten

AU - Kjærsgaard, Mimi

AU - Bøgeskov, Lars

AU - Skjøth-Rasmussen, Jane

AU - Hauerberg Tamm, John

AU - Poulsgaard, Lars

AU - Gudrunardottir, Thora

AU - Grønbæk, Sylvester Klöcker

AU - Blichfeldt, Alberte

AU - Raben-Levetzau, Felix Nicolai

AU - Thude Callesen, Michael

AU - Rathe, Mathias

AU - Klokker, Rikke Bassø

AU - von Oettingen, Gorm

AU - Henriksen, Louise Tram

AU - Cortnum, Søren

AU - Tofting-Olesen, Kamilla

AU - Karppinen, Atte

AU - Clausen, Niels

AU - On behalf of The CMS study group

PY - 2022/8

Y1 - 2022/8

N2 - Purpose: Cerebellar mutism syndrome (CMS) is a severe neurological complication of posterior fossa tumour surgery in children, and postoperative speech impairment (POSI) is the main component. Left-handedness was previously suggested as a strong risk factor for POSI. The aim of this study was to investigate the relationship between handedness and the risk of POSI. Methods: We prospectively included children (aged < 18 years) undergoing surgery for posterior fossa tumours in 26 European centres. Handedness was assessed pre-operatively and postoperative speech status was categorised as either POSI (mutism or reduced speech) or habitual speech, based on the postoperative clinical assessment. Logistic regression was used in the risk factor analysis of POSI as a dichotomous outcome. Results: Of the 500 children included, 37 (7%) were excluded from the present analysis due to enrolment at a reoperation; another 213 (43%) due to missing data about surgery (n = 37) and/or handedness (n = 146) and/or postoperative speech status (n = 53). Out of the remaining 250 (50%) patients, 20 (8%) were left-handed and 230 (92%) were right-handed. POSI was observed equally frequently regardless of handedness (5/20 [25%] in left-handed, 61/230 [27%] in right-handed, OR: 1.08 [95% CI: 0.40–3.44], p = 0.882), also when adjusted for tumour histology, location and age. Conclusion: We found no difference in the risk of POSI associated with handedness. Our data do not support the hypothesis that handedness should be of clinical relevance in the risk assessment of CMS.

AB - Purpose: Cerebellar mutism syndrome (CMS) is a severe neurological complication of posterior fossa tumour surgery in children, and postoperative speech impairment (POSI) is the main component. Left-handedness was previously suggested as a strong risk factor for POSI. The aim of this study was to investigate the relationship between handedness and the risk of POSI. Methods: We prospectively included children (aged < 18 years) undergoing surgery for posterior fossa tumours in 26 European centres. Handedness was assessed pre-operatively and postoperative speech status was categorised as either POSI (mutism or reduced speech) or habitual speech, based on the postoperative clinical assessment. Logistic regression was used in the risk factor analysis of POSI as a dichotomous outcome. Results: Of the 500 children included, 37 (7%) were excluded from the present analysis due to enrolment at a reoperation; another 213 (43%) due to missing data about surgery (n = 37) and/or handedness (n = 146) and/or postoperative speech status (n = 53). Out of the remaining 250 (50%) patients, 20 (8%) were left-handed and 230 (92%) were right-handed. POSI was observed equally frequently regardless of handedness (5/20 [25%] in left-handed, 61/230 [27%] in right-handed, OR: 1.08 [95% CI: 0.40–3.44], p = 0.882), also when adjusted for tumour histology, location and age. Conclusion: We found no difference in the risk of POSI associated with handedness. Our data do not support the hypothesis that handedness should be of clinical relevance in the risk assessment of CMS.

KW - Cerebellar mutism syndrome

KW - Handedness

KW - Posterior fossa syndrome

KW - Prospective Studies

KW - Humans

KW - Risk Factors

KW - Cerebellar Diseases/complications

KW - Functional Laterality

KW - Mutism/complications

KW - Infratentorial Neoplasms/complications

KW - Postoperative Complications/epidemiology

KW - Speech

KW - Cerebellar Neoplasms/surgery

KW - Child

UR - http://www.scopus.com/inward/record.url?scp=85135051641&partnerID=8YFLogxK

U2 - 10.1007/s00381-022-05567-8

DO - 10.1007/s00381-022-05567-8

M3 - Journal article

C2 - 35759029

AN - SCOPUS:85135051641

SN - 0256-7040

VL - 38

SP - 1479

EP - 1485

JO - Child's Nervous System

JF - Child's Nervous System

IS - 8

ER -

Left-handedness should not be overrated as a risk factor for postoperative speech impairment in children after posterior fossa tumour surgery: a prospective European multicentre study

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