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Strömberg, B
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Publications (10 of 25) Show all publications
Kristiansen, I., Strinnholm, M., Strömberg, B. & Frisk, P. (2019). Clinical characteristics, long-term complications and health related quality of life (HRQoL) in children and young adults treated for low-grade astrocytoma in the posterior fossa in childhood. Journal of Neuro-Oncology, 142(1), 203-210
Open this publication in new window or tab >>Clinical characteristics, long-term complications and health related quality of life (HRQoL) in children and young adults treated for low-grade astrocytoma in the posterior fossa in childhood
2019 (English)In: Journal of Neuro-Oncology, ISSN 0167-594X, E-ISSN 1573-7373, Vol. 142, no 1, p. 203-210Article in journal (Refereed) Published
Abstract [en]

Pilocytic astrocytoma is the most common brain tumour in childhood but knowledge concerning its long-term outcome is sparse. The aim of the study was to investigate if children treated for low-grade pilocytic astrocytoma in the posterior fossa had complications affecting physical and psychological health, cognitive functions, learning difficulties and HRQoL.

A descriptive single-centre study, where 22 children and young adults out of 27 eligible patients (81%) treated for pilocytic astrocytoma, with a mean follow-up time of 12.4 years (5-19 years) participated (14 adults, two by telephone interviews and eight children). The study included a review of medical records, an interview, neurological investigation, screening tools for psychiatric symptoms (Beck Depression and Anxiety Inventories and Beck Youth Inventory Scales) and HRQoL measures (RAND-36).

Motor complications were most common, reported in 12 patients and mainly affecting fine-motor skills. Seven patients reported cognitive difficulties affecting performance in school. Educational support was given in the period immediately after treatment but not after primary school. None had elevated levels of psychiatric symptoms and the level of HRQoL as well as their psychosocial and educational situation was in correspondence with Swedish norms. The HRQoL score for vitality (VT) almost reached statistical significance.

The long-term functional outcome for children treated for low-grade astrocytoma is favourable. However, some patients report neurological complications and learning difficulties, which are unmet in school. Therefore, there is a need to identify those who need more thorough medical and cognitive follow-up programmes including interventions in school.

National Category
Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-372137 (URN)10.1007/s11060-018-03085-9 (DOI)000461075200020 ()30623287 (PubMedID)
Funder
Swedish Childhood Cancer Foundation
Available from: 2019-01-06 Created: 2019-01-06 Last updated: 2020-01-06Bibliographically approved
Hafström, M., Källén, K., Serenius, F., Maršál, K., Rehn, E., Drake, H., . . . Strömberg, B. (2018). Cerebral Palsy in Extremely Preterm Infants. Pediatrics, 141(1), Article ID e20171433.
Open this publication in new window or tab >>Cerebral Palsy in Extremely Preterm Infants
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2018 (English)In: Pediatrics, ISSN 0031-4005, E-ISSN 1098-4275, Vol. 141, no 1, article id e20171433Article in journal (Refereed) Published
Abstract [en]

BACKGROUND AND OBJECTIVES: The risk of cerebral palsy (CP) is high in preterm infants and is often accompanied by additional neurodevelopmental comorbidities. The present study describes lifetime prevalence of CP in a population-based prospective cohort of children born extremely preterm, including the type and severity of CP and other comorbidities (ie, developmental delay and/or cognitive impairment, neurobehavioral morbidity, epilepsy, vision and hearing impairments), and overall severity of disability. In this study, we also evaluate whether age at assessment, overall severity of disability, and available sources of information influence outcome results.

METHODS: All Swedish children born before 27 weeks' gestation from 2004 to 2007 were included (the Extremely Preterm Infants in Sweden Study). The combination of neonatal information, information from clinical examinations and neuropsychological assessments at 2.5 and 6.5 years of age, original medical chart reviews, and extended chart reviews was used.

RESULTS: The outcome was identified in 467 (94.5%) of eligible children alive at 1 year of age. Forty-nine (10.5%) children had a lifetime diagnosis of CP, and 37 (76%) were ambulatory. Fourteen (29%) had CP diagnosed after 2.5 years of age, 37 (76%) had at least 1 additional comorbidity, and 27 (55%) had severe disability. The probability for an incomplete evaluation was higher in children with CP compared with children without CP.

CONCLUSIONS: Children born extremely preterm with CP have various comorbidities and often overall severe disability. The importance of long-term follow-up and of obtaining comprehensive outcome information from several sources in children with disabilities is shown.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-335962 (URN)10.1542/peds.2017-1433 (DOI)000419003300017 ()29222398 (PubMedID)
Funder
Swedish Research Council, 2006-3858, 2009-4250, 523-2011-3981Marianne and Marcus Wallenberg Foundation, 2011.0085The Karolinska Institutet's Research Foundation, ALF-20160227Region Västra Götaland, RFR-66881The Swedish Brain Foundation
Available from: 2017-12-11 Created: 2017-12-11 Last updated: 2018-02-07Bibliographically approved
Ehrstedt, C., Rydell, A.-M., Hallsten, M. G., Strömberg, B. & Ahlsten, G. (2018). Cognition, Health-Related Quality Of Life and Mood in Children and Young Adults Diagnosed with a Glioneuronal Tumor in Childhood. Paper presented at 18th International Symposium on Pediatric Neuro-Oncology (ISPNO), JUN 30-JUL 03, 2018, Denver, CO. Neuro-Oncology, 20, 161-161
Open this publication in new window or tab >>Cognition, Health-Related Quality Of Life and Mood in Children and Young Adults Diagnosed with a Glioneuronal Tumor in Childhood
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2018 (English)In: Neuro-Oncology, ISSN 1522-8517, E-ISSN 1523-5866, Vol. 20, p. 161-161Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Oxford University Press, 2018
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-366681 (URN)10.1093/neuonc/noy059.600 (DOI)000438339000602 ()
Conference
18th International Symposium on Pediatric Neuro-Oncology (ISPNO), JUN 30-JUL 03, 2018, Denver, CO
Available from: 2018-11-23 Created: 2018-11-23 Last updated: 2018-11-23Bibliographically approved
Ehrstedt, C., Rydell, A.-M., Hallsten, M. G., Strömberg, B. & Ahlsten, G. (2018). Cognition, health-related quality of life, and mood in children and young adults diagnosed with a glioneuronal tumor in childhood. Epilepsy & Behavior, 83, 59-66
Open this publication in new window or tab >>Cognition, health-related quality of life, and mood in children and young adults diagnosed with a glioneuronal tumor in childhood
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2018 (English)In: Epilepsy & Behavior, ISSN 1525-5050, E-ISSN 1525-5069, Vol. 83, p. 59-66Article in journal (Refereed) Published
Abstract [en]

Aims: The aim of this study was to investigate long-term cognitive outcome, health-related quality of life (HRQoL), and psychiatric symptoms in children and young adults diagnosed with a glioneuronal tumor in childhood.

Methods: Twenty-eight children and adolescents (0-17.99 years) with a minimum postoperative follow-up time of five years were eligible for the study; four persons declined participation. A cross-sectional long-term follow-up evaluation was performed using the following study measures: Wechsler Intelligence Scale for Children (WISC-IV) or Wechsler Adult Intelligence Scale (WAIS-IV), Reys Complex Figure Test (RCFT), Short Form 36 version 2 (SF-36v2), Short Form 10 (SF-10), Quality of Life in Epilepsy 31 (QOLIE-31), Hospital Anxiety Depression Scale (HADS) or Beck Youth Inventory Scales (BYI), and Rosenberg Self-Esteem Scale. Historical WISC-III and RCFT data were used to compare cognitive longitudinal data.

Results: Mean follow-up time after surgery was 12.1 years. Sixty-three percent (15/24) were seizure-free. Despite a successive postoperative gain in cognitive function, a significant reduction relative to norms was seen in the seizure-free group with respect to perceptual reasoning index (PRI), working memory index (WMI), and full-scale intelligence quotient (FSIQ). Seizure freedom resulted in acceptable HRQoL. Thirty-two percent and 16% exceeded the threshold level of possible anxiety and depression, respectively, despite seizure freedom.

Conclusion: Although lower than in corresponding reference groups, cognitive outcome and HRQoL are good provided that seizure freedom or at least a low seizure severity can be achieved. There is a risk of elevated levels of psychiatric symptoms. Long-term clinical follow-up is advisable.

Keywords
Glioneuronal brain tumors, Cognition, Quality of life, Mood, Long-term outcome
National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-357694 (URN)10.1016/j.yebeh.2018.03.026 (DOI)000434400600009 ()29654937 (PubMedID)
Available from: 2018-08-22 Created: 2018-08-22 Last updated: 2019-01-07Bibliographically approved
Ehrstedt, C., Canto Moreira, N., Casar Borota, O., Strömberg, B. & Ahlsten, G. (2017). Glioneuronal tumors in childhood - Before and after surgery. A long-term follow-up study. Epilepsy & Behavior, 72, 82-88
Open this publication in new window or tab >>Glioneuronal tumors in childhood - Before and after surgery. A long-term follow-up study
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2017 (English)In: Epilepsy & Behavior, ISSN 1525-5050, E-ISSN 1525-5069, Vol. 72, p. 82-88Article in journal (Refereed) Published
Abstract [en]

Aim: To give a detailed description of the long-term outcome of a cohort of children with glioneuronal tumors regarding pre-and postsurgical factors, including "dual" and "double" pathology, seizure freedom, and psychosocial outcome.

Methods: During a fifteen-year period (1995-2009), all patients (age 0-17.99 years) with a glioneuronal brain tumor diagnosed and treated at Uppsala University Children's Hospital were identified from the National Brain Tumor Registry and the National Epilepsy Surgery Registry. Hospital medical records were reviewed and neuroradiological and neuropathological findings were re-evaluated. A cross-sectional long-term follow-up prospective evaluation, including an interview, neurologic examination, and electroencephalogram, was accomplished in patients accepting participants in the study.

Results: A total of 25 out of 28 (89%) eligible patientswere included. The M: F ratiowas 1.5: 1. Mean follow-up time after surgery was 12.1 years (range 5.0-19.3). Twenty patients were adults (N18 years) at follow-up. Seizure freedomwas achieved in 64%. Gross total resection (GTR) was the only preoperative factor significantly correlating to seizure freedom (p= 0.027). Thirty-eight percent were at some time postoperatively admitted for a psychiatric evaluation. There was a trend towards both higher educational level and employment status in adults who became seizure free.

Conclusion: Long-termoutcome is good regarding seizure freedom if GTR can be achieved, but late seizure recurrence can occur. "Dual" and "double" pathology is uncommon and does not influence seizure outcome. Obtaining seizure freedomseems to be important for psychosocial outcome, but there is a risk for psychiatric comorbidities and long-term follow-up by a multi-professional team is advisable.

Place, publisher, year, edition, pages
ACADEMIC PRESS INC ELSEVIER SCIENCE, 2017
Keywords
Glioneuronal tumor, Childhood, "Dual" pathology, "Double" pathology, Seizure outcome, Psychosocial outcome
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-333399 (URN)10.1016/j.yebeh.2017.02.012 (DOI)000406321300015 ()28575773 (PubMedID)
Available from: 2017-11-16 Created: 2017-11-16 Last updated: 2019-01-07Bibliographically approved
Montgomery, C., Johansen, K., Lucas, S., Strömberg, B. & Persson, K. (2017). The Structured Observation of Motor Performance in Infants can detect cerebral palsy early in neonatal intensive care recipients. Early Human Development, 113, 31-39
Open this publication in new window or tab >>The Structured Observation of Motor Performance in Infants can detect cerebral palsy early in neonatal intensive care recipients
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2017 (English)In: Early Human Development, ISSN 0378-3782, E-ISSN 1872-6232, Vol. 113, p. 31-39Article in journal (Refereed) Published
Abstract [en]

Background

The detection of motor problems in infancy requires a detailed assessment method that measures both the infants' level of motor development and movement quality.

Aim

To evaluate the ability of the Structured Observation of Motor Performance in Infants (SOMP-I) to detect cerebral palsy (CP) in neonatal intensive care recipients.

Study design

Prospective cohort study analyzed retrospectively.

Subjects

212 (girls: 96) neonatal intensive care recipients (mean gestational age 34 weeks, range: 23–43). Twenty infants were diagnosed with CP.

Outcome measures

The infants were assessed using SOMP-I at 2, 4, 6 and 10 months' corrected age. Accuracy measures were calculated for level of motor development, quality of motor performance and a combination of the two to detect CP at single and repeated assessments.

Results

At 2 months, 17 of 20 infants with CP were detected, giving a sensitivity of 85% (95% CI 62–97%) and a specificity of 48% (95% CI 40–55%), while the negative likelihood ratio was 0.3 (95% CI 0.1–0.9) and the positive likelihood ratio was 1.6 (95% CI 1.3–2.0). At 6 months all infants with CP were detected using SOMP-I, and all infants had repeatedly been assessed outside the cut-offs. Specificity was generally lower for all assessment ages, however, for repeated assessments sensitivity reached 90% (95% CI 68–99%) and specificity 85% (95% CI 79–90%).

Conclusions

SOMP-I is sensitive for detecting CP early, but using the chosen cut-off can lead to false positives for CP. Assessing level and quality in combination and at repeated assessments improved predictive ability.

National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-316405 (URN)10.1016/j.earlhumdev.2017.07.009 (DOI)000415776000006 ()28728014 (PubMedID)
Note

Cecilia Montgomery and Kine Johansen share first authorship

Available from: 2017-03-01 Created: 2017-03-01 Last updated: 2018-02-26Bibliographically approved
Ehrstedt, C., Kristiansen, I., Ahlsten, G., Casar Borota, O., Dahl, M., Libard, S. & Strömberg, B. (2016). Clinical characteristics and late effects in CNS tumours of childhood: Do not forget long term follow-up of the low grade tumours. European journal of paediatric neurology, 20(4), 580-587
Open this publication in new window or tab >>Clinical characteristics and late effects in CNS tumours of childhood: Do not forget long term follow-up of the low grade tumours
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2016 (English)In: European journal of paediatric neurology, ISSN 1090-3798, E-ISSN 1532-2130, Vol. 20, no 4, p. 580-587Article in journal (Refereed) Published
Abstract [en]

Aim: To investigate clinical characteristics and late effects of CNS tumours in childhood with a special focus on low-grade tumours, especially low-grade astrocytoma and glib neuronal tumours. Methods: A retrospective population based study was performed at Uppsala University Children's Hospital, a tertiary referral centre for children with CNS tumours. Patients were identified from the National Brain Tumour Registry and the National Epilepsy Surgery Registry. Hospital medical records were analysed for patients with a follow up of >= 5 years after diagnosis. A re-evaluation of the neuro-pathological diagnosis was performed. Results: A total of 193 patients (age 0-17.99 years) during a twelve-year period (1995-2006) were included; 149 survived >= 5 years. Three larger subgroups could be identified: astrocytic, embryonal and glioneuronal tumours. A supratentorial location was found in 52%. Medical late effects were mainly neurological and endocrinological, affecting 81% and 26% of surviving patients. Cognitive late effects were a frequent finding in the whole group but also in low-grade astrocytoma and glioneuronal tumours (53% and 67%). Thirty per cent had some kind of pedagogic support in school. Conclusion: Late effects are common in long-term survivors of CNS tumours in childhood. Low-grade astrocytoma and glioneuronal tumours are no exception, and the findings support the need for long-term follow up.

Keywords
Childhood, CNS-tumour, Cognitive, Late effects, Low grade
National Category
Neurology Pediatrics Clinical Laboratory Medicine
Research subject
Pathology
Identifiers
urn:nbn:se:uu:diva-300544 (URN)10.1016/j.ejpn.2016.04.009 (DOI)000379106700014 ()27157245 (PubMedID)
Available from: 2016-08-10 Created: 2016-08-09 Last updated: 2019-04-02Bibliographically approved
Serenius, F., Farooqi, A., Fellman, V., Hafström, M., Kallen, K., Lindberg, E., . . . Aden, U. (2016). Developmental problems in extremely preterm children with borderline intellectual functioning and free from neurosensory disabilities at 6.5 years in Sweden (the EXPRESS study). European Journal of Pediatrics, 175(11), 1551-1552
Open this publication in new window or tab >>Developmental problems in extremely preterm children with borderline intellectual functioning and free from neurosensory disabilities at 6.5 years in Sweden (the EXPRESS study)
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2016 (English)In: European Journal of Pediatrics, ISSN 0340-6199, E-ISSN 1432-1076, Vol. 175, no 11, p. 1551-1552Article in journal, Meeting abstract (Refereed) Published
National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-315014 (URN)000390040700444 ()
Available from: 2017-02-08 Created: 2017-02-08 Last updated: 2017-11-29Bibliographically approved
Van't Hooft, I., Norberg, A. L., Björklund, A., Lönnerblad, M. & Strömberg, B. (2016). Multiprofessional follow-up programmes are needed to address psychosocial, neurocognitive and educational issues in children with brain tumours. Acta Paediatrica, 105(6), 676-683
Open this publication in new window or tab >>Multiprofessional follow-up programmes are needed to address psychosocial, neurocognitive and educational issues in children with brain tumours
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2016 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 105, no 6, p. 676-683Article in journal (Refereed) Published
Abstract [en]

AIM: The aim of this study was to coordinate the structured psychosocial, neurocognitive and educational follow-up of children treated for brain tumours with the medical protocol and apply the model in two Swedish healthcare regions.

METHODS: We invited all children living in the two regions, who had been diagnosed with a brain tumour from October 1, 2010, through June 30, 2012, to participate along with their parents. The follow-up programme evaluated the emotional status of the parents and patients and assessed the children's general cognitive level, working memory, speed of performance, executive functions and academic achievement from diagnosis through to adult care.

RESULTS: During the study period, 61 children up to the age of 17.1 years were diagnosed with a brain tumour, but 18 of these were excluded for various reasons. The majority of the mothers (70%) displayed significantly poor emotional status, as did 34% of the fathers and 21% of the children. The majority of the children (57%) also showed poor neurocognitive performance and needed special adaptations at school (66%).

CONCLUSION: Our findings indicate the need for coordinated, multiprofessional follow-up programmes, well anchored in the healthcare organisation, for children diagnosed with brain tumours.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-269579 (URN)10.1111/apa.13207 (DOI)000376265400026 ()26355275 (PubMedID)
Funder
Swedish Childhood Cancer Foundation
Available from: 2015-12-17 Created: 2015-12-17 Last updated: 2017-12-01Bibliographically approved
Kallen, K., Serenius, F., Westgren, M. & Marsal, K. (2015). Impact of obstetric factors on outcome of extremely preterm births in Sweden: prospective population-based observational study (EXPRESS). Acta Obstetricia et Gynecologica Scandinavica, 94(11), 1203-1214
Open this publication in new window or tab >>Impact of obstetric factors on outcome of extremely preterm births in Sweden: prospective population-based observational study (EXPRESS)
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2015 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 94, no 11, p. 1203-1214Article in journal (Refereed) Published
Abstract [en]

IntroductionA population-based observational study investigated the contribution of obstetric factors to the survival and postnatal development of extremely preterm infants. Material and methodsMortality up to 1year and neurodevelopment at 2.5years (Bayley-III test, cerebral palsy, vision, hearing) were evaluated in infants born before 27weeks of gestation in Sweden 2004-2007 (n=1011), using logistic regression analyses of risk factors. ResultsOf 844 fetuses alive at admission, 8.4% died in utero before labor, 7.8% died intrapartum. Of 707 live-born infants, 15% died within 24h, 70% survived 365days, 64% were assessed at 2.5years. The risk of death within 24h after birth decreased with gestational age [odds ratio (OR) 0.3; 95% CI 0.2-0.4], antenatal corticosteroids (OR 0.3; 95% CI 0.1-0.6), and cesarean section (OR 0.4; 95% CI 0.2-0.9); it increased with multiple birth (OR 3.0; 95% CI 1.5-6.0), vaginal breech delivery (OR 2.3; 95% CI 1.0-5.1), 5-min Apgar score <4 (OR 50.4; 95% CI 28.2-90.2), and birth at a level II hospital (OR 2.6; 95% CI 1.2-5.3). The risk of death between 1 and 365days remained significantly decreased for gestational age and corticosteroids. The risk of mental developmental delay at 2.5 years decreased with gestational age, birthweight and fetal growth; it increased with vaginal breech delivery (OR 2.0; 95% CI 1.2-7.4), male gender, low Apgar score and high Clinical Risk Index for Babies score. ConclusionSeveral obstetric factors, including abdominal delivery, influenced the risk of death within the first day of life, but not later. Antenatal corticosteroids and gestational age decreased the mortality up to 1year. Mental developmental delay was related to vaginal breech delivery.

Keywords
Extremely preterm birth, mortality, risk factors, obstetric interventions, neurodevelopmental outcome, cesarean section, breech delivery
National Category
Obstetrics, Gynecology and Reproductive Medicine Pediatrics
Identifiers
urn:nbn:se:uu:diva-266682 (URN)10.1111/aogs.12726 (DOI)000362844400009 ()26249263 (PubMedID)
Funder
Swedish Research Council, 2006-3855, 2009-4250
Note

Co-author: Bo Strömberg, Uppsala universitet, Institutionen för kvinnors och barns hälsa, pediatrik, forskargrupp Barnneurologisk forskning ingår i EXPRESS-gruppen.

Available from: 2015-11-12 Created: 2015-11-10 Last updated: 2017-12-07Bibliographically approved
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