Responsiveness of the MD-Childhood Rating Scale in dyskinetic cerebral palsy patients undergoing anticholinergic treatment

Background: Movement Disorder-Childhood Rating Scale (MD-CRS) is a new tool for assessment of movement disorders during developmental age. Aim: In this study we evaluated a cohort of 47 patients affected by dyskinetic cerebral palsy and treated with anticholinergic drug (trihexyphenidyl) over one year in order to verify the responsiveness of the new scale. Methods: The participants were divided into two groups according to their age (0-3 years; 4-18 years) and were evaluated using MD-CRS 0-3 or MD-CRS 4-18 at baseline, i.e. before starting pharmacological treatment (T0), after 6 (T1) and 12 months (T2) of treatment. Univariate repeated measures ANOVA with a Greenhouse-Geisser correction was performed to analyse the scale responsiveness for the three indexes (e.g. Index I, Index II and Global Index) in each group with time (T0, T1 and T2). In addition, Bonferroni test was performed to identify the source of significant differences among means. Results: Significant differences were found between time points (T1 vs T0, T2 vs T0 and T2 vs T1) in both scales for all indexes with the exception for T2 vs T1 for Index II in both scales and for T2 vs T1 for the Global Index in the older age group. There was not significant correlation between observed changes in the scores and age of children, either for MD-CRS 0-3 or MD-CRS 4-18. Conclusions: Our results suggest that MD-CRS is a suitable tool to detect changes and could be used as outcome measure for clinical trials. Further studies will be necessary to prove the efficacy of trihexyphenidyl for dyskinetic cerebral palsy.