Homage to Gudrun and Bengt Hagberg - icps.org.uk Himmelmann.pdf · tle Liverpool Belfast Dublin...
Transcript of Homage to Gudrun and Bengt Hagberg - icps.org.uk Himmelmann.pdf · tle Liverpool Belfast Dublin...
Low profile research assistant at the Pediatric Department
• Smarter than the rest of us
• Never pointed that out
• Why not write her own thesis? ”I would never put
myself in that position”
PhD h.c. in 1989
“Her scientific papers have attracted international attention and she has made a decisive contribution to the knowledge in areas such as neuropediatric epidemiology, cerebral palsy and mental retardation.”
CP classification
Hagberg
Spastic hemiplegia
Spastic/atactic diplegia
Spastic tetraplegia
Dyskinetic CP
Ataxia
Clinical classification of cerebral palsy syndromes in children
d' AVIGNON, BILLE B, HAGBERG B, OLOW I. Lakartidn. 1960 Sep 9;57:2533-45.
0
0,5
1
1,5
2
2,5
3
1954-
1958
1959-
1962
1963-
1966
1967-
1970
1971-
1974
1975-
1978
1979-
1982
1983-
1986
1987-
1990
1991-
1994
1995-
1998
1999-
2002
2003-
2006
Prevalence per
1000 live births
Cerebral palsy in western Sweden
1954-2006
24,5/1000 4,7/1000Perinatal mortality
0
0.5
1
1.5
2
2.5
3
Total CP
Term CP
Preterm CP
Preterm diplegia
The changing panorama of cerebral palsy in Sweden
All CP types covered
• Ataxia – Sanner 1974
• Dyskinetic CP – Kyllerman 1982
• Diplegia – Velkeen 1983
• Hemiplegia – Uvebrant 1988
• Tetraplegia – Edebol-Tysk 1989
Risk factors, not only for CP• Kyllerman M, Hagberg G. Reduced optimality in
pre- and perinatal conditions in a Swedish newborn
population.Neuropediatrics. 1983 Feb;14(1):37-42
• Uvebrant P, Hagberg G. Intrauterine growth in
children with cerebral palsy. Acta Paediatr. 1992
May;81(5):407-12.
• Jacobsson B, Hagberg G, Hagberg B, Ladfors L,
Niklasson A, Hagberg H. Cerebral palsy in preterm
infants: a population-based case-control study of
antenatal and intrapartal risk factors. Acta Paediatr.
2002;91(8):946-51
Where are we going?• In western Sweden the CP prevalence for children
born <26 weeks has increased from 78 to 107 per
1000 live births <26 weeks
0
2
4
6
8
10
12
14
16
18
1999-2002 2003-2006
27
26
25
24
23
1
10
100
Per
1,0
00 l
ive
bir
ths
Birth year
<28 w
28-31 w
32-36 w
>36 w
Gestational age
Himmelmann K, Uvebrant P..
Acta Paediatr. 2014;103:618-24.
Collaborations and network
• Extensive worldwide network ”Bengt was the social
one and I was happy to be in the background”
• Collaborations with e.g. Ingeborg Krägeloh-Mann
and Richard Michaelis regarding bilateral spastic
CP
• Member from the start in Surveillance of Cerebral
Palsy
Grenoble
Toulouse
Oxford
Newcastle
Liverpool
Belfast
DublinCork
Norway
Göteborg
Denmark
Tübingen
Roma
Madrid
KaunasC17
Galway
Portugal
Nicosia
C09
C08
C04
C05
C07
C10
C11
C18
C21
C15
C06
C12 C20
C22
C19
C01
C02
C13
C23
Slovenia Pecs
Riga
C24
IcelandC25
Edinburgh
C03
ArnhemC14
BolognaC16
C27
C26
C28
C31
Croatia
Leuven
Edinburgh
Newcastle
Innsbruck
Greece
Nicosia
Surveillance of cerebral palsy in Europe
Classification – type and
distribution
CP classification
Hagberg SCPE
Spastic hemiplegia Unilateral spastic CP
Spastic/atactic diplegia Bilateral spastic CP
Spastic tetraplegia
Dyskinetic CP Dyskinetic CP
Ataxia Ataxia
SCPE Surveillance of Cerebral Palsy in Europe
Ongoing research based on the CP Register of western Sweden
(n≈2350 born 1954-2010)
Examples
• Report on prevalence and origin of CP in the birth-
years 2007-2010
• Neuropsychiatric disorders in CP
• Survival studies
• Health and quality of life in adults with CP living in
western Sweden (clinical and register study)
• Follow-up on gross and fine motor function,
communication and interventions