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Reliability and Stability of Cerebral Palsy Classification Scales for Individuals with STXBP1 Related Disorders and SYNGAP1 Related Disorders

Pierce, S. R.; Orlando, J. M.; Cunningham, K.; Ruggiero, S. M.; McKee, J. L.; Helbig, I.

2025-11-06 neurology
10.1101/2025.11.04.25339413 medRxiv
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AimTo determine the interrater reliability and stability of the Gross Motor Function Classification System (GMFCS), mini-Manual Ability Classification System (mini-MACS), Manual Ability Classification System (MACS), and Communication Function Classification System (CFCS) in individuals with STXBP1-Related Disorder (STXBP1-RD) and SYNGAP1-Related Disorder (SYNGAP1-RD). MethodsData were collected from 83 individuals with STXBP1-RD (mean age = 9.8 years) and 101 individuals with SYNGAP1-RD (mean age = 10.9 years). Two raters completed the GMFCS, MACS/MiniMACS, and CFCS assessments on the same day, and test-retest stability was evaluated for participants with two longitudinal assessments. ResultsInterrater agreement varied from 73.8% to 77.3% for the STXBP1-RD cohort and from 60.5% to 83.3% for the SYNGAP1-RD cohort. Interrater reliability weighted kappa scores for the STXBP1-RD cohort varied from 0.83 to 0.93 while the SYNGAP1-RD cohort ranged from 0.66-0.81. Test-retest stability scores for the STXBP1-RD group varied from 0.62 to 0.94 while the SYNGAP1-RD group ranged from 0.38 to 0.78. Significant correlations were found between all assessment scales for both STXBP1-RD (Kendalls Tau range from 0.25-0.42) and SYNGAP1-RD (Kendalls Tau range from 0.19-0.45). InterpretationThe GMFCS, MACS/MiniMACS, and CFCS demonstrate appropriate levels of interrater reliability and stability for individuals with STXBP1-RD and SYNGAP1-RD. What this paper addsO_LIClassification tools are reliable and stable in individuals with STXBP1-RD and SYNGAP1-RD. C_LIO_LIGross motor function is least affected for both conditions. C_LIO_LILanguage function is most affected for both conditions. C_LIO_LICorrelations are decreased compared to children with cerebral palsy due to phenotype differences. C_LI

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