LUCIND: Profiling respiratory comorbidity in paediatric neurological diseases

Background Children and adolescents with neurodisability (ND) are at high risk for respiratory comorbidity and secondary pulmonary disease due to impaired airway clearance, thoracic restriction, dysphagia, and microbial airway colonization. Despite the clinical relevance of these complications, systematic imaging data on structural lung changes and their clinical correlates in this population remain scarce. Methods LUCIND ( Lu ng C omorbidity I n N eurological D iseases) is a prospective, cross-sectional imaging study enrolling 150 children and adolescents with ND without primary pulmonary disease. Participants are stratified into three risk-based subgroups (n=50 each): (1) ND with tracheostomy, (2) ND with dysphagia, and (3) ND without dysphagia. The primary objective is to detect chronic structural lung abnormalities such as bronchiectasis, bronchial wall thickening and consolidations using ultra-low-dose photon-counting CT (PCCT). This technique yields robust morphological data at radiation levels approaching those of conventional radiography. Due to ultra-short acquisition times, imaging is performed without sedation, ensuring high patient safety and feasibility in this vulnerable population. Secondary aims include the correlation of radiologic findings with clinical features, such as swallowing function, respiratory infection burden, microbial airway colonization, and therapeutic measures including airway clearance and antibiotic use. Imaging will be complemented by standardised clinical data, logopaedic assessment, and detailed caregiver questionnaires. Conclusion LUCIND will provide a unique dataset to refine our understanding of chronic lung disease in children with ND. Results may inform future risk stratification, early intervention strategies, and optimised clinical pathways, potentially improving both quality of life and long-term respiratory outcomes. Trial registration number: DRKS00038747