Treatment of Cerebral Palsy : New Hope from Modern Research

Introduction

Uncover the new treatment of cerebral palsy for the children. 

Cerebral Palsy (CP) compromises a child’s ability to move or maintain balance. ‘Cerebral’ means brain, and ‘palsy’ means weakness or inability to use muscles efficiently. The global burden of CP is estimated to be more than 17 million cases. The symptoms of CP vary among individuals depending on the severity of abnormal brain development. The current treatment regimen does not provide a permanent cure for the disease and incurs lifelong costs. 

To mitigate such challenges, consideration of emerging treatments for Cerebral Palsy (CP) is of utmost importance. 

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March: CP Awareness Month

The month of March is recognized for CP awareness. Gather us in raising awareness about CP signs and symptoms, available treatment options, and the importance of emerging treatment options. Recognize the importance of research and support for CP.

What are the Types of Cerebral Palsy?

Clinicians classify CP depending on affected brain areas and movement disorders- spasticity, dyskinesia, and ataxia. The four major sub-types include:

Spastic CP

• • The most common type of CP affects more than 80% cases
  • Increased muscle tone, stiffer muscles, awkward movement
  • Spastic CP type includes:
    • Diplegic spastic cerebral palsy affects the lower limbs more, with tight hip and leg muscles—problem with functional mobility. The legs get pulled together in an inward direction, scissoring appearance.
    • Spastic hemiplegia affects one side of the body, mainly the arms.
    • Spastic quadriplegia most severe form of CP; all limbs, face and trunk are affected. Affected individuals cannot walk and have other disabilities (seizures, problems with hearing, speech, vision, etc.)

Dyskinetic CP

• Problem with hand, arm, feet or leg movement
• Difficulty in walking or sitting
• Includes dystonic cerebral palsies, athetoid, and choreoathetoid
• Change in muscle tone (too tight/ too loose)

Ataxic CP

• Problem with balance or coordination
• Unsteady walking, no control over their hands or arms
• Cerebellar ataxia treatment involves physical, occupational, or speech therapy. Introduction of an assertive device, such as cranes or braces, if required

Mixed CP

• More than one type of CP symptoms present
• The common type is spastic-dyskinetic CP

What is Conventional Cerebral Palsy Treatment?

In the current treatment regime, there is no cure for CP. The major treatment approach targets managing the discomfort and symptoms. The positive outcomes depend on factors like severity, symptoms, and early diagnosis. The treatment includes:

• Palliative Care: Treatment of seizures, spasticity, pain, etc. Muscle relaxant, including oral medication baclofen or pumps.  Medications are prescribed for other associated conditions, such as mental health conditions.
• Physical Therapy: Focus on improving muscular strength, balance and motor skills. It focuses on movement and reduces muscle tightness.
• Occupational Therapy: Focus on improving a patient’s daily life skills like dressing, eating, walking, etc.
• Speech Therapy: Children facing problems with communication or speech are introduced to speech therapy. It helps in developing communication skills, speech, articulation, swallowing, etc. 
• Surgery: Orthopedic surgery for bone alignment, selective dorsal rhizotomy (SDR) for severe spasticity
• Mental Health Therapy: Individuals affected with CP might get mental health conditions like anxiety or depression. A therapist or counselor helps in coping with these conditions.

What is the Newest Treatment for Cerebral Palsy?

Stem cell therapy is a regenerative approach that intends to address the root cause of cerebral palsy. Early findings suggest stem cells’ ability to improve gross motor function. Stem cells possess multi-lineage ability, that is, the ability to differentiate into different cell types. Research focused on the use of mesenchymal stem cells (MSCs) for CP. The major cell source includes umbilical cord tissue/blood, adipose tissue, and bone marrow.

How Stem Cell Therapy Works for Cerebral Palsy?

Stem cell treatment involves the injection of stem cells intrathecally in the spinal column via lumbar puncture. Stem cells potentially differentiate into nerve cells and form naive neural connections. There are multiple mechanisms via which stem cell therapy works. This includes:

• Regeneration of New Nerve Cells: Stem cell therapy aids in differentiation into new nerve cells. They can potentially reverse origin damage in the brain caused by CP development.
• Neurological Improvement: Studies showed significant Improvement in muscle tone and neurological Improvement. The generation of new nerve cells improves the neural network, the brain connection, and signalling for motor coordination.
• Neuroprotection: Stem cells release various neurotrophic factors such as glia-derived neurotrophic factor (GDNF) and brain-derived neurotrophic factor (BDNF). This extends neuroprotection. 
• Enhance Brain Function: There is an increase in the number of oligodendrocytes, which enables adequate brain myelination. They increase microglia that are responsible for repairing brain damage and preserving normal brain tissue.
• Immunomodulation: Immune response induces an inflammatory response that contributes to neurodegeneration. Stem cells induce immunomodulatory effects, suppress inflammation, and modulate immune response.
• Antioxidants: there is a reduction in free radical effects, including ROS, that have detrimental effects on the nervous system. These include neuron–cell apoptosis. Stem cells mitigate the effect of free radicals and create a supportive microenvironment [1, 2]

What are the Benefits of Stem Cell Therapy?

Preclinical and clinical studies have established the multifold benefits of stem cell therapy. This includes:

• Success among 85% treatment cases
• Improvement in gross motor function (walk, jump, sit, crawl)
• Fine motor function (simple hand or leg movement)
• Improvement in muscle tone, improved range of motion
• Improved stem cell function (alert & consciousness)
• Language and speech improvement
• Social skills adaptability
• Communication and speech 
• Improvement in psychiatric health, improved mood [1, 2]

How can Stem Cell Therapy Improve?

Stem cell therapy for CP is promising. The future research must focus on:

• Standardization of stem cell source and dosage
• Cell viability and quality of stem cells
• Determination of an effective administration method
• Determining the stem cell type for the best outcome
• Effective age for transplantation
• Follow-up time and Aftercare
• Large-scale clinical trial for establishing long-term safety
• Effective measures in adapting a combinational approach. Stem cell therapy with conventional therapy can display better outcomes.

“Advancells, India, is a well-established stem cell research laboratory that focuses on cutting-edge research. The laboratory is GMP certified and maintains superior quality MSCs”

Conclusion

Stem cell therapy for CP is emerging as a potential curative option. The combination of conventional treatment with stem cell administration shows better outcomes. The early identification of CP and opting for adequate cerebral palsy treatment is key for positive outcome. The future research must focus on large-scale clinical trials for establishing the long-term effect.

Cerebral Palsy Patient Success Stories

References

1. Kiasatdolatabadi A, Lotfibakhshaiesh N, Yazdankhah M, Ebrahimi-Barough S, Jafarabadi M, Ai A, Sadroddiny E, Ai J. The role of stem cells in the treatment of cerebral palsy: a review. Molecular neurobiology. 2017 Sep;54(7):4963-72. 
2. Paul S, Nahar A, Bhagawati M, Kunwar AJ. A review of recent advances in cerebral palsy. Oxidative medicine and cellular longevity. 2022;2022(1):2622310.

FAQ’s

Q- What Causes Cerebral Palsy?

Cerebral palsy is associated with abnormal brain development. It affects the motor function, position, and muscle tone. The key cause includes prenatal infection, genetic mutation, bleeding in the brain, and lack of oxygen supply in the brain.

Q- What are the Signs and Symptoms of Cerebral Palsy?

The common signs and symptoms include- spasticity, abnormal muscle tone, rigidity, writhing movement, delayed speech, drooling, intellectual disability, swallowing difficulty, and psychiatric issues.

Q- What Type of Stem Cells are Used for Cerebral Palsy?

MSCs are used for cerebral palsy. The cells are sourced from umbilical cord blood/tissue, bone marrow, and adipose tissue.