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Cerebral palsy: searching for a better way to predict children’s future needs and abilities

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What did the project achieve?

“Our preliminary results show that new MRI brain scans have the potential to identify key differences in the brains of children with cerebral palsy,” says Professor Chris Clark of UCL Great Ormond Street Institute of Child Health. “This is an important first step towards our goal of using these scans to predict the severity of a child’s movement problems, reducing uncertainty for parents.”

Around 2,000 babies in the UK are diagnosed with cerebral palsy every year.1,2 Usually caused by damage to a baby’s brain before, during or soon after birth, children with cerebral palsy have difficulty controlling their muscles and movement and can face a lifetime of challenges. But the severity of symptoms can vary greatly from child to child – and currently, it is hard to predict how a baby’s future will be affected.

Professor Clark’s team used specialised MRI scanning techniques to measure connections inside the brains of children with cerebral palsy aged between six and twelve years. They then compared these with the same measures from healthy children.

“Out of the eight children with cerebral palsy where we were able to assess specific brain connections, most had lower than expected values for one or more of our measures,” says Professor Clark. “But we did not find a single connection measure that is always lower in all children with cerebral palsy, suggesting that we will need to assess several regions of the brain to identify important disruptions that affect movement.”

“A larger study will now be necessary to find out if any of the disrupted connections identified relate to the severity of a child’s movement difficulties and whether they could be used to predict the severity of symptoms in younger children,” he adds.

References

  1. Wimalasundera, N. & Stevenson, V.L., Cerebral palsy. BMJ Practical Neurology 2016; 16:184-194.
  2. Office for National Statistics. Vital statistics in the UK: births, deaths and marriages – 2018 update. https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/datasets/vitalstatisticspopulationandhealthreferencetables [website accessed 31 October 2019]

This research was completed on

Around 1,800 babies are diagnosed with cerebral palsy every year in the UK. 1 They will experience lifelong difficulties with movement and coordination. The severity of these difficulties varies greatly from one child to another, and parents are often keen to know exactly how their own baby’s life will be affected – whether they’ll be able to walk and live independently during adulthood, for example. Unfortunately, making predictions like this is difficult at present, leaving many with uncertainty. Dr Chris Clark, of University College London’s Institute of Child Health, is investigating whether new brain scans might one day provide answers.

How are children’s lives affected now?

Estimates suggest around one in every 400 children in the UK has cerebral palsy.1 Children are normally quite young – less than 18 months old – when their condition is diagnosed.

“When parents find out their baby has cerebral palsy, it’s common for them to ask about the future,” says Dr Clark. “Parents often want to know how severe their child’s movement problems will be – whether their child is likely to need a wheelchair, for example, or master everyday activities like eating and getting dressed. It’s possible to anticipate these things to a degree, but accurately predicting how a child will be affected remains difficult.”

In fact, babies with cerebral palsy can have very different futures, as Dr Clark explains: “Some children with cerebral palsy can run and have only minimal restrictions to their movement, whereas others can be profoundly disabled, with other problems too such as epilepsy or learning difficulties, meaning they need life-long care.”

How could this research help?

Dr Clark and his team are investigating whether new MRI brain scans might benefit children with cerebral palsy and their families.

“The movement problems that children with cerebral palsy experience result from damage to the brain,” explains Dr Clark. “We are using new MRI scans developed by the team to find out more about this damage and how it relates to children’s movement difficulties.”

“More research will be needed, but we hope that, one day, doctors will be able to use these new brain scans to help them predict what sort of movement difficulties children with cerebral palsy are likely to experience in the future,” continues Dr Clark. “This could help parents feel more prepared and make it easier to plan children’s care – from the support of physiotherapists, speech therapists and so on, to adaptations in the home – so all children with cerebral palsy can have the best possible quality of life.”

 

References

1. NHS Choices, Cerebral palsy, How common is cerebral palsy? http://www.nhs.uk/conditions/cerebral-palsy/pages/introduction.aspx Website accessed 23 January 2014.

 

Project Leader Dr C A Clark, BSc MSc PhD
Project Team Dr B Vollmer Dr med PhDDr N Wimalasundera MBBS MScDr L J Carr MD MbChb FRCP FRCPCHDr J D Clayden PhD MSc MADr D E Saunders MD FRCR
Project Location Imaging and Biophysics Unit, Institute of Child Health, University College London
Project Location Other Depatment of Neurodisability and Radiology Department, Great Ormond Street Hospital, LondonAcademic Unit of Clinical and Experimental Sciences, Paediatric Neurosciences, University of Southampton
Project duration 2 years
Date awarded 15 November 2013
Project start date 1 December 2013
Project end date 30 September 2017
Grant amount £37,500
Grant code GN2173

 

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