Conditions

Cerebral Palsy

Cerebral palsy (CP) is a disorder of movement, muscle tone and/or posture that begins at or around birth. It is the most common physical disability in childhood affecting up to 1 in 500 newborns and over 17 million people worldwide.

Physical disability of CP is diverse and can range from muscle weakness to complete lack of movement. In addition to physical disability, children with CP are likely to have other medical conditions and impairments. Intellectual impairment, behavior disorders, sleep disorders and others are common.

Although CP is a life-long condition without a known cure, early treatment and intervention can improve symptoms and the quality of life of those who have the condition. The conventional approach includes physical therapy, occupational therapy, massage therapy, speech therapy, behavioral/cognitive therapies, surgery, etc. Medications are also prescribed to CP patients in order to reduce symptoms and treat other medical conditions. Despite these various treatment options, the conventional approach to treating CP is limited and often does not produce significant improvement in symptoms or quality of life. The search for more effective treatment options continues.

Stem cell therapy has been found to be one of the most effective treatments for children with neurological disorders including CP. Several studies have demonstrated the effectiveness of stem cell therapy in improving gross motor function, muscle tone, spasticity, development and quality of life in patients with CP. Stem cell therapy has also been shown to reduce brain inflammation, increase whole brain connectivity and activate motor regions of the brain.

Stem cell therapy using various different cell types and tissue types such as umbilical cord derived mesenchymal stem cells (UCMSCs), bone marrow derived mononuclear cells (BMMNCs) and umbilical cord blood (UCB) have been shown to be safe and well tolerated. Many studies use umbilical cord blood as the intervention due to its rich content of diverse cell types including various stem cells and progenitor cells. Evidence suggests that these cells produce signaling molecule to modulate the immune system and facilitate functional brain repair.

Based on early human clinical trials there appears to be a strong argument for the safe and effective use of stem cell therapy in the treatment of CP. While we wait for phase II/III trials the current data is encouraging and supports use of stem cell therapy in the clinical setting.

Proven Benefits From Early Human Clinical Trials of stem Cell Therapy in Cerebral Palsy (CP)

• Improvement in gross motor abilities in lying and rolling, sitting, crawling and kneeling, standing and walking, running, and jumping. (Huang et al, Sun et al, Novak et al, Min et al)
• Improvement in comprehensive function in cognizance, language competence, self-care, motor function, and social adaptability.(Huang et al)
• Improvement in muscle tone and muscle strength. (Romanov et al, Kang et al)
• Improvement in neurological and physical status.(Romanov et al)
• Improvement in intellectual development and mental status.(Romanov et al)
• Decreased brain inflammation and inflammatory markers in blood. (Kang et al)
• Increased whole brain connectivity and metabolism in motor regions of brain. (Sun et al, Kang et al)

Specific Conclusions From Selected Studies:

“The results of the study indicated that hUCB-MSC infusion with basic rehabilitation was safe and effective in improving gross motor and comprehensive functions in children with CP.”

• A Randomized, Placebo-Controlled Trial of Human Umbilical Cord Blood Mesenchymal Stem Cell Infusion for Children With Cerebral Palsy (Huang et al 2018)

“Results of this study suggest that appropriately dosed autologous cord blood (ACB) infusion improves brain connectivity and gross motor function in young children with CP.”

• Effect of Autologous Cord Blood Infusion on Motor Function and Brain Connectivity in Young Children with Cerebral Palsy: A Randomized, Placebo-Controlled Trial (Sun et al 2017)

“Stem cells appeared to induce short-term improvements in motor skills.

• Concise Review: Stem Cell Interventions for People with Cerebral Palsy: Systematic Review with Meta-Analysis (Novak et al 2016)

“The results confirm that multiple intravenous infusions of allogeneic AB0/Rh-identical UCB cells may be a safe and effective procedure and could be included in treatment and rehabilitation programs for juvenile patients with cerebral palsy.”

• Human allogeneic AB0/Rh-identical umbilical cord blood cells in the treatment of juvenile patients with cerebral palsy (Romanov et al 2015)

“In this trial, treatment with UCB alone improved motor outcomes and induced systemic immune reactions and anti-inflammatory changes in the brain. Generally, motor outcomes were positively correlated with the number of UCB cells administered: a higher number of cells resulted in better outcomes.”

• Involvement of Immune Responses in the Efficacy of Cord Blood Cell Therapy for Cerebral Palsy (Kang et al 2015)

“In conclusion, UCB treatment ameliorated motor and cognitive dysfunction in children with CP undergoing active rehabilitation, accompanied by structural and metabolic changes in the brain.”

• Umbilical cord blood therapy potentiated with erythropoietin for children with cerebral palsy: A double-blind, randomized, placebo-controlled trial (Min et al 2013)

“Autologous CB infusion is safe and feasible, and has yielded potential benefits in children with CP.”

• Safety and feasibility of countering neurological impairment by intravenous administration of autologous cord blood in cerebral palsy. (Lee et al 2012)

For additional information on stem cell therapy in cerebral palsy and more details regarding these studies please visit our Research Archive.

SOURCES

• https://cparf.org/what-is-cerebral-palsy/facts-about-cerebral-palsy/
• https://cnnh.org/did-you-know-6-facts-about-cerebral-palsy/
• https://www.cdc.gov/features/cerebral-palsy-11-things/index.html
• https://cerebralpalsy.org.au/our-research/about-cerebral-palsy/what-is-cerebral-palsy/types-of-cerebral-palsy/spastic-cerebral-palsy/
• https://cerebralpalsygroup.com/treatment/
• Nguyen, T. L., Nguyen, H. P., & Nguyen, T. K. (2018). The effects of bone marrow mononuclear cell transplantation on the quality of life of children with cerebral palsy. Health and Quality of Life Outcomes, 16(1), 164. https://doi.org/10.1186/s12955-018-0992-x
• Romanov, Y. A., Tarakanov, O. P., Radaev, S. M., Dugina, T. N., Ryaskina, S. S., Darevskaya, A. N., … Smirnov, V. N. (2015). Human allogeneic AB0/Rh-identical umbilical cord blood cells in the treatment of juvenile patients with cerebral palsy. Cytotherapy, 17(7), 969–978. https://doi.org/10.1016/j.jcyt.2015.02.010