Every 20 hours, an Australian baby is born with a brain injury that underlies cerebral palsy. It is a permanent, life-long condition with no cure. Around 34,000 Australians have cerebral palsy.
View video | Dr Courtney McDonald and Dr Madeleine Smith explain more about consulting the cerebral palsy community over stem cell treatment.
What is cerebral palsy?
Cerebral palsy is an umbrella term for a group of related but unique symptoms that encompass abnormal motor function or posture. Cerebral palsy is caused by abnormal development or damage to the parts of the developing brain in the areas that control movement, balance and posture. This damage happens to the baby mostly during pregnancy, but it may also occur during or shortly after birth.
Cerebral palsy is usually diagnosed in a child’s first two years of life and displays as floppy or stiff muscles or involuntary muscle movement or an infant not reaching his/her milestone. It is often accompanied by other deficits that can include impaired cognition, vision, hearing, speech, eating and learning.
The word ‘cerebral’ refers to the brain’s cerebrum, which is the part of the brain that regulates motor function, while ‘palsy’ describes the lack of muscle control.
What are the causes of cerebral palsy?
Causes include
Reduced blood and oxygen supply to the brain (asphyxia)
An infection caught by the mother during pregnancy eg rubella, chickenpox, toxoplasmosis
A stroke that involves bleeding in the baby’s brain or the blood supply to their brain is obstructed
Head injuries sustained during birth or within the first few years of infancy
Ingestion of toxins or drugs during pregnancy
Genetic disorders
Something goes wrong during a child’s birth.
What are the types of cerebral palsy?
There are four main types of cerebral palsy.
Spastic – affects stiffness and difficult movements
Dyskinetic (athetoid) – affects uncontrolled movement
Ataxic – affects balance and coordination difficulties
Mixed – includes a range of the above characteristics.
What are the risk factors for cerebral palsy?
Being born prematurely (before the 37th week of pregnancy). Babies born at 32 weeks or earlier are at a particularly high risk. Up to 50 percent of children with cerebral palsy were born preterm.
Having a low birthweight
Prematurity and low birth weight
Some pregnancy complications
An infection caught by the mother during pregnancy
Prolonged loss of oxygen during pregnancy or childbirth, or severe jaundice after birth
Injury or bleeding in the baby’s brain
Mutations in the genes that affect the brain’s development
Being a twin, triplet or other multiple birth.
What are the symptoms of cerebral palsy?
Movement and walking disabilities
Speech difficulties
Learning disabilities
Cognitive impairments
Hearing or vision loss
Epilepsy
Emotional and behavioural challenges
Spinal deformities
Joint problems.
These terms are used in cerebral palsy to describe the part of the body affected.
Hemiplegia – one side of the body is affected
Diplegia – two limbs are affected
Monoplegia – one limb is affected
Quadriplegia – all four limbs (and usually the whole body) are affected.
Treatment
Currently there is no cure for cerebral palsy. A child’s quality of life can improve through
Therapy, including physical therapy, occupational therapy, and speech therapy
Treatment that may involve surgery
Equipment to aid mobility and communication.
Our cerebral palsy research
Research into cerebral palsy prevention at Hudson Institute is multifaceted. By understanding the mechanisms involved in cerebral palsy our researchers are identifying where intervention and treatment can significantly improve wellbeing and physical outcomes for a child.
Cord blood stem cells to prevent cerebral palsy
Stem cell therapies. Babies who are born preterm are at the greatest risk of developing cerebral palsy. Professor Suzie Miller and Dr Courtney McDonald are characterising the brain injury that is most often associated with preterm birth (white matter brain injury) and examining whether cord blood stem cells can protect white matter development within the preterm brain, and in turn prevent brain injury.
Anti-inflammatory therapies for preventing brain injury
Molecular studies. New treatment. Too much inflammation in the brain is one of the main mechanisms that leads to the development of cerebral palsy. Dr Galinsky and his team are working on improving the understanding of how inflammation disturbs healthy brain development and developing new anti-inflammatory therapies for preventing brain injury in preterm infants.
New treatment. Seizures in neonates, babies less than four weeks old, are relatively common and are strong predictors of long-term cognitive and developmental impairment like cerebral palsy. Current anti-seizure therapies like phenobarbitone have been shown to cause brain injury as they have the potential to be neurotoxic. In this project the team is investigating the effects of two anti-seizure agents: ganaxolone and levetiracetam against the current first line treatment (phenobarbitone) as a treatment to protect the developing brain and reduce seizures for the first 48 hours of life.
Delivering neural stem cells to the developing brain
Treatment delivery. Neural stem cells (NSCs) offer great promise as a neuroprotective therapy against a range of neurological conditions like cerebral palsy. A major challenge of NSC therapy for neurological conditions is delivering the cells to the brain. Current intracerebral delivery of NSCs is highly invasive and carries significant risks for the patient. This project is investigating the development a novel, non-invasive MRI-guided focused ultrasound (MRIgFUS) method for delivery of NSCs to the brain using a preclinical model.
Preventing acute brain injury resultant from resuscitation of asphyxiated newborns
Birth practice. Birth asphyxia is a common cause of cerebral palsy. Professor Graeme Polglase is aiming to improve the initial way asphyxiated infants are treated in the delivery room to reduce the brain injury leading to cerebral palsy. The team’s focus includes improving the delivery of CPR, reducing oxygen toxicity, restoring cardiac output optimally and as quick as possible, and undertaking advanced CPR during delayed umbilical cord clamping.
Molecular studies. New treatments. The initiation of respiratory support after birth increases brain inflammation and injury resulting in white matter injury and increased risk of cerebral palsy. Further, brain inflammation can inhibit brainstems respiratory control resulting in an increased requirement for respiratory support, thus further exacerbating injury. Professor Polglase’s studies are investigating the underlying mechanisms in which respiratory support increases brain and brainstem inflammation and injury, and developing therapies, such as inflammatory inhibitors, to reduce brain inflammation and injury.
Stem cell therapies. Babies who are born preterm are at the greatest risk of developing cerebral palsy. Professor Suzie Miller and Dr Courtney McDonald are characterising the brain injury that is most often associated with preterm birth (white matter brain injury) and examining whether cord blood stem cells can protect white matter development within the preterm brain, and in turn prevent brain injury.
Molecular studies. New treatment. Too much inflammation in the brain is one of the main mechanisms that leads to the development of cerebral palsy. Dr Galinsky and his team are working on improving the understanding of how inflammation disturbs healthy brain development and developing new anti-inflammatory therapies for preventing brain injury in preterm infants.
Treatment delivery. Neural stem cells (NSCs) offer great promise as a neuroprotective therapy against a range of neurological conditions like cerebral palsy. A major challenge of NSC therapy for neurological conditions is delivering the cells to the brain. Current intracerebral delivery of NSCs is highly invasive and carries significant risks for the patient. This project is investigating the development a novel, non-invasive MRI-guided focused ultrasound (MRIgFUS) method for delivery of NSCs to the brain using a preclinical model.
