Cerebral Palsy Research Group
Professor Alastair H MacLennan AO,
MB,ChB, MD, FRCOG, FRANZCOG,
Discipline of Obstetrics & Gynaecology,
The University of Adelaide, AUSTRALIA
Thus, we have two differing opinions on the role of genetics in cerebral palsy, given the current state of knowledge. Both the authors of the article and the experts from Australia agree that genetics is a factor in some, perhaps many, cases of cerebral palsy. The disagreement is in how certain we can be about the percentage of those cases at this time and whether there is sufficient knowledge about this relationship to warrant extensive and expensive genetic testing in every case, especially when there is confidence about the cause. This may be yet another instance where technology has advanced faster than the ability of a clinician to interpret the results of very sophisticated genetic tests. It is often difficult to interpret various abnormalities that may be revealed – that is, do they have anything to do with the condition being tested for? Until we know what such abnormalities mean, they may serve only to frighten and worry parents or individuals with cerebral palsy. This would clearly be the case if such testing were done as part of prenatal counseling. The Moreno-De-Luca article serves to call attention to a possibly more prominent role of genetics in cerebral palsy than previously appreciated. However, a call for universal genetics testing of all individuals with cerebral palsy may be premature at this time. Rather, individualizing such recommendations as part of a comprehensive care plan would seem sensible. Persons with or parents of children with cerebral palsy interested in a possible genetic cause should discuss this question with an expert in cerebral palsy, such as a developmental pediatrician, neurologist, or physiatrist. Additional consultation with a genetics expert might be warranted in some cases.
Moreno-De-Luca A, Ledbetter DH, Martin CL. Genetic insights into the causes and classification of the cerebral palsies.