At the 10/24/13 board of directors meeting, $1,535,000 was committed for future funding of eight new multi-year research projects, with continued/additional funding of $500,000 for seven ongoing research programs, representing a total research commitment of $2,035,000; more than half ($1,070,000) will be funded in FY’14. We are particularly pleased that the Cerebral Palsy Alliance in Australia has agreed to Co-Fund the study at Kennedy Krieger Institute, Johns Hopkins University being conducted by Alexander Hoon, which is indicative of our shared organizational objective to work collaboratively on areas of scientific interest.
In addition to our research projects at Children’s Hospital of Pennsylvania, the State University of New York, the University of Alberta (Canada), Boston Children’s Hospital, Columbia University Medical Center, the Washington School of Medicine, and Modash Medical Centre (Australia), the following new projects will begin in January of 2014:
New Research (FY 2014)
Exploratory Research Grants – $500,000 ($50,000/year for two years)
Glen Lichtwark, University of Queensland (“The Relationship between Muscle Quality, Functional Capacity and Functional Performance through the Adult Lifespan in Cerebral Palsy”) Email: email@example.com
As people with cerebral palsy age, they often experience greater challenges in mobility due to muscle weakness, increased joint stiffness, and reduced control of muscles. We do not know how the natural effects of aging interact with the musculoskeletal adaptations that occur due to CP. Is there deterioration in muscle quality in adults with CP and does this limit the ability to perform daily activities like walking? To answer this question we need to examine the structure and function of muscles in CP and relate this to the ability to perform functional tasks or participate in physical activity. This information will enable us to recommended interventions that slow decline in function, improve health and reduce risk of falls.
Alexander Hoon, John Hopkins University School of Medicine (“Quantitative Mapping of the Basal Ganglia and Related Structure In Children with Dyskinetic Cerebral Palsy”) Email: firstname.lastname@example.org
Brain injury affecting the brain’s basal ganglia (BG), due to low oxygen at birth or genetic metabolic disorders, result in movement disorders called dyskinetic cerebral palsy. Quantitative Susceptibility Mapping (QSM) is a new neuroimaging technique that has never been applied to the study of brain structure and basal ganglia injury in children with dyskinetic CP. The aim of this study which is being co-funded by the Cerebral Palsy Alliance in Australia is to map injury to basal ganglia (BG) and related structures in 15 children with dyskinetic cerebral palsy (CP) and 15 unaffected children. More precise quantifications of basal ganglia structures and their connections in children with dyskinetic cerebral palsy will help refine targets for therapeutic interventions such as Deep Brain Stimulation (DBS).
An Massaro, The George Washington University School of (“Quantifying Basal Ganglia Thalamic Injury i n Neonatal Hypoxic Ischemic Encephalopathy – A Method for Early Assessment of CP Risk”) Email: ANguyenM@cnmc.org
Hypoxic ischemic encephalopathy (HIE) refers to brain injury resulting from reduced blood and oxygen delivery to a baby’s brain near the time of birth. Advanced magnetic resonance imaging (MRI) is a safe, non-invasive tool that can be used to measure tissue health and blood flow in deep brain structures. Using brain MRI measurements in newborns to predict later childhood disability can advance clinical care by providing means to assess the immediate effects of treatments for brain injury. This project aims to evaluate advanced MRI tools that can help prevent or ameliorate disability due to cerebral palsy that is often a consequence of HIE and other neurologic disorders in the newborn.
Ming Wu, Rehabilitation Institute of Chicago (“Robotic Pelvis Manipulation Improves Dynamic Balance and Walking in Children with Cerebral Palsy”) Email: email@example.com
Horseback riding (hippotherapy) has been shown to improve balance in children with CP. However, this beneficial therapy is not available for a majority of patients because of limited access to horses, weather conditions, and the relatively high cost due to the need for multiple professional staff during a hippotherapy session. As a result, there is a need to develop a novel robotic system to make this type of therapy more widely available for children with CP. We propose to test whether providing controlled 3D movement (similar to that of a horse) astride a cable-driven robotic system will improve dynamic balance and walking function in children with CP.
Bernadette Gillick, University of Minnesota Program in Physical Therapy Medical School (“Application of Non-Invasive Brain Stimulation (NBS) in Children with Hemiparesis to Improve Hand Function”) Email: firstname.lastname@example.org
Weakness on one side of the body due to cerebral palsy, or hemiparesis, affects the functional ability of an individual during childhood and throughout the lifespan. Using a specific form of stimulation, transcranial direct current stimulation or tDCS, brain cells that were inactive due to injury have the potential to become instrumental in function. tDCS is painless, cost-effective, and portable and has shown no evidence of seizure or other serious adverse event. The proposed research combines tDCS with constraint-induced movement therapy (CIMT) to investigate their benefit on hand function in children with hemiparetic cerebral palsy.
Hausman Clinical Scholars Award – $225,000 ($75,000/year for three years)
Kathryn Connaghan, Northeastern University (“Prosodic Differences and Their Impact on Speech Intelligibility in Cerebral Palsy”) Email: email@example.com
The clinical presentation of cerebral palsy frequently includes motor speech impairments which can substantially impair communication. Even in its mildest forms, atypical speech can impact social interactions and quality of life. Through a series of speaking and listening studies we will examine the interaction of perception and production of prosody (rhythm and pattern of sounds) and its impact on speech intelligibility in CP. In addition to contributing to the scientific and clinical knowledge base, findings from this work may challenge current clinical assumptions and lead to novel, more efficacious inventions that address the complex communication needs of individuals with CP.
Cerebral Palsy Research Center of Excellence – $600,000 ($200,000/year for three years)
“Prevention and/or Cure of White Matter Injury among Preterm Infants”
The purpose of this research funding ($1 million over five years) initiative is to support innovative research and/or infrastructural needs leading to prevention and/or cure of cerebral palsy due to white matter injury among preterm infants. The proposed research aims should address one or more novel approaches to prevention and/or cure and lead to a human application within the project period (i.e. five years or less). Importantly, this project should serve as the foundation of the establishment of an integrated, interdisciplinary Cerebral Palsy Center of Research Excellence (CPCRE), focused on prevention and/or cure of cerebral palsy, which will endure and flourish beyond the timeframe of this particular project.
Proposals have been submitted and are under review by an international panel of experts. Announcement of the winner of this competition is expected in late Spring, 2014.
Deep Brain Stimulation Registry – $210,000 ($70,000 per year for three years)
Deep brain stimulation (DBS) is a new neurosurgical treatment involving the implantation of a medical device called a brain pacemaker, which sends electrical impulses to specific parts of the brain. DBS in select brain regions has provided remarkable therapeutic benefits for otherwise treatment-resistant movement disorders such as Parkinson disease, tremor and dystonia.
To date there has been minimal exploration of the utility of DBS in cerebral palsy (CP). Before DBS becomes more widely utilized in CP, with the risk of inappropriate use and even harm, it is imperative that it be subjected to rigorous scientific scrutiny.
CPIRF has facilitated and funded two meetings regarding establishment of a DBS in CP registry to which neurologists and neurosurgeons around the world would contribute data regarding their patients with CP who undergo DBS. Such a registry would provide invaluable guidance regarding optimal patient candidates, best sites of electrode implantation, complications, and outcomes. Based on the collective experience in various medical centers globally, an informed prospective clinical trial of DBS in CP can be implemented. The DBS in CP registry will be operational in early 2014.