Cerebral palsy research funding from the National Institutes of Health, 2001 to 2013

Wu, Yvonne W.; Mehravari, Alison S.; Numis, Adam L.; Gross, Paul

doi:10.1111/dmcn.12789

Cited by 22 publications

(20 citation statements)

References 8 publications

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“…A diagnosis of CP is often made based on the observation of abnormal muscle tone or posture, delayed motor milestones, or the presence of gait abnormalities in young children, which range from mild, i.e., toe-walking, to severe, i.e., crouched, internally rotated gait (Wu et al, 2004). Gait begins to stabilize around age 3–4 years and matures by 7 years of age (Wu et al, 2015). Among children with CP who are not walking by age 2 years, only 10% walk independently by age 7 (Wu et al, 2004), underscoring the importance of early identification and intervention.…”

Section: Introductionmentioning

confidence: 99%

Neurologic Correlates of Gait Abnormalities in Cerebral Palsy: Implications for Treatment

Zhou

Butler

Rose

2017

Front. Hum. Neurosci.

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Cerebral palsy (CP) is the most common movement disorder in children. A diagnosis of CP is often made based on abnormal muscle tone or posture, a delay in reaching motor milestones, or the presence of gait abnormalities in young children. Neuroimaging of high-risk neonates and of children diagnosed with CP have identified patterns of neurologic injury associated with CP, however, the neural underpinnings of common gait abnormalities remain largely uncharacterized. Here, we review the nature of the brain injury in CP, as well as the neuromuscular deficits and subsequent gait abnormalities common among children with CP. We first discuss brain injury in terms of mechanism, pattern, and time of injury during the prenatal, perinatal, or postnatal period in preterm and term-born children. Second, we outline neuromuscular deficits of CP with a focus on spastic CP, characterized by muscle weakness, shortened muscle-tendon unit, spasticity, and impaired selective motor control, on both a microscopic and functional level. Third, we examine the influence of neuromuscular deficits on gait abnormalities in CP, while considering emerging information on neural correlates of gait abnormalities and the implications for strategic treatment. This review of the neural basis of gait abnormalities in CP discusses what is known about links between the location and extent of brain injury and the type and severity of CP, in relation to the associated neuromuscular deficits, and subsequent gait abnormalities. Targeted treatment opportunities are identified that may improve functional outcomes for children with CP. By providing this context on the neural basis of gait abnormalities in CP, we hope to highlight areas of further research that can reduce the long-term, debilitating effects of CP.

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Section: Introductionmentioning

confidence: 99%

Neurologic Correlates of Gait Abnormalities in Cerebral Palsy: Implications for Treatment

Zhou

Butler

Rose

2017

Front. Hum. Neurosci.

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“…However, there are no long-term prospective studies in the CP literature examining the effects of selective dorsal rhizotomy alongside a variety of treatments, including orthopedic surgery, intrathecal baclofen treatment, Botox injection, antispasticity medication, and physical therapy. Lack of sufficient research on long-term outcomes may be attributed to the low prevalence of patients diagnosed with CP in the United States, which is about 1 in 323, resulting in the designation of low priority grant funding for costly long-term CP research [18]. It is unlikely that CP research funding will improve in the near future, and thus, other research options should be sought out.…”

Section: Discussionmentioning

confidence: 99%

Beneficial Effects of Childhood Selective Dorsal Rhizotomy in Adulthood

Park¹,

Edwards²,

Liu³

et al. 2017

Cureus

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Background: Selective dorsal rhizotomy (SDR) has been used to treat children with spastic cerebral palsy (CP) for over three decades. However, little is known about the outcomes of childhood SDR in adults. Objectives: 1) To study the effects of childhood SDR on the quality of life and ambulatory function in adult life. 2) To determine late side effects of SDR in adults. Methods: Adults (> 17.9 years) who underwent SDR in childhood (2 - 17.9 years) between 1987 and 2013 were surveyed in 2015. Patients completed a survey, including questions on demographic information, quality of life, health, surgical outcomes, motor function, manual ability, pain, braces/orthotics, post-SDR treatment, living situation, education level, work status, and side effects of SDR. Results: In our study population of 294 patients (18.0 - 37.4 years), patients received SDR during the ages of 2.0 - 17.9 years and were followed up 2.2 to 28.3 years after surgery. Eighty-four percent had spastic diplegia, 12% had spastic quadriplegia, and 4% had spastic triplegia. The majority (88%) of patients reported improved post-SDR quality of life and 1% considered the surgery detrimental. Most (83%) would recommend the procedure to others and 3% would not. However, patients who would not recommend SDR to others ambulated with a walker or were not ambulatory at all prior to SDR. The majority (83%) of patients improved (30%) or remained stable (53%) in ambulation. Twenty-nine percent of patients reported pain, mostly in the back and lower limbs, with a mean pain level of 4.4 ± 2.4 on the Numeric Pain Rating Scale (NPRS). Decreased sensation in small areas of the lower limbs was reported by 8% of patients, though this did not affect daily life. Scoliosis was diagnosed in 28%, with 40% of these patients pursuing treatment. Whether scoliosis was related to SDR is not clear, though scoliosis is known to occur in patients with CP and also in the general population. Only 4% of patients underwent spinal fusion. Orthopedic surgeries were pursued by 59% of patients. The most common orthopedic surgeries were hamstring lengthenings (31%), Achilles tendon lengthenings (18%), adductor lengthenings (16%), and derotational osteotomies (16%). Twenty-four percent of all patients later underwent hip surgery and 8% had surgeries on their knees. Conclusion: Results of this study indicate that the beneficial effects of childhood SDR extend to adulthood quality of life and ambulatory function without late side effects of surgery.

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“…Categorization for the key phrase 'cerebral palsy', and summarised the data as basic or clinical research. 12 The NIH funding is shown in this study as the combined total amount, and in terms of award year rather than expenditure year.…”

Section: Funding Typementioning

confidence: 99%

“…The NIH funding is shown in terms of award year rather than expenditure year as provided by Wu et al 12 Funding for CP in the USA has greatly increased in real terms (figure 4). The mean increase in funding per year was: $105 000 for NHMRC funding, $184 000 for CPARF funding and US$ $4.9 million per year for NIH funding.…”

Section: Comparison With Nihmentioning

confidence: 99%

Funding for cerebral palsy research in Australia, 2000–2015: an observational study

et al. 2016

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ObjectivesTo examine the funding for cerebral palsy (CP) research in Australia, as compared with the National Institutes of Health (NIH).DesignObservational study.SettingFor Australia, philanthropic funding from Cerebral Palsy Alliance Research Foundation (CPARF) (2005–2015) was compared with National Health and Medical Research Council (NHMRC, 2000–2015) and Australian Research Council (ARC, 2004–2015) and CPARF and NHMRC funding were compared with NIH funding (USA).ParticipantsCerebral Palsy researchers funded by CPARF, NHMRC or NIH.ResultsOver 10 years, total CPARF philanthropic funding was $21.9 million, including people, infrastructure, strategic and project support. As competitive grants, CPARF funded $11.1 million, NHMRC funded $53.5 million and Australian Research Council funded $1.5 million. CPARF, NHMRC and NIH funding has increased in real terms, but only the NIH statistically significantly increased in real terms (mean annual increase US$4.9 million per year, 95% CI 3.6 to 6.2, p<0.001). The NHMRC budget allocated to CP research remained steady over time at 0.5%. A network analysis indicated the relatively small number of CP researchers in Australia is mostly connected through CPARF or NHMRC funding.ConclusionsFunding for CP research from the Australian government schemes has stabilised and CP researchers rely on philanthropic funding to fill this gap. In comparison, the NIH is funding a larger number of CP researchers and their funding pattern is consistently increasing.

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Cerebral palsy research funding from the National Institutes of Health, 2001 to 2013

Cited by 22 publications

References 8 publications

Neurologic Correlates of Gait Abnormalities in Cerebral Palsy: Implications for Treatment

Neurologic Correlates of Gait Abnormalities in Cerebral Palsy: Implications for Treatment

Beneficial Effects of Childhood Selective Dorsal Rhizotomy in Adulthood

Funding for cerebral palsy research in Australia, 2000–2015: an observational study

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