Is Stem Cell Therapy the New Savior for Cerebral Palsy Patients? A Review

Abstract

Cerebral Palsy (CP) is one of the foremost causes of childhood motor disability and disrupts the individual's development and ability to function. Several factors contribute to the development of CP such as preterm delivery, low birth weight, infection/inflammation, and additional pregnancy complications, both in preterm and term infants. As there is no specific treatment for CP, rehabilitation is the current option for the management of patients. The serious nature of this condition creates deficits that last a lifetime. We collected studies that were published in the past 10 years, using PubMed as our main database. We chose studies that were relevant to CP and stem cell therapy. We mainly focused on various types of stem cells that can be used in treatment, mechanism of action (MOA) of stem cells, routes, dosage, and adverse effects, their efficacy, and safety in CP patients. Of all the 38 studies we reviewed, we found that five articles discussed the utilization of human umbilical cord blood [hUCB], four articles discussed autologous bone marrow stem cells, and one discussed allogeneic umbilical cord blood usage. One article discussed neural stem-like cells (NSLCs) derived from bone marrow and the remaining 27 articles were about CP and its treatment. We reviewed detailed information about the possible stem cell therapies and their benefits in patients with CP. We found that immune modulation is the major mechanism of action of stem cells, and among all the types of stem cells. Autologous umbilical cord mesenchymal stem cells appear to be safe and most effective in treatment compared to other stem cell treatments. Among all symptoms, motor symptoms are best corrected by stem cell therapy. Still, it did not show any marked improvement in treating other symptoms like speech defects, sensory or cognitive defects, or visual impairment.

Umbilical cord blood CD34+ cells administration improved neurobehavioral status and alleviated brain injury in a mouse model of cerebral palsy

“…Furthermore, both autologous [ 32 – 34 ] and allogeneic [ 35 – 37 ] UCB cells have been proved to be therapeutically safe and effective in clinical trials. However, these clinical trials are all performed over a short-time period, and the long-term effects of UCB cells administration, especially on the behavioral outcomes, have not been extensively studied [ 38 ]. Other studies have used human cells in rat models for long-term data [ 39 , 40 ], but they are still insufficient for an increased risk of immunological reaction and clearance of stem cells.…”

Stem Cell Therapies for Cerebral Palsy and Autism Spectrum Disorder—A Systematic Review

“…A very similar situation exists with cerebral palsy. It consists in a group of permanent movement and posture disorders caused by anomalies in the developing brain [ 33 , 34 , 35 , 36 ]. These disorders are most often accompanied by sensory, perceptual, cognitive, visual, hearing problems, epilepsy, and musculoskeletal problems [ 36 , 37 , 38 , 39 ].…”

“…The prevalence rate reaches higher values in developing countries [ 44 , 45 , 47 ]. The etiology is still unknown, but a complex contribution of genetic, prenatal factors (such as hypoxia, intrauterine growth restriction, or infection) and prematurity is suspected [ 33 , 48 , 49 , 50 ]. However, in about 80% of cases, the cause of onset cannot be determined and is considered idiopathic [ 33 , 51 ].…”

“…The etiology is still unknown, but a complex contribution of genetic, prenatal factors (such as hypoxia, intrauterine growth restriction, or infection) and prematurity is suspected [ 33 , 48 , 49 , 50 ]. However, in about 80% of cases, the cause of onset cannot be determined and is considered idiopathic [ 33 , 51 ]. It is suspected that CP patients develop persistent inflammation of the nervous system and subsequent apoptosis, which usually occurs as a result of hypoxia-induced trauma [ 52 ].…”

“…It is suspected that CP patients develop persistent inflammation of the nervous system and subsequent apoptosis, which usually occurs as a result of hypoxia-induced trauma [ 52 ]. The current therapeutic management of CP patients requires a multidisciplinary approach that takes into account the medical, social, psychological, and educational needs of the patient [ 33 , 36 , 53 ]. Treatment includes the use of neurotrophic drugs, physiotherapy, rehabilitation, surgical procedures (such as neurectomy and rhizotomy) and intramuscular injections of botulinum toxin, and other types of symptomatic treatment tailored to the symptoms reported by the patient or their caregivers [ 33 , 36 , 53 ].…”