Gray Matter Grows in Brains of Children with Cerebral Palsy Following Therapy, Study Finds

BIRMINGHAM, Alabama — What’s a little gray matter between researchers?
A lot, it seems, as University of Alabama at Birmingham scientists become the first to show that a certain type of rehabilitation can remodel the brains of children by adding gray matter.
The findings are published today in the journal Pediatrics.

The study focused on 10 children who were given Constraint-Induced Movement (CI) therapy over a course of three weeks. One MRI was taken three weeks before the therapy; one right before therapy started; and the last one after it was over, said Chelsey Sterling, a graduate student in medical psychology and first author of the study.

“Following therapy we saw increases in the kids’ gray matter in the sensorimotor cortices  and in the hippocampus,”  Sterling said. “We don’t know exactly the cause, but it is correlated with improvements in motor skills.”

Gray matter is part of the central nervous system and is made up of neurons, glial cells and dendrites
One of the study’s co-authors, Gitendra Uswatte, described gray matter as the brain’s computer chips, and the therapy adds circuits to those chips.

Constraint-Induced Movement therapy was pioneered by Edward Taub in stroke rehabilitation. Taub is a university professor in the UAB Department of Psychology and co-author of this study.
CI therapy involves constraining the good limb so that the subject is forced to use the impaired limb.
For this study, researchers focused on children who had hemiparetic cerebral palsy, or CP that primarily affects one side of the body, Taub said.

The children’s good arm was placed in a cast to induce the restraint.
But the restrain aspect is only one small part of CI therapy, Taub said.
Successful therapy also involves the continuation of work at home involving family members to help the child focus on daily living activities: brushing their teeth, combing their hair and putting on shoes.
It’s not always easy, Taub chuckled, remembering when one child was asked to do something.
The child responded: “I have CP. Hasn’t anyone told you!”

While the study found a correlation between the increased gray matter and improved motor skills, it’s too early to which one caused the other, researchers said.
“The brain change could cause the motor improvement or the motor improvement could cause the brain change,” Taub said.
Uswatte is preparing to embark upon a study which may get closer to answering that question.
In the pending study, researchers would combine CI therapy with the administration of Prozac, or fluoxetine.

The study, he hopes, “will go some way to showing there is a causal relationship.”
Unfortunately, Uswatte said, the $2 million grant for the study is on hold due to sequestration – that series of automatic budget cuts directly caused by Congress not agreeing on a budget.
“There’s lots of research that is ready to go that can help people and help patients that can’t be done because of the stalemate over the budget,” Uswatte said.