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Brain Mapping Technique May Help Cerebral Palsy Patients

WINSTON-SALEM, N.C. – Children who have cerebral palsy (CP) may benefit from a new way of mapping the brain to guide which therapy can best help them, according to a neuroscientist at Wake Forest University Baptist Medical Center.

“I want to make sure that these children can be prescribed the best treatment practices we have to increase the likelihood that they will be able to care for themselves and live productive lives,” said George F. Wittenberg, M.D., Ph.D., a neuro-rehabilitation specialist.

With a grant from the National Institutes of Health, Wittenberg and colleagues will use transcranial magnetic stimulation (TMS) in patients with CP to pinpoint areas of the brain that control movement. TMS uses repeated short bursts of magnetic energy to stimulate nerve cells in the brain.

Patients with CP often have difficulty moving their arms and legs. Depending on the severity of the disease, some patients are unable to walk, feed themselves or do small routine tasks.

“By localizing which areas are responsible for certain movements, we may be able to select therapies for these patients that can help them recover some of that lost function,” Wittenberg said. “We know the brain can reorganize or retrain itself to perform tasks that a damaged area of the brain is unable to do. Each patient is different depending on the level of damage. Sometimes, because of the way the brain has reorganized itself, a patient’s arms will work much better than their legs. If we are able to pinpoint the exact location of the brain which controls specific muscles, we might be able to determine if one area is overburdened and may benefit more from one type of therapy versus another.”

Wittenberg and his colleagues will study 50 CP patients, ages 7 to 16, over a two-year period. “We aren’t able to study younger children because they require stronger stimulation with the magnet, likely due to immature insulation around their nerve cells,” he said. “As children mature their brains become easier to map.”

However, Wittenberg says he is interested in mapping children at a young age as opposed to waiting for them to grow older, because therapies may be more effective if applied earlier.

CP occurs when there is an injury to the brain (or a deficit of oxygen to the brain) which results in loss of motor function or rigidity in a person’s limbs. Mental retardation, seizures and vision loss are also associated with CP. Premature infants or babies born at a very low birth weight are more likely to develop CP. In most cases the brain injury occurs during pregnancy or the first few years of life. There is no cure for CP and many patients experience varying degrees of the disease, based on the amount of damage to the brain.

L. Andrew Koman, M.D., a pediatric orthopaedic surgeon, and other colleagues at Wake Forest Baptist will assist with the study.

For more information or to participate in the diagnostic study, call Sybil Snow at 336-716-3949. Recruitment for the study will begin immediately.

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Media Contacts: Rae Bush, rbush@wfubmc.edu, or Shannon Koontz, skoontz@wfubmc.edu, at 336-716-4587.

Wake Forest University Baptist Medical Center is an academic health system comprised of North Carolina Baptist Hospital, Wake Forest University Health Sciences and Brenner Children’s Hospital. The system comprises 1,187 acute care, rehabilitation, psychiatry and long-term care beds and is consistently ranked as one of “America’s Best Hospitals” by U.S. News & World Report. Brenner Children’s was named one of the top children’s hospitals in the nation by Child magazine.

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