Severity of Spastic Cerebral Palsy Linked to Blood Levels of a Cytokine, TNF-alpha

Severity of Spastic Cerebral Palsy Linked to Blood Levels of a Cytokine, TNF-alpha

The levels of tumor necrosis factor alpha (TNF-α) in the blood correlate with disease severity in some forms of cerebral palsy, according to a study, “Plasma Tumor Necrosis Factor-alpha (TNF-α) Levels Correlate with Disease Severity in Spastic Diplegia, Triplegia, and Quadriplegia in Children with Cerebral Palsy,” published in the Medical Science Monitor journal.

Cerebral palsy is characterized by motor deficits as a result of abnormalities during in utero development, and is estimated to occur in 2 of every 1,000 live births in developed countries. Inflammatory responses in both the utero and in neonates were previously reported to be involved in the development of brain white matter lesions, causing cerebral palsy.

TNF-α is a powerful cytokine involved in systemic inflammation, and hence has widespread action, including in activating neutrophils, stimulating mononuclear cells into producing IL-1β and IL-6, and in inducing antibody production by B cells. In the central nervous system, TNF-α is secreted by a myriad of cells — astrocytes, microglia, blood-borne macrophages, and vascular endothelial cells — and has been reported to induce changes in the brain.

The research team investigated the role of TNF-α in spastic cerebral palsy. To this end, researchers measured the levels of TNF-α in 54 children with spastic cerebral palsy, which were subdivided into two groups, those ages 1 to 3 (n=27) and those 4 to 12 years old (n=27). Levels of TNF-α in these children were compared to those in 28 age-matched healthy controls, also divided in age subgroups (1-3 and 4-12 years old). Additionally, motor function and activities of daily living were assessed in each group at the enrollment phase and after six months of rehabilitation.

Researchers found that TNF-α was higher in patients with cerebral palsy when compared to controls, in both age groups. Notably, while control subgroups exhibited no differences in TNF-α levels, differences were detected in both cerebral palsy groups, and the younger patients had significantly higher TNF-α levels than the older ones. Moreover, the team found that TNF-α levels significantly correlated with gross motor function in patients with spastic triplegia and quadriplegia, and with diplegia.

In conclusion, the results suggested that circulating levels of TNF-α may be a valuable marker for the severity of motor dysfunction in some types of spastic cerebral palsy.