Finding of Bone Loss Marker in Non-Ambulatory CP Patients May Aid in Future Research

Non-ambulatory patients with cerebral palsy (CP) have increased bone loss in their spine and thigh bones — accompanied by increased levels of a factor known as sclerostin — compared to CP patients who can walk.

These findings might offer researchers an insight into the biological processes guarding bone loss, which may lead to new treatment options to prevent this aspect of the disease in patients with CP, according to researchers at the Yonsei University College of Medicine in South Korea.

The study, “Patients with non-ambulatory cerebral palsy have higher sclerostin levels and lower bone mineral density than patients with ambulatory cerebral palsy,” opted to focus on sclerostin because recent research has shown it is a key molecule in bone cells called osteoclasts.

The molecule appears to work as a so-called mechanosensor, informing processes of bone growth and breakdown in response to weight-bearing activities. Bone health is maintained by a balance of bone formation and degradation, and since sclerostin prevents bone formation, higher levels ultimately lead to bone loss.

To study the role of sclerostin in cerebral palsy, researchers recruited 28 CP patients, of which they measured a range of disease and bone-related factors.

Their findings, presented in the journal Bone, showed that people with spastic CP had a lower bone mineral density in the lower spine and thigh bone compared to patients with the so-called dyskinetic type of the disease.

They found even more differences between patients who could and could not walk. Non-ambulatory patients had reduced bone density levels, and lower levels of creatinine and parathyroid hormone — factors that are linked to poor bone health.

Importantly, they also had higher levels of sclerostin in the blood compared to patients who could walk.

A statistical analysis demonstrated that walking ability was significantly impacting plasma sclerostin levels.

Scientists have seen similar results in studies involving healthy volunteers who were sedentary for a prolonged time. This and other studies have made researchers consider drugs that block sclerostin as potential treatments for bone loss in cerebral palsy.

The research team hopes their findings will not only aid in future research, but also help diagnostic procedures of bone loss in CP.