Cerebral Palsy & Stem Cell Treatments

Key points to remember about cerebral palsy and stem cell treatments

• increased knowledge about stem cells has led scientists to explore whether stem cells can be used to treat a range of conditions including cerebral palsy
• stem cell treatments may have potential for improving function in cerebral palsy
• there are different types of stem cells and different types of stem cell treatments
• doctors and scientists are still finding out about how to use stem cells in cerebral palsy
• if you are planning to use stem cell treatment for your child, talk with your healthcare team and check the bottom of the page for some questions to answer

Why might I consider stem cell treatment for my child with a disability?

Parents who have a child with a disability, especially a severe disability that significantly limits function and/or quality of life, may want to consider any therapy that offers hope of a cure or significant improvement.

The discovery of stem cells in adult brains has led scientists to explore whether they can use stem cells to treat different conditions affecting the brain, including cerebral palsy.

Doctors and scientists have used stem cell treatments in a number of different conditions affecting other parts of the body. 

What is a stem cell?

A stem cell is a primitive cell that has the potential to develop into a range of cell types and form different tissues. Stem cells have the ability to renew themselves by dividing.

There are 2 main types of stem cells:

1. Embryonic stem cells that are found in the very early embryo. These cells have the potential to develop into all the different tissues and organs that the developing embryo will need as it matures.
2. Adult stem cells that are found in the tissues of humans who have matured beyond the embryonic stage (that is, in the tissues of fetuses, infants, children and adults). The function of adult stem cells is to supply new cells for repairing tissues; for example, bone marrow stem cells develop into blood cells.

What is cerebral palsy?

Cerebral palsy is a permanent physical condition that affects movement and posture and can cause a range of other problems. It is caused by damage to, or lack of development in a part of the brain that controls movement. Cerebral palsy is the most common physical disability in childhood occurring in 1 in every 500 babies. Cerebral palsy is often called ‘CP’ for short. For more information, see the cerebral palsy page on this website.

Could stem cell therapy help my child with cerebral palsy?

Scientists are developing stem cell therapies for the replacement or repair of damaged tissues such as nerves, muscle and other parts of the body.

Doctors and scientists are carrying out ongoing research into stem cell therapy and are looking at the best ways to use stem cells in cerebral palsy.  

How could stem cell therapy help?

The aim is for the stem cells to develop into the kind of cells that can take over the function of the damaged areas of the brain. As more information becomes available from carefully conducted scientific studies, how this therapy can help children with cerebral palsy will become clearer.

What happens in a stem cell transplant in a child with cerebral palsy?

First there needs to be a source of stem cells

Stem cells can come from a range of sources including:

• cord blood - a child's own cord blood or from a donor cord blood bank
• bone marrow from the child or from a related or unrelated donor

Scientists are also exploring whether they can use stem cells from other body tissues. 

Then the doctor injects the stem cells into the child

The method used will depend on the centre carrying out the therapy. The injection may be:

• an intravenous infusion into the child's bloodstream, or
• into the space around the spinal cord by a lumbar puncture

What happens next?

For a stem cell treatment in cerebral palsy to work, several things may need to happen:

• the stem cells need to develop into nerve cells (also called neurons)
• the stem cells may work by developing into support or helper cells that are important for the nerve cells to function - this is an area of ongoing research

Most centres offering this treatment also recommend intensive physical therapy programmes

To make the treatment more likely to be effective, most centres offering this treatment also recommend intensive physical therapy programmes following the stem cell treatment. This makes it hard to know whether changes are the result of the stem cell treatment itself, or the intensive physical therapy, or are the result of the child growing and developing.

Can anything go wrong with a stem cell transplant in a child with cerebral palsy?

Yes, things can go wrong.

Where these treatments happen is important

If you plan to travel overseas to get stem cell treatment for your child with cerebral palsy, talk with your healthcare team about whether the place you plan to travel to for treatment is safe. Some of these treatments happen in countries where standards of healthcare are different from those in New Zealand.

There is a risk of disease and infection from donor cells

There is the risk of introducing viral diseases and prion diseases (such as Creutzfeldt–Jakob disease - CJD) from donor cells. It is really important to know where the donor cells came from and whether the person who donated them was a healthy individual. This is not always carefully regulated in non-approved trials.

There is also a risk of bacterial infections from donor cells, especially if the donor cells have not been properly stored.

There is a risk of stem cells developing into cells that are harmful

Ther is ongoing research into the factors that influence the development of stem cells into the kind of cells that are needed. There is a possibility that stem cells may develop into cells that are harmful. Stem cells that multiply (remember that is the function of a stem cell) without differentiating or developing into mature cells may cause complications. These complications may be serious depending on where in the body this happens.

Does stem cell transplant in a child with cerebral palsy work?

Results from studies are beginning to show that stem cell transplants may be helpful for some children with cerebral palsy.

Ethically approved studies

There are a number of clinical studies in progress. If you want to find out more about these, check the information about stem cell therapy clinical trials at the Canchild website.

Commercial clinics

The interest in stem cell therapy has led to the development of many commercial clinics claiming to offer stem cell therapies. In some parts of the world these clinics are unregulated and uncontrolled.

In some clinics, the treatment they offer may not be what is claimed and the cells given may not even be true stem cells.

Success stories on the internet

There are many claims on the internet of dramatic improvements following stem cell treatments. There are real concerns about exploiting vulnerable families who only want to do the best for their children. Find out as much information as you can and talk to your healthcare team before planning to travel for treatment.

How can I decide about a stem cell transplant in my child with cerebral palsy?

If you are planning to use this option for your child, carefully consider the following points:

1. What information is available about the donor cells?
2. Who donated them?
3. Was that person healthy?
4. Is there a risk that my child could be infected with a serious disease as a result of this treatment?
5. How will the treatment be given?
6. How much will this treatment cost? Remember that there is always more than a dollar cost. Think about the disruption to the rest of the family as a result of travelling overseas; the safety of the destination; loss of earnings.
7. What qualifications do the people giving the treatment have?
8. What follow-up and treatment evaluation will they offer?