CLASSIFICATION OF CEREBRAL PALSY SUBTYPES TRAINING STUDY

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. There are many different types of cerebral palsy. Traditionally, we separate these different types by the way movement is affected. Children with spastic hemiplegia type of CP have difficulty moving one side of their body; children with spastic diplegia type of CP have difficulty moving both arms and legs, but their legs are worse than their arms. This way of separating the different types of CP is not accurate. We have many tests which we use to measure motor function. Some ("standardized questionnaires") give an excellent overall picture of how the children move; others ("tests of motor control") give us more detail about the movement problems. These second type of tests might be better at identifying the type of CP. For instance, when some children with hemiplegia type move one hand, the other hand makes unwanted movements. These are called mirror movements. We don't know why this happens but we think it may be a good way of telling which children have more severe CP. This study will also help us learn about what is at the root of the movement problems so that we can find better treatments. For instance, although many children with CP have very stiff muscles ("spasticity"), the muscles can also be weak. We don't know if the movement problems are due to the stiffness or to the weakness. We will enroll children from 4 to 18 years of age who have CP and age-matched healthy controls. The first aim of this study will be to develop a reliable way of telling the different types of CP apart. To do this we will ask three experts to examine children with CP to see if they can agree on which type of CP the children have. The second aim of this study is to measure the movement problems in children with CP. Specifically, we want to see which tests can help us identify the two different types of CP (spastic hemiplegia and spastic diplegia). We will do this by assessing the movement problems using the standardized questionnaires and the motor control tests and comparing them together. The third aim of this study is to measure the muscle and nerve problems that are at the root of the movement problems. We will do this by measuring muscle stiffness, muscle weakness, and muscle and brain wave patterns and we will examine how these relate to the movement problems.