New Combination Therapy Offers Hope for Improved Movement for Cerebral Palsy
March 3, 2025
What if we could transform movement recovery in cerebral palsy by combining advanced cell therapy with rehabilitation?
A new study from the Childhood Cerebral Palsy Integrated Neuroscience Discovery Network (CP-NET), one of OBI’s Integrated Discovery Programs, explores this innovative approach, showing how two different treatments—Neural Precursor Cell transplantation and Constraint-Induced Movement Therapy—work together to promote brain repair and improve motor function. Through its funding and support, OBI is helping bridge the translational gap—turning discoveries into real-world treatments that can improve outcomes for individuals living with brain disorders. This type of groundbreaking research is not only expanding scientific knowledge but also paving the way for new innovations, including the development of regenerative therapies that could transform care for cerebral palsy and other neurological conditions.
What was the study about?
Cerebral palsy (CP) is one of the most common childhood-onset disabilities, impacting movement and coordination. It affects approximately 17 million people worldwide and can also cause sensory challenges, cognitive difficulties, epilepsy, and muscle-related complications. The annual cost of direct care is significant, reaching an estimated one billion Canadian dollars across Canada, with the indirect costs reaching to $5000/year per patient. Finding effective treatments is essential.
A new study published in the International Journal of Molecular Sciences explores a promising approach to treating hemiplegic CP, a form of CP where one side of the body is more affected than the other. Researchers investigated how two different therapies—Neural Precursor Cell transplantation and Constraint-Induced Movement Therapy—work together to enhance brain repair and improve movement. This particular approach combines two of CP-NET’s areas of research: neural mechanisms of brain repair and rehabilitation.
Neural Precursor Cells (NPCs): These specialized cells can develop into various types of brain cells and aid in repairing brain damage. By transplanting NPCs into the brain, scientists aimed to harness the brain’s natural regenerative capabilities to promote healing and restore function.
Constraint-Induced Movement Therapy (CIMT): This well-established rehabilitation technique encourages the use of the weaker limb by restricting movement of the stronger one, forcing the brain to rewire and strengthen neural connections for improved motor function.
What did the scientists uncover?
Using a mouse model of hemiplegic CP, researchers tested the effects of NPC transplantation alone, CIMT alone, and a combination of both. The study yielded three major findings:
1. NPCs activate the brain’s natural repair system
After transplantation, NPCs successfully survived, integrated into the brain, and extended connections to key regions like the cortex and hippocampus. These cells mostly remained as stem cells but contributed to brain repair, likely by releasing growth factors and supporting other brain cells. CIMT did not significantly affect NPC survival or integration.
Despite a low survival rate, the transplanted NPCs helped restore brain structures and function. Some brain areas, like the corpus callosum (CC), were fully repaired, while others, such as the hippocampus, showed partial recovery. NPCs also played a key role in remyelination—repairing the protective coating around nerve fibers—which likely contributed to improved motor function.
2. CIMT improves neuroplasticity and motor function
CIMT alone led to significant improvements in brain structure and function, although some areas, like the cortex and CC, did not fully return to normal. The therapy encouraged remyelination and helped unmyelinated nerve fibers recover, though not as effectively as NPC transplantation. Motor function improvements were noticeable by day 42 and continued until full recovery by day 84.
Similar to past studies, CIMT likely worked by promoting nerve growth and reducing inhibitors that block recovery. This therapy has been shown to remodel neurons and boost brain plasticity, leading to better movement control.
3. Combining NPC transplantation and CIMT amplifies recovery
When NPCs and CIMT were used together, they did not significantly increase structural brain recovery compared to using either treatment alone. However, they led to a much higher increase in the population of supportive brain cells (oligodendrocytes), which are essential for nerve function. Electrophysiological tests confirmed that this combination improved nerve signal transmission. Behavior tests also showed that movement recovery happened earlier and was more pronounced compared to single treatments. While the additional benefits faded over time, all treated groups eventually reached near-normal function by the end of the study. This synergy could pave the way for more effective therapeutic strategies for CP.
"Our findings suggest that combining regenerative therapy with rehabilitation could speed up recovery, which is critical for children with CP," says Dr. Michael Fehlings. "Although further studies are needed, this approach brings us closer to personalized treatments that could dramatically improve mobility and independence."
From Lab to Clinical Innovation
While CIMT is already used in pediatric rehabilitation, NPC transplantation remains an experimental therapy. However, this research is driving forward new possibilities for regenerative treatments in CP.
One exciting outcome of this work is the launch of Inteligex, a biotechnology company focused on developing regenerative therapies for brain and spinal cord injuries. Inteligex, based at the JLabs facility in MaRS, received a translational grant from the Ontario Brain Institute (OBI), demonstrating OBI’s commitment to turning discoveries into real-world solutions.
A Future of Personalized Brain Repair
This research was conducted within the CP-NET translational neuroscience network and funded by the Ontario Brain Institute, with additional support from the Kids Brain Health Network Centres of Excellence. By combining rehabilitation with regenerative medicine, scientists are laying the groundwork for new treatments that could help children with CP gain greater mobility and independence.
By Narem Karakoyun