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Bone Metabolism in Cerebral Palsy and the Effect of Light-Emitting Diode (LED) Irradiation
Yoshimi Asagai1, Kengo Yamamoto2, Toshio Ohshiro3
1Shinano Handicapped Children's Hospital, Nagano, Japan.
Insights
Children with cerebral palsy experience altered bone metabolism, with reduced bone formation. LED irradiation shows promise in normalizing bone metabolism markers, potentially aiding in fracture treatment for this population.
Area of Science:
- Orthopedics
- Pediatrics
- Biochemistry
Background:
- Osteoporosis diagnosis and treatment have advanced in the elderly due to bone metabolism markers.
- Bone metabolism in children with cerebral palsy (CP) remains under-examined.
- Children with CP are prone to insufficiency fractures, lacking established treatment methods.
Purpose of the Study:
- To investigate bone metabolism in children with cerebral palsy.
- To explore the potential of LED irradiation as a therapeutic intervention for bone metabolism in severe CP.
- To assess the impact of LED irradiation on bone metabolism markers and bone density.
Main Methods:
- Longitudinal assessment of bone metabolism markers (osteogenesis and resorption) in children with CP.
- Intervention with LED irradiation in children with severe CP.
- Measurement of Insulin-like Growth Factor-1 (IGF-1), undercarboxylated Osteocalcin (ucOC), Bone Alkaline Phosphatase (BAP), and urinary N-telopeptide of Type I collagen to Creatinine ratio (NTx/Cr).
- Bone density assessment using the DIP method.
Main Results:
- Bone metabolism markers showed reduced osteogenesis and mild reduction in bone resorption, varying with CP severity.
- Markers decreased around ages 8 and 15, with bone resorption markers showing mild advancement post-15.
- LED irradiation tended to normalize IGF-1, ucOC, BAP, and NTx/Cr.
- IGF-1, BAP, and NTx/Cr significantly increased one month after LED irradiation compared to controls.
- No significant short-term changes in bone density were observed.
Conclusions:
- LED irradiation demonstrates a potential positive effect on bone metabolism in children with severe cerebral palsy.
- This non-invasive approach may offer a novel therapeutic avenue for managing bone health and insufficiency fractures in children with CP.
- Further research is warranted to confirm long-term efficacy and optimal parameters for LED irradiation therapy.
Abstract:
In recent years, through the availability of examination by bone metabolism markers, diagnosis and treatment for osteoporosis in elderly people has been greatly advanced. However, bone metabolism in cases of cerebral palsy has not been fully examined. Though children with cerebral palsy tend to be susceptible to insufficiency fractures, a method of treatment for insufficiency fractures has not been established. In the longitudinal progress of bone metabolism, although there was a difference depending on the severity, reduced bone resorption tended to be mild but osteo-genesis tended to decrease in the severe cases. Osteogenesis and bone resorption markers decreased at around ages 8 and 15. The bone resorption marker maintained mild advancement after age 15. With LED irradiation, all of IGF-1, ucOC, osteogenic marker; BAP, and urinary bone resorption marker; NTx/Cr showed a tendency to normalize. In particular, IGF-1, BAP, and NTx/Cr increased significantly one month after irradiation, compared to the non-irradiation group. Bone density assessed by the DIP method showed no apparent change in the short term either. Irradiation by a commercial LED light bulb indicated a possible positive effect on bone metabolism for children with severe cerebral palsy.
