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Nutritional intervention and neurodevelopmental outcome in infants with suspected cerebral palsy: the Dolphin infant
Morag J Andrew1, Jeremy R Parr2, Christine Montague-Johnson1
1Department of Paediatrics, University of Oxford, Oxford, UK.
Insights
This study investigated if docosahexaenoic acid (DHA), choline, and uridine-5-monophosphate (UMP) supplementation improved neurodevelopment in infants with suspected cerebral palsy (CP). No significant differences were found, but the treatment group showed a clinically meaningful cognitive and language advantage.
Area of Science:
- Neuroscience
- Pediatrics
- Nutritional Science
Background:
- Cerebral palsy (CP) affects infant neurodevelopment.
- Docosahexaenoic acid (DHA), choline, and uridine-5-monophosphate (UMP) are crucial for brain development.
- Investigating nutritional interventions for suspected CP is important.
Purpose of the Study:
- To determine if DHA, choline, and UMP supplementation enhances neurodevelopmental outcomes in infants with suspected CP.
- To compare cognitive, language, and motor development between supplemented and control groups.
Main Methods:
- A double-blind randomized control trial involving infants aged 1-18 months with suspected CP.
- Daily supplementation (treatment or control) for two years.
- Primary outcome: cognitive composite score (Bayley-III); secondary outcomes: language and motor composite scores.
Main Results:
- Thirty-five infants completed supplementation; 29 finished the two-year study.
- The treatment group showed non-significantly higher cognitive and language scores compared to the control group.
- No statistically significant differences in neurodevelopmental outcomes were observed between groups.
Conclusions:
- Two-year nutritional supplementation with DHA, choline, and UMP was feasible for families of infants with suspected CP.
- No statistically significant neurodevelopmental advantage was found, but clinically meaningful cognitive and language benefits were noted.
- Further research is warranted to explore the neurodevelopmental effects of this supplementation in infants with suspected CP.
Aim:
To investigate whether docosahexaenoic acid (DHA), choline, and uridine-5-monophosphate (UMP) supplementation improves neurodevelopmental outcome in infants with suspected cerebral palsy (CP) versus a comparison group of children.
Method:
Infants aged 1 to 18 months with suspected CP were recruited from UK child development centres. Participants received daily treatment or control supplementation for 2 years (double-blind randomized control design). Stratification was by age, sex, predominant pattern of motor involvement (four limbs or other), and visual impairment (or not). The primary outcome was the cognitive composite score of the Bayley Scales of Infant and Toddler Development, Third Edition (CCS-Bayley-III). Secondary outcomes included language composite and motor composite scores of the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III).
Results:
Forty infants were recruited; 35 began supplementation, 29 completed 1 to 2 years' supplementation. The treatment group CCS-Bayley-III was non-significantly higher than the comparison group (mean 77.7 [SD 19.2] and 72.2 [SD 19.8] respectively, mean modelled difference 4.4 [-2.8, 11.6]). The treatment group language scores, but not motor scores, were non-significantly higher than for the comparison group.
Interpretation:
Most families found supplementation feasible. No statistically significant differences in neurodevelopmental outcome between the treatment and comparison groups were identified. Further investigation of neurodevelopmental outcome after supplementation with DHA, choline, and UMP of infants with suspected CP is warranted.
What This Paper Adds:
This was the first trial of phosphatidylcholine precursor supplementation in infants with suspected cerebral palsy (CP). Families of infants with suspected CP found 2-year nutritional supplementation feasible. There was no statistically significant neurodevelopmental advantage for the treatment group versus the comparison group. However, treatment group cognitive and language advantage were of clinically meaningful magnitude.
