Assessment & Research

Inflammatory biomarkers in children with cerebral palsy: A systematic review.

Magalhães et al. (2019) · Research in developmental disabilities 2019
★ The Verdict

High IL-1β, IL-6, TNF, and CXCL8/IL-8 in blood or spinal fluid line up with worse early neurological signs in infants at risk for cerebral palsy.

✓ Read this if BCBAs who assess or treat infants and toddlers with known or suspected CP in hospital, early-intervention, or outpatient clinics.
✗ Skip if Practitioners working only with older CP clients whose inflammatory profiles have already stabilized.

01Research in Context

01

What this study did

Magalhães et al. (2019) looked at every paper that measured inflammatory markers in babies and toddlers who later got a cerebral palsy diagnosis. They pulled blood and spinal-fluid results from studies around the world.

The team asked a simple question: do higher cytokine levels line up with worse early neurological signs?

02

What they found

Most studies agreed on one pattern. When IL-1β, IL-6, TNF, or CXCL8/IL-8 were high, the child showed more abnormal movement, tone, or brain scans.

The review does not give cut-off numbers, but the direction was steady across papers.

03

How this fits with other research

Arnfield et al. (2013) already showed that MRI lesion type predicts later gross-motor level. Coelho adds a blood-side view: inflammation seen on a lab slip can flag the same risk.

Lipscombe et al. (2016) found that early communication skill links motor ability to later social play. Coelho’s data say the immune system is another early piece you can measure before words or steps emerge.

Kocher et al. (2015) tracked participation drops in preschool CP; their predictors were age, sex, and cognition. Coelho does not contradict this — it simply points to a biological marker that may sit underneath those same declines.

04

Why it matters

You now have two low-cost, early flags: an MRI picture and a cytokine panel. Either can tell you which baby needs the most intensive motor, communication, and family coaching from day one. When you write your next assessment plan, ask the pediatrician to share any neonatal blood-spot or follow-up cytokine results. Pair those numbers with your own motor and communication baselines so nothing slips through the cracks.

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Add a quick line to your intake form: 'Any neonatal or follow-up cytokine lab results available?' Request the values before you plan goals.

02At a glance

Intervention
not applicable
Design
systematic review
Population
developmental delay
Finding
not reported

03Original abstract

BACKGROUND: An exacerbated systemic inflammatory response has been associated with the occurrence of central nervous system injuries that may determine, in long term, motor, sensorial and cognitive disabilities. Persistence of this exacerbated inflammatory response seems to be involved in the pathophysiology of cerebral palsy (CP). METHODS: A systematic search was conducted in Bireme, Embase, PubMed and Scopus including studies that were published until August 2019. The key words used were "cerebral palsy", "brain injury", "inflammation", "oxidative stress", "cytokines", "chemokines", "neuropsychomotor development", "neurodevelopment outcomes" and "child". The quality of the eligible studies was determined according to the criteria suggested by the Newcastle-Ottawa Scale (NOS). RESULTS: Fourteen eligible studies aimed to investigate the association between peripheral inflammatory molecules and neurodevelopment in infants. The studies differed regarding CP-related risk factors and its classification. Inflammatory proteins were measured in blood, plasma, serum, cerebrospinal fluid or urine. In ten studies, higher circulating levels of cytokines, including IL-1β, IL-6, TNF and CXCL8/IL-8, were associated with abnormal neurological findings. CONCLUSION: The investigation of the potential association between inflammatory molecules and neurological development in children with CP requires further original studies in order to clarify the influence of prenatal and perinatal inflammation on neurological outcomes.

Research in developmental disabilities, 2019 · doi:10.1016/j.ridd.2019.103508