Thursday, May 8, 2025

Connections Between Cerebral Palsy, Malnutrition and Cognition

 

Connections Between Cerebral Palsy, Malnutrition and Cognition

A person holding a baby

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Image 1) My father holding my CP diagnosed younger brother in the NICU

Introduction

Imagine being a new parent and having a doctor tell you your child is diagnosed with cerebral palsy. The doctor further explains that the child may never walk, and cognitive abilities are questionable. This is the jarring reality that many parents have had to endure. Cerebral Palsy (CP) affects 2.1 out of every 1000 births worldwide. (Baggaley et al 2025 pg. 2) It is caused by damage to the brain or irregular development of motor controls within the brain. Despite numerous safety precautions, some forms of CP are not preventable, and its impacts affect many aspects of a person’s life. Connections between cerebral palsy, malnutrition, and cognition have been linked through studies conducted by research and medical professionals.

 

What is Cerebral Palsy?

Cerebral palsy is a group of motor impairment disorders that affect movement. There are three types of cerebral palsy. These are spastic paralysis, dyskinesia, and ataxia cerebral palsy. CP is often congenital, mearing it is present prior to, during or shortly after birth. It is caused by several factors including maternal infections, genetic predisposition, prenatal head injuries, and hypoxia. (Silva-Araújo et al 2024 pg. 1) Hypoxia, or oxygen deprivation, can occur utero by a host of concerns, included by not limited to, malformations that block blood supply, severe anemia, preeclampsia, placental issues, and even stroke. Brain areas most affected by cerebral palsy include the basil ganglia, motor cortex, and cerebellum. Damage to these areas of the brain affects a child’s motor abilities by inducing tremors, involuntary movements and postural instability.

 

Cerebral Palsy and Nutrition

Because cerebral palsy is a motor impairment, some movement is either impaired or entirely nonfunctional. This loss of motor movement means the neurons that embed themselves in skeletal muscle are either not functioning properly or are not sufficiently myelinated to send and receive the tiny electrical signals from the brain. Myelination is the development of myelin sheaths that insulate nerve fibers and allow brain transmissions to travel faster along neural pathways. In 2011, a study sought to find a solution to the problem of demyelination of neurons in children with CP. The study focused on levels of folate and vitamin B12. Both of these are vital for the myelinization cycle and the synthesis of S-adenosylmethionine (SAM). SAM is essential in the development of myelin sheaths. The study revealed that children with CP, even those with a gastrostomy feeding tube, were often severely malnourished. Researchers concluded that because muscle movement was compromised, those children may not have received adequate nutrition to allow DNA and neurons to be properly myelinated. (Schoendorfer et al 2012 pg. 768-769) Although this study found that children with CP can have difficulty obtaining sufficient nutrients, there are proven therapy programs that assist in developing skills and abilities necessary for simple movements. These include large and small movements at joints such hands, feet, wrists, ankles, and the jaw.

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Image 2) Picture of the myelin sheath on the axon of a neuron

 

Cerebral Palsy and Cognitive Ability

While many often connect cerebral palsy with cognitive issues, that is not always the case. Cerebral palsy is a motor impairment disorder that has very little connection with cognitive function. Alternatively, studies connecting malnutrition and reduced cognitive function exist. Researchers in India found that undernourished children were more likely to earn significantly lower scores on intelligence tests. Researchers further explained that during the first two years of life, children experience rapid brain growth. When coupled with malnutrition, brain growth can be stunted and negatively impact development. (Das et al 2023 pg.951) Effects of malnutrition can be seen in utero, but local and governmental programs such as food banks and Women and Infant Children (WIC) strive to provide adequate nutrition. Cerebral palsy patients who experience compromised muscle movement are at risk for malnutrition. When cerebral palsy patients suffer malnutrition, cognitive ability can be compromised.

 

Parents of Cerebral Palsy Diagnosed Children

While having a child diagnosed with cerebral palsy can be extremely difficult for parents, support programs have been beneficial to some. Researchers asked parents to reflect on their experience raising a child with CP and found that most focused on the macrosystem for their child. The macrosystem refers to cultural and societal norms, nationality, and even the legal system that influence a person’s development. Parents in this study often felt there were insufficient community support systems readily available to assist them and their child to be successful. Conversely, some parents were satisfied with the support options available and credited those programs with their child’s success. Parents of CP children also experience relationship issues. Marital strain and social isolation are common among this population of parents. (Reid et al 2011 pg.171-177)

 

Conclusion

While the diagnosis of cerebral palsy can be jarring to receive, it does not have to be devastating to the parents or child. Numerous medical professionals and researchers continue to work tirelessly to learn new and effective ways to address issues such as motor impairment, nutritional deficits, and cognitive dysfunction. In this process, parents are not overlooked. Their sacrifice and dedication are essential in mitigating the challenges their children face. It is important that parents, children and the medical community continue to hold on to hope as experimental treatments and therapies are discovered and implemented in hospitals and clinics around the world.

 

By Aden Holder

I am a Nursing student at Franciscan University in Baton Rouge, Louisiana. I am hoping to earn a BSN and RN while also pursuing a minor in psychology. Cerebral palsy is a condition near to my heart because my little brother was diagnosed when he was six months old. My parents were unprepared to receive the neurologist’s opinion that their tiny preemie would never walk or live independently. Despite feeling shocked and defeated by the diagnosis, my mother was committed to limiting the negative effects CP would have on his life. Today, he plays varsity baseball, maintains a 3.5 GPA, and has dreams of becoming a lawyer. Cerebral palsy has presented challenges in his life, but he never allowed them to define him. No one would ever look at him today and know he was diagnosed with cerebral palsy.


Final Thoughts

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Works Cited

Schoendorfer, N. C., Obeid, R., Moxon-Lester, L., Sharp, N., Vitetta, L., Boyd, R. N., & Davies, P. S. W. (2012). Methylation capacity in children with severe cerebral palsy. European Journal of Clinical Investigation, 42(7), 768–776. https://doi-org.ezproxy.franu.edu/10.1111/j.1365-2362.2011.02644.x


Das, B. K., & Kaushik, J. S. (2023). Cognitive Development in Children With Malnutrition: A 50-Year Tale. Indian Pediatrics, 60(11), 951–953.

 

Reid, A., Imrie, H., Brouwer, E., Clutton, S., Evans, J., Russell, D., & Bartlett, D. (2011). “If I Knew Then What I Know Now”: Parents’ Reflections on Raising a Child with Cerebral Palsy. Physical & Occupational Therapy in Pediatrics, 31(2), 169–183. https://doi-org.ezproxy.franu.edu/10.3109/01942638.2010.540311

 

Baggaley, J., Seiboth, C., Rapley, T., & Basu, A. (2025). From eligibility to diagnosis: candidacy and the complex journey of cerebral palsy diagnosis within primary care. BMC Pediatrics, 25(1), 112. https://doi-org.ezproxy.franu.edu/10.1186/s12887-025-05455-5

 

Silva-Araújo, E. R., Toscano, A. E., Gouveia, H. J. C. B., & Manhães-de-Castro, R. (2024). Riboflavin as a potential new therapeutic agent for perinatal encephalopathies caused by cerebral oxygen deprivation. Nutritional Neuroscience, 1–4. https://doi-org.ezproxy.franu.edu/10.1080/1028415x.2024.2415087

 

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