Bone health in children with severe cerebral palsy

Vincent Barbier; Vincent Goeb; Richard Gouron; Severine Fritot; Romuald Mentaverri; Céline Klein

doi:10.3389/fped.2023.1264111

Bone health in children with severe cerebral palsy

Front Pediatr. 2023 Nov 29:11:1264111. doi: 10.3389/fped.2023.1264111. eCollection 2023.

Authors

Vincent Barbier^{1

2

3

4}, Vincent Goeb⁵, Richard Gouron^{4

6}, Severine Fritot³, Romuald Mentaverri^{4

7}, Céline Klein^{4

6}

Affiliations

¹ Department of Paediatric Physical Medicine and Rehabilitation, Amiens University Hospital and Jules Verne University of Picardie, Amiens, France.
² Three Valleys Rehabilitation Center, Victor Pauchet Group, Corbie, France.
³ Department of Paediatric Physical Medicine and Rehabilitation, Corbie Hospital, Corbie, France.
⁴ MP3CV-UR-UPJV 7517, CURS, Amiens University Hospital, Jules Verne University of Picardie, Amiens, France.
⁵ Department of Rheumatology, Amiens University Hospital and Jules Verne University of Picardie, Amiens, France.
⁶ Department of Paediatric Orthopaedic Surgery, Amiens University Hospital and Jules Verne University of Picardie, Amiens, France.
⁷ Department of Biochemistry and Endocrine Biology, Amiens University Hospital, Jules Verne University of Picardie, Amiens, France.

Abstract

Aim: To describe bone health and associated factors in children with severe cerebral palsy.

Method: In a retrospective, single-centre study, we performed a comprehensive bone evaluation (including clinical, densitometric and bone biomarker assessments) of children with severe cerebral palsy.

Results: None of the 19 included children had a normal BMC^TBLH Z score, and only one had a BMD^TBLH Z score greater than -2. Six children had a BMD^LS Z score greater than -2. The bone biomarker data were suggestive of excessive bone remodelling. Levels of bone remodelling markers factors and densitometric variables were not significantly related. Age, weight and pubertal stage were significantly related to bone mass.

Discussion: Our results highlights the insufficient increase in bone mass with age (probably due to excessive bone remodelling) and confirms the high prevalence of low bone mineral density in children with severe cerebral palsy. Possible preventive measures might include calcium + vitamin D supplementation and the systematic management of underweight and delayed puberty. Bone remodelling markers might be of value for follow-up.

Keywords: bone; bone fragility; cerebral palsy; low bone mineral density; osteoporosis.

Grants and funding

The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.