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Growth Hormone and the Auditory Pathway: Neuromodulation and Neuroregeneration. Int J Mol Sci 2021; 22:ijms22062829. [PMID: 33799503 PMCID: PMC7998811 DOI: 10.3390/ijms22062829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 02/26/2021] [Accepted: 03/05/2021] [Indexed: 02/06/2023] Open
Abstract
Growth hormone (GH) plays an important role in auditory development during the embryonic stage. Exogenous agents such as sound, noise, drugs or trauma, can induce the release of this hormone to perform a protective function and stimulate other mediators that protect the auditory pathway. In addition, GH deficiency conditions hearing loss or central auditory processing disorders. There are promising animal studies that reflect a possible regenerative role when exogenous GH is used in hearing impairments, demonstrated in in vivo and in vitro studies, and also, even a few studies show beneficial effects in humans presented and substantiated in the main text, although they should not exaggerate the main conclusions.
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Growth Hormone (GH) and Rehabilitation Promoted Distal Innervation in a Child Affected by Caudal Regression Syndrome. Int J Mol Sci 2017; 18:ijms18010230. [PMID: 28124993 PMCID: PMC5297859 DOI: 10.3390/ijms18010230] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 01/17/2017] [Accepted: 01/19/2017] [Indexed: 02/02/2023] Open
Abstract
Caudal regression syndrome (CRS) is a malformation occurring during the fetal period and mainly characterized by an incomplete development of the spinal cord (SC), which is often accompanied by other developmental anomalies. We studied a 9-month old child with CRS who presented interruption of the SC at the L2–L3 level, sacral agenesis, a lack of innervation of the inferior limbs (flaccid paraplegia), and neurogenic bladder and bowel. Given the known positive effects of growth hormone (GH) on neural stem cells (NSCs), we treated him with GH and rehabilitation, trying to induce recovery from the aforementioned sequelae. The Gross Motor Function Test (GMFM)-88 test score was 12.31%. After a blood analysis, GH treatment (0.3 mg/day, 5 days/week, during 3 months and then 15 days without GH) and rehabilitation commenced. This protocol was followed for 5 years, the last GH dose being 1 mg/day. Blood analysis and physical exams were performed every 3 months initially and then every 6 months. Six months after commencing the treatment the GMFM-88 score increased to 39.48%. Responses to sensitive stimuli appeared in most of the territories explored; 18 months later sensitive innervation was complete and the patient moved all muscles over the knees and controlled his sphincters. Three years later he began to walk with crutches, there was plantar flexion, and the GMFM-88 score was 78.48%. In summary, GH plus rehabilitation may be useful for innervating distal areas below the level of the incomplete spinal cord in CRS. It is likely that GH acted on the ependymal SC NSCs, as the hormone does in the neurogenic niches of the brain, and rehabilitation helped to achieve practically full functionality.
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Devesa J, Almengló C, Devesa P. Multiple Effects of Growth Hormone in the Body: Is it Really the Hormone for Growth? Clin Med Insights Endocrinol Diabetes 2016; 9:47-71. [PMID: 27773998 PMCID: PMC5063841 DOI: 10.4137/cmed.s38201] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 09/12/2016] [Accepted: 09/19/2016] [Indexed: 12/17/2022] Open
Abstract
In this review, we analyze the effects of growth hormone on a number of tissues and organs and its putative role in the longitudinal growth of an organism. We conclude that the hormone plays a very important role in maintaining the homogeneity of tissues and organs during the normal development of the human body or after an injury. Its effects on growth do not seem to take place during the fetal period or during the early infancy and are mediated by insulin-like growth factor I (IGF-I) during childhood and puberty. In turn, IGF-I transcription is dependent on an adequate GH secretion, and in many tissues, it occurs independent of GH. We propose that GH may be a prohormone, rather than a hormone, since in many tissues and organs, it is proteolytically cleaved in a tissue-specific manner giving origin to shorter GH forms whose activity is still unknown.
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Affiliation(s)
- Jesús Devesa
- Scientific Direction, Medical Center Foltra, Teo, Spain
| | | | - Pablo Devesa
- Research and Development, Medical Center Foltra, 15886-Teo, Spain
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Kiebzak W, Żurawski A, Dwornik M. Vojta method in the treatment of developmental hip dysplasia - a case report. Ther Clin Risk Manag 2016; 12:1271-6. [PMID: 27578980 PMCID: PMC5001670 DOI: 10.2147/tcrm.s106014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Developmental dysplasia of the hip joint is one of the most common congenital defects and often results in functional and structural disorders. Such cases particularly demand optimizing therapeutic effects and maximally reducing the duration of therapy. Purpose The aim of this case report is to present the therapeutic process in a child with developmental hip dysplasia. Case report This is a case report of a female child with a birth weight of 2,800 g and an Apgar score of 9 points born to a gravida 3 para 3 mother at 37 weeks. The child was delivered by cesarean section, and the pregnancy was complicated by oligohydramnios. Subluxation of the left hip joint was diagnosed by an orthopedist in the third month of life. The treatment followed was the Vojta method (the first phase of reflex turning and reflex crawling). Results During the 6 weeks of the Vojta treatment, the left half of the femoral head was centralized, and the process of formation of the hip joint acetabulum was influenced effectively enough to change the acetabulum’s Graff type from the baseline D to IIb after 41 days of treatment. Conclusion The diagnostic work-up of congenital hip joint dysplasia should involve a physiotherapist who will investigate the child’s neuromuscular coordination, in addition to a neonatologist and a pediatrician. The therapy for a disorder of hip joint development of neuromotor origin should involve the application of global patterns according to Vojta. Children with congenital dysplasia of the hip joint should commence rehabilitation as early as possible.
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Affiliation(s)
- Wojciech Kiebzak
- Center for Pediatrics, Regional Hospital in Kielce, Kielce, Poland; Department of Physiotherapy, Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Arkadiusz Żurawski
- Department of Physiotherapy, Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Michał Dwornik
- Department of Osteopathic Medicine and Physiotherapy, Medical College of Podkowa Lesna, Podkowa Lesna, Poland
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Devesa J, Lema H, Zas E, Munín B, Taboada P, Devesa P. Learning and Memory Recoveries in a Young Girl Treated with Growth Hormone and Neurorehabilitation. J Clin Med 2016; 5:jcm5020014. [PMID: 26821051 PMCID: PMC4773770 DOI: 10.3390/jcm5020014] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Revised: 01/16/2016] [Accepted: 01/19/2016] [Indexed: 11/16/2022] Open
Abstract
Background-To describe the results obtained after treating a non growth hormone-deficient 10-year-old girl who suffered asphyxia during delivery, resulting in important cognitive deficits, with growth hormone (GH) and neurorehabilitation. Methods-GH was administered (mg/day) at doses of 0.5 over three months followed by 0.9, every two weeks over three months, and then alternating 1.2 three days/week and 0.3 two days/week. Neurorehabilitation consisted of daily sessions of neurostimulation, speech therapy, occupational therapy and auditive stimulation. Treatment lasted nine months. Results-Scores obtained in all the areas treated showed that, at discharge, the patient clearly increased her cognitive abilities, memory and language competence index; her intelligence quotient score increased from 51 to 80, and the index of functional independence measure reached a value of 120 over 126 (maximal value). Conclusions-This case suggests that GH administration may play a role in improving cognitive deficits during neurorehabilitation in children with brain damage suffered during delivery. This agrees with the known effects of GH on cognition.
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Affiliation(s)
- Jesús Devesa
- Medical Centre Foltra, Travesía de Montouto 24, Teo 15886, Spain.
- Department of Physiology, School of Medicine, University of Santiago de Compostela, Santiago de Compostela 15710, Spain.
| | - Hortensia Lema
- Medical Centre Foltra, Travesía de Montouto 24, Teo 15886, Spain.
| | - Eva Zas
- Medical Centre Foltra, Travesía de Montouto 24, Teo 15886, Spain.
| | - Borja Munín
- Medical Centre Foltra, Travesía de Montouto 24, Teo 15886, Spain.
| | - Pilar Taboada
- Medical Centre Foltra, Travesía de Montouto 24, Teo 15886, Spain.
| | - Pablo Devesa
- Medical Centre Foltra, Travesía de Montouto 24, Teo 15886, Spain.
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Devesa J, Díaz-Getino G, Rey P, García-Cancela J, Loures I, Nogueiras S, Hurtado de Mendoza A, Salgado L, González M, Pablos T, Devesa P. Brain Recovery after a Plane Crash: Treatment with Growth Hormone (GH) and Neurorehabilitation: A Case Report. Int J Mol Sci 2015; 16:30470-82. [PMID: 26703581 PMCID: PMC4691184 DOI: 10.3390/ijms161226244] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Revised: 12/12/2015] [Accepted: 12/16/2015] [Indexed: 12/20/2022] Open
Abstract
The aim of this study is to describe the results obtained after growth hormone (GH) treatment and neurorehabilitation in a young man that suffered a very grave traumatic brain injury (TBI) after a plane crash. Methods: Fifteen months after the accident, the patient was treated with GH, 1 mg/day, at three-month intervals, followed by one-month resting, together with daily neurorehabilitation. Blood analysis at admission showed that no pituitary deficits existed. At admission, the patient presented: spastic tetraplegia, dysarthria, dysphagia, very severe cognitive deficits and joint deformities. Computerized tomography scanners (CT-Scans) revealed the practical loss of the right brain hemisphere and important injuries in the left one. Clinical and blood analysis assessments were performed every three months for three years. Feet surgery was needed because of irreducible equinovarus. Results: Clinical and kinesitherapy assessments revealed a prompt improvement in cognitive functions, dysarthria and dysphagia disappeared and three years later the patient was able to live a practically normal life, walking alone and coming back to his studies. No adverse effects were observed during and after GH administration. Conclusions: These results, together with previous results from our group, indicate that GH treatment is safe and effective for helping neurorehabilitation in TBI patients, once the acute phase is resolved, regardless of whether or not they have GH-deficiency (GHD).
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Affiliation(s)
- Jesús Devesa
- Scientific Direction Medical Centre Foltra, Teo 15886, Spain.
- Department of Physiology, School of Medicine, University of Santiago de Compostela, Santiago de Compostela 15710, Spain.
| | | | - Pablo Rey
- Scientific Direction Medical Centre Foltra, Teo 15886, Spain.
| | | | - Iria Loures
- Scientific Direction Medical Centre Foltra, Teo 15886, Spain.
| | - Sonia Nogueiras
- Scientific Direction Medical Centre Foltra, Teo 15886, Spain.
| | | | - Lucía Salgado
- Scientific Direction Medical Centre Foltra, Teo 15886, Spain.
| | - Mónica González
- Scientific Direction Medical Centre Foltra, Teo 15886, Spain.
| | - Tamara Pablos
- Scientific Direction Medical Centre Foltra, Teo 15886, Spain.
| | - Pablo Devesa
- Scientific Direction Medical Centre Foltra, Teo 15886, Spain.
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Malheiros SRP, Monteiro CBDM, da Silva TD, Torriani-Pasin C, de Andrade MSR, Valenti VE, Raimundo RD, Roosch A, Rodrigues LMR, Manhabusque KV, Camargo RCT, Drezzet J, Quadrado VH, de Abreu LC. Functional capacity and assistance from the caregiver during daily activities in Brazilian children with cerebral palsy. Int Arch Med 2013; 6:1. [PMID: 23302576 PMCID: PMC3599980 DOI: 10.1186/1755-7682-6-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Accepted: 12/15/2012] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Cerebral Palsy (CP) presents changes in posture and movement as a core characteristic, which requires multiprofessional clinical treatments during children's habilitation or rehabilitation. Besides clinical treatment, it is fundamental that professionals use evaluation systems to quantify the difficulties presented to the individual and their families in their daily lives. We aimed to investigate the functional capacity of individuals with CP and the amount of assistance required by the caregiver in day-to-day activities. METHODS Twenty patients with CP, six-year-old on average, were evaluated. The Pediatric Evaluation Inventory of Incapacities was used (PEDI - Pediatric Evaluation Disability Inventory), a system adapted for Brazil that evaluates child's dysfunction in three 3 dimensions: self-care, mobility and social function. To compare the three areas, repeated measures analysis of variance (ANOVA) were used. RESULTS We found the following results regarding the functional capacity of children: self-care, 27.4%, ±17.5; mobility, 25.8%, ±33.3 and social function, 36.3%, ±27.7. The results of the demand of aid from the caregiver according to each dimension were: self-care, 9.7%, ±19.9; mobility, 14.1%, ± 20.9 and social function, 19.8%, ±26.1. CONCLUSION We indicated that there was no difference between the performance of the subjects in areas of self-care, mobility and social function considering the functional skills and assistance required by the caregiver.
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Affiliation(s)
- Silvia RP Malheiros
- Faculdade Metropolitanas Unidas (FMU), Av. Santo Amaro 1239. 04506-000, São Paulo, SP, Brazil
- Laboratório de Escrita Científica, Faculdade de Medicina do ABC, Av. Príncipe de Gales, 821. 09060-650, Santo André, SP, Brazil
| | - Carlos B de Mello Monteiro
- Escola de Artes, Ciência e Humanidades da Universidade de São Paulo (USP), Rua Arlindo Béttio, 1000. 03828-000, São Paulo, SP, Brazil
- Laboratório de Escrita Científica, Faculdade de Medicina do ABC, Av. Príncipe de Gales, 821. 09060-650, Santo André, SP, Brazil
- Departamento de Saúde Materno-infantil, Faculdade de Saúde Pública, USP, Av. Dr. arnaldo, 715. 01246-904, São Paulo, SP, Brazil
| | - Talita Dias da Silva
- Escola de Artes, Ciência e Humanidades da Universidade de São Paulo (USP), Rua Arlindo Béttio, 1000. 03828-000, São Paulo, SP, Brazil
- Laboratório de Escrita Científica, Faculdade de Medicina do ABC, Av. Príncipe de Gales, 821. 09060-650, Santo André, SP, Brazil
| | - Camila Torriani-Pasin
- Escola de Artes, Ciência e Humanidades da Universidade de São Paulo (USP), Rua Arlindo Béttio, 1000. 03828-000, São Paulo, SP, Brazil
| | - Michele SR de Andrade
- Escola de Artes, Ciência e Humanidades da Universidade de São Paulo (USP), Rua Arlindo Béttio, 1000. 03828-000, São Paulo, SP, Brazil
| | - Vitor E Valenti
- Laboratório de Escrita Científica, Faculdade de Medicina do ABC, Av. Príncipe de Gales, 821. 09060-650, Santo André, SP, Brazil
- Departamento de Fonoaudiologia, Faculdade de Filosofia e Ciências, Universidade Estadual Paulista, UNESP, Av. Hygino Muzzi Filho, 737, 17525-900, Marília, SP, Brazil
| | - Rodrigo Daminello Raimundo
- Escola de Artes, Ciência e Humanidades da Universidade de São Paulo (USP), Rua Arlindo Béttio, 1000. 03828-000, São Paulo, SP, Brazil
- Laboratório de Escrita Científica, Faculdade de Medicina do ABC, Av. Príncipe de Gales, 821. 09060-650, Santo André, SP, Brazil
| | - Anelise Roosch
- Laboratório de Escrita Científica, Faculdade de Medicina do ABC, Av. Príncipe de Gales, 821. 09060-650, Santo André, SP, Brazil
- Departamento de Saúde Materno-infantil, Faculdade de Saúde Pública, USP, Av. Dr. arnaldo, 715. 01246-904, São Paulo, SP, Brazil
| | - Luciano MR Rodrigues
- Laboratório de Escrita Científica, Faculdade de Medicina do ABC, Av. Príncipe de Gales, 821. 09060-650, Santo André, SP, Brazil
| | - Katia Valeria Manhabusque
- Laboratório de Escrita Científica, Faculdade de Medicina do ABC, Av. Príncipe de Gales, 821. 09060-650, Santo André, SP, Brazil
- Departamento de Saúde Materno-infantil, Faculdade de Saúde Pública, USP, Av. Dr. arnaldo, 715. 01246-904, São Paulo, SP, Brazil
| | - Regina Céliac Trindade Camargo
- Laboratório de Escrita Científica, Faculdade de Medicina do ABC, Av. Príncipe de Gales, 821. 09060-650, Santo André, SP, Brazil
| | - Jefferson Drezzet
- Laboratório de Escrita Científica, Faculdade de Medicina do ABC, Av. Príncipe de Gales, 821. 09060-650, Santo André, SP, Brazil
| | - Virginia Helena Quadrado
- Escola de Artes, Ciência e Humanidades da Universidade de São Paulo (USP), Rua Arlindo Béttio, 1000. 03828-000, São Paulo, SP, Brazil
| | - Luiz Carlos de Abreu
- Laboratório de Escrita Científica, Faculdade de Medicina do ABC, Av. Príncipe de Gales, 821. 09060-650, Santo André, SP, Brazil
- Departamento de Saúde Materno-infantil, Faculdade de Saúde Pública, USP, Av. Dr. arnaldo, 715. 01246-904, São Paulo, SP, Brazil
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Wen Z, Zeng W, Dai J, Zhou X, Yang C, Duan F, Liu Y, Yang H, Yuan L. Paravertebral fascial massage promotes brain development of neonatal rats via the insulin-like growth factor 1 pathway. Neural Regen Res 2012; 7:1185-91. [PMID: 25722713 PMCID: PMC4340037 DOI: 10.3969/j.issn.1673-5374.2012.15.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2011] [Accepted: 03/20/2012] [Indexed: 01/31/2023] Open
Abstract
Massage in traditional Chinese medicine can promote body and brain development of premature and normal newborn infants. In the present study, neonatal rats (1 day old) underwent paravertebral fascial massage (15 consecutive days), followed by subcutaneous injection of insulin-like growth factor 1 receptor antagonist, JB1 (9 consecutive days). Paravertebral fascial massage significantly increased insulin-like growth factor 1 expression and cell proliferation in the subventricular zone of the lateral ventricle and dentate gyrus of the hippocampus. However, JB1 inhibited this increase. Results suggest that paravertebral fascial massage can promote brain development of neonatal rats via the insulin-like growth factor 1 pathway.
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Affiliation(s)
- Zhongqiu Wen
- Key Laboratory of Tissue Construction and Detection of Guangdong Province, Department of Anatomy, Southern Medical University, Guangzhou 510515, Guangdong Province, China
| | - Wenqin Zeng
- Key Laboratory of Tissue Construction and Detection of Guangdong Province, Department of Anatomy, Southern Medical University, Guangzhou 510515, Guangdong Province, China
| | - Jingxing Dai
- Key Laboratory of Tissue Construction and Detection of Guangdong Province, Department of Anatomy, Southern Medical University, Guangzhou 510515, Guangdong Province, China
| | - Xin Zhou
- Key Laboratory of Tissue Construction and Detection of Guangdong Province, Department of Anatomy, Southern Medical University, Guangzhou 510515, Guangdong Province, China
| | - Chun Yang
- Key Laboratory of Tissue Construction and Detection of Guangdong Province, Department of Anatomy, Southern Medical University, Guangzhou 510515, Guangdong Province, China
| | - Fuhua Duan
- Key Laboratory of Tissue Construction and Detection of Guangdong Province, Department of Anatomy, Southern Medical University, Guangzhou 510515, Guangdong Province, China
| | - Yufeng Liu
- Key Laboratory of Tissue Construction and Detection of Guangdong Province, Department of Anatomy, Southern Medical University, Guangzhou 510515, Guangdong Province, China
| | - Huiying Yang
- Key Laboratory of Tissue Construction and Detection of Guangdong Province, Department of Anatomy, Southern Medical University, Guangzhou 510515, Guangdong Province, China
| | - Lin Yuan
- Key Laboratory of Tissue Construction and Detection of Guangdong Province, Department of Anatomy, Southern Medical University, Guangzhou 510515, Guangdong Province, China
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Hamza RT, Ismail MA, Hamed AI. Growth hormone deficiency in children and adolescents with cerebral palsy: relation to gross motor function and degree of spasticity. Pak J Biol Sci 2011; 14:433-40. [PMID: 21902055 DOI: 10.3923/pjbs.2011.433.440] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Children with Cerebral Palsy (CP) often have poor linear growth during childhood with short final height. Thus, we aimed to assess serum growth hormone (GH), insulin like growth factor-1 (IGF-1) and insulin like growth factor binding protein-3 (IGFBP-3) levels among CP patients and their relation to each of gross motor function and degree of spasticity. Fifty CP children and adolescents were studied in comparison to 50 healthy age-, sex- and pubertal stage-matched children and adolescents. All subjects were subjected to clinical evaluation, Intelligence Quotient (IQ) assessment and measurement of serum GH, IGF-1 and IGFBP-3. All auxological and hormonal parameters were significantly lower among cases. Fifty two% of cases were GH-deficient and 62% had reduced IGF-land IGFBP-3 levels. Gross Motor Function Measure- 88 (GMFM-88) score correlated negatively with each of basal (r = -0.71, p = 0.02) and peak stimulated GH (r =-0.88, p = <0.001); IGF-1 (r = -0.64, p = 0.04) and IGFBP-3 (r = -0.69, p = 0.031). There were significant negative correlations between the degree of spasticity assessed by Modified Ashworth Scale and each of basal (r = -0.61, p = 0.032) and peak stimulated GH (r = -0.78, p = 0.01); IGF-1 (r = -0.65, p = 0.041) and IGFBP-3 (r = -0.62, p = 0.035). Growth Hormone Deficiency (GHD) is prevalent in children with CP and could be one of the causes of their short stature.
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Affiliation(s)
- Rasha T Hamza
- Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Devesa J, Alonso B, Casteleiro N, Couto P, Castañón B, Zas E, Reimunde P. Effects of recombinant growth hormone (GH) replacement and psychomotor and cognitive stimulation in the neurodevelopment of GH-deficient (GHD) children with cerebral palsy: a pilot study. Ther Clin Risk Manag 2011; 7:199-206. [PMID: 21691590 PMCID: PMC3116807 DOI: 10.2147/tcrm.s21403] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2011] [Indexed: 12/02/2022] Open
Abstract
Cerebral palsy (CP) is the main cause of physical disability in childhood and is an important health issue that has a strong socioeconomic impact. There is no effective treatment for CP and therapeutic approaches report only partial benefits for affected people. In this study we assessed the effects of growth hormone (GH) treatment combined with psychomotor and cognitive stimulation in the neurodevelopment of children with CP and GH deficiency (GHD). The study was carried out in 11 patients (7 boys and 4 girls; 4.12 ± 1.31 years) with GHD and CP who were treated with recombinant GH (rGH) and psychomotor and cognitive stimulation during 2 months. Battelle Developmental Inventory Screening Test (BDIST) was performed 2 months before commencing GH treatment, just before commencing GH administration, and after 2 months of combined treatment involving GH and cognitive stimulation. Psychomotor and cognitive status did not change during the period in which only cognitive stimulation was performed; however, significant improvements in personal and social skills, adaptive behavior, gross motor skills and total psychomotor abilities, receptive and total communication, cognitive skills and in the total score of the test (P < 0.01), and in fine motor skills and expressive communication (P < 0.02) were observed after the combined treatment period. Therefore, GH replacement together with psychomotor and cognitive stimulation seem to be useful for the appropriate neurodevelopment of children with GHD and CP.
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Affiliation(s)
- Jesús Devesa
- Medical Center "Proyecto Foltra", Cacheiras (Teo), A Coruña, Spain
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