Adipose Tissue Infiltration of Bone Marrow and Skeletal Muscle in Children with Mild Spastic Cerebral Palsy

Abstract

Non-ambulatory children with severe cerebral palsy (CP) have a high degree of adipose tissue (AT) infiltration which could play a role in the development of insulin resistance and fractures. The objective of this study was to determine the degree of AT infiltration within the bone marrow cavity of the middle tibia and within the surrounding muscle in ambulatory children with mild spastic CP (5-11 y) compared to typically developing controls matched for age and sex (n = 8/group). The concentration of AT in the bone marrow and muscle, and the intermuscular, subfascial and subcutaneous AT volume, muscle volume, cortical bone volume and bone strength (i.e., section modulus, Z and polar moment of inertia, J) were estimated using magnetic resonance imaging. Children with CP vs. controls had a higher (P < 0.05) concentration of AT in the bone marrow (83 ± 2 % vs. 81 ± 2 %) and muscle (27 ± 7 % vs. 18 ± 5 %). Children with CP vs. controls also had higher (P < 0.05) subfascial AT (357 %), and lower muscle volume (40%), cortical bone volume (26 %), Z (31 %) and J (38 %). Although not statistically significant (P = 0.07), children with CP vs. controls also had higher intermuscular AT (391 %). Whether the high concentration of AT in bone marrow and muscle during childhood are early indicators of insulin resistance and future fracture requires further investigation. Supported by the NIH(Grant HD071397-01).