Abstract

Cerebral palsy (CP) is a common pediatric neurodevelopmental disorder, frequently resulting in motor and developmental deficits and often accompanied by cognitive impairments. A regular pathobiological hallmark of CP is oligodendrocyte maturation impairment resulting in white matter (WM) injury and reduced axonal myelination. Regeneration therapies based on cell replacement are currently limited, but neural precursor cells (NPCs), as cellular support for myelination, represent a promising regeneration strategy to treat CP, although the transplantation parameters (e.g., timing, dosage, mechanism) remain to be determined. We optimized a hemiplegic mouse model of neonatal hypoxia-ischemia that mirrors the pathobiological hallmarks of CP and transplanted NPCs into the corpus callosum (CC), a major white matter structure impacted in CP patients. The NPCs survived, engrafted, and differentiated morphologically in male and female mice. Histology and MRI showed repair of lesioned structures. Furthermore, electrophysiology revealed functional myelination of the CC (e.g., restoration of conduction velocity), while cylinder and CatWalk tests demonstrated motor recovery of the affected forelimb. Endogenous oligodendrocytes, recruited in the CC following transplantation of exogenous NPCs, are the principal actors in this recovery process. The lack of differentiation of the transplanted NPCs is consistent with enhanced recovery due to an indirect mechanism, such as a trophic and/or “bio-bridge” support mediated by endogenous oligodendrocytes. Our work establishes that transplantation of NPCs represents a viable therapeutic strategy for CP treatment, and that the enhanced recovery is mediated by endogenous oligodendrocytes. This will further our understanding and contribute to the improvement of cellular therapeutic strategies.

Highlights

  • Cerebral palsy (CP) is an overarching term encompassing a variety of movement disorders that manifest early in childhood

  • neural precursor cells (NPCs) transplanted at PND21 into the injured corpus callosum (CC) (Fig. 2A) survived for up to 19 weeks (Fig. 2B–I)

  • Transplanted NPCs migrated through the CC, colonized the injury site, and engrafted in the brain tissue, with an initial change in shape at day 4 (PND25)

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Summary

Introduction

Cerebral palsy (CP) is an overarching term encompassing a variety of movement disorders that manifest early in childhood. A common pathologic cause of CP is periventricular leukomalacia (PVL), which mainly results from hypoxiaischemia and infection/inflammation (Khwaja and Volpe, 2008). The periventricular region is highly vascularized and prone to injury following cerebral blood flow alteration, occasionally leading to hemorrhage (De Reuck, 1971; Volpe, 2009a,b). The unilateral injury to one brain hemisphere by PVL results in hemiplegic CP, characterized by the paralysis (hemiplegia) or weakening (hemiparesis) of one side of the body. PVL frequently affects white matter (WM) structures, resulting in failed myelination of axons connecting different brain regions and leading to cognitive and motor deficiencies (Coq et al, 2016; Back, 2017; Sampaio-Baptista and Johansen-Berg, 2017). WM injury is characterized by astrogliosis, microgliosis, and hypo-myelination, due to oligodendrocyte (OL) maturation disruption (Khwaja and Volpe, 2008; Volpe, 2009a,b; Buser et al, 2012; Back and Miller, 2014)

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