Suboptimal Nutrition and Low Physical Activity Are Observed Together with Reduced Plasma Brain-Derived Neurotrophic Factor (BDNF) Concentration in Children with Severe Cerebral Palsy (CP).

Solvejg Hansen,Jakob Lorentzen,Martin Jorsal,Jens Nielsen,Jessica Pingel,Bente Kiens,Frederikke Hendrich,Lin Pedersen

doi:10.3390/nu11030620

Abstract

Brain-derived neurotrophic factor (BDNF) is a mediator of exercise and nutrition-induced neural plasticity. In children with cerebral palsy (CP), neuromuscular deficits and mobility impairment have a negative impact on their physical activity level and nutritional status, but whether these children have reduced BDNF concentrations is unknown. Therefore, the aim of the present study was to investigate the plasma BDNF concentration, nutritional status, and physical activity level in children with mild to severe CP. Blood sampling, dietary registration, and questionnaires were completed for children with mild CP (gross motor function classification system (GMFCS) I–II, n = 31, age 10.6 ± 0.6 years), severe CP (GMFCS IV–V, n = 14, age 10.9 ± 1.1 years) and typically developed (TD) children (n = 22, age 10.9 ± 0.6 years). Children with severe CP had ~40% lower plasma BDNF concentration than TD children (p < 0.05). Furthermore, children with severe CP had lower daily physical activity level than TD children (p < 0.01), and a daily intake of energy, n-3 fatty acids, and dietary fibers that was only ~50% of TD (p > 0.001). Reduced plasma BDNF concentrations were observed in children with severe CP. This may be of significance for optimal neural growth and plasticity. This was observed together with low physical activity levels and a suboptimal intake of energy, n-3 fatty acids, and dietary fibers.

Highlights

There has been an intense focus on daily physical activity level and nutritional status in children the last two decades
cerebral palsy (CP) ranging from level I to II (CP I–II) and severe CP ranging from level IV to V (CP IV–V)
Body weight, and BMI in average and as z-scores did not differ between typically developed (TD) and CP I–II

Summary

Introduction

There has been an intense focus on daily physical activity level and nutritional status in children the last two decades. This is partly because of strong associations between sedentary behavior, suboptimal nutrition, and childhood obesity [1], and because physical activity and nutritional status can influence brain plasticity and function as well as learning and memory [2,3]. In children with cerebral palsy, neuromuscular deficit and mobility impairment have a negative impact on these parameters. Studies have reported lower levels of daily physical activity [9] and physical fitness [10,11,12] in children with CP compared to typically developed (TD) control children. A high risk of malnutrition due to the insufficient intake of dietary energy has been identified in children with CP in both high [13] and low/middle-income [14,15,16] countries

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