The goal of this planning grant is to form an interdisciplinary collaboration between scientists at the University of California, San Diego and Beijing Normal University, People's Republic of China (P.R. China) to increase the capacity for the study of neurodevelopmental disorders in P.R. China and advance the basic understanding of the effect that early neural disruption has on cognitive development in children. This grant focuses on the neurodevelopmental disorder of cerebral palsy (CP) in its most common form, spastic diplegia (SDCP). SDCP is a motor disorder of spasticity in the lower limbs that results from prenatal white matter lesions that disrupt cortical-spinal motor fibers. Since SDCP is diagnosed based on motor deficits and has been mainly studied as a motor disorder, relatively little is known about its effects on cognitive and ongoing brain development. CP is internationally prevalent and in P.R. China, which has the world's largest national population, an incident rate of 3.250 presents an urgent problem. At the same time, the scale of the population and high occurrence provides an opportunity to study SDCP as a model of neurodevelopmental pathology and to examine the effects of early and frank disruption of brain growth on cognitive outcome.
The specific aims of this grant are to assist in building an infrastructure for neuropsychology and developmental cognitive neuroscience research with pediatric patient populations in P.R. China and to conduct pilot studies to demonstrate the feasibility of assessing cognitive development in children with SDCP in P.R. China. This project studies the profile of cognitive abilities, and their functional and structural neural correlates in a well defined population of children with SDCP. The study focuses on children's visuospatial abilities, shown to be compromised with SDCP, and will examine the underlying functional organization of visuospatial processes. To determine whether or not children's cognitive impairments are specific to visuospatial processing, we will also examine language performance, which has been characterized as being spared with SDCP. The examination of cognitive abilities uses a combination of standardized tests and experimental measures that are specifically designed to probe visuospatial and language abilities. The functional organization of the brain for mediation of visuospatial processes will be examined with functional magnetic resonance imaging (FMRI) and the structural integrity of connective white matter tracts will be assessed with diffusion tensor magnetic resonance imaging. The long-term goal of the project is to lay the foundation for a future R01 grant that will propose interventions that can be tested empirically and are designed to facilitate cognitive development in children with SDCP. The findings from this project will also inform our knowledge of the fundamental principles of brain development and plasticity following early insult using CP as one model of inquiry.
This project aims to increase our understanding of cognitive and brain development in an internationally prevalent neurodevelopmental disorder, spastic diplegia cerebral palsy. Since little is known about the cognitive impairments indicated in this motor disorder, characterizing these deficits is an important first step toward intervention. This project will also inform our knowledge of the general principles of brain development and plasticity following early insult.