Hypercapnic hypoxia improves cognitive and motor functions of children with cerebral palsy

ABSTRACT

A randomized, triple-blind, placebo-controlled trial involving 42 patients between 3 and 7 years of age with spastic cerebral palsy was performed. For the treatment test group (n=22), daily respiratory exercises with hypercapnic hypoxia were performed using a Carbonic training apparatus for 20 minutes per day; a total of 14 to 16 sessions were performed. Before the start of the study and the day after training was completed, the patients underwent neurological and neurophysiological examinations (electroencephalography, magnetic stimulation of the pyramidal tract, and cognitive potentials Р300).The evoked potentials showed a decrease in the peak latency of the P3 component of the test group after treatment (302 ms) that was more pronounced than that of the placebo group (305 ms; p<0.05). Magnetic stimulation showed that hypercapnic hypoxic training resulted in reductions in central motor conduction time by 2.2 to 2.5 ms (p<0.05) and in the excitation threshold of the motor cortex by 12% to 16% (р<0.01) depending on the lateralization; The strategy of adjusting to hypercapnic hypoxia, either unfavorable (hyperventilation and avoidance) or favorable (homeostatic with the achievement of preset values for hypercapnia and hypoxia), did not change during the process of training in the placebo group; however, it shifted considerably toward favorable (from 33% to 57%; р<0.05) in the test group.Respiratory training with hypercapnic hypoxia can have a positive impact on the functional state of the nervous system of children with cerebral palsy and can be considered a method of improving the efficiency of standard therapy.              

KEYWORDS:

• hypoxia
• hypercapnia
• rehabilitation
• cerebral palsy
• neuroprotection

Disclosure statement

No potential conflict of interest was reported by the author(s).

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

The study was supported by a grant from the Russian Foundation for Basic Research (project no. 1 5-44-04169).

Notes on contributors

Vladimir Kulikov

Vladimir Kulikov - Professor, Doctor of Medical Sciences, Advisor to the Rector of the Altai State Medical University, Barnaul, Russia.

Pavel Tregub

Pavel Tregub – Candidate of Medical Sciences, Researcher, Laboratory of Experimental Neurocytology, Scientific Center of Neurology, Moscow, Russia.

Dmitry Parshin

Dmitry Parshin – neurologist, Regional Psychoneurological Children's Sanatorium, Barnaul, Russia.

Yulia Smirnova

Yuliya Smirnova - Doctor of Medical Sciences, Pediatrician, Head of the Neurophysiological Laboratory of the Altai Regional Clinical Center for Maternal and Child Health, Barnaul, Russia.

Konstantin Smirnov

Konstantin Smirnov - Candidate of Medical Sciences, Pediatrician, Chief Physician of the Altai Regional Clinical Center for Maternal and Child Health, Barnaul, Russia.