Evaluation of Brain MRI Changes in Cerebral Palsy Patients

Evaluation of Brain Changes in Cerebral Palsy Patients

Cerebral palsy (CP) is a neurodevelopmental syndrome characterized by sensorimotor impairment that arises during early childhood defined as a static insult to the developing brain. A key part of the definition for CP is a non-progressive brain injury; however, as individuals with CP age, a functional decline greater than neurotypical individuals is often present. The investigators are doing this research study to improve understanding of whether there is brain and spinal cord atrophy over time that could indicate neurodegeneration. To do this, the investigators will partner with the Cerebral Palsy Research Network to obtain brain and spinal cord MRIs from people with CP across the United States. The investigators will perform analyses on multiple longitudinal MR images of the brain and spinal cord obtained from adults with CP. Putative changes will be related with changes in function across time.

This will be a single-center study that will compare retrospective clinical and imaging data with similar prospective data. The objective is to find out if people with Cerebral Palsy (CP) experience changes in the structures of their brain over time. A key part of the CP definition is that it is a non-progressive brain injury. However, as people with CP age, their function often deteriorates. This study seeks to determine whether changes in the brain structure may result in function changes, as they do in other types of brain injuries.

The investigators are doing this research study to improve understanding of whether there is brain and spinal cord atrophy over time that could indicate neurodegeneration. To do this, the investigators will partner with the Cerebral Palsy Research Network to obtain brain and spinal cord MRIs from people with CP across the United States, as well as locally. The investigators will perform analyses on multiple longitudinal MR images of the brain and spinal cord obtained from adults with CP. Putative changes will be related with changes in function across time.

Study Overview

• Status: Recruiting
• Conditions: Cerebral Palsy; Spastic Diplegia; Spastic Hemiplegia; Spastic Quadriplegia

Detailed Description

Cerebral palsy is a neurodevelopmental syndrome that arises during fetal or infant development. Cerebral palsy is defined by a static insult to the brain, such as hypoxia, brain ischemia from stroke or hypotension, infection, or trauma. This brain insult then gives rise to impairment in movement and posture. In developed nations, cerebral palsy accounts for the most common cause of childhood motor disability. Additionally, as medical care advances, survival into adulthood is increasing. Thus, studying the changes associated with cerebral palsy during the aging process is important to providing care to these individuals.

A key part of the cerebral palsy definition is a non-progressive brain injury. However, as people with cerebral palsy age, their function often deteriorates. This study seeks to determine whether changes to brain structure may underlie the functional changes, as they do in other traumatic or ischemic brain injuries. There are established findings of white matter changes, grey matter changes, stroke, and vascular malformation using brain MRI in cerebral palsy, although approximately 13-14% of patients imaged have no injuries visible seen on a clinical MRI brain examination.

These MRI changes are believed to be the representative static lesion(s) that occurred during fetal development or infancy and caused cerebral palsy. The investigators propose that there are structural changes identifiable through MR brain imaging in patients with cerebral palsy over time. Additionally, the clinical and functional worsening seen in cerebral palsy patients as they age may correlate with these MRI changes.

• Study Type: Observational
• Enrollment (Estimated): 30

Contacts and Locations

• Study Contact: Name: Jason Carmel, MD, PhD; Phone Number: 3 212-305-2700; Email: jbc28@cumc.columbia.edu
• Study Contact Backup: Name: Shaker Dukkipati, MD, PhD; Phone Number: 3 212-305-2700; Email: sd3850@cumc.columbia.edu

Study Locations

• United States
  • New York
    • New York, New York, United States, 10040
      • Recruiting
      • Weinberg Family Cerebral Palsy Center, Columbia University
      • Contact: Jason Carmel, MD, PhD; Phone Number: 3 212-305-2700; Email: jbc28@cumc.columbia.edu
      • Contact: Shaker Dukkipati, MD, PhD; Phone Number: 3 212-305-2700; Email: sd3850@cumc.columbia.edu
      • Principal Investigator: Jason Carmel, MD, PhD
      • Sub-Investigator: Frank Provenzano, PhD
      • Sub-Investigator: Shaker Dukkipati, MD, PhD
      • Sub-Investigator: Michelle Corkrum, MD, PhD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

People with cerebral palsy across the United States

Description

Inclusion Criteria:

• Have multiple MRI scans of brain and/or spinal cord spaced at least 24 months apart
• Between 18-80 years of age with at least one MRI scan after the age of 18
• No known central or peripheral neurological disease or injury other than cerebral palsy causing brain degeneration
• Inclusion in CPRN registry
• diagnosis of Cerebral Palsy
• >18 years of age
• Have received at least one past brain MRI scan as part of standard care (patients who have two or more brain MRI scans can be included in the retrospective arm only)

Exclusion Criteria:

• History of more than one seizure in lifetime
• History of known degenerative genetic disorder
• History of brain tumor, abscess, or multiple sclerosis
• History of moderate or severe head trauma
• History of metal implants in head

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
Retrospective; Patients who have a diagnosis of cerebral palsy, are adults (>18 years of age), and have at least one brain MRI will be identified through chart review. Those patients who have two or more brain MRI scans will be included in the retrospective arm only.
Prospective; Patients who have only one brain MRI scan will be included in the prospective arm of the study. These patients will undergo MRIs of both the brain and cervical spine without contrast.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Total brain volume	This is a number, measured in cubic millimeters, that includes the output from segmentation of each individual MRI scan per subject.	From first MRI scan to second MRI scan, composed of a timespan of at least 2 or more years

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Cortical thickness	This is a number, measured in millimeters, that includes the output from segmentation of each individual MRI scan per subject. This is calculated as the shortest distance between gray/white matter boundary and the pial surface in both directions, with an average to produce the final thickness value.	From first MRI scan to second MRI scan, composed of a timespan of at least 2 or more years.

Collaborators and Investigators

• Sponsor: Columbia University
• Investigators: Principal Investigator: Jason Carmel, MD, PhD, Columbia University

Study record dates

Study Major Dates

• Study Start (Actual): June 20, 2023
• Primary Completion (Estimated): July 1, 2028
• Study Completion (Estimated): July 1, 2029

Study Registration Dates

• First Submitted: February 20, 2026
• First Submitted That Met QC Criteria: February 20, 2026
• First Posted (Actual): February 25, 2026

Study Record Updates

• Last Update Posted (Actual): May 13, 2026
• Last Update Submitted That Met QC Criteria: May 11, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: aging; brain volume; cortical thickness
• Additional Relevant MeSH Terms: Neurologic Manifestations; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Brain Damage, Chronic; Paralysis; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Cerebral Palsy; Quadriplegia; Hemiplegia
• Other Study ID Numbers: AAAU1870

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No