Cerebellar Deep Brain Stimulation for Movement Disorders in Cerebral Palsy in Children and Young Adults

Open to people ages 7-25

• Diagnosis of DCP (dystonic and/or choreoathetotic cerebral palsy) with or without comorbid spasticity, with a clear history of hypoxic ischemic brain injury preceding motor symptoms made by a pediatric neurologist, with supporting MRI findings.
• Age 7-25 at the time of surgery.
• Gross Motor Function Classification System (GMFCS) Levels II-V.
• History of appropriate therapy with oral medications with inadequate relief as determined by a movement disorders or pediatric neurologist. Prior history of selective dorsal rhizotomy is allowed.
• Patient and family have requested surgical intervention with DBS for their movement disorder.
• No gross cerebellar abnormalities observed and reported on structural MRI.
• Written informed consent and written/verbal assent for those younger than 18 years of age.
• Ability to comply with study follow-up visits for brain recordings, neuroimaging and testing of sham and effective stimulation and clinical assessments.

• Coagulopathy, uncontrolled epilepsy, severe cardiopulmonary or gastrointestinal conditions, or other medical conditions considered to place the patient at elevated risk for surgical complications.
• Pregnancy: all women of child-bearing potential will be required to have a negative urine pregnancy test prior to undergoing their surgical procedure.
• Exclusion of genetic mimics of cerebral palsy: exclusion of conditions that manifest with a clinical syndrome similar to CP, in the absence of documented risk factors or neuroimaging findings consistent with a history of brain injury or congenital cerebral malformation. Work up may include comparative genomic hybridization (CGH) microarray and multi-gene panel and/or whole genome or whole exome sequencing.)
• Severe fixed contractions and skeletal deformities that would preclude determination of improvement.
• Traumatic brain injury (i.e., non-accidental trauma) or history of infectious or autoimmune encephalitis.
• Requirement of diathermy, electroconvulsive therapy or transcranial magnetic stimulation.