# Neurophysiology of Pain in Children with Cerebral Palsy

> **NIH NIH R21** · FATHER FLANAGAN'S BOYS' HOME · 2020 · $101,640

## Abstract

PROJECT SUMMARY/ABSTRACT
Cerebral palsy (CP) is one of the most prevalent and costly pediatric neurologic conditions diagnosed in the
United States. Although the brain injuries seen in these children are non-progressive, they often instigate a
cascade of structural (i.e., boney malalignments, muscular contractures) and functional (i.e., co-contractions,
spasticity) abnormalities within the musculoskeletal system that can become worse throughout development.
These secondary changes are presumed to be primarily responsible for the chronic musculoskeletal pain that is
seen in a large percentage of children with CP. However, currently there is a major lack of knowledge in this
area, especially in regard to the neurophysiological mechanisms of the persistent pain, as most studies to date
have focused on quantifying the prevalence of pain symptoms and not the underlying physiology. Without this
critical information, the prevention, treatment and evaluation of the chronic musculoskeletal pain will not advance.
Our extensive magnetoencephalographic (MEG) brain imaging program has identified that the early brain insults
experienced by children with CP result in aberrant processing of the peripheral sensations by the somatosensory
cortices. Recently, we have extended these results by showing that children with CP who have more abnormal
somatosensory cortical oscillations following peripheral stimulation of the feet, also have higher reported pain.
This relationship implies that there might be a fundamental link between the integrity of somatosensory
cortical processing and the pain perceptions of children with CP. The goal of this proposal is to test our
scientific premise that the disturbed somatosensory neural connections, potentially arising from maladaptive
neuroplastic changes following early brain injuries, are altered in children with CP and that this leads to
heightened activity in the pain perception network and chronic pain. Our approach is of “high risk”, but has the
potential to be remarkably “rewarding,” as it may lead to novel insights and a paradigm shift in our understanding
of pain perception in children with CP. The Specific Aims of this proposal will (1) demonstrate that the strength
of somatosensory cortical oscillations following peripheral stimulation of the mechano- and nociceptors of the
feet and hands will scale with a child’s perceived pain levels, and (2) determine if the strength of somatosensory
cortical oscillations following peripheral stimulation are differentially altered in children with CP who have low
versus high pain levels, and whether both groups differ from typically-developing (TD) children. Briefly, our study
will use MEG, advanced image reconstruction methods, and time series analysis to quantify the strength of
somatosensory cortical oscillations following stimulation of peripheral mechano- and nociceptors in TD children,
and children who have spastic diplegic CP and different pain levels (i.e., severity). Achiev...

## Key facts

- **NIH application ID:** 10313339
- **Project number:** 7R21HD096390-03
- **Recipient organization:** FATHER FLANAGAN'S BOYS' HOME
- **Principal Investigator:** Max J Kurz
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $101,640
- **Award type:** 7
- **Project period:** 2019-04-01 → 2022-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10313339

## Citation

> US National Institutes of Health, RePORTER application 10313339, Neurophysiology of Pain in Children with Cerebral Palsy (7R21HD096390-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10313339. Licensed CC0.

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