# High Fidelity Diffusion MRI for Children with Cerebral Palsy in Stem Cell Therapy

> **NIH NIH R01** · DUKE UNIVERSITY · 2020 · $352,188

## Abstract

Abstract:
Cerebral palsy (CP) is the most prevalent motor disorder of childhood with complications in other cognitive
impairments, affecting 3 out of every 1,000 children. Largely due to in utero or perinatal injuries to the
developing brain, CP results in white matter pathology including impairments to the motor pathway.
Diffusion MRI (e.g. diffusion tensor imaging, or DTI) can help characterize these white matter impairments,
as well as any potential connectivity improvement during treatment. Over the past five years, we have applied
high-fidelity diffusion MRI in pediatric CP patients during autologous umbilical cord blood (UCB) stem cell
therapies, and developed an understanding of the impact and benefit autologous UCB stem cells have on
improving functional outcome and brain connectivity in pediatric CP patients. Specifically, we have found
strong evidences in relevant brain networks that: 1) brain connectivity impairments account for the motor
and cognitive abnormalities in children with CP at the pre-treatment baseline, 2) brain connectivity increases
have a direct impact on functional and behavioral improvements during UCB stem cell therapy, 3) brain
connectivity increases beyond that of typical development trajectory have a direct correlation with stem cell
dosage above a potential threshold of 1.98 x 107 cells/kg, and 4) the severity of baseline connectivity
abnormalities predicts the risk of further decline and the benefit of cell therapy. It was also found that the
brain connectivity increase may be associated with improved myelination during cell therapy, through
additional preliminary investigations using quantitative susceptibility mapping (QSM). Advancing from this
solid foundation, we propose this renewal application to further develop ultrahigh resolution diffusion MRI
and connectivity imaging methodologies to study the positive effect of allogenic stem cells derived from UCB
(stored at the North Carolina Cord Blood Bank), which can both reach the necessary high dosage (as opposed
to the limited autologous UCB stem cells) and be applied to more CP patients (rather than just the ones with
UCB saved at birth). Specifically, we propose to: 1) achieve unprecedented magnetic field homogeneity based
on our recent innovation on simultaneous RF reception and Bo shimming technology to enable the highest
possible spatial resolution and fidelity, 2) achieve multi-band multi-shot 3D diffusion MRI acquisition with
ultrahigh submillimeter spatial resolution, optimized SNR and high throughput, and 3) acquire and analyze
ultrahigh resolution diffusion MRI and brain connectome maps, as well as DTI-guided myelin-sensitive QSM
along white matter pathways and throughout the brain connectome, in pediatric CP patients during the
course of innovative therapies using UCB-derived allogenic stem cells. It is expected that our continued and
concerted efforts will greatly advance our understanding of the neural mechanisms on both connectivity
impairments i...

## Key facts

- **NIH application ID:** 9971587
- **Project number:** 5R01NS075017-09
- **Recipient organization:** DUKE UNIVERSITY
- **Principal Investigator:** ALLEN W SONG
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $352,188
- **Award type:** 5
- **Project period:** 2012-02-15 → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9971587

## Citation

> US National Institutes of Health, RePORTER application 9971587, High Fidelity Diffusion MRI for Children with Cerebral Palsy in Stem Cell Therapy (5R01NS075017-09). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9971587. Licensed CC0.

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