Hypercapnic hypoxia improves cognitive and motor functions of children with cerebral palsy. (3rd August 2022)

• Record Type: Journal Article
• Authors: Kulikov, Vladimir; Tregub, Pavel; Parshin, Dmitry; Smirnova, Yulia; Smirnov, Konstantin
• Is Part Of: Neurological research. Volume 44:Number 8(2022)
• Page Start: 738
• Page End: 747
• Publication Date: 2022-08-03
• Subjects: hypoxia -- hypercapnia -- rehabilitation -- cerebral palsy -- neuroprotection; Neurology -- Periodicals; Neurosciences -- Periodicals; 616.8005
• DOI: 10.1080/01616412.2022.2051130
• Languages: English
• ISSNs: 0161-6412

Abstract

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.