Features of Metabolism of Thigh in Patients with Cerebral Palsy at Different Levels of Movement Disorders (a Pilot Study)

INTRODUCTION: Investigation of metabolic characteristics of skeletal muscles of patients with cerebral palsy will permit substantiation of the most effective methods of pharmacological correction of pathochemical disorders. AIM: To evaluate biochemical changes in m. gracilis in children with spastic forms of cerebral palsy and different levels of movement disorders. MATERIALS AND METHODS: The metabolic parameters of m. gracilis were studied in children with moderate and severe forms of cerebral palsy. The patients were divided into three groups on the basis of classification of the basic motor functions: group 1 (n=8) — children with level III motor disorders according to GMFCS; group 2 (n=9) — with level IV; group 3 (n=26) — with level V. The activity of enzymes and energy metabolism substrates, proteolytic activity, the level of proteins and peroxidation products were determined in the muscles. RESULTS: The level of myosin in m. gracilis was statistically significantly higher in patients of group 1 relative to groups 2 and 3. In group 2 myosin was 3.0% decreased compared to group 1 and 4.5% decreased compared to group 3. Reliably lower values of acid phosphatase activity were detected in children of groups 2 and 3. Patients of group 2 had a reliably higher proportion of type I muscle fibers in m. gracilis, while the lowest percent of such fibers was detected in patients of group 3. Group 3 also demonstrated statistically significant reduction in the activity of lactate dehydrogenase and creatine phosphokinase. CONCLUSION: In patients with cerebral palsy with the underlying prominent limitation of motor activity, a decrease in the synthesis of contractile proteins and in the intensity of aerobic oxidative processes in the skeletal muscles is noted. At the same time, depression of protein synthesis is noted in patients with GMFCS IV and significant disorders in energy metabolism in patients with GMFCS V.