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Nutritional intervention and neurodevelopmental outcome in infants with suspected cerebral palsy: The Dolphin infant double-blind randomized controlled trial

Lookup NU author(s): Professor Jeremy Parr

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This is the authors' accepted manuscript of an article that has been published in its final definitive form by Wiley-Blackwell, 2018.

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Abstract

© 2017 Mac Keith Press. Aim: To investigate whether docosahexaenoic acid (DHA), choline, and uridine-5-monophosphate (UMP) supplementation improves neurodevelopmental outcome in infants with suspected cerebral palsy (CP) versus a comparison group of children. Method: Infants aged 1 to 18 months with suspected CP were recruited from UK child development centres. Participants received daily treatment or control supplementation for 2 years (double-blind randomized control design). Stratification was by age, sex, predominant pattern of motor involvement (four limbs or other), and visual impairment (or not). The primary outcome was the cognitive composite score of the Bayley Scales of Infant and Toddler Development, Third Edition (CCS-Bayley-III). Secondary outcomes included language composite and motor composite scores of the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). Results: Forty infants were recruited; 35 began supplementation, 29 completed 1 to 2 years' supplementation. The treatment group CCS-Bayley-III was non-significantly higher than the comparison group (mean 77.7 [SD 19.2] and 72.2 [SD 19.8] respectively, mean modelled difference 4.4 [-2.8, 11.6]). The treatment group language scores, but not motor scores, were non-significantly higher than for the comparison group. Interpretation: Most families found supplementation feasible. No statistically significant differences in neurodevelopmental outcome between the treatment and comparison groups were identified. Further investigation of neurodevelopmental outcome after supplementation with DHA, choline, and UMP of infants with suspected CP is warranted. What this paper adds: This was the first trial of phosphatidylcholine precursor supplementation in infants with suspected cerebral palsy (CP). Families of infants with suspected CP found 2-year nutritional supplementation feasible. There was no statistically significant neurodevelopmental advantage for the treatment group versus the comparison group. However, treatment group cognitive and language advantage were of clinically meaningful magnitude.


Publication metadata

Author(s): Andrew MJ, Parr JR, Montague-Johnson C, Laler K, Qi C, Baker B, Sullivan PB

Publication type: Article

Publication status: Published

Journal: Developmental Medicine and Child Neurology

Year: 2018

Volume: 60

Issue: 9

Pages: 906-913

Print publication date: 01/09/2018

Online publication date: 12/10/2017

Acceptance date: 23/08/2017

ISSN (print): 0012-1622

ISSN (electronic): 1469-8749

Publisher: Wiley-Blackwell

URL: https://doi.org/10.1111/dmcn.13586

DOI: 10.1111/dmcn.13586


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