Movement Recovery Seminar April 2024. Open to clincians and researchers, email cpresearch@cumc.columbia.edu to register
Movement Recovery Lab at the Weinberg Family Cerebral Palsy Center
Altered tendon development contributes to neuromuscular contracture formation
Speakers: Varun Arvind, PhD, Alice H. Huang, PhD, Jason B. Carmel, MD, PhD, Columbia University Irving Medical Center -
Precise range-of-motion of the musculoskeletal system requires coordinated lengthening of the myotendon unit (MTU) and skeleton during development. In patients with cerebral palsy (CP), shortening of the MTU results in constrained range of motion due to discrepancy between skeletal and MTU lengthening resulting in neuromuscular contracture (NC) formation. Among children with CP, development of NC is common and occurs at a combined incidence of 4 per 1,000 children with an estimated prevalence of at least 17 million people worldwide. In CP, treatment of muscle hypertonia/ spasticity has had minimal improvement in the progression of fixed NC even when combined with physical therapy. Therefore, further investigation of the tissue-specific causes of MTU shortening that lead to NC are required to for improved care. Most research on tissue-specific changes that occur during NC formation have focused on muscle. While increased muscle fibrosis has been observed, these changes have not been found to sufficiently account for degree of MTU shortening leading to NC. These findings have motivated investigation into tendon as another contributor to NC formation. To investigate the changes of muscle, tendon, and MTJ during NC formation we established a pre-clinical model of NC formation in mice that reflects changes in humans. We identified novel changes in tendon and myotendon growth that contribute to neuromuscular contracture formation. These findings highlight opportunities for novel tendon-directed therapies to treat NC.