Serum L-Carnitine Level and Its Correlation With The Degree Of Motor Function Impairment in Children With Spastic Cerebral Palsy

Abstract

Background: Cerebral palsy (CP) encompasses permanent movement and posture disorders. L-carnitine (LC) is essential cofactor for energy metabolism in mitochondria. Disturbances in this pathway may contribute to impaired muscle function and disease severity in neurodevelopmental disorders, yet its specific role in spastic CP requires further investigation.

Objective: to assess serum L-carnitine level in children having spastic CP and to assess the relation between serum L-carnitine concentration and the degree of motor function impairment.

Patients and methods: This cross-sectional analytical research has been done at the Pediatric and Physical Therapy Outpatient Clinics of October 6 University Hospital. The study included 90 participants, comprising 45 children with spastic CP and 45 healthy controls. The extent of motor function disability has been evaluated utilizing the Gross Motor Function Classification System (GMFCS), classifying the cases into five levels. Serum L-carnitine levels have been measured by ELISA in both cases & controls.

Results: Compared to controls, the CP group's serum LC concentrations were substantially reduced. (median: 790.0 vs. 5270.0 ng/mL, p<0.001). L-carnitine demonstrated good diagnostic accuracy for discriminating CP cases from controls (AUC=0.893, sensitivity: 82.22%, specificity:77.78%). L-carnitine levels exhibited a highly significant negative association with GMFCS classification (r=-0.865, p below 0.001) and delayed developmental milestones, while positively correlated with independent walking ability.

Conclusion: Serum L-carnitine levels are significantly reduced in children with spastic CP and are significantly inversely correlated to the severity of motor impairment.