Cerebral Palsy Link to Sensorimotor System, Cognition, Emotion and Nociplastic Pain

Abstract

This narrative review provides an overview of the link between the sensorimotor system, cognition, emotion and pain syndromes in persons due to deconditioning or delayed sensorimotor development, then applied to persons with cerebral palsy (CP). The brain damage that occurs before, during or even after birth pathophysiologically alters the structure and subsequent function of the sensorimotor function, which is inseparably linked to cognition, emotion, behavior and pain. This damage results in a functional developmental disorder that also affects the structure and function of the neuromatrix in a graded manner due to chronic deconditioning. It is the basis for both primary and secondary chronic degenerative diseases. This leads to an increasing prevalence of chronic pain syndromes, which may be very high in persons with CP. Thus, CP is both a disposing factor and a causal factor for nociplastic pain, defined as persistent pain arising from altered nociception without evidence of tissue or somatosensory damage. Therapy interventions are crucial to optimize movement, cognition and emotion, as well as pain reduction in persons with CP.

Keywords: cerebral palsy; chronic pain; cognition; deconditioning; emotions; movement; sensorimotor developmental delay.

Figure 1

Physical activity for children, adolescents 5–17 years [14].

Figure 2

Stimulation of maturation and growth; SMS: sensorimotor system.

Figure 3

Pain inhibition through endurance, strength and sensorimotor coordination; CNS: central nervous system.

Figure 4

Deconditioning as factor for development of chronic degenerative disease. Chronic physical activity leads to deconditioning and this over time leads to chronic degenerative disease.

Figure 5

Cognition and movement.

Figure 6

Pathological processes.