Genetics associations in cerebral palsy; an issue still under study
DOI:
https://doi.org/10.28957/rcmfr.v26n1a3Keywords:
Palsy, Cerebra, Genetics.Abstract
Cerebral palsy (CP) is a motor disorder of central origin with a heterogeneous
presentation, which is attributed multiple risk factors; but in fact its etiology is little known. New advances in genetics as exome and genomic sequencing have allowed to be closer to the genetic associations with the PC. It have been found the involvement of genetic factors that appear to be predisposing and in other cases, mutations in genes that can be potentially pathogenic, also associated with other neurological disorders. Understanding the underlying genetic factors in the presentation of the PC; it have allowed reevaluate the concepts that exists about the PC as well as the possibility of a better classification of this, which enables routing the therapeutic alternatives with a greater certainty. Nevertheless there is still needs to know the causal role in the PC. Genetic research becomes an important tool in patients with PC, especially after exhausting other diagnostic tools and continuous lack of knowledge
of its etiology.
References
1. Bax M, Goldstein M, Rosenbaum P, et al. Proposed definition and classification of cerebral palsy. Dev Med Child Neurol. 2005; 47(April 2005):571-576. doi:10.1017/S001216220500112X.
2. MacLennan AH, Thompson SC, Gecz J. Cerebral palsy: causes, pathways, and the role of genetic variants. Am J Obstet Gynecol.
2015;213(June):1-10. doi:10.1016/j.ajog. 2015.05.034.
3. Platt MJ, Cans C, Johnson A, et al. Trends in cerebral palsy among infants of very low birthweight (<1500 g) or born prematurely
(<32 weeks) in 16 European centres: a data base study. Lancet. 2007;369(9555):43-50. doi:10.1016/S0140-6736(07)60030-0.
4. Jacobsson B, Hagberg G. Antenatal risk factors for cerebral palsy. Best Pract Res Clin Obstet Gynaecol. 2004;18(3):425-436. doi:10.
1016/j.bpobgyn.2004.02.011.
5. Fan HC, Ho LI, Chi CS, et al. Current proceedings of cerebral palsy. Cell Transplant. 2015;24(3):471-485.doi:10.3727/096368915X
686931.
6. Erickson RP. The Importance of De Novo Mutations for Pediatric Neurological Disease—It’s not all In Utero or Birth Trauma. Mutat Res Mutat Res. 2016. doi:10.1016/j.mrrev.2015.12.002.
7. Phimister EG, Biesecker LG, Green RC. Diagnostic Clinical Genome and Exome Sequencing. N Engl J Med. 2014;370:2418-2425. doi:10.1056/NEJMra1312543.
8. Hollegaard MV, Grauholm J, Nielsen R, Grove J, Mandrup S, Hougaard DM. Archived neonatal dried blood spot samples can be used for accurate whole genome and exome-targeted next-generation sequencing. Mol Genet Metab. 2013;110(1-2):65-72. doi:10.1016/j.ymgme.2013.06.004.
9. Ong FS, Lin JC, Das K, Grosu DS, Fan JB. Translational utility of next-generation sequencing. Genomics. 2013;102(3):137-139.
doi:10.1016/j.ygeno.2013.04.012.
10. Shevell M, Dagenais L, Oskoui M. The epidemiology of cerebral palsy: New perspectives from a Canadian registry. Semin Pediatr Neurol. 2013;20(2):60-64. doi:10.1016/j.spen.2013.06.008.
11. Moreno-de-Luca A, Ledbetter DH, Martin CL. Genomic insights into the causes and classification of the cerebral palsies. Lancet Neurol. 2012;11(3):283-292. doi:10.1016/S1474-4422(11)70287-3.
12. Schaefer GB. Genetics Considerations in Cerebral Palsy. Semin Pediatr Neurol. 2008; 15(1):21-26.doi:10.1016/j.spen.2008. 01.004.
13. Hayes BC, Ryan S, McGarvey C, et al. Brain magnetic resonance imaging and outcome after hypoxic ischaemic encephalopathy. J Matern Neonatal Med. 2015;00(00):1-6. doi:10.3109/14767058.2015.1018167.
14. Eunson P. Aetiology and epidemiology of cerebral palsy. Paediatr Child Heal (United Kingdom). 2012;22(9):361-366. doi:10.1016/
j.paed.2012.05.008.
15. Krigger KW. Cerebral Palsy?: An Overview. 2006.
16. Hoon Jr. AH, Stashinko EE. Quality of life in adolescents with cerebral palsy. Lancet. 2015;385(9969):670-672. doi:10.1016/S0140- 6736(14)61599-3.
17. Cans C, De-la-Cruz J, Mermet MA.Epidemiology of cerebral palsy. Paediatr Child Health (Oxford). 2008;18(9):393-398. doi:10.1016/j.paed.2008.05.015.
18. Clark SL, Hankins GD V. Temporal and demographic trends in cerebral palsy - Fact and fiction. Am J Obstet Gynecol. 2003;188(3):
628-633. doi:10.1067/mob.2003. 204.
19. Herskind A, Greisen G, Nielsen JB. Early identification and intervention in cerebral palsy. Dev Med Child Neurol. 2015;57(1):29-
36. doi:10.1111/dmcn.12531.
20. McMichael G, Bainbridge MN, Haan E, et al. Whole-exome sequencing points to considerable genetic heterogeneity of cerebral palsy. Mol Psychiatry. 2015;20(2):176-182. doi:10.1038/mp.2014.189.
21. Ku³ak W, Okurowska-Zawada B, Sienkiewicz D, Paszko-Patej G, Krajewska-Ku³ak E. Risk factors for cerebral palsy in term birth
infants. Adv Med Sci. 2010;55(2):216-221. doi:10.2478/v10039-010-0030-7.
22. Novak I. Evidence-Based Diagnosis, Health Care, and Rehabilitation for Children With Cerebral Palsy. J Child Neurol. 2014;29(8): 1141-1156. doi:10.1177/0883073814535503.
23. Hatakenaka Y, Kotani H. Pediatric Neurology Infant Motor Delay and Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations in Japan. Pediatr Neurol. 2016;54:55-63. doi:10.1016/j.pediatrneurol.2015.09.008.
24. Pervin R, Ahmed S, Hyder RT, et al. Cerebral Palsy-An Update. 2013;5(1):293-296.
25. Livingston MH, Rosenbaum PL. Adolescents with cerebral palsy: stability in measurement of quality of life and health-related quality
of life over 1 year. Dev Med Child Neurol. 2008;50(9):696-701. doi:DMCN3053 [pii]\r10.1111/j.1469-8749.2008.03053.x.
26. Hadders-Algra M. Early Diagnosis and Early Intervention in Cerebral Palsy. Vol 5. Roberta Shepherd; 2014. doi:10.11604/pamj.2014.
17.244.4157\r10.3389/fneur.2014.00185.
27. Majnemer A, Mazer B. New Directions in the Outcome Evaluation of Children with Cerebral Palsy. Semin Pediatr Neurol. 2004;11(1):11-17. doi:10.1016/j.spen.2004.01.003.
28. Waldman A, O’Connor E, Tennekoon G. Childhood multiple sclerosis: a review. Ment Retard Dev Disabil Res Rev. 2006;12(2):147-156.
doi:10.1002/mrdd.
29. Longo MG, Félix TM, Ashton-Prolla P, Vedolin LM. Brain Imaging and Genetic Risk in the Pediatric Population, Part 2: Congenital Malformations of the Central Nervous System. Neuroimaging Clin N Am. 2015;25(1):53-67. doi:10.1016/j.nic.2014.09.003.
30. Benini R, Dagenais L, Shevell MI. Normal imaging in patients with cerebral palsy: What does it tell us? J Pediatr. 2013;162(2). doi:10.1016/j.jpeds.2012.07.044.
31. novak I, Mcintyre S, Morgan C, et al. A systematic review of interventions for children with cerebral palsy: State of the evidence. Dev
Med Child Neurol. 2013;55(10):885-910. doi:10.1111/dmcn.12246.
32. Bash E. No Title No Title. PhD Propos. 2015;1. doi:10.1017/CBO9781107415 324.004.
33. Costeff H. Estimated frequency of genetic and nongenetic causes of congenital idiopathic cerebral palsy in West Sweden. Ann Hum Genet. 2004;68(5):515-520. doi:10.1046/j.1529-8817.2004.00105.x.
34. Hemminki K, Li X SK et al. High familial risk for cerebral palsy implicates partial heritable aetiology. Paediatr Perinat Epidemiol. 2007; 21:235-241.
35. Dizon-Townson DS. Preterm labour and delivery: A genetic predisposition. Paediatr Perinat Epidemiol. 2001;15 Suppl 2:57-62.
doi:ppe008 [pii].
36. Hollegaard MV, Skogstrand K, Thorsen P, Nørgaard-Pedersen B, Hougaard DM, Grove J. Joint Analysis of SNPs and Proteins Identifies Regulatory IL18 Gene Variations Decreasing the Chance of Spastic Cerebral Palsy. Hum Mutat. 2013;34(1):143-148. doi:10.1002/humu.22173.
37. Shevell MI, Majnemer A, Morin I. Etiologic yield of cerebral palsy: A contemporary case series. Pediatr Neurol. 2003;28(5):352-359.
doi:10.1016/S0887-8994(03)00006-7.
38. Djukic M, Gibson CS, Maclennan AH, et al. Genetic susceptibility to viral exposure may increase the risk of cerebral palsy. Aust New Zeal J Obstet Gynaecol. 2009;49(3):247- 253. doi:10.1111/j.1479-828X.2009.00999.x.
39. Khankhanian P, Baranzini SE, Johnson B a, et al. Sequencing of the IL6 gene in a case— control study of cerebral palsy in children. BMC Med Genet. 2013;14(1):126. doi:10.1186/1471-2350-14-126.
40. Antecedents H, Torres-merino S, Thompsonbonilla MR, Leon-chavez BA, Martinez-fong D, Gonzalez-barrios JA. Functional Polymorphism of the Interleukin-1betaGene Promoter is Associated with Increased Risk for Cerebral Palsy in Mexican Children with Perinatal. 2015;4(1):1-7. doi:10.4172/2167-0897.1000167.
41. Hagberg H, Mallard C, Ferriero DM, et al. The role of inflammation in perinatal brain injury. Nat Rev Neurol. 2015;11(4):192-208.
doi:10.1038/nrneurol.2015.13.
42. Chen M, Li T, Lin S, et al. Association of Interleukin 6 gene polymorphisms with genetic susceptibilities to spastic tetraplegia
in males: A case-control study. Cytokine. 2013; 61(3):826-830.doi:10.1016/j.cyto. 2013.01.011.
43. Kapitanovi?? Vidak H, Catela Ivkovi?? T, Joki?? M, Spaventi R, Kapitanovi?? S. The association between proinflammatory cytokine polymorphisms and cerebral palsy in very preterm infants. Cytokine. 2012; 58(1):57-64.doi:10.1016/j.cyto. 2011.12.018.
44. Wu D, Zou Y-F, Xu X-Y, et al. The association of genetic polymorphisms with cerebral palsy: a meta-analysis. Dev Med Child Neurol. 2011;53(3):217-225. doi:10.1111/j.1469- 8749.2010.03884.x.
45. Berardi N, Sale A, Maffei L. Brain structural and functional development: Genetics and experience. Dev Med Child Neurol. 2015;
57(s2):4-9. doi:10.1111/dmcn.12691.
46. Miyatake S, Matsumoto N. Genetics: Clinical exome sequencing in neurology practice. Nat Rev Neurol. 2014;10(12):676-678. doi:10.1038/
nrneurol.2014.213.
47. Schnekenberg RP, Perkins EM, Miller JW, et al. De novo point mutations in patients diagnosed with ataxic cerebral palsy. 2015.
doi:10.1093/brain/awv117.
48. Landau YE, Lichter-Konecki U, Levy HL. Genomics in newborn screening. J Pediatr. 2014;164(1):14-19.doi:10.1016/j.jpeds.
2013.07.028.
49. Fleiss B, Gressens P. Tertiary mechanisms of brain damage: A new hope for treatment of cerebral palsy? Lancet Neurol. 2012; 11(6):556-566.doi:10.1016/S1474-4422(12)70058-3.
50. Gonzalez FF, Ferriero DM. Therapeutics for neonatal brain injury. Pharmacol Ther. 2008;120(1):43-53. doi:10.1016/j.pharmthera.
2008.07.003.
51. Bjornsson HT, Daniele Fallin M, Feinberg AP. An integrated epigenetic and genetic approach to common human disease. Trends Genet. 2004; 20(8):350-358. doi:10.1016/j.tig.2004.06.009.
52. Rempel G. The Importance of Good Nutrition in Children with Cerebral Palsy. Phys Med Rehabil Clin N Am. 2015;26(1):39-56. doi:10.1016/j.pmr.2014.09.001.
53. Peterson MD, Gordon PM, Hurvitz EA. Chronic disease risk among adults with cerebral palsy: The role of premature sarcopoenia,
obesity and sedentary behaviour. Obes Rev. 2013;14(2):171-182. doi:10.1111/j.1467-789X.2012.01052.x.
2. MacLennan AH, Thompson SC, Gecz J. Cerebral palsy: causes, pathways, and the role of genetic variants. Am J Obstet Gynecol.
2015;213(June):1-10. doi:10.1016/j.ajog. 2015.05.034.
3. Platt MJ, Cans C, Johnson A, et al. Trends in cerebral palsy among infants of very low birthweight (<1500 g) or born prematurely
(<32 weeks) in 16 European centres: a data base study. Lancet. 2007;369(9555):43-50. doi:10.1016/S0140-6736(07)60030-0.
4. Jacobsson B, Hagberg G. Antenatal risk factors for cerebral palsy. Best Pract Res Clin Obstet Gynaecol. 2004;18(3):425-436. doi:10.
1016/j.bpobgyn.2004.02.011.
5. Fan HC, Ho LI, Chi CS, et al. Current proceedings of cerebral palsy. Cell Transplant. 2015;24(3):471-485.doi:10.3727/096368915X
686931.
6. Erickson RP. The Importance of De Novo Mutations for Pediatric Neurological Disease—It’s not all In Utero or Birth Trauma. Mutat Res Mutat Res. 2016. doi:10.1016/j.mrrev.2015.12.002.
7. Phimister EG, Biesecker LG, Green RC. Diagnostic Clinical Genome and Exome Sequencing. N Engl J Med. 2014;370:2418-2425. doi:10.1056/NEJMra1312543.
8. Hollegaard MV, Grauholm J, Nielsen R, Grove J, Mandrup S, Hougaard DM. Archived neonatal dried blood spot samples can be used for accurate whole genome and exome-targeted next-generation sequencing. Mol Genet Metab. 2013;110(1-2):65-72. doi:10.1016/j.ymgme.2013.06.004.
9. Ong FS, Lin JC, Das K, Grosu DS, Fan JB. Translational utility of next-generation sequencing. Genomics. 2013;102(3):137-139.
doi:10.1016/j.ygeno.2013.04.012.
10. Shevell M, Dagenais L, Oskoui M. The epidemiology of cerebral palsy: New perspectives from a Canadian registry. Semin Pediatr Neurol. 2013;20(2):60-64. doi:10.1016/j.spen.2013.06.008.
11. Moreno-de-Luca A, Ledbetter DH, Martin CL. Genomic insights into the causes and classification of the cerebral palsies. Lancet Neurol. 2012;11(3):283-292. doi:10.1016/S1474-4422(11)70287-3.
12. Schaefer GB. Genetics Considerations in Cerebral Palsy. Semin Pediatr Neurol. 2008; 15(1):21-26.doi:10.1016/j.spen.2008. 01.004.
13. Hayes BC, Ryan S, McGarvey C, et al. Brain magnetic resonance imaging and outcome after hypoxic ischaemic encephalopathy. J Matern Neonatal Med. 2015;00(00):1-6. doi:10.3109/14767058.2015.1018167.
14. Eunson P. Aetiology and epidemiology of cerebral palsy. Paediatr Child Heal (United Kingdom). 2012;22(9):361-366. doi:10.1016/
j.paed.2012.05.008.
15. Krigger KW. Cerebral Palsy?: An Overview. 2006.
16. Hoon Jr. AH, Stashinko EE. Quality of life in adolescents with cerebral palsy. Lancet. 2015;385(9969):670-672. doi:10.1016/S0140- 6736(14)61599-3.
17. Cans C, De-la-Cruz J, Mermet MA.Epidemiology of cerebral palsy. Paediatr Child Health (Oxford). 2008;18(9):393-398. doi:10.1016/j.paed.2008.05.015.
18. Clark SL, Hankins GD V. Temporal and demographic trends in cerebral palsy - Fact and fiction. Am J Obstet Gynecol. 2003;188(3):
628-633. doi:10.1067/mob.2003. 204.
19. Herskind A, Greisen G, Nielsen JB. Early identification and intervention in cerebral palsy. Dev Med Child Neurol. 2015;57(1):29-
36. doi:10.1111/dmcn.12531.
20. McMichael G, Bainbridge MN, Haan E, et al. Whole-exome sequencing points to considerable genetic heterogeneity of cerebral palsy. Mol Psychiatry. 2015;20(2):176-182. doi:10.1038/mp.2014.189.
21. Ku³ak W, Okurowska-Zawada B, Sienkiewicz D, Paszko-Patej G, Krajewska-Ku³ak E. Risk factors for cerebral palsy in term birth
infants. Adv Med Sci. 2010;55(2):216-221. doi:10.2478/v10039-010-0030-7.
22. Novak I. Evidence-Based Diagnosis, Health Care, and Rehabilitation for Children With Cerebral Palsy. J Child Neurol. 2014;29(8): 1141-1156. doi:10.1177/0883073814535503.
23. Hatakenaka Y, Kotani H. Pediatric Neurology Infant Motor Delay and Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations in Japan. Pediatr Neurol. 2016;54:55-63. doi:10.1016/j.pediatrneurol.2015.09.008.
24. Pervin R, Ahmed S, Hyder RT, et al. Cerebral Palsy-An Update. 2013;5(1):293-296.
25. Livingston MH, Rosenbaum PL. Adolescents with cerebral palsy: stability in measurement of quality of life and health-related quality
of life over 1 year. Dev Med Child Neurol. 2008;50(9):696-701. doi:DMCN3053 [pii]\r10.1111/j.1469-8749.2008.03053.x.
26. Hadders-Algra M. Early Diagnosis and Early Intervention in Cerebral Palsy. Vol 5. Roberta Shepherd; 2014. doi:10.11604/pamj.2014.
17.244.4157\r10.3389/fneur.2014.00185.
27. Majnemer A, Mazer B. New Directions in the Outcome Evaluation of Children with Cerebral Palsy. Semin Pediatr Neurol. 2004;11(1):11-17. doi:10.1016/j.spen.2004.01.003.
28. Waldman A, O’Connor E, Tennekoon G. Childhood multiple sclerosis: a review. Ment Retard Dev Disabil Res Rev. 2006;12(2):147-156.
doi:10.1002/mrdd.
29. Longo MG, Félix TM, Ashton-Prolla P, Vedolin LM. Brain Imaging and Genetic Risk in the Pediatric Population, Part 2: Congenital Malformations of the Central Nervous System. Neuroimaging Clin N Am. 2015;25(1):53-67. doi:10.1016/j.nic.2014.09.003.
30. Benini R, Dagenais L, Shevell MI. Normal imaging in patients with cerebral palsy: What does it tell us? J Pediatr. 2013;162(2). doi:10.1016/j.jpeds.2012.07.044.
31. novak I, Mcintyre S, Morgan C, et al. A systematic review of interventions for children with cerebral palsy: State of the evidence. Dev
Med Child Neurol. 2013;55(10):885-910. doi:10.1111/dmcn.12246.
32. Bash E. No Title No Title. PhD Propos. 2015;1. doi:10.1017/CBO9781107415 324.004.
33. Costeff H. Estimated frequency of genetic and nongenetic causes of congenital idiopathic cerebral palsy in West Sweden. Ann Hum Genet. 2004;68(5):515-520. doi:10.1046/j.1529-8817.2004.00105.x.
34. Hemminki K, Li X SK et al. High familial risk for cerebral palsy implicates partial heritable aetiology. Paediatr Perinat Epidemiol. 2007; 21:235-241.
35. Dizon-Townson DS. Preterm labour and delivery: A genetic predisposition. Paediatr Perinat Epidemiol. 2001;15 Suppl 2:57-62.
doi:ppe008 [pii].
36. Hollegaard MV, Skogstrand K, Thorsen P, Nørgaard-Pedersen B, Hougaard DM, Grove J. Joint Analysis of SNPs and Proteins Identifies Regulatory IL18 Gene Variations Decreasing the Chance of Spastic Cerebral Palsy. Hum Mutat. 2013;34(1):143-148. doi:10.1002/humu.22173.
37. Shevell MI, Majnemer A, Morin I. Etiologic yield of cerebral palsy: A contemporary case series. Pediatr Neurol. 2003;28(5):352-359.
doi:10.1016/S0887-8994(03)00006-7.
38. Djukic M, Gibson CS, Maclennan AH, et al. Genetic susceptibility to viral exposure may increase the risk of cerebral palsy. Aust New Zeal J Obstet Gynaecol. 2009;49(3):247- 253. doi:10.1111/j.1479-828X.2009.00999.x.
39. Khankhanian P, Baranzini SE, Johnson B a, et al. Sequencing of the IL6 gene in a case— control study of cerebral palsy in children. BMC Med Genet. 2013;14(1):126. doi:10.1186/1471-2350-14-126.
40. Antecedents H, Torres-merino S, Thompsonbonilla MR, Leon-chavez BA, Martinez-fong D, Gonzalez-barrios JA. Functional Polymorphism of the Interleukin-1betaGene Promoter is Associated with Increased Risk for Cerebral Palsy in Mexican Children with Perinatal. 2015;4(1):1-7. doi:10.4172/2167-0897.1000167.
41. Hagberg H, Mallard C, Ferriero DM, et al. The role of inflammation in perinatal brain injury. Nat Rev Neurol. 2015;11(4):192-208.
doi:10.1038/nrneurol.2015.13.
42. Chen M, Li T, Lin S, et al. Association of Interleukin 6 gene polymorphisms with genetic susceptibilities to spastic tetraplegia
in males: A case-control study. Cytokine. 2013; 61(3):826-830.doi:10.1016/j.cyto. 2013.01.011.
43. Kapitanovi?? Vidak H, Catela Ivkovi?? T, Joki?? M, Spaventi R, Kapitanovi?? S. The association between proinflammatory cytokine polymorphisms and cerebral palsy in very preterm infants. Cytokine. 2012; 58(1):57-64.doi:10.1016/j.cyto. 2011.12.018.
44. Wu D, Zou Y-F, Xu X-Y, et al. The association of genetic polymorphisms with cerebral palsy: a meta-analysis. Dev Med Child Neurol. 2011;53(3):217-225. doi:10.1111/j.1469- 8749.2010.03884.x.
45. Berardi N, Sale A, Maffei L. Brain structural and functional development: Genetics and experience. Dev Med Child Neurol. 2015;
57(s2):4-9. doi:10.1111/dmcn.12691.
46. Miyatake S, Matsumoto N. Genetics: Clinical exome sequencing in neurology practice. Nat Rev Neurol. 2014;10(12):676-678. doi:10.1038/
nrneurol.2014.213.
47. Schnekenberg RP, Perkins EM, Miller JW, et al. De novo point mutations in patients diagnosed with ataxic cerebral palsy. 2015.
doi:10.1093/brain/awv117.
48. Landau YE, Lichter-Konecki U, Levy HL. Genomics in newborn screening. J Pediatr. 2014;164(1):14-19.doi:10.1016/j.jpeds.
2013.07.028.
49. Fleiss B, Gressens P. Tertiary mechanisms of brain damage: A new hope for treatment of cerebral palsy? Lancet Neurol. 2012; 11(6):556-566.doi:10.1016/S1474-4422(12)70058-3.
50. Gonzalez FF, Ferriero DM. Therapeutics for neonatal brain injury. Pharmacol Ther. 2008;120(1):43-53. doi:10.1016/j.pharmthera.
2008.07.003.
51. Bjornsson HT, Daniele Fallin M, Feinberg AP. An integrated epigenetic and genetic approach to common human disease. Trends Genet. 2004; 20(8):350-358. doi:10.1016/j.tig.2004.06.009.
52. Rempel G. The Importance of Good Nutrition in Children with Cerebral Palsy. Phys Med Rehabil Clin N Am. 2015;26(1):39-56. doi:10.1016/j.pmr.2014.09.001.
53. Peterson MD, Gordon PM, Hurvitz EA. Chronic disease risk among adults with cerebral palsy: The role of premature sarcopoenia,
obesity and sedentary behaviour. Obes Rev. 2013;14(2):171-182. doi:10.1111/j.1467-789X.2012.01052.x.
How to Cite
1.
Lara Arroyo ND, Arias Franco M, Valencia Valencia D. Genetics associations in cerebral palsy; an issue still under study. Rev. Colomb. Med. Fis. Rehabil. [Internet]. 2016 Oct. 24 [cited 2024 May 15];26(1):30-7. Available from: https://revistacmfr.org/index.php/rcmfr/article/view/168
Downloads
Download data is not yet available.
