Abstract
Background: Cerebral palsy (CP) is a debilitating condition characterized by abnormal movement or posture beginning early in development. Recent evidence has shown that immunological abnormalities are associated with an increased risk of CP. However, there are no valuable biomarkers for CP diagnosis. Methods: In this case-control study, we recruited 108 children with CP and 52 healthy children as controls. The white blood cell (WBC) counts and the levels of inflammatory markers (interleukin-1β (IL-1β), sIL-2R, interleukin-6 (IL-6), IL-8, IL-10, and tumor necrosis factor-α (TNF-α)), neuron-specific enolase (NSE), immunoglobulin E (IgE), and C3/C4 in the blood were measured and the results were statistically analyzed. Subgroup analyzes based on age, complications, and clinical subtypes were also carried out. Results: Compared with the controls, CP patients had elevated levels of NSE, sIL-2R, and TNF-α. There were no differences in WBC count, IL-1β, IL-6, IL-8, IL-10, IgE, C3, or C4. Subgroup analysis revealed significant differences in the personal-social developmental quotient (DQ) among the different CP subtypes. We found that TNF-α, sIL-2R, gross motor DQ, and adaptive DQ were greater in children with CP without epilepsy (EP) than in those with EP. Correlation analysis revealed positive correlations between TNF-α and sIL-2R, gross motor DQ, fine motor DQ, adaptive DQ, and personal-social DQ; moreover, sIL-2R was positively correlated with TNF-α, gross motor DQ, adaptive DQ, personal-social DQ, and eosinophil (EO) count and negatively correlated with age. NSE and TNF-α were associated with a 1.64-fold and 1.66-fold increased risk of CP, respectively. The peripheral blood NSE and TNF-α levels exhibited good diagnostic value for CP. Moreover, receiver operating characteristic (ROC) curve analysis revealed a significant increase in the area under the curve (AUC) when these indicators were combined. Conclusions: This study revealed significant associations between NSE and TNF-α and CP risk, suggesting that NSE and TNF-α might be useful blood biomarkers for identifying patients at high risk of CP.