What is cerebral palsy?

Cerebral palsy is a group of permanent disorders of movement and posture caused by injury to, or abnormal development of, the developing brain. The underlying brain lesion is considered non-progressive, although functional limitations and secondary problems may change over a person’s lifetime.

Depending on type and severity, cerebral palsy may involve spasticity, coordination problems, impaired hand function, speech or swallowing difficulties, sensory impairment and other neurological comorbidities.

The 2026 German AWMF guideline on unilateral spastic cerebral palsy focuses on structured diagnosis and individually selected conservative and neuro-orthopaedic measures, including evidence-based occupational and physical therapy, orthoses, speech therapy and neuropsychological approaches. PRP is not listed as an established treatment.^[7]

What is PRP?

PRP is an autologous blood preparation with a higher platelet concentration than the starting material. After activation, platelets can release biologically active proteins and signalling molecules including PDGF, VEGF, TGF-β and IGF-1.

An important issue is that PRP is not a completely standardised preparation. Starting blood, platelet concentration, leukocyte content, centrifugation, activation and other processing steps can influence the final product, which limits direct comparison between studies.^[3]

Why is PRP being studied in relation to the nervous system?

The biological rationale is understandable: several signalling molecules in platelet-rich preparations participate in processes that are also relevant to neural tissue. This supports research hypotheses, but does not establish a clinical effect in cerebral palsy.

Results from cell cultures, animal models or peripheral-nerve research do not prove that intravenously administered PRP regenerates damaged brain structures. The presence of growth factors in PRP also does not show that clinically relevant concentrations reach target tissue in the central nervous system.^[3]

The frequently cited 2015 PRP case report

In 2015, Alcaraz, Oliver and Sánchez described a six-year-old boy with perinatal cerebral palsy, cognitive impairment and marked generalised spasticity. He received a single intravenous dose of 25 ml concentrated autologous PRP, with follow-up at three and six months.

The authors reported changes in memory, language, complex tasks and acquisition of new abilities, and described changes on cortical PET imaging. A small haematoma at the venous access site was reported as an adverse event.

These observations are scientifically interesting but do not demonstrate efficacy. This was one patient without a control group. Ongoing rehabilitation, normal development, repeated-testing effects and other influences cannot be excluded. PET changes also do not prove that damaged neurons or brain structures were repaired.^[1]

The 2016 study involving 50 children

In 2016, the same research group published a case-control study involving 50 children aged five to 15 years. All participated in a comparable neurorehabilitation programme. Twenty-five children additionally received a single intravenous dose of 25 ml of a concentrated leukocyte-rich plasma/growth-factor preparation.

The authors reported differences favouring the treated group in measured functional or cognitive parameters after two months. Over the observation period, however, there was no correspondingly clear relationship between measured growth-factor concentrations and the reported development.

The investigated preparation cannot automatically be equated with every product currently described as PRP. The small sample, study design and absence of independent replication limit the conclusions.^[2]

How robust is the direct PRP evidence?

These two early publications account for much of the directly cited clinical PRP literature in cerebral palsy, and both came from the same research group. Independent replication in larger randomised controlled trials would be substantially more informative.

What has research shown since 2016?

Regenerative-medicine research in cerebral palsy has continued, but largely in directions other than classical PRP. A 2026 systematic review analysed 18 clinical studies involving 1,087 children, focusing mainly on products derived from umbilical-cord material, different cell therapies and other regenerative approaches.

Some studies reported changes in motor outcomes, while the review also highlighted small study populations, heterogeneous protocols, limited follow-up and missing long-term data. Crucially, these studies do not create a modern robust evidence base for classical PRP in cerebral palsy.^[4]

PRP is not the same as cord blood or cell therapy

Regenerative medicine covers biologically different interventions. Positive results from one approach must not be transferred to another.^{[5] [6]}

Is there an established PRP protocol for cerebral palsy?

No. Published studies do not support a generally accepted PRP dose, optimal platelet concentration, repeat interval or standard route of administration.

Specific claims about repeat treatment every three to six months, intrathecal administration or supposedly optimal target concentrations should therefore not be presented as a validated cerebral-palsy protocol. PRP research in general also shows substantial variability in processing methods and protocols.

What is known about safety?

PRP is produced from autologous blood, giving it a different risk profile from donor cell or tissue products. This does not mean that an application is inherently risk-free.

The two early cerebral-palsy publications did not report serious adverse events; each described a small haematoma at the venous access site. The limited number of treated patients cannot establish general or long-term safety of intravenous PRP in children with cerebral palsy.

Statements such as “allergic reactions are excluded” or that PRP is “one of the safest regenerative methods” go beyond the available evidence.^{[1] [2]}

Is PRP effective in cerebral palsy?

There are early positive observations, but they are insufficient to establish an accepted treatment. It would also be too absolute to claim that any possible effect has been ruled out. The scientifically appropriate position is that the hypothesis remains of research interest but is not adequately clinically confirmed.^{[1] [2]}

What would stronger future research require?

Larger, preferably multicentre randomised controlled trials would be required. Patient groups, age and cerebral-palsy subtypes should be clearly defined, and the PRP preparation should be fully characterised, including platelet and leukocyte concentrations, processing, activation, dose and route of administration.

Concomitant measures such as physiotherapy or neurorehabilitation should be comparable between groups. Standardised, clinically meaningful outcomes should assess motor function, daily activities, communication and quality of life.^{[3] [4]}

Frequently asked questions

References and further reading