Cognitive Changes after Cellular Therapy in a Case of Intellectual Disability

Intellectual Disability (ID) is a developmental disability characterized by sub average intellectual functioning, occurring in 2-3% of the population. The underlying cause in ID is the sub-functioning of the neurons which significantly affects cognition, learning and adaptive behavior of an individual. The conventional management strategies address specific symptoms observed in ID and not the core pathology. In this case study, we evaluated the symptomaticand functional improvements after intrathecal transplantation of autologous Bone Marrow Mononuclear Cells (BMMNCs) in a 13-yearold girl diagnosed with ID. As a part of the protocol, she was also put on a multidisciplinary rehabilitation program. She underwent two cellular therapies twice at an interval of 11 months. Follow up was done at regular intervals of four and eleven months after each cellular therapy. No major adverse events were recorded post intervention. Improvements in command following, eye contact, sitting tolerance, balance, aggressive behaviour, hyperactivity and clarity of speech were observed over a period of 30 months of first intervention. Functional Independence Score (FIM) score increased from 76 to 78. On comparison of pre-intervention and post intervention after 11 months PET CT scan, improvement in metabolic activity of frontal lobe, cerebellum and the mesial temporal structures was recorded. These objective changes suggest that cellular therapy in combination with rehabilitation improves neuronal functioning, hence improving processing of information in ID. However, larger randomized control studies will be required to demonstrate long term benefits of cellular transplantation in ID.