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PubMed1986

Pharmacologic treatment of psychiatric and neurodevelopmental disorders in children and adolescents (Part 1).

A review is presented of the diagnosis and drug treatment of the more common psychiatric and developmental disorders in the pediatric population. Where applicable, DSM III (Diagnostic and Statistical Manual of Psychiatric Disorders, III) criteria are utilized to describe the behavioral syndromes. The indications for usage and appropriate dosages of antipsychotics, antidepressants, anxiolytics, stimulants, and lithium are described. Those disorders discussed are attention deficit disorder, conduct disorders, anxiety disorders, sleep disorders, schizophrenia, autism, Tourette's syndrome, mental retardation, depressive illness, manic depressive illness, eating disorders, and enuresis.

Adolescent↗
PubMed1993

Nutrition and neurodevelopmental disorders.

Since the 1960s the structural requirements for the growth, development and function of the brain have become better understood due to the recognition of the prodigious energy needs for brain development and its structural requirements for lipids. The most vulnerable period of neural development is during embryonic and fetal growth. There is now both retrospective and prospective evidence that maternal nutrition prior to conception is most important to pregnancy outcome. Our studies on maternal nutrition in pregnancy again illustrate the relationship of maternal nutrition to birthweight and head circumference. In a study of 513 pregnancies we found that nutrient intakes in mothers of low birthweight babies were well below those of mothers whose babies were in the 3.5-4.5 Kg range at which morbidity is at its lowest. Nutrient intakes tracked with birthweight, independent of smoking and alcohol up to, but not above 3,270 g. The closest correlations were obtained with the diet of the mother at or about the time of conception rather than later in the pregnancy. Our studies also reveal that premature and intrauterine growth retarded babies were born with deficits of the types of essential fatty acids (arachidonic AA, docosahexaenoic DHA acids) known to be required for brain development. Deficits of brain DHA have been found experimentally to impair visual and cognitive development and also to cause haemorrhage, not unlike peri-ventricular haemorrhage in low birthweight babies, the above evidence is suggestive of a route to test the prevention and treatment of these types of membrane related disorders.

Cephalometry↗
PubMed2001

Selective vulnerability of embryonic cell populations to ethanol-induced apoptosis: implications for alcohol-related birth defects and neurodevelopmental disorder.

BACKGROUND: Ethanol-induced cell death has been characterized in very few stages of embryogenesis. This investigation comprehensively maps patterns of both programmed and ethanol-induced cell death in the central nervous system and craniofacial region at 0.5-day intervals from gestational day (GD) 6.5 to 11 in mice. METHODS: A teratogenic dosage of ethanol (2.9 g/kg) or vehicle was administered via two intraperitoneal injections to pregnant C57BL/6J mice at various stages of gestation. Cell death patterns were characterized using Nile blue sulfate vital staining and histological analysis of plastic sections. Confocal laser scanning microscopy of LysoTracker Red-stained specimens allowed for three-dimensional visualization of areas of apoptosis and precise sectional imaging of mouse embryos. Apoptosis was also documented using a TUNEL technique on histological sections. RESULTS: Normal programmed cell death in control embryos was noted in the prechordal plate region at GD 8, the neuroepithelium of the fourth ventricle and anterior neuropore at GD 9, and within the ganglia of cranial nerves V, VII-VIII, IX, and X at GD 10. Acute maternal ethanol administration 12 hr before examination resulted in a dramatic increase in apoptosis within sites of programmed cell death in the embryo. Moreover, ethanol-exposed specimens exhibited stage-dependent excessive cell death in other distinct cell populations, particularly within the developing central nervous system. Ethanol-induced apoptosis was notable as follows: GD 7.5-neuroectoderm; GD 8-neural plate and primitive streak; GD 9-alar plate and presumptive neural crest of the rostral hindbrain, especially at the mesencephalon/rhombencephalon junction; GD 9.5-10-branchial arches and rhombomeres; and GD 11-diencephalon, basal ganglia, pons, and developing cerebellum. CONCLUSIONS: The results of this study revealed developmental stage-specific cell populations of the developing brain and craniofacial region that are vulnerable to ethanol-induced apoptosis and provide new insight relative to the genesis of alcohol-related birth defects.

Animals↗
PubMedDate not supplied

[Neurodevelopmental disorders in children with an antecedent of subependymal/intraventricular hemorrhage at 3 years of age].

UNLABELLED: Intraventricular and subependymal hemorrhage are common complications among preterm infants. The aim of the present study was to assess its implication in the neurodevelopment at 3 years of age. MATERIAL AND METHODS: Cerebral ultrasonography with evidence of any stage of intraventricular hemorrhage (Papille's classification) during neonatal period and a neurologic evaluation at 3 years of age were performed on each patient. One hundred twenty four patients were enrolled and assigned to four groups according the intraventricular hemorrhage (IVH) stage: Grade 1, 14 patients, grade II, 84, grade III, 22, and grade IV nine patients. RESULTS: Morbility was similar for all groups; hydrocephalus was more frequent in group III (73%), and in group IV chronic pulmonary disease (77%) was more frequent. Forty five percent of the sample showed neurologic alterations with the greatest proportion in group IV (89%); OR for groups III and IV was 3.51 with a 95% confidence interval of (1.49, 8.28 p = 0.005). Grades III&IV showed lowest Terman Merril scores and grade IV scores were within the range of mental retardation. No statistical difference was found between grades at audition evaluation. CONCLUSIONS: Neurologic alterations were greater in poorer grades of IVH, and risk will increment for grades III and IV. Associated pathologies for IVH grades III and IV were hydrocephalus and chronic pulmonary disease.

Birth Weight↗
PubMed2006

[Language and neurodevelopmental disorders. A review of their clinical characteristics].

INTRODUCTION: Language is a keystone in the normal social and cognitive development of any group of children and early, fitting interventions can largely reduce the repercussions that the deficit has in this area. The article analyses the definition of language as 'the result of a complex nervous activity that allows individuals to communicate mental states by the production of multi-modal signs that symbolise these states in accordance with a linguistic community's own convention'. Other language-related terms are also dealt with. DEVELOPMENT: Different classifications of language disorders are also discussed and we analyse its characteristics in different neurological disorders, such as motor disorders with a central origin, autistic spectrum, learning disorders, mental retardation, and attention deficit and disruptive behaviour disorders. CONCLUSIONS: Disorders affecting language clearly display semiological heterogeneity, and therefore it is advisable to take into account the classifications and terms related to it. It is also necessary to be familiar with the specific features of each alteration in the different neurological disorders so as to be able to reach an accurate diagnosis that allows the implementation of suitable lines of behaviour and interventions. Additionally, this will also allow timely measures to be taken in order to avoid later complications.

Adolescent↗
PubMed2006

[Techniques for the functional evaluation of neurodevelopmental disorders].

AIM: To review the evaluation of neuropsychological functions by using non-invasive functional neuroimaging methods. DEVELOPMENT: Non-invasive functional neuroimaging methods can be sorted into two broad categories: the first includes those that make use of electromagnetic techniques, such as event-related potentials and magnetoencephalography (MEG), and the second consists of those involving haemodynamic techniques, such as positron emission tomography and functional magnetic resonance imaging. These methods have been employed in particular to evaluate the following functions: attention, perception, imagination, language, working memory, semantic retrieval, episodic memory, episodic memory retrieval, priming and procedural memory. The capacity of MEG, both for analysis and for organising the information it receives, is so large that it takes only a few milliseconds to evaluate brain activity and to create functional maps of the brain in which the brain structure is set out in blocks of cubic centimetres or even millimetres. This makes it possible to generate functional maps of brain activity that are capable of being organised and represented in terms of both time and space. It also enables us to obtain images that result from the signalling activity of sets of nerve cells (especially from the dendritic currents) and the electromagnetic signal that carries this information to the outer surface of the head, where the magnetic flow can be recorded. CONCLUSIONS: With the findings from these studies it has become possible to establish a topographic correlation between the functions and the basic brain processes involved in each paradigm. A growing body of clinical evidence proves the value of using them (especially MEG) with cases of epilepsy, language, dyslexia, autism and attention deficit hyperactivity disorder.

Cerebrovascular Circulation↗
PubMed2006

A meta-analysis epidemiological assessment of neurodevelopmental disorders following vaccines administered from 1994 through 2000 in the United States.

BACKGROUND: Thimerosal is an ethylmercury-containing compound (49.6% mercury by weight) used as at the preservative level in vaccines (0.005% to 0.01%). METHODS: Statistical modeling in a meta-analysis epidemiological assessment of the Vaccine Adverse Event Reporting System (VAERS) for neurodevelopment disorders (NDs) reported following Diphtheria-Tetanus-whole-cell-Pertussis (DTP) vaccines in comparison to Diphtheria-Tetanus-whole-cell-Pertussis-Haemophilus Influenzae Type b (DTPH) vaccines (administered: 1994-1997) and following Thimerosal-containing Diphtheria-Tetanus-acellular-Pertussis (DTaP), vaccines in comparison to Thimerosal-free DTaP vaccines (administered: 1997-2000), was undertaken. RESULTS: Significantly increased adjusted (sex, age, vaccine type, vaccine manufacturer) risks of autism, speech disorders, mental retardation, personality disorders, thinking abnormalities, ataxia, and NDs in general, with minimal systematic error or confounding, were associated with TCV exposure. CONCLUSION: It is clear from the results of the present epidemiological study and other recently published data associating mercury exposure with childhood NDs, additional ND research should be undertaken in the context of evaluating mercury-associated exposures, especially from Thimerosal-containing vaccines.

Child, Preschool↗
PubMed1997

Rett Syndrome: Meeting the Challenge of This Gender-Specific Neurodevelopmental Disorder.

Rett syndrome (RS) is an incurable neurological disorder that occurs in females. Although the biological basis is unknown, there is substantial evidence suggesting a genetic basis. RS is characterized by an initial period of apparently normal psychomotor development followed by loss of communication skills and purposeful hand movement. Then, hand stereotypies, gait dyspraxia, and deceleration of head growth become apparent. Other problems include growth failure and epilepsy. There is no biological marker for RS; the diagnosis is based on well-delineated clinical criteria. The prevalence of RS is 1:23,000 live female births. Survival to 30-40 years or beyond is the rule rather than the exception. Treatment is both palliative and supportive. A vigorous approach to all aspects of care, including educational, medical, and psychosocial issues, is recommended.

Journal Article↗
PubMedDate not supplied

Volumetric neuroimaging in children with neurodevelopmental disorders--mapping the brain and behavior.

The recent volumetric neuroimaging studies in children with fragile X syndrome, Down syndrome (DS), Rett syndrome (RS), and Tourette syndrome (TS) were reviewed. Neuroimaging studies and cognitive and behavioral phenotypes pertinent to each disorder were reviewed within the context of current knowledge of their neurobiological mechanisms. The mainly involved brain regions in fragile X syndrome are the cerebellar vermis, temporal areas, and the caudate nucleus which may be related to autistic tendency, problems of memory and language and deficits in executive function, respectively. The preferential involvement of frontal lobe, cerebellum and mesial temporal areas may correspond to the selective language and speech deficits in DS children. There was significantly generalized cerebral volume reduction with greater loss of gray matter in comparison to white matter, consistent with the extensive clinical features of RS. Right side predominance of basal ganglia supported the suggestion that the basal ganglia is related to pathogenesis of TS, which may also be related to the impaired executive function and the absence of functional asymmetry. Further prospectives for integrating neuroanatomic findings and neurobehavioral studies also were discussed.

Brain↗
PubMed1998

Proton MR spectroscopy in psychiatric and neurodevelopmental childhood disorders: early experience.

Variations in brain morphology are increasingly being found in patients with psychiatric disorders. There is early evidence that some metabolic abnormalities may also be present in these patients. In many patients with psychiatric disorders, the diagnosis is not straight forward and may be confounded by co-morbid processes. Establishing the correct diagnosis is important as it leads to institution of appropriate therapies. Descriptions of the authors early experience using proton MR spectroscopy in the evaluation of children with bipolar affective disorder, attention deficit hyperactivity disorder, neurodevelopmental abnormalities in patients with neurofibromatosis type 1, and the effects of certain types of treatment used for these disorders are discussed.

Attention Deficit Disorder with Hyperactivity↗