The spatiotemporal group-level patterns of brain macrostructural development across adolescence have over the past decades been relatively well documented. Efforts are now being directed towards understanding individual variability in brain development, as well as its causes and consequences. While genetic factors and pre- and perinatal events have critical impact on brain structural development, calls are now made to also study the brain in dynamic transactional interplay with the different aspects of an individual’s physical and social environment across all stages of development. Such a focus is highly relevant for research on adolescence, a period of life involving a multitude of contextual changes paralleled by continued refinement of complex cognitive and affective neural systems. Insights into the relations between environmental factors and adolescent brain development and the consequences for mental health, have the potential to provide valuable directions for policy changes and targets for prevention. Here, we discuss associations between selected aspects of an individual’s physical and social environment and adolescent brain structural development, and possible links to mental health. We also touch on methodological considerations for future research.

Insufficient maternal folate concentrations appear to be a fetal risk factor for neural tube defects (NTD). Erythrocyte folate concentrations are widely accepted as an indicator of tissue folate storage. We retrospectively evaluated erythrocyte folate concentrations to examine if a recommended daily dosage of 5 mg folic acid is sufficient to balance the impact of antiepileptic drugs (AED) on folate metabolism in women with epilepsy. Data of 48 women (mean age 30.3 years) with idiopathic epilepsy with generalized seizures (n=12) or symptomatic epilepsy with focal seizures (n=36) were available, 43 women submitted to further analysis and 30 women received AED monotherapy. Duration of folic acid supplementation varied between 0.5 and 12 months. The daily dosage of folic acid ranged from 0.4 to 15 mg and 32 women received 5 mg/day. Erythrocyte folate concentrations ranged from 282 to 1596 ng/ml (mean 780 ng/ml). In 29 out of the 32 women (90.6%) on 5 mg folic acid per day, red cell folate was ≥400 ng/ml. In previous studies the risk for NTD was estimated to be 0.8‰ if red cell folate was ≥400 ng/ml. Our results suggest that 5 mg/day folic acid as preconception supplementation in women with epilepsy is effective to balance the impact of AEDs on folate metabolism in women with epilepsy.

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ZusammenfassungWirbelkörperfrakturen sind eine mögliche, häufig aber übersehene Folge generalisierter tonisch-klonischer Anfälle. Wir berichten von zwei Patienten, die die Einnahme ihrer antiepileptischen Medikation beendeten und daraufhin epileptische Anfälle mit assoziierter Wirbelkörperfraktur erlitten. Aufgrund der häufig fehlenden neurologischen Defizite sollte speziell bei postiktalem Rückenschmerz an eine mögliche Wirbelkörperfraktur gedacht werden und eine radiologische Diagnostik erfolgen.