Early intervention in neurodevelopmental disorders: underlying neural mechanisms

Abstract

MRIMagnetic Resonance Imaging EI Early Intervention ICT Information and Communications Technology CT CareToyNeurodevelopmental disorders affect motor, cognitive, language, learning, and behavioural development with lifelong consequences. Early identification of infants at risk for neurodevelopmental disorders is a major prerequisite for intervention programmes. This ensures that interventions which aim to positively modify the natural history of these disorders can start in the first weeks or months of life. As indicated by recent scientific evidence, gene abnormalities or congenital brain lesions are not the sole determinants for the neurodevelopmental outcome of affected infants. In fact, environment and experience may modify brain development and improve the outcome in infants at risk for neurodevelopmental disorders. In this review, we analyse the complexity and sensitivity of the brain to environmental stimuli, highlighting clinical effects of early intervention, mainly reported so far in preterm infants, and summarizing the effects of enriched environment on human and animal models. Finally, we discuss some new approaches to early intervention, based on recent neurophysiological theories and new breakthroughs in biotechnologies for diagnosis and rehabilitation.In the last decades several studies have explored and demonstrated the effects of environment and experience on brain development and plasticity. This review aims to (1) highlight some underlying neuronal and biological mechanisms of environmental enrichment both in animal and human models; (2) summarize the effects of early intervention in infants at risk for neurodevelopmental disorders and report their most representative results; and (3) explore the new breakthroughs of early intervention in the field of novel recent neurophysiological theories, and application of information and communication technologies. NEURODEVELOPMENTAL DISORDERS: THE IMPORTANCE OF EARLY IDENTIFICATION AND INTERVENTIONNeurodevelopmental disorders are impairments of brain growth and development affecting several brain functions, and include cognitive, motor, language, learning, and behavioural disorders due to many causes -genetic, lesional, and environmental. 1 Infants at high risk for neurodevelopmental disorders can be identified early, i.e. in the first weeks or months of life, through careful clinical evaluation (i.e. developmental tests, neurological examination, observation of spontaneous movement patterns) combined with specific technical tools such as neuroimaging (cranial ultrasounds, brain magnetic resonance imaging [MRI]), neurophysiological tests (e.g. electroencephalography, evoked potentials), and genetic tests (karyotype, comparative genomic hybridization-microarray). The application of evidence-based recommendations or decision-making processes, which combine the use of clinical and technical tools at a proper point during development, is crucial for early detection of infants at risk for neurodevelopmental disorders by clinicians.An example of early identif...

A randomized clinical trial in preterm infants on the effects of a home-based early intervention with the 'CareToy System'

“…In recent years, interest in early intervention (EI) has increased considerably with the awareness that it may be pivotal in improving neurodevelopmental outcome for infants at risk for NDDs [4]. …”

Early intervention at home in infants with congenital brain lesion with CareToy revised: a RCT protocol

“…Early diagnosis has considerable importance because it allows for an early medical response and intervention which, as indicated by literature, can improve developmental outcome of high-risk children [7]. Moreover, early intervention (EI) is crucial because it targets brain plasticity, which for many functions has a maximum expressivity in an early limited time window or “critical period” [8, 9]. …”

Differential Roles of Environmental Enrichment in Alzheimer’s Type of Neurodegeneration and Physiological Aging

“…(Janssen et al, 2014; Polito et al, 2014; Cioni et al, 2016; Rosbergen et al, 2016). Particularly, prevention or treatment of Alzheimer-type neurodegeneration is one of the most challenging questions in the modern neuroscience which is directly linked to the controlled modulation of hippocampal plasticity (Balietti et al, 2012) In such context, EE provides a lot of premises for its effective application: prevention of hippocampal astroglial dysfunction in the AD transgenic mice (Rodriguez et al, 2013), up-regulation of brain-derived growth factor expression in the hippocampus of senescence-accelerated prone mice (Yuan et al, 2012), prevention of amyloid β (Aβ) deposition and memory impairment in AD model mice (Maesako et al, 2012), modulation of hippocampal synaptic proteins expression (Barak et al, 2013).…”