Reducing neurodevelopmental disorders and disability through research and interventions

Boivin, Michael J.; Kakooza, Angelina; Warf, Benjamin C.; Davidson, Leslie L.; Grigorenko, Elena L.

doi:10.1038/nature16029

Cited by 120 publications

(61 citation statements)

References 71 publications

(70 reference statements)

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“…Importantly, if such exposures occur during a critical period of brain development, alterations in both brain and behavioral development may be permanent. 12 This interrelationship not only governs the trajectory of a child's development, but is also important in the assessment of child neurodevelopment. Research conducted in LRS focused on the intersection of nutrition and inflammation and their effects on children's development requires attention to the type of research being conducted, its primary purpose, and the methods used.…”

Section: Assessment Of Neurodevelopmentmentioning

confidence: 99%

“…This definition has been modified for this effort from an earlier version recently published in Nature. 12 Nutrition is defined as the science of food, the nutrients and other substances therein, their action, interaction, and balance in relation to health and disease, and the processes of ingestion, absorption, use, and excretion. 13 Inflammation is a stereotypical physiologic response to infections, tissue injury, psychological stress, and other insults.…”

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confidence: 99%

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Assessment of Neurodevelopment, Nutrition, and Inflammation From Fetal Life to Adolescence in Low-Resource Settings

et al. 2017

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Efforts to improve child neurodevelopment are critical to health, equity, and sustainable development, particularly in low-resource settings in the United States and globally. The colliding epidemics of food insecurity, infectious diseases, and noncommunicable diseases interact and impact neurodevelopment. Understanding the complex relationships between nutrition, inflammation, and neurodevelopment can inform clinical and public health interventions to improve outcomes. This article reviews key definitions, tools, and considerations for the assessment of nutrition, inflammation, and child neurodevelopment. The effectiveness of existing assessment tools to reflect status and biology, particularly in relation to each other, and to predict long-term changes in health is examined. The aim of this review is to present the extant evidence, identify critical research gaps, and suggest a research agenda for future longitudinal and intervention studies to address the assessment of nutrition, inflammation, and child neurodevelopment, particularly in lowresource settings. Despite research gaps, there is a strong relationship between nutrition, inflammation, environmental factors, and child neurodevelopment, which emphasizes the need to evaluate targeted, early interventions to improve long-term health and well-being.

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Section: Assessment Of Neurodevelopmentmentioning

confidence: 99%

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confidence: 99%

Assessment of Neurodevelopment, Nutrition, and Inflammation From Fetal Life to Adolescence in Low-Resource Settings

et al. 2017

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“…12 The treatment of hydrocephalus is focused on relieving the symptoms it causes, which often includes the placement of ventriculoperitoneal shunts that are subject to frequent failure and surgical revision.…”

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confidence: 99%

Cerebrospinal fluid hypersecretion in pediatric hydrocephalus

Karimy¹,

Durán²,

Hu³

et al. 2016

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Hydrocephalus, despite its heterogeneous causes, is ultimately a disease of disordered CSF homeostasis that results in pathological expansion of the cerebral ventricles. Our current understanding of the pathophysiology of hydrocephalus is inadequate but evolving. Over this past century, the majority of hydrocephalus cases has been explained by functional or anatomical obstructions to bulk CSF flow. More recently, hydrodynamic models of hydrocephalus have emphasized the role of abnormal intracranial pulsations in disease pathogenesis. Here, the authors review the molecular mechanisms of CSF secretion by the choroid plexus epithelium, the most efficient and actively secreting epithelium in the human body, and provide experimental and clinical evidence for the role of increased CSF production in hydrocephalus. Although the choroid plexus epithelium might have only an indirect influence on the pathogenesis of many types of pediatric hydrocephalus, the ability to modify CSF secretion with drugs newer than acetazolamide or furosemide would be an invaluable component of future therapies to alleviate permanent shunt dependence. Investigation into the human genetics of developmental hydrocephalus and choroid plexus hyperplasia, and the molecular physiology of the ion channels and transporters responsible for CSF secretion, might yield novel targets that could be exploited for pharmacotherapeutic intervention.

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“…Many of the international surgical initiatives for hydrocephalus to date have attempted to address the aforementioned issues by improving the longevity and continuity of local initiatives, providing training for local health professionals and fellowship programs for the next generation of local neurosurgeons, following up with patients, and crafting innovative interventions, such as ETV/CPC, that are ultimately more suitable to a developing nation's scarce resources. 10,11,45,48,62,66,68 …”

Section: Ethics Of International Aidmentioning

confidence: 99%

Global surgery for pediatric hydrocephalus in the developing world: a review of the history, challenges, and future directions

Muir

Wang

Warf

2016

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OBJECTIVE Pediatric hydrocephalus is one of the most common neurosurgical conditions and is a major contributor to the global burden of surgically treatable diseases. Significant health disparities exist for the treatment of hydrocephalus in developing nations due to a combination of medical, environmental, and socioeconomic factors. This review aims to provide the international neurosurgery community with an overview of the current challenges and future directions of neurosurgical care for children with hydrocephalus in low-income countries. METHODS The authors conducted a literature review around the topic of pediatric hydrocephalus in the context of global surgery, the unique challenges to creating access to care in low-income countries, and current international efforts to address the problem. RESULTS Developing countries face the greatest burden of pediatric hydrocephalus due to high birth rates and greater risk of neonatal infections. This burden is related to more general global health challenges, including malnutrition, infectious diseases, maternal and perinatal risk factors, and education gaps. Unique challenges pertaining to the treatment of hydrocephalus in the developing world include a preponderance of postinfectious hydrocephalus, limited resources, and restricted access to neurosurgical care. In the 21st century, several organizations have established programs that provide hydrocephalus treatment and neurosurgical training in Africa, Central and South America, Haiti, and Southeast Asia. These international efforts have employed various models to achieve the goals of providing safe, sustainable, and cost-effective treatment. CONCLUSIONS Broader commitment from the pediatric neurosurgery community, increased funding, public education, surgeon training, and ongoing surgical innovation will be needed to meaningfully address the global burden of untreated hydrocephalus.

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Reducing neurodevelopmental disorders and disability through research and interventions

Cited by 120 publications

References 71 publications

Assessment of Neurodevelopment, Nutrition, and Inflammation From Fetal Life to Adolescence in Low-Resource Settings

Assessment of Neurodevelopment, Nutrition, and Inflammation From Fetal Life to Adolescence in Low-Resource Settings

Cerebrospinal fluid hypersecretion in pediatric hydrocephalus

Global surgery for pediatric hydrocephalus in the developing world: a review of the history, challenges, and future directions

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