What is Neurodevelopmental Disorder?
Neurodevelopmental disorders are a group of conditions with impairment of the growth and development of the brain or central nervous system. These disorders typically occur in infancy and childhood and unfold as the individual grows, affecting a child’s ability to learn, speak, coordinate movement, socialize, or interpret stimulation properly. Types of neurodevelopmental disorders include attention deficit hyperactivity disorder (ADHD), Tourette disorder (TD), autism spectrum disorder (ASD), intellectual disability, learning disorders, communication disorders, speech and language disorder, and some genetic disorders such as fragile-X syndrome, Down syndrome, Rett syndrome, and epilepsy. The prevalence of developmental disorders has increased at an alarming rate. It is estimated the prevalence of ADHD ranges from 20.8 to 44.5%, of TD from 1.8 to 17.7%, and of ASD from 2.3 to 10.3%.
Causes
Genetics plays an important role in the development of many neurodevelopmental disorders. For example, Down syndrome, also known as Trisomy 21, is caused by an extra chromosome 21. Other genetically determined neurodevelopmental disorders include Fragile X syndrome, Rett syndrome, and Williams syndrome.
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Environmental contaminants
Some environmental contaminants such as lead, methylmercury, and polychlorinated biphenyls (PCBs) have been revealed to negatively affect a child’s developing brain and nervous system. Lead exposure in childhood may reduce cognitive function, attention-related behavioral problems, and increase the incidence of problem behaviors such as delinquent, criminal, or antisocial behavior.
Some infectious diseases that can be transmitted either congenitally or in early childhood can cause serious neurodevelopmental disorders. Congenital toxoplasmosis may cause the formation of cysts in the brain and other organs, resulting in a variety of neurological deficits. Measles may progress to subacute sclerosing panencephalitis.
Nutritional deficits may cause neurodevelopmental disorders. For example, a deficiency of folic acid during pregnancy may lead to a baby’s neural tube defects.
Brain trauma is also a common cause of neurodevelopmental disorders. Congenital injury or injury occurring in infancy or childhood may both cause neurodevelopmental disorders.
Treatment
The treatment of neurodevelopmental disorders is divided into pharmacological interventions such as psychotropic medications and anti-psychotic medication and non-pharmacological therapy such as behavioral therapy, psychosocial support, and neuropsychological rehabilitation. At present, non-pharmacological therapy is of greatest concern.
The selection of treatment strategies for neurodevelopmental disorders largely depends on the type of disorder and the major symptoms of each individual.
Schizophrenia is a serious mental illness that is caused by the interplay of genetic and environmental factors. Antipsychotic medications are the most commonly prescribed drugs for schizophrenia treatment. However, these medications may cause serious side effects. Therefore, non-pharmacological interventions may be preferable for schizophrenia treatment. Cognitive-behavioral therapies and neuroplasticity-based cognitive training approaches have been shown to promote functional recovery in the distributed neural system, relieving the symptoms of schizophrenia.
ASD is characterized by problems with communication and social interaction. The treatment for autism includes pharmacological interventions and non-pharmacological therapy. Aripiprazole and risperidone medications are applied for controlling irritability. Stimulant medications can help with ADHD symptoms. Newer targeted treatments that suppress the enhanced activity of the mGluR5 pathway and GABA agonists have been revealed to reduce ASD symptoms in the animal models. Targeted treatments and intensive behavioral and/or educational programs will be beneficial if started early. Besides, early behavioral interventions may effectively manage the signs and symptoms of ASD.
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