Neurodevelopment and chronic illness: Mechanisms of disease and treatment

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Abstract

Successful treatment of many childhood diseases once considered terminal has resulted in the emergence of long-term effects of the disease or consequences of treatment that were previously unrecognized. Many of these long-term effects involve the central nervous system (CNS) and are developmental in the way that they emerge over time. Because we are now able to observe the natural history of childhood diseases such as sickle cell anemia or HIV, or the consequences of treatment of disease such as leukemia, brain tumors, or kidney disease, we are also able to study a number of biological mechanisms that result in long-term neurocognitive impairment. While some of the neurodevelopmental outcomes can be directly linked to structural damage of the CNS, other systems (e.g., hematologic, immunologic, pulmonary) appear to play crucial indirect roles in the development of the CNS and neurocognitive abilities because of the way that they affect the course of brain development and activity of the brain across time. Important interactions between acute disease factors, biological mechanisms, age at the time of disease or treatment effect, and disruptions in patterns of development after successful treatment or management all provide support for a neurodevelopmental model of childhood chronic illness. Testing this model may make it possible to more accurately predict the timing and degree of severity of long-term neurodevelopmental consequences, provide guidance for improved treatment and prevention, and offer better understanding of neurodevelopmental disruptions that occur in other non-chronic illness related disabilities.

Original languageEnglish
Pages (from-to)168-173
Number of pages6
JournalMental Retardation and Developmental Disabilities Research Reviews
Volume12
Issue number3
DOIs
StatePublished - Nov 3 2006

Fingerprint

Chronic Disease
Central Nervous System
Brain
Kidney Diseases
Biological Factors
Sickle Cell Anemia
Brain Diseases
Acute Disease
Natural History
Brain Neoplasms
Leukemia
HIV
Lung

Keywords

  • Childhood chronic illness
  • Childhood disease late effects
  • Neurocognitive impairment
  • Neurodevelopmental disability

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Neuropsychology and Physiological Psychology
  • Genetics(clinical)

Cite this

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