Birbeck Gretchen L, Meyer Ana-Claire, Ogunniyi Adesola
Epilepsy Division, Department of Neurology, University of Rochester, 265 Crittenden Boulevard, CU420694, Rochester, New York 14642-0694, USA.
Chikankata Epilepsy Care Team, Chikankata Hospital, Private Bag S2, Mazabuka, Zambia.
Nature. 2015 Nov 19;527(7578):S167-71. doi: 10.1038/nature16031.
The resiliency of the adult nervous system is markedly affected by the environment and the circumstances during infant and child development. As such, adults in resource-limited settings who may have experienced early deprivation are particularly vulnerable to subsequent neurological disorders. Adult populations in countries with relatively recent advances in economic development may still have a higher susceptibility to neurological illness or injury that is reflective of the socioeconomic environment that was present during that population's infancy and childhood. Brain and peripheral nervous system research conducted over the past decade in resource-limited settings has led to an impressive and growing body of knowledge that informs our understanding of neurological function and dysfunction, independent of geography. Neurological conditions feature prominently in the burgeoning epidemic of non-communicable diseases facing low- and middle-income countries. Neurological research in these countries is needed to address this burden of disease. Although the burden of more prevalent and severe neurological disease poses public health and clinical challenges in settings with limited neurological expertise, the same factors, along with genetic heterogeneity and the relative absence of ingrained clinical care practices, offer circumstances well-suited for the conduct of crucial future research that is globally relevant.
成人神经系统的弹性受到婴幼儿发育期间环境和情况的显著影响。因此，在资源有限环境中可能经历过早剥夺的成年人特别容易患上随后的神经系统疾病。在经济发展相对较新的国家，成年人群体可能仍然对神经系统疾病或损伤具有较高的易感性，这反映了该人群在婴幼儿期和童年期所处的社会经济环境。过去十年在资源有限环境中进行的大脑和周围神经系统研究产生了令人印象深刻且不断增长的知识体系，这些知识有助于我们理解神经功能和功能障碍，而不受地理因素影响。神经疾病在低收入和中等收入国家面临的非传染性疾病新兴流行中占据显著地位。这些国家需要开展神经学研究以应对这一疾病负担。尽管在神经学专业知识有限的环境中，更普遍和严重的神经疾病负担带来了公共卫生和临床挑战，但同样的因素，加上基因异质性以及相对缺乏根深蒂固的临床护理实践，为开展具有全球相关性的关键未来研究提供了非常合适的条件。
