Klin A, Jones W
Children's Healthcare of Atlanta and Emory University School of Medicine. Atlanta, Georgia, EE.UU.
Rev Neurol. 2018 Mar 1;66(S01):S3-S15.
The future of neurodevelopmental medicine has the potential of situating child neurology at the forefront of a broad-based public health effort to optimize neurodevelopmental outcomes of children born with high-prevalence and diverse genetic, pre- and peri-natal, and environmental burdens compromising early brain development and leading to lifetime disabilities. Building on advancements in developmental social neuroscience and in implementation science, this shift is already occurring in the case of emblematic neurodevelopmental disorders such as autism. Capitalizing on early neuroplasticity and on quantification of trajectories of social-communicative development, new technologies are emerging for high-throughput and cost-effective diagnosis and for community-viable delivery of powerful treatments, in seamless integration across previously fragmented systems of healthcare delivery. These solutions could be deployed in the case of other groups of children at greater risk for autism and communication delays, such as those born extremely premature or with congenital heart disease. The galvanizing concept in this aspirational future is a public health focus on promoting optimal conditions for early brain development, not unlike current campaigns promoting pre-natal care, nutrition or vaccination.
神经发育医学的未来有可能使儿童神经病学处于一项广泛的公共卫生努力的前沿，该努力旨在优化那些因高发性、多样的遗传、产前和围产期以及环境负担而出生的儿童的神经发育结果，这些负担会损害早期大脑发育并导致终身残疾。基于发育社会神经科学和实施科学的进展，这种转变已经在诸如自闭症等典型神经发育障碍的情况下发生。利用早期神经可塑性以及社会交际发展轨迹的量化，新的技术正在出现，用于高通量且具有成本效益的诊断以及在社区可行的强大治疗方法的提供，以无缝整合先前分散的医疗保健提供系统。这些解决方案可应用于其他患自闭症和沟通延迟风险更高的儿童群体，例如那些极早产或患有先天性心脏病的儿童。在这个充满抱负的未来中，激励人心的理念是公共卫生专注于促进早期大脑发育的最佳条件，这与当前促进产前护理、营养或疫苗接种的运动并无不同。
