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产前应激与大脑发育:神经发育障碍的风险。

Prenatal stress and the developing brain: Risks for neurodevelopmental disorders.

机构信息

University of Leuven.

University Hospital Jena.

出版信息

Dev Psychopathol. 2018 Aug;30(3):743-762. doi: 10.1017/S0954579418000342.

Abstract

The prenatal period is increasingly considered as a crucial target for the primary prevention of neurodevelopmental and psychiatric disorders. Understanding their pathophysiological mechanisms remains a great challenge. Our review reveals new insights from prenatal brain development research, involving (epi)genetic research, neuroscience, recent imaging techniques, physical modeling, and computational simulation studies. Studies examining the effect of prenatal exposure to maternal distress on offspring brain development, using brain imaging techniques, reveal effects at birth and up into adulthood. Structural and functional changes are observed in several brain regions including the prefrontal, parietal, and temporal lobes, as well as the cerebellum, hippocampus, and amygdala. Furthermore, alterations are seen in functional connectivity of amygdalar-thalamus networks and in intrinsic brain networks, including default mode and attentional networks. The observed changes underlie offspring behavioral, cognitive, emotional development, and susceptibility to neurodevelopmental and psychiatric disorders. It is concluded that used brain measures have not yet been validated with regard to sensitivity, specificity, accuracy, or robustness in predicting neurodevelopmental and psychiatric disorders. Therefore, more prospective long-term longitudinal follow-up studies starting early in pregnancy should be carried out, in order to examine brain developmental measures as mediators in mediating the link between prenatal stress and offspring behavioral, cognitive, and emotional problems and susceptibility for disorders.

摘要

产前阶段越来越被认为是预防神经发育和精神疾病的关键时期。了解其病理生理机制仍然是一个巨大的挑战。我们的综述揭示了产前大脑发育研究的新见解,包括(表观)遗传学研究、神经科学、最新的成像技术、物理建模和计算模拟研究。使用脑成像技术研究产前暴露于母体压力对子代大脑发育的影响,揭示了出生时和成年后的影响。在包括前额叶、顶叶和颞叶以及小脑、海马体和杏仁核在内的几个脑区观察到结构和功能变化。此外,还观察到杏仁核-丘脑网络以及内在大脑网络(包括默认模式和注意力网络)的功能连接改变。观察到的变化是后代行为、认知、情感发展以及对神经发育和精神疾病易感性的基础。结论是,用于大脑的测量方法在预测神经发育和精神疾病的敏感性、特异性、准确性或稳健性方面尚未得到验证。因此,应该开展更多从怀孕早期开始的前瞻性长期纵向随访研究,以检查大脑发育测量作为中介,在产前压力与后代行为、认知和情感问题以及易患障碍之间的联系中发挥作用。

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