Instituto de Biología Celular y Neurociencia "Prof. E. De Robertis", Facultad de Medicina, UBA, Buenos Aires,Argentina | Department of Obstetrics and Gynecology, Klinikum rechts der Isar, Technical University of Munich, Germany.
Department of Obstetrics and Gynecology, University of Washington, Seattle, WA,United States.
Curr Neuropharmacol. 2022;20(1):94-106. doi: 10.2174/1570159X19666210125150955.
Functional development of affective and reward circuits, cognition and response inhibition later in life exhibits vulnerability periods during gestation and early childhood. Extensive evidence supports the model that exposure to stressors in the gestational period and early postnatal life increases an individual's susceptibility to future impairments of functional development. Recent versions of this model integrate epigenetic mechanisms of the developmental response. Their understanding will guide the future treatment of the associated neuropsychiatric disorders. A combination of non-invasively obtainable physiological signals and epigenetic biomarkers related to the principal systems of the stress response, the Hypothalamic-Pituitary axis (HPA) and the Autonomic Nervous System (ANS), are emerging as the key predictors of neurodevelopmental outcomes. Such electrophysiological and epigenetic biomarkers can prove to timely identify children benefiting most from early intervention programs. Such programs should ameliorate future disorders in otherwise healthy children. The recently developed Early Family-Centered Intervention Programs aim to influence the care and stimuli provided daily by the family and improving parent/child attachment, a key element for healthy socio-emotional adult life. Although frequently underestimated, such biomarker-guided early intervention strategy represents a crucial first step in the prevention of future neuropsychiatric problems and in reducing their personal and societal impact.
生命后期情感和奖励回路、认知和反应抑制的功能发育在妊娠期和幼儿期表现出脆弱期。大量证据支持这样一种模式,即妊娠期和新生儿期暴露于应激源会增加个体未来功能发育受损的易感性。该模型的最新版本整合了发育反应的表观遗传机制。对其的理解将指导相关神经精神障碍的未来治疗。与应激反应的主要系统(下丘脑-垂体轴 (HPA) 和自主神经系统 (ANS))相关的非侵入性获得的生理信号和表观遗传生物标志物的组合,正在成为神经发育结果的关键预测指标。这些电生理和表观遗传生物标志物可以证明能够及时识别最受益于早期干预计划的儿童。此类计划应改善其他健康儿童的未来障碍。最近开发的早期家庭为中心的干预计划旨在影响家庭提供的日常护理和刺激,并改善父母/孩子的依恋,这是健康社会情感成人生活的关键因素。尽管经常被低估,但这种基于生物标志物的早期干预策略是预防未来神经精神问题和减少其个人和社会影响的关键第一步。