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• Consensus document on European brain research
  Michael A. Crawford
  Published on: 24 July 2006

• Published on: 24 July 2006

  Consensus document on European brain research

  • Michael A. Crawford, Research Director
  • Other Contributors:
    • London Metropolitan University

  Dear Editor,

  This document is timely and important. It contains a wealth of information about brain disorders and the need for research and testing action where there is evidence for interventions.

  There is however, one serious omission: neurodevelopmental disorder. This should have appeared in the section under neurogenesis but it did not.

  During the last trimester of pregnancy, the human fe...

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  Dear Editor,

  This document is timely and important. It contains a wealth of information about brain disorders and the need for research and testing action where there is evidence for interventions.

  There is however, one serious omission: neurodevelopmental disorder. This should have appeared in the section under neurogenesis but it did not.

  During the last trimester of pregnancy, the human fetal brain consumes 70% of all the energy directed to the fetus from the mother. This is a critical period for bran development for missing a developmental milestone means it is missed for life, disorder of development means disorder for life. There is no cure for cerebral palsy and disorder which may lead to autism, cognitive defects, learning disabilities, visual, audio and motor distortions are usually life long.

  The risk of central nervous system disorder rises from about 1 or 2 per 1,000 live births at normal birthweights but rises to over 200/1,000 at weights below 1.5Kg when the babies will most likely be also born preterm. At the extreme end we have cerebral palsy. The most severe cases will require 24 hour nursing care. However, a high proportion of those who escape severe CNS disorder are likely to grow up with poor learning abilities and behavioural disorders.

  Low birthweight is known to affect the lower socio-economic classes more so than others. Moreover there is increasing evidence that environmental factors, both epidemiologically and experimentally will affect gene expression and lead to prenatal programming of gene behaviour which can have lasting effects.

  There is a good probability that epilepsy, autism, attention deficit and hyperactivity disorder and schizophrenia may have prenatal and or early post-natal origins..

  It seemed to me the whole thrust of the Consensus statement was focussed on measures designed to treat disorder. There is no harm in that but it would be prudent and indeed balanced scientifically if the causes of neurodevelopmental disorders were addressed as well as the means to prevent them.

  The Little Foundation has just completed its European Study of cerebral palsy. Four year old children were examined by state of the art MRI.. The results were reported in Monaco and the Royal Society of Medicine, London recently. In effect by identifying the location of the origins of the lesions, the researchers were able to establish that the majority were within 40 weeks after conception.. That combined with the known socio-economic, nutritional and other risk factors identifies areas of scientific enquiry on cause and prevention.

  You may know that there was an increase in such disorders amongst the low and very low birthweight infants from the late 1960s to late 1980s. The Little Foundation estimated that the cost in the UK alone is of the order of £4 billion a year which across the EU adds substantially to the overall burden of brain disorders. .

  The gravity of the rise in brain disorders cannot be over emphasised. It was predicted that brain disorders would rise following on the previous rise in death from cardio-vascular disease, in view of the common biological requirements as regards environmental and nutritional requirements common to both. The brain just happens to be better protected.

  This means that this century there is likely to be a continued increase in brain disorders because of the time lag between the factors operating on CVD and the CNS. That is a very serious matter which I would wish to add to your otherwise superlative document.

  Professor Michael A Crawford,
  The Mother and Child Foundation.
  http://www.mother-and-child.org

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  Conflict of Interest:
  None declared.

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