Mechanistic comparisons of functional domains across pediatric and adult bipolar disorder highlight similarities, as well as differences, influenced by the developing brain

Recent neuroimaging studies have uncovered much about the specific neural deficits in adult bipolar disorder (ABD), but despite promising results, neuroimaging research for pediatric bipolar disorder (PBD) is still developing. The neuroimaging literature is highly heterogeneous, varying in the paradigms used and in participants' mood states and medication status. Despite this variability, several dominant patterns emerge. In response to emotional stimuli, both ABD and PBD show limbic hyperactivity coupled with hypoactivity in ventral prefrontal emotion regulation systems. This pattern occurred most robustly in response to negative incidental stimuli and was especially apparent in manic PBD. ABD showed more variability in ventral prefrontal activity, possibly due to maturational and medication factors. On numerous cognitive paradigms, PBD showed dorsal prefrontal hypoactivity linked to ventral dysfunction, whereas ABD showed compensatory frontal, parietal, and temporal activity with paradigm-specific variations. In emotion-cognition interaction paradigms, patients show dysregulation in regions interfacing between cognitive and emotional brain systems (e.g., ventral prefrontal and cingulate cortices), which expend extra effort to process emotional stimuli effectively and recruit additional posterior attention systems to cope with affective instability. In addition, novel functional connectivity techniques have uncovered connectivity deficits between frontal and limbic regions in ABD and PBD at rest and during active emotional and cognitive tasks. Finally, the neuroimaging literature currently lacks cross-sectional studies comparing PBD with ABD and longitudinal studies following children and adolescents with BD into adulthood. Such studies would provide important insights into patients' prognosis and would determine targets for early interventions in the evolving illness diathesis.

A life course approach to the development of mental skills

A wide variety of factors across the life course jointly influence cognitive and emotional development. Indeed, research from a variety of disciplines strongly suggests that cognition and mental health are intertwined across the life course, by their common antecedents and underlying physiology in development and in their interplay across adult and later life. We suggest that cognitive and socioemotional function fuse to form skills for life supporting self-regulation, competence, and quality of life that persist into later life through linked reciprocal processes of genetic influence, nurturing, schooling, work, and lifestyle.

Attentional control constrains visual short-term memory: insights from developmental and individual differences

The mechanisms by which attentional control biases mnemonic representations have attracted much interest but remain poorly understood. As attention and memory develop gradually over childhood and variably across individuals, assessing how participants of different ages and ability attend to mnemonic contents can elucidate their interplay. In Experiment 1, 7-year-olds, 10-year-olds, and adults were asked to report whether a probe item had been part of a previously presented four-item array. The initial array could either be uncued, be preceded ("precued"), or followed ("retrocued") by a spatial cue orienting attention to one of the potential item locations. Performance across groups was significantly improved by both cue types, and individual differences in children's retrospective attentional control predicted their visual short-term and working memory span, whereas their basic ability to remember in the absence of cues did not. Experiment 2 imposed a variable delay between the array and the subsequent orienting cue. Cueing benefits were greater in adults than in 10-year-olds, but they persisted even when cues followed the array by nearly 3 seconds, suggesting that orienting operated on durable short-term representations for both age groups. The findings indicate that there are substantial developmental and individual differences in the ability to control attention to memory and that in turn these differences constrain visual short-term memory capacity.

A latent variables examination of processing speed, response inhibition, and working memory during typical development

This study addressed three related aims: (a) to replicate and extend previous work regarding the nonunitary nature of processing speed, response inhibition, and working memory during development; (b) to quantify the rate at which processing speed, response inhibition, and working memory develop and the extent to which the development of these latter abilities reflect general changes in processing speed; and (c) to evaluate whether commonly used tasks of processing speed, response inhibition, and working memory are valid and reliable when used with a developmentally diverse group. To address these aims, a latent variables approach was used to analyze data from 147 participants 6-24years of age. Results showed that processing speed, response inhibition, and working memory were separable abilities and that the extent of this separability was stable across the age range of participants. All three constructs improved as a function of age; however, only the effect of age on working memory remained significant after processing speed was controlled. The psychometric properties of tasks used to assess the constructs were age invariant, thereby validating their use in studies of executive development.

Modeling the effects of physician emigration on human development

We analyzed the effects of physician emigration on human development indicators in developing countries. First, the geographical distribution of physician brain drain was documented for the period 1991-2004. Second, random and fixed effects models were employed to investigate the effects of physicians in the home countries and abroad on child mortality and vaccination rates. Third, models were estimated to investigate migration-induced incentives in the medical sector that would increase the number of physicians. The results showed positive effects of migration prospects on medical training though the magnitude was too small for generating a net brain gain. Also, infant and child mortality rates were negatively associated with the number of physicians per capita after adult literacy rates exceeded 60%. The results for DPT and measles vaccinations underscored the importance of literacy rates and physicians per capita for higher vaccination rates. From the standpoint of Millennium Development Goals, reducing medical brain drain is likely to have only small benefits for child mortality and vaccination rates.

Principles of therapeutic drug monitoring

Therapeutic drug monitoring (TDM) is central to optimize drug efficacy in children, because the pharmacokinetics and pharmacodynamics of most drugs differ greatly between children and adults. Many factors should be analyzed to implement TDM in the pediatric population, including a validated pharmacological parameter and an analytical method adapted to children as limited sampling volumes and high sensitivity are required. The use of population approaches, new analytical methods such as saliva and dried blood spots, and pharmacodynamic monitoring give attractive options to improve TDM, individualize therapy in order to optimize efficacy and reduce adverse drug reactions.

Basics and dynamics of neonatal and pediatric pharmacology

Understanding the role of ontogeny in the disposition and actions of medicines is the most fundamental prerequisite for safe and effective pharmacotherapeutics in the pediatric population. The maturational process represents a continuum of growth, differentiation, and development, which extends from the very small preterm newborn infant through childhood, adolescence, and to young adulthood. Developmental changes in physiology and, consequently, in pharmacology influence the efficacy, toxicity, and dosing regimen of medicines. Relevant periods of development are characterized by changes in body composition and proportion, developmental changes of physiology with pathophysiology, exposure to unique safety hazards, changes in drug disposition by major organs of metabolism and elimination, ontogeny of drug targets (e.g., enzymes, transporters, receptors, and channels), and environmental influences. These developmental components that result in critical windows of development of immature organ systems that may lead to permanent effects later in life interact in a complex, nonlinear fashion. The ontogeny of these physiologic processes provides the key to understanding the added dimension of development that defines the essential differences between children and adults. A basic understanding of the developmental dynamics in pediatric pharmacology is also essential to delineating the future directions and priority areas of pediatric drug research and development.

Developmental pharmacokinetics

The advances in developmental pharmacokinetics during the past decade reside with an enhanced understanding of the influence of growth and development on drug absorption, distribution, metabolism, and excretion (ADME). However, significant information gaps remain with respect to our ability to characterize the impact of ontogeny on the activity of important drug metabolizing enzymes, transporters, and other targets. The ultimate goal of rational drug therapy in neonates, infants, children, and adolescents resides with the ability to individualize it based on known developmental differences in drug disposition and action. The clinical challenge in achieving this is accounting for the variability in all of the contravening factors that influence pharmacokinetics and pharmacodynamics (e.g., genetic variants of ADME genes, different disease phenotypes, disease progression, and concomitant treatment). Application of novel technologies in the fields of pharmacometrics (e.g., in silico simulation of exposure-response relationships; disease progression modeling), pharmacogenomics and biomarker development (e.g., creation of pharmacodynamic surrogate endpoints suitable for pediatric use) are increasingly making integrated approaches for developmentally appropriate dose regimen selection possible.

The story of Sam: continuities and discontinuities in development, transforming into and out of a perversion

The aim of this paper is to suggest new ways of understanding development that offer new therapeutic possibilities. I use observational and interview data showing the development of one research subject over forty years to highlight that the concepts of continuity and discontinuity need to be considered together to grasp the full complexity of psychological development. In the subject an unanticipated transformation occurs at age 14, the emergence of a perversion, whichfades by age 28. I will show that the observations can be best understood by co-ordinating the influence of antecedents that exert a pull backward with the transformative potential arising from the pull forward into new structures, compromises, and organizations.

Postural strategies and sensory integration: no turning point between childhood and adolescence

In this study, we investigated the sensory integration to postural control in children and adolescents from 5 to 15 years of age. We adopted the working hypothesis that considerable body changes occurring during these periods may lead subjects to under-use the information provided by the proprioceptive pathway and over-use other sensory systems such as vision to control their orientation and stabilize their body. It was proposed to determine which maturational differences may exist between the sensory integration used by children and adolescents in order to test the hypothesis that adolescence may constitute a specific phase in the development of postural control. This hypothesis was tested by applying an original protocol of slow oscillations below the detection threshold of the vestibular canal system, which mainly serves to mediate proprioceptive information, to the platform on which the subjects were standing. We highlighted the process of acquiring an accurate sensory and anatomical reference frame for functional movement. We asked children and adolescents to maintain a vertical stance while slow sinusoidal oscillations in the frontal plane were applied to the support at 0.01 Hz (below the detection threshold of the semicircular canal system) and at 0.06 Hz (above the detection threshold of the semicircular canal system) with their eyes either open or closed. This developmental study provided evidence that there are mild differences in the quality of sensory integration relative to postural control in children and adolescents. The results reported here confirmed the predominance of vision and the gradual mastery of somatosensory integration in postural control during a large period of ontogenesis including childhood and adolescence. The youngest as well as the oldest subjects adopted similar qualitative damping and segmental stabilization strategies that gradually improved with age without reaching an adult's level. Lastly, sensory reweighting for postural strategies as assessed by very slow support oscillations presents a linear development without any qualitative turning point between childhood and adolescence.

Age-related differences in lower-limb muscle cross-sectional area and torque production in boys with Duchenne muscular dystrophy

OBJECTIVE

To examine the relationship between lower-extremity muscle cross-sectional area, muscle strength, specific torque, and age in ambulatory boys with Duchenne muscular dystrophy (DMD) compared with controls.

DESIGN

Observational cross-sectional study.

SETTING

University research setting.

PARTICIPANTS

Volunteer sample of boys with DMD (n=22) and healthy control boys (n=10), ages 5 through 14 years.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Maximal muscle cross-sectional area (CSA(max)) assessed by magnetic resonance imaging of quadriceps, plantarflexors (PFs) and dorsiflexors (DFs), peak isometric torque from dynamometry, and timed functional tests.

RESULTS

The average CSA(max) of the triceps surae muscle group was approximately 60% higher in boys with DMD compared with controls (39.1+/-13.6 cm(2) vs 24.5+/-9.3 cm(2); P=.002), while the tibialis anterior muscle showed age-appropriate increases in CSA(max). The increase in quadriceps CSA(max) was also distinctly different in boys with DMD compared with controls. Specific torque (ie, peak torque/CSA(max)) was impaired in all 3 muscles groups, with the knee extensor (KE) and PF muscles showing 4-fold, and the DF muscles 2-fold, higher values in controls compared with boys with DMD. Large age-related gains in specific torque were observed in all 3 muscle groups of control subjects, which were absent in ambulatory boys with DMD. Correlations were observed between performance on functional tasks and quadriceps and PF torque production (r=-.45 to -.57, P<.05), but not with DF strength.

CONCLUSIONS

Age-related changes in muscle cross-sectional area and specific torque production in lower-extremity muscles showed distinctly different patterns in the KE, PF, and DF muscles of boys with DMD compared with controls.

[Teaching experience in integrated course of human development and genetics]

Establishment of integrated course system in human development and genetics is an important part of course reformation, and the improvement of this system is achieved by integrating the content of course, stabilizing teaching force, building teaching materials and applying problem-based learning. Integrity-PBL teaching model is founded and proved to be feasible and effective by teaching practice. Therefore, it maybe play an important role in improving teaching effect and cultivating ability of students to analyse and solve problems.

[Contribution of epigenetics to understand human development]

Epigenetics refers to the study of how genes produce their effect on the phenotype of the organism. This article is a review on the scope and importance of recently discovered epigenetic mechanisms on human development and their relationship to perinatal epidemiological issues. It shows a general view and present concepts about epigenetics and its contribution to the comprehension of several physiologic and pathological conditions of human beings. Secondly, it analyzes the evidence coming from epidemiological and animal studies, about the influence of events that occur in the perinatal and early postnatal periods on adult life and the possible epigenetic mechanisms involved. Lastly, it underscores the implications of these results of future research and the design of public policies that take into account the importance of events in early life in the future development of individuals.

DEVELOPMENT OF THE INHIBITORY COMPONENT OF THE EXECUTIVE FUNCTIONS IN CHILDREN AND ADOLESCENTS

The development of inhibitory control, one component of the executive functions, during childhood and adolescence was the focus of the present study. A group of 99 participants between 6 and 17 years of age were studied using the Stroop test. Results suggest the existence of age-related differences both in response times and errors that follow a nonlinear relationship. Interference increased in the first age groups, declining from around 10 years till 17 years. Data also suggest that word reading plays an important role in the performance of the task. When reading is blocked, linear relationships between age and interference measures emerge, showing an increase in inhibitory functions during childhood and adolescence.

Early determinants of development: a lipid perspective

This article results from an International Life Sciences Institute workshop on early nutritional determinants of health and development. The presentation on lipids focused mainly on the longer-chain products of the essential fatty acids, particularly docosahexaenoic acid (22:6n-3), and cognitive development as among the most studied lipids and outcomes, respectively, in early human nutrition. Because there have been several recent reviews on this topic, the present review takes a broader perspective with respect to both early development and lipids: an expanded research agenda is plausible on the basis of observations from some human studies and from animal studies. Other lipids known to be provided in variable amounts to infants through human milk are cholesterol and gangliosides. Short sections address the current state of knowledge and some questions that could be pursued.

How does the mind work? Insights from biology

Cognitive scientists must understand not just what the mind does, but how it does what it does. In this paper, I consider four aspects of cognitive architecture: how the mind develops, the extent to which it is or is not modular, the extent to which it is or is not optimal, and the extent to which it should or should not be considered a symbol-manipulating device (as opposed to, say, an eliminative connectionist network). In each case, I argue that insights from developmental and evolutionary biology can lead to substantive and important compromises in historically vexed debates.

Evidence of in situ proliferation of adult adipose tissue-derived progenitor cells: influence of fat mass microenvironment and growth

CONTEXT

Adipocyte formation in human adult adipose tissue (hAT) originates from resident progenitor cell differentiation in the stroma vascular fraction of the AT. The processes involved in the self-renewal of this cell population remain to be defined.

OBJECTIVE

The objective was to study in situ and in vitro hAT progenitor cell (defined as CD34(+)/CD31(-) cells) proliferation.

DESIGN AND PARTICIPANTS

In situ progenitor cell proliferation was assessed by immunohistochemistry and flow cytometry analyses on hAT from lean to obese subjects using the proliferation marker Ki-67. The effects of adipokines, hypoxia, and conditioned media (CM) from adipocytes, capillary endothelial cells, and macrophages isolated by an immunoselection approach were studied on hAT progenitor cell growth. Cell death in hAT was assessed by the terminal deoxynucleotidyl transferase-mediated dUTP-fluorescein end labeling method.

RESULTS

Ki-67-positive staining was observed in AT progenitor cells. Fat mass enlargement in obese patients was associated with an increased Ki-67(+) progenitor cell population together with a new fraction of small adipocytes and increased cell death. HIF-1alpha mRNA expression in freshly harvested progenitor cells was positively correlated with body mass index. Adipocyte- and capillary endothelial cell-CM, hypoxia, leptin, IL-6, lysophosphatidic acid, and vascular endothelial growth factor, all increased hAT progenitor cell proliferation in vitro. Macrophage-CM had an antiproliferative effect that was suppressed by an antioxidant.

CONCLUSIONS

The fraction of proliferative progenitor cells in adult hAT is modulated by the degree of adiposity. Changes in the progenitor cell microenvironment involving adipokines, hypoxia, and oxidative stress might play a key role in the control of the self-renewal of the local pool of AT progenitor cells.

[A Prospective Twin Registry in Southwestern China: exploring the effects of genetic and environmental factors on cognitive and behavioral development and mental health well-being in children and adolescents]

OBJECTIVE

The goals, prospects and methods of the Prospective Twin Registry in Southwestern China (TRiSC) are described. The aim of this study is to measure children's behavioral development and psychopathology from phenotypic, genetic and environmental perspectives.

METHODS

The children's self-report, as well as parental and teachers' informant report were used to measure the children's behavior and psychopathology, and the latter was related to the children's general cognitive abilities, and to the parenting style. Other variables of interest such as children's temperament and parental health status were also used.

RESULTS

Nine thousand and three hundred thirty nine pairs of 0-16 years old twins have been registered, 324 pairs of them were monozygotic based on DNA samples as well as the detailed information on behavioral and cognitive aspects.Analysis has been performed for the influences of genetic and environmental factors on children's behavior and cognition.

CONCLUSION

School-based twins recruitment is a helpful method in child and adolescent twin study. TRiSC has been a valuable resource for research on the development of children's behavior and cognition.

Increased brain signal variability accompanies lower behavioral variability in development

As the brain matures, its responses become optimized. Behavioral measures show this through improved accuracy and decreased trial-to-trial variability. The question remains whether the supporting brain dynamics show a similar decrease in variability. We examined the relation between variability in single trial evoked electrical activity of the brain (measured with EEG) and performance of a face memory task in children (8-15 y) and young adults (20-33 y). Behaviorally, children showed slower, more variable response times (RT), and less accurate recognition than adults. However, brain signal variability increased with age, and showed strong negative correlations with intrasubject RT variability and positive correlations with accuracy. Thus, maturation appears to lead to a brain with greater functional variability, which is indicative of enhanced neural complexity. This variability may reflect a broader repertoire of metastable brain states and more fluid transitions among them that enable optimum responses. Our results suggest that the moment-to-moment variability in brain activity may be a critical index of the cognitive capacity of the brain.

Steroid-induced sexual differentiation of the developing brain: multiple pathways, one goal

Hormone exposure, including testosterone and its metabolite estradiol, induces a myriad of effects during a critical period of brain development that are necessary for brain sexual differentiation. Nuclear volume, neuronal morphology, and astrocyte complexity are examples of the wide range of effects by which testosterone and estradiol can induce permanent changes in the function of neurons for the purpose of reproduction in adulthood. This review will examine the multitude of mechanisms by which steroid hormones induce these permanent changes in brain structure and function. Elucidating how steroids alter brain development sheds light on how individual variation in neuronal phenotype is established during a critical period.

Life history theory and the immune system: steps toward a human ecological immunology

Within anthropology and human biology, there is growing interest in immune function and its importance to the ecology of human health and development. Biomedical research currently dominates our understanding of immunology, and this paper seeks to highlight the potential contribution of a population-based, ecological approach to the study of human immune function. Concepts from life-history theory are applied to highlight the major challenges and demands that are likely to shape immune function in a range of ecological contexts. Immune function is a major component of maintenance effort, and since resources are limited, trade-offs are expected between investment in maintenance and other critical life-history functions involving growth and reproduction. An adaptationist, life-history perspective helps make sense of the unusual developmental trajectory of immune tissues, and emphasizes that this complex system is designed to incorporate information from the surrounding ecology to guide its development. As a result, there is substantial population variation in immune development and function that is not considered by current biomedical approaches. In an attempt to construct a framework for understanding this variation, immune development is considered in relation to the competing life-history demands that define gestation, infancy, childhood, adolescence, and adulthood. Each life stage poses a unique set of adaptive challenges, and a series of hypotheses is proposed regarding their implications for immune development and function. Research in human ecological immunology is in its earliest stages, but this is a promising area of exploration, and one in which anthropology is well-positioned to make important contributions.

Natural history of Homo erectus

Our view of H. erectus is vastly different today than when Pithecanthropus erectus was described in 1894. Since its synonimization into Homo, views of the species and its distribution have varied from a single, widely dispersed, polytypic species ultimately ancestral to all later Homo, to a derived, regional isolate ultimately marginal to later hominin evolution. A revised chronostratigraphic framework and recent work bearing either directly or indirectly on reconstructions of life-history patterns are reviewed here and, together with a review of the cranial and postcranial anatomy of H. erectus, are used to generate a natural history of the species. Here I argue that H. erectus is a hominin, notable for its increased body size, that originates in the latest Pliocene/earliest Pleistocene of Africa and quickly disperses into Western and Eastern Asia. It is also an increasingly derived hominin with several regional morphs sustained by intermittent isolation, particularly in Southeast Asia. This view differs from several current views, most especially that which recognizes only a single hominin species in the Pleistocene, H. sapiens, and those which would atomize H. erectus into a multiplicity of taxa. Following Jolly ([2001] Yrbk Phys Anthropol 44:177-204), the regional morphs of H. erectus may be productively viewed as geographically replacing allotaxa, rather than as the focus of unresolvable species debates. Such a view allows us to focus on the adaptations and biology of local groups, including questions of biogeographic isolation and local adaptation. A number of issues remain unresolved, including the significance of diversity in size and shape in the early African and Georgian records.