Neuroembryonic and fetal brain development: Relevance to fetal/neonatal neurological training

IF 2.9 3区 医学 Q1 PEDIATRICS
Harvey B. Sarnat , Laura Flores-Sarnat
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引用次数: 0

Abstract

Insight into neuroembryology, developmental neuroanatomy and neurophysiology distinguish the diagnostic approaches of paediatric from adult neurologists and general paediatricians. These fundamental disciplines of basic neuroscience could be more effectively taught during paediatric neurology and most residency programmes, that will strengthen career-long learning. Interdisciplinary training of fetal-neonatal neurology within these programs requires working knowledge of neuroembryology applied to maternal reproductive health influencing the maternal-placental-fetal triad, neonate, and young child. Systematic didactic teaching of development in terms of basic neuroscience with neuropathological context would better address needed clinical skill sets to be incorporated into paediatric neurology and neonatology residencies to address brain health and diseases across childhood. Trainees need to recognize the continuity of development, established by maternal reproductive health before conception with gene -environment influences over the first 1000 days. Considerations of neuroembryology that explain earlier brain development during the first half of pregnancy enhances an understanding of effects throughout gestation through parturition and into neonatal life. Neonatal EEG training enhances these clinical descriptions by applying serial EEG-state analyses of premature neonates through early childhood to recognize evolving patterns associated with neuronal maturation and synaptogenesis. Neuroimaging studies offer comparisons of normal structural images with malformations and destructive lesions to correlate with clinical and neurophysiological findings. This analysis better assesses aberrant developmental processes in the context of neuroembryology. Time-specific developmental events and semantic precision are important for accurate phenotypic descriptions for a better understanding of etiopathogenesis with maturation. Certification of paediatric neurology training programme curricula should apply practical knowledge of basic neuroscience in the context of nervous system development and maturation from conception through postnatal time periods. Interdisciplinary fetal-neonatal neurology training constitutes an important educational component for career-long learning.

神经胚胎和胎儿大脑发育:与胎儿/新生儿神经系统训练的相关性
对神经胚胎学、发育神经解剖学和神经生理学的深入了解使儿科神经学家和普通儿科医生的诊断方法有别于成人神经学家和普通儿科医生。在儿科神经病学和大多数住院医师培训课程中,可以更有效地教授这些基础神经科学的基本学科,从而加强终身学习。在这些课程中进行胎儿-新生儿神经学的跨学科培训,需要将神经胚胎学知识应用于影响母体-胎盘-胎儿三元组、新生儿和幼儿的孕产妇生殖健康。从基础神经科学和神经病理学的角度系统地讲授发育知识,能更好地满足儿科神经病学和新生儿科住院医生所需的临床技能,以应对整个儿童期的脑健康和疾病问题。受训人员需要认识到发育的连续性,这种连续性是由受孕前的母体生殖健康与最初 1000 天的基因-环境影响共同决定的。从神经胚胎学的角度来解释妊娠前半期大脑的早期发育,可以加深对整个妊娠期、分娩期和新生儿期的影响的理解。新生儿脑电图培训通过对早产新生儿到幼儿期的连续脑电图状态分析,来识别与神经元成熟和突触发生相关的演变模式,从而加强这些临床描述。神经影像学研究可将正常结构图像与畸形和破坏性病变进行比较,从而与临床和神经生理学发现相关联。这种分析能更好地评估神经胚胎学背景下的异常发育过程。特定时间的发育事件和语义的精确性对于准确的表型描述非常重要,有助于更好地了解成熟期的病因发病机制。儿科神经病学培训课程认证应在神经系统从受孕到出生后的发育和成熟过程中应用基础神经科学的实用知识。胎儿-新生儿神经学跨学科培训是职业学习的重要教育组成部分。
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来源期刊
CiteScore
6.40
自引率
3.30%
发文量
49
审稿时长
6-12 weeks
期刊介绍: Seminars in Fetal & Neonatal Medicine (formerly Seminars in Neonatology) is a bi-monthly journal which publishes topic-based issues, including current ''Hot Topics'' on the latest advances in fetal and neonatal medicine. The Journal is of interest to obstetricians and maternal-fetal medicine specialists. The Journal commissions review-based content covering current clinical opinion on the care and treatment of the pregnant patient and the neonate and draws on the necessary specialist knowledge, including that of the pediatric pulmonologist, the pediatric infectious disease specialist, the surgeon, as well as the general pediatrician and obstetrician. Each topic-based issue is edited by an authority in their field and contains 8-10 articles. Seminars in Fetal & Neonatal Medicine provides: • Coverage of major developments in neonatal care; • Value to practising neonatologists, consultant and trainee pediatricians, obstetricians, midwives and fetal medicine specialists wishing to extend their knowledge in this field; • Up-to-date information in an attractive and relevant format.
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