Significant shifts in preclinical and clinical neurotoxicology: a review and commentary

Pressman, Peter; Clemens, Roger; Hayes, A. Wallace

doi:10.1080/15376516.2022.2109228

Cited by 3 publications

(2 citation statements)

References 60 publications

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“…Harmful effects from these substances exacerbate these effects. While cannabidiol is currently a popular choice with recreational and medicinal benefits ( 69 ), neurotoxic effects also result, particularly when combined with substance exposures such as alcohol, tobacco, amphetamines, and opiates. Prescribed CNS-active psychoactive and antiepileptic medications also act as xenobiotics with similar undesirable neuronal effects ( 70 , 71 ).…”

Section: The Pregnancy Exposomementioning

confidence: 99%

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Interdisciplinary fetal-neonatal neurology training applies neural exposome perspectives to neurology principles and practice

Scher

2024

Front. Neurol.

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An interdisciplinary fetal-neonatal neurology (FNN) program over the first 1,000 days teaches perspectives of the neural exposome that are applicable across the life span. This curriculum strengthens neonatal neurocritical care, pediatric, and adult neurology training objectives. Teaching at maternal-pediatric hospital centers optimally merges reproductive, pregnancy, and pediatric approaches to healthcare. Phenotype–genotype expressions of health or disease pathways represent a dynamic neural exposome over developmental time. The science of uncertainty applied to FNN training re-enforces the importance of shared clinical decisions that minimize bias and reduce cognitive errors. Trainees select mentoring committee participants that will maximize their learning experiences. Standardized questions and oral presentations monitor educational progress. Master or doctoral defense preparation and competitive research funding can be goals for specific individuals. FNN principles applied to practice offer an understanding of gene–environment interactions that recognizes the effects of reproductive health on the maternal-placental-fetal triad, neonate, child, and adult. Pre-conception and prenatal adversities potentially diminish life-course brain health. Endogenous and exogenous toxic stressor interplay (TSI) alters the neural exposome through maladaptive developmental neuroplasticity. Developmental disorders and epilepsy are primarily expressed during the first 1,000 days. Communicable and noncommunicable illnesses continue to interact with the neural exposome to express diverse neurologic disorders across the lifespan, particularly during the critical/sensitive time periods of adolescence and reproductive senescence. Anomalous or destructive fetal neuropathologic lesions change clinical expressions across this developmental-aging continuum. An integrated understanding of reproductive, pregnancy, placental, neonatal, childhood, and adult exposome effects offers a life-course perspective of the neural exposome. Exosome research promises improved disease monitoring and drug delivery starting during pregnancy. Developmental origins of health and disease principles applied to FNN practice anticipate neurologic diagnoses with interventions that can benefit successive generations. Addressing health care disparities in the Global South and high-income country medical deserts require constructive dialogue among stakeholders to achieve medical equity. Population health policies require a brain capital strategy that reduces the global burden of neurologic diseases by applying FNN principles and practice. This integrative neurologic care approach will prolong survival with an improved quality of life for persons across the lifespan confronted with neurological disorders.

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Section: The Pregnancy Exposomementioning

confidence: 99%

“…Xenobiotics from air, water, and soil exposures ( 69 ) alter prenatal brain structure and function involving these different neuronal populations. Climate changes further exaggerate adverse genetic and epigenetic teratogenic effects ( 74 ).…”

Section: Neuropathology Correlates Of Tsimentioning

confidence: 99%