In perhaps the most famous study of neglect in childhood, the researchers monitored the progress, or lack of celui- one, in children who lived as infants in dark orphanages in Romania and are now teenagers. A new analysis now shows that these children, who have a variety of behavioral and cognitive problems, have less white matter in their brains that make a comparable group of children in local families. affected brain regions include the nerve bundles that support the attention of the general cognition, and processing of emotion. The work suggests that sensory deprivation early in life can have dramatic anatomical effects on the brain and may help explain the long-term negative effects previously documented behavior. But there is some good news possibilities: A small group of children who had been abducted orphanages and moved to shelters to 2 years seemed to bounce back, at least in brain structure
"This is an exciting and important. study, "says Harvard Medical School psychiatric researcher Martin Teicher, who runs the Biopsychiatry research program development at McLean Hospital in Belmont, Massachusetts. The "crucial question" of whether children can recover from the setback of early adversity has not been answered before, he added.
The work is based on MRI and other measures taken in Romania by researchers at the Bucharest Early Intervention Project (BEIP). The group, led by neurologist Charles Nelson of Harvard Medical School, was moved to action by the collapse of Nicolae Ceausescu regime in Romania in 1989, which had shunted tens of thousands of unwanted children in orphanages run by the state. Nelson said that guards in orphanages worked factorylike team; children could see as much as 17 different guards in a week. Infants rarely enjoyed the interactions one-on-one, which are considered essential to normal development.
Orphanages have sharply reduced their consumption today. But there's more than a decade, when they were still in favor of BEIP leaders saw a need for humanitarian assistance; they also saw a rare opportunity to study the effects of child neglect. Drawing mainly on the research funding from the US government, BEIP offered a limited number of children a chance to get out of orphanages in foster care, providing desperately needed attention. BEIP also worked with Romanian officials to recruit orphans and local children in clinical studies.
BEIP initially enrolled 136 children in research. Only 69 participated in the MRI study published online today in JAMA Pediatrics . Of these, 23 have been established in the group randomly assigned to foster care, 26 from a group assigned to remain in orphanages, and 20 of the local community, as witnesses. The lead author Johanna Bick, a clinical psychologist at Children's Hospital Boston, and colleagues in the BEIP group used an MRI imaging technique called diffusion tensor to watch 48 microstructural white matter tracts in each child, comparing the results at 2 and 8 years of age.
The analysis revealed that children who remain in orphanages were still worse off with the less mature development in four key sets of white matter. The most affected routes included neural circuits involved in cognitive overall performance, emotion, maintaining attention and executive function and sensory processing. Further analysis suggests that the foster care group was more like the community group in brain development, but this conclusion seems to be less robust.
Other non-randomized studies have reported broad cognitive deficits or reduced white matter in adults and some children who have suffered neglect or abuse in the past. They stressed "the same areas we find ourselves affected by the negligence of early life. These results and those of BEIP converge, "claims Bick.
More importantly, Bick said, compared with the children taken by adoptive parents suggests that the loss of white matter may be reversible. What worked in Romania to improve the brain development of children moving in an environment breadwinner could work elsewhere as a remedy for child neglect. "This has very important implications," she said. He suggests that the damage that occurs in a family setting may reversible, too
In a prepared statement, a psychiatric researcher Andrea Danese of King's College London has welcomed the study but noted that more research is needed to determine how these changes in the white matter are related to changes in behavior.
Bick agrees on this point. "What I'm really interested in the investigation right now," she said, "is whether the improvements [seen in the foster children’s white matter profiles] effectively support improvements in the security superior capabilities" such as IQ, the attention and control of emotion. BEIP plans to collect new neurological data this year Romanian orphans as they turn 16.
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