When it comes to brain disorders, the standard method used to find a drug for children is upside down, says Donna Ferriero, MD, chief of pediatric neurology at Lucile Packard Children's Health Services at UCSF. New drug therapies typically are designed for adults and tested on them. Studies to find out if the drug can be used for children usually are limited to finding the right, scaled-down child-size dose.
It is time that children got their own treatments, Ferriero writes in an editorial in the December 1998 issue of Current Opinion in Pediatrics. She says that scientists now have enough information about young children's developing brains to start looking for appropriate therapies specifically targeted at childhood neurological disorders.
Her editorial introduces five scientific articles on different brain disorders, bound together by new knowledge about how they cause brain injury. An international conference slated for December 8-9 in Washington, D.C. will focus on interventions that might work against one of the most common causes of brain damage, perinatal asphyxia, where a newborn is accidentally deprived of oxygen and blood flow during birth.
The scientists are spurred partly by the history of adult drugs used on children -- some are ineffective, some have unexpected results, some even cause the opposite effect that they have in adults. But Ferriero says the most compelling reason for child-specific treatment is the growing body of evidence that a young child's nervous system is not a miniature version of an adult's. From before birth throughout the first decade of life, the brain continues to develop and change, as some neurons grow and make connections and others are pared away. When children's brains are damaged by a disease or an accident, the effect can be widespread, because the injury can alter a whole stage of brain development.
That also means that drugs must be designed to avoid damaging the developing
brain. An ideal drug
Contact: Janet Basu
University of California - San Francisco