Neurodevelopmental Behavioral and Cognitive Disorders

Shafali Spurling Jeste, MD Behavioral Neurology and Neuropsychiatry p. 690-714 June 2015, Vol.21, No.3 doi: 10.1212/01.CON.0000466661.89908.3c
Article as PDF
-- Select an option --

Purpose of Review: Neurodevelopmental disorders are a group of heterogeneous conditions characterized by a delay or disturbance in the acquisition of skills in a variety of developmental domains, including motor, social, language, and cognition. This article reviews the most commonly diagnosed neurodevelopmental disorders, which include attention deficit hyperactivity disorder (ADHD), autism spectrum disorder, global developmental delay, and intellectual disability and also provides updates on diagnosis, neurobiology, treatment, and issues surrounding the transition to adulthood.

Recent Findings: Although symptoms emerge at discrete points in childhood, these disorders result from abnormal brain maturation that likely precedes clinical impairment. As a result, research has focused on the identification of predictive biological and behavioral markers, with the ultimate goal of initiating treatments that may either alter developmental trajectories or lessen clinical severity. Advances in the methods used to identify genetic variants, from chromosomal microarray analysis to whole exome sequencing, have facilitated the characterization of many genetic mutations and syndromes that share common pathways to abnormal circuit formation and brain development. Not only do genetic discoveries enrich our understanding of mechanisms underlying atypical development, but they also allow us to identify more homogeneous subgroups within this spectrum of conditions. Impairments do continue into adulthood, with challenges in the transition to adulthood including the management of comorbidities and the provision of educational and vocational supports.

Summary: Advances in our understanding of the neurobiology and developmental trajectories of these disorders will pave the way for tremendous advances in treatment. Mechanism-based therapies for genetic syndromes are being studied with the goal of expanding targeted treatments to nonsyndromic forms of neurodevelopmental disorders.

Address correspondence to Dr Shafali Jeste, University of California, Los Angeles, 10534 Clarkson Road, Los Angeles, California 90064, [email protected].

Relationship Disclosure: Dr Jeste receives personal compensation as a consultant for Hoffmann La-Roche, Ltd, and receives honoraria for invited lectures from the Autism Consortium, The Help Group, Simons Center for the Social Brain, and the Tuberous Sclerosis Alliance.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Jeste reports no disclosure.

© 2015 American Academy of Neurology