Forskning
Udskriv Udskriv
Switch language
Rigshospitalet - en del af Københavns Universitetshospital
Udgivet

Exogenous glucocorticoids and adverse cerebral effects in children

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  1. Decline in severe spastic cerebral palsy at term in Denmark 1999-2007

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Pediatric autoimmune encephalitis in Denmark during 2011-17: A nationwide multicenter population-based cohort study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. SLC35A2-related congenital disorder of glycosylation: Defining the phenotype

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. EEG with extreme delta brush in young female with methotrexate neurotoxicity supports NMDA receptor involvement

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Cigarette smoking and cerebral blood flow in a cohort of middle-aged adults

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Brain Changes Induced by Electroconvulsive Therapy Are Broadly Distributed

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Diagnostic added value of electrical source imaging in presurgical evaluation of patients with epilepsy: A prospective study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Vis graf over relationer
Glucocorticoids are commonly used in treatment of paediatric diseases, but evidence of associated adverse cerebral effects is accumulating. The various pharmacokinetic profiles of the exogenous glucocorticoids and the changes in pharmacodynamics during childhood, result in different exposure of nervous tissue to exogenous glucocorticoids. Glucocorticoids activate two types of intracellular receptors, the mineralocorticoid receptor and the glucocorticoid receptor. The two receptors differ in cerebral distribution, affinity and effects. Exogenous glucocorticoids favor activation of the glucocorticoid receptor, which is associated with unfavorable cellular outcomes. Prenatal treatment with glucocorticoids can compromise brain growth and is associated with periventricular leukomalacia, attentions deficits and poorer cognitive performance. In the neonatal period exposure to glucocorticoids reduces neurogenesis and cerebral volume, impairs memory and increases the incidence of cerebral palsy. Cerebral effects of glucocorticoids in later childhood have been less thoroughly studied, but apparent brain atrophy, reduced size of limbic structures and neuropsychiatric symptoms have been reported. Glucocortioids affect several cellular structures and functions, which may explain the observed adverse effects. Glucocorticoids can impair neuronal glucose uptake, decrease excitability, cause atrophy of dendrites, compromise development of myelin-producing oligodendrocytes and disturb important cellular structures involved in axonal transport, long-term potentiation and neuronal plasticity. Significant maturation of the brain continues throughout childhood and we hypothesize that exposure to exogenous glucocorticoids during preschool and school age causes adverse cerebral effects. It is our opinion that studies of associations between exposure to glucocorticoids during childhood and impaired neurodevelopment are highly relevant.
OriginalsprogEngelsk
TidsskriftEuropean Journal of Paediatric Neurology
Vol/bind15
Udgave nummer6
Sider (fra-til)465-77
Antal sider13
ISSN1090-3798
DOI
StatusUdgivet - 2011

ID: 33245277