Neurodevelopment in Children Exposed to Zika in utero: Clinical and Molecular Aspects
Lavínia Schuler-Faccini1,2, Miguel Del Campo3, Alfredo García-Alix4
1Universidade Federal do Rio Grande do Sul, UFRGS, Porto Alegre, Brazil.
Insights
Congenital Zika syndrome (CZS) causes severe developmental deficits in children. However, milder forms exist, and outcomes vary based on infection timing and cofactors.
Area of Science:
- Neurology
- Developmental Biology
- Infectious Diseases
Background:
- Zika virus identified as a human teratogen.
- Congenital Zika syndrome (CZS) presents significant neurodevelopmental challenges.
- Understanding CZS manifestations and prognosis is crucial.
Purpose of the Study:
- To review early clinical manifestations of CZS.
- To analyze factors influencing CZS severity and outcomes.
- To highlight the spectrum of neurodevelopmental effects.
Main Methods:
- Literature review of early clinical manifestations of CZS.
- Analysis of factors affecting vertical transmission and neurodevelopment.
- Examination of experimental studies on Zika virus outcomes.
Main Results:
- CZS often leads to severe cerebral palsy and impaired motor, cognitive, and language development.
- Milder deficits occur, and some non-microcephalic children show normal neurodevelopment.
- Later pregnancy Zika infections result in less frequent vertical transmission and brain disruption.
- Cofactors (genetic, environmental, nutritional, social) influence CZS development and distribution.
Conclusions:
- Congenital Zika syndrome presents a spectrum of neurodevelopmental outcomes.
- Maternal infection timing and cofactors significantly impact CZS severity.
- Social determinants affect both CZS prevalence and access to treatment.
Abstract:
Five years after the identification of Zika virus as a human teratogen, we reviewed the early clinical manifestations, collectively called congenital Zika syndrome (CZS). Children with CZS have a very poor prognosis with extremely low performance in motor, cognitive, and language development domains, and practically all feature severe forms of cerebral palsy. However, these manifestations are the tip of the iceberg, with some children presenting milder forms of deficits. Additionally, neurodevelopment can be in the normal range in the majority of the non-microcephalic children born without brain or eye abnormalities. Vertical transmission and the resulting disruption in development of the brain are much less frequent when maternal infection occurs in the second half of the pregnancy. Experimental studies have alerted to the possibility of other behavioral outcomes both in prenatally infected children and in postnatal and adult infections. Cofactors play a vital role in the development of CZS and involve genetic, environmental, nutritional, and social determinants leading to the asymmetric distribution of cases. Some of these social variables also limit access to multidisciplinary professional treatment.
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