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Published on: March 6, 2018
Neurotoxicity and Outcomes from Developmental Lead Exposure: Persistent or Permanent?
1Department of Pathology and Genomic Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Insights
Childhood lead poisoning causes persistent, not permanent, neurotoxic effects. Research into neurorehabilitation and enrichment strategies is recommended to improve cognitive and behavioral outcomes in affected children.
Area of Science:
- Environmental Health
- Neuroscience
- Public Health
Background:
- Childhood lead poisoning is a significant global public health concern.
- While primary prevention is crucial, mitigating neurotoxic effects in already poisoned children is also vital.
- The perception of lead-induced neurotoxicity as permanent versus persistent influences remediation strategies.
Purpose of the Study:
- To discuss the concepts of permanence and persistence regarding lead's neurotoxic effects.
- To explore potential mitigation strategies for lead-induced neurotoxicity.
- To suggest approaches for improving cognitive and behavioral outcomes in lead-poisoned children.
Main Methods:
- Review and discussion of existing literature on lead neurotoxicity.
- Consideration of recent insights into mitigating lead's effects on the brain and behavior.
- Integration of clinical neurorehabilitation information.
Main Results:
- Evidence suggests that some adverse outcomes of lead exposure are persistent rather than permanent.
- These persistent effects may be amenable to mitigation under specific circumstances.
- Distinguishing between permanent and persistent damage has implications for public health policy.
Conclusions:
- Further clinical and interventional research is recommended to explore neurorehabilitative and enrichment strategies.
- The goal is to enhance brain plasticity and functioning in lead-poisoned children.
- Translating preclinical findings on lead-induced brain damage mitigation to human applications is a key objective.
Background:
Childhood lead poisoning remains an important public health issue in the United States, as well as elsewhere in the world. Although primary prevention is a major goal and it is critically important to keep children from getting poisoned, it is also important to explore ways to reduce the neurotoxic effects of lead in those children already poisoned. Whether lead-induced neurotoxicity and its related adverse outcomes are viewed as "permanent" or "persistent" may influence the way in which potential remediation efforts are considered for improving outcomes from childhood lead poisoning.
Objectives:
The objective of this commentary was to discuss the ideas of permanence and persistence in relation to the direct neurotoxic effects of lead on the brain and the resulting adverse outcomes from these effects. Recent new insights regarding potential mitigation of lead-induced neurotoxic effects on brain and behavior are considered along with clinical information on neurorehabilitation to suggest potential strategies for improving cognitive/behavioral outcomes in lead-poisoned children.
Discussion:
The distinction between permanent and persistent in regard to lead-induced neurotoxicity and its resulting outcomes may have broad implications for public health policies in response to the problem of childhood lead exposure. The term permanent implies that the damage is irreversible with little chance of improvement. However, there is evidence that at least some of the adverse cognitive/behavioral outcomes from lead exposure are persistent rather than permanent and potentially amenable, under the appropriate circumstances, to some level of mitigation. This author recommends that clinical, interventional research efforts be devoted to exploring optimal neurorehabilitative and enrichment conditions to stimulate plasticity and enhance functioning to determine the extent to which promising results from preclinical studies of lead-induced brain damage and the mitigation of these effects can be successfully translated to humans. https://doi.org/10.1289/EHP12371.
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