From Structure to Function of Fetal Brain: A Long Journey

Abstract

Understanding the structure and function of the fetal nervous system has been the dream of physicians for centuries. The pioneering efforts of Ian Donald in obstetric ultrasound (US) in the latter part of the 20th century have permitted this dream to become a reality. The initial contribution of obstetric US focused on normal and abnormal structures. Initially, anencephaly was described and followed by increasingly subtle central nervous system (CNS) abnormalities such as agenesis of the corpus callosum. The current and evolving challenge for investigators in obstetric US is to have similar success with the understanding of fetal neurological function. There are many functional neurological abnormalities, such as cerebral palsy (CP), whose causes are poorly understood. There are also an escalating number of results illustrating that a large presence of neurological problems, such as minimal cerebral dysfunction, schizophrenia, epilepsy, or autism, upshot at least in part from prenatal neurodevelopmental problems. Clinical and epidemiological studies have revealed that CP most often results from prenatal rather than perinatal or postnatal causes. Currently, although momentous advances in prenatal and perinatal care, there are no means to identify or expect the development of these disorders. Therefore, the development of diagnostic strategies to avoid and condense the saddle of perinatal brain damage has to turn into one of the most imperative tasks of contemporary perinatal medicine. The application of the new neurobehavioral test Kurjak’s antenatal neurobehavioral test (KANET) might improve our understanding of prenatal neurodevelopmental events and possibly antenatal detection of CP and other neurological diseases.