Brain development/Law/Policy School of Medicine

Nature vs. nurture

Joan Luby, MD, observes a parent and child through a one-way mirror and, using a microphone and earpiece, coaches the parent on how to help keep the child’s emotions under control. The intervention helps relieve symptoms of clinical depression in young children. (Photo: Matt Miller)

Compelled by the potential to improve the lives of vulnerable children, emeritus trustee Walter Metcalfe and his wife, Cynthia, have committed nearly $4 million through outright and estate gifts to support the work of Joan L. Luby, MD, a highly regarded child psychiatrist.

Luby and her colleagues have linked adversity, including poverty and neglect in the first years of life, to changes in brain anatomy. These changes increase the risk of learning difficulties, clinical depression and behavioral problems that affect a child’s well-being.

Their research also demonstrates that, by contrast, extensive nurturing from parents and supportive early therapeutic intervention can limit, or even eliminate, the impact of adversity on the developing brain.

With support from the Metcalfes, Luby is expanding a project to gauge the effects of environmental stress on brain development and overall health in children by recruiting their mothers while they are still pregnant. Luby will measure stress and adversity experienced during pregnancy and after the children are born. The study, funded by an $11.6 million grant from the National Institute of Mental Health (NIMH), will follow 370 children in the St. Louis area from before birth to age 3.

Luby, the Samuel and Mae S. Ludwig Professor of Child Psychiatry and director of the school’s Early Emotional Development Program, will assess emotional and behavioral development. Meanwhile, co-investigators Christopher D. Smyser, MD, associate professor of neurology, will use MRI to track brain development, while professor of pediatrics Barbara B. Warner, MD, examines the impact of environmental stress on the children’s gut microbiome and immune systems.

The study will include an expanded focus on epigenetics. Described as the interface of nature and nurture, epigenetics investigates the influence of environment on gene expression.The researchers will collect saliva samples from infants at birth and 12, 24 and 36 months of age to analyze genetic information. They are looking for any changes that might appear throughout the genome and are storing the DNA from the children for further analysis should patterns emerge. The eventual plan is to learn how gene-environment interactions influence brain development and emotional and behavioral health.

Luby’s team has demonstrated poverty’s negative effects on the developing brain. In previous work, the researchers found that a type of interactive therapy that helps parents be more nurturing, and teaches them to enhance their child’s emotional development, can reduce rates of childhood depression and other mental health problems. Although these problems present particular problems for poor children, they also affect children across the income spectrum.

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