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Brain Development and Toxic Stress
Jordan Greenbaum, MDStephanie V. Blank Center for Safe and Healthy ChildrenChildren’s Healthcare of Atlanta
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Basics of Brain Development• Most neurons present at birth• From birth to 5 years, brain triples in
mass• Growth involves connections
Brain Maturation
Location is everything!
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Sensitive Periods
• Windows of opportunity
– Effects of experience on brain are very strong
– Vary with area of brain
– Initial experience is more influential
• Plasticity persists (it’s never too late!)
Neural Plasticity
• Continues to a certain extent throughout life
• Decreases with age• Allows us to
compensate for injuries, change behavior, learn
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Some Critical Areas of the Brain
• Emotions and stress response
• Contextual memory
• Executive functions
• Interact with each other
Prefrontal cortex
Let’s Talk About Stress!!
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Hot Spots for the Human Stress Response
prefrontal cortex
cingulate gyrus
Sympathetic Nervous System
Fight
Flight
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Hypothalamic-Pituitary-Adrenal Axis
• Initiated by amygdala
• Cortisol secreted within
minutes
• Effects seen for hours
So, how does this work?
Prefrontal Cortex
(Super ego)
Amygdala(Emotion)
Hippocampus(Facts, ma’am)
Hypothalamus
Pituitary
Adrenal Gland
Brainstem
Arousal,FocusingFFF
Cortisol
Thalamus
KaBoom!
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Toxic Stress
• Toxic stress:
– Strong, frequent or prolonged
– Often uncontrollable
– No supportive adult
• Particularly malleable during fetal and early childhood periods
• Experience influences later responses to stress• Fear conditioning
– Neutral stimulus associated with aversive one that causes fear
– Gradually neutral stimulus comes to elicit fear– Can generalize further to other neutral stimuli
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Stress Response
• Increases fear, stress, anxiety in ‘safe’ situations
• Impacts social interaction, behavior, learning
• Prefrontal cortex damage is key• Can occur even in infants• Removing the danger doesn’t ‘fix’ the
child
Generalized Fear-Conditioning
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Prefrontal Cortex
Amygdala
Hippocampus
Brainstem
Arousal,FocusingFFFPrefrontal
Cortex
Amygdala
Cortisol
Pituitary
Hypothalamus
Hippocampus
Effects of Chronic Stress
Adrenal Gland Cortisol
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My contact info:Jordan Greenbaum, MDCell: [email protected] anytime!
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