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Mapping Adolescent Brain Change 81“At what point in development does the cortex of the perisylvian region becometoo thick in these children with neurodevelopmental disorders?” Our studies ofnormal development have shown cortical thinning and thickening during the adolescentperiod. Perhaps the trajectory of brain maturation is altered prior to thedevelopment of symptoms of ADHD, for example. Of course, insults to the brainare known to occur in utero in children with prenatal alcohol exposure, but it ispossible that the cascade of cellular events that occur throughout developmentcontinue to be affected long after the exposure to alcohol. Longitudinal studiesare needed to determine whether these brain abnormalities are static or dynamicin the childhood to adolescent age range.The relevant questions in this volume are, “What neurodevelopmental processesin children and adolescents could be altered so that mental disorders might beprevented?” and “What interventions or life experiences might be able to introducesuch changes?” These are difficult questions to answer given our currentknowledge and technology. Although children who are normally developing, orsuffer from ADHD or prenatal alcohol exposure are not the target populations inthis volume, we may be able to glean information from them that is relevant toadolescent psychopathology. We know that normal developmental changes canbe measured over relatively brief time intervals with longitudinal studies. It seemsplausible, then, to speculate that targeting at-risk populations for inclusion inlongitudinal studies may be fruitful in aiding the development of prophylactictreatments. The idea here is that children who are at risk could be assessed forabnormalities in cortical development that ultimately characterize adolescents whohave the disorder. Pharmacologic, or perhaps even behavioral and educationalinterventions could then be developed with the brain anatomical measures asgauges for effectiveness of treatment prior to the onset of symptoms. We couldalso potentially use brain anatomical studies to assess departure from normal inat-risk individuals. The idea would be to conduct periodic anatomical analyseson at-risk children, and as soon as any abnormality is seen in the brain data, fasttrackthese children into the appropriate treatments. Clearly, we would first needto characterize cortical abnormalities in the psychopathological disorders of interestin longitudinal study designs.ReferencesAnnese, J., Pitiot, A., Dinov, I. D., & Toga, A. W. (2004). A myelo-architectonic methodfor the structural classification of cortical areas. Neuroimage, 21, 15–26.Archibald S. L., Fennema-Notestine, C., Gamst, A., Riley, E. P., Mattson, S. N., & Jernigan,T. L. (2001). Brain dysmorphology in individuals with severe prenatal alcohol exposure.Developmental Medicine and Child Neurology, 43, 148–154.Ashburner, J., & Friston, K. J. (2000). Voxel-based morphometry—The methods.Neuroimage, 11, 805–821.