Peripheral Innervation in Children With Global Developmental Delay: Biomarker for Risk for Self-Injurious Behavior? - PubMed (original) (raw)

Peripheral Innervation in Children With Global Developmental Delay: Biomarker for Risk for Self-Injurious Behavior?

Frank J Symons et al. J Child Neurol. 2015 Nov.

Abstract

The relation between somatosensory mechanisms and self-injury among children with neurologic impairments associated with developmental delay is not well understood. We evaluated the feasibility of procuring skin biopsies to examine epidermal nerve fiber density and reported self-injury. Following informed parental consent, epidermal skin biopsies were obtained from a distal leg site with no pre-existing skin damage from 11 children with global developmental delay (55% male; mean age = 36.8 months, 17-63 months). Visual microscopic examination and quantitative analyses showed extremely high epidermal nerve fiber density values for some children. Children with reported self-injury (5/11) had significantly (P < .02) greater density values (138.8, standard deviation = 45.5) than children without self-injury (80.5, standard deviation = 17.5). Results from this novel immunohistologic analysis of skin in very young children with neurodevelopmental delays suggest it may be a useful tool to study peripheral innervation as a possible sensory risk factor for self-injury.

Keywords: developmental delay; peripheral innervation; risk; self-injury; sensory.

© The Author(s) 2015.

PubMed Disclaimer

Conflict of interest statement

CONFLICTS OF INTEREST

There are no conflicts of interest to declare.

Figures

Figure 1

Figure 1

Confocal images of epidermal nerve fibers (ENFs) in skin in children with global developmental delay with (a) and without (b) self-injurious behavior (SIB). a. Nerve, protein gene product 9.5 immunolocalization, (green) distribution in superficial skin of a representative pediatric SIB case. Basement membrane, type IV collagen immunolocalization (red), reveals capillaries (Cap) and the dermal-epidermal junction (DEJ) that separates the epidermis (Epid) from deeper dermis. ENFs were counted as they crossed the DEJ. Epidermal nerve fibers (ENFs) arising from the sub-epidermal neural plexus (SNP) are abundant. The density for this participant was 209.39 ENFs/mm. b. Developmental delay skin sample with no SIB and a more typical normal innervation pattern. ENF density for this participant was 77.3 ENFs/mm. Thickness of epidermis may vary from participant to participant regardless of disease state. Scale bar = 100 μm for all images.

Figure 2

Figure 2

ENFd quantification via dot-plot comparison of individual ENFd values between No SIB (lft, red) and SIB (right, blue) groups. Mean ENF density for the SIB group = 138.8 (SD = 45.5), mean ENF density for the no SIB group = 80.5 (SD = 17.5), t5 = 2.7, p< 0.02.

References

    1. Schroeder SR, Oster-Granite ML, Berkson G, et al. Self-injurious behavior: Gene-brain-behavior relationships. Ment Retard Dev Disabil Res Rev. 2001;7(1):3–12. - PubMed
    1. Treatment of destructive behaviors in persons with developmental disabilities. Washington, D.C: National Institute of Health; 1989. pp. 91–2410. - PubMed
    1. Rojahn J, Schroeder SR, Hoch TA. Self-injurious behavior in intellectual disabilities. Oxford, UK: Elsevier Ltd; 2008.
    1. Symons FJ, Koppekin A, Wehby JH. Treatment of self-injurious behavior and quality of life for persons with mental retardation. Mental Retard. 1999;37(4):297–307. - PubMed
    1. Iwata BA, Dorsey MF, Slifer KJ, et al. Toward a functional analysis of self-injury. J Appl Behav Anal. 1994;27(2):197–209. - PMC - PubMed

Publication types

MeSH terms

Substances

LinkOut - more resources