1. Neurodevelopmental Effects of Lead in Children

2. Effects of Lead on IQ

3. Lead Absorption

4. Lead is a Child’s Poison  Greater absorption than adults  Greater retention than adults  More deposited in brain than adults  More toxic to developing neurons

5. Lead: A Potent Environmental Toxin That Affects the Structure and Function of the Nervous System n Developmental Pb exposure affects the structure of the CNS (hard-wiring) by affecting the formation and structure of nerve cells (neurons) and support cells (glia) n Functional toxin that interferes with gene transcription, protein expression, cell signaling, and multiple molecular and cellular mechanisms that alter the function of the CNS

6. Effects of Lead on Developing Brain Cells Patrick & Anderson, 2000

8. Reduced Tissue Volume After Lead Exposure KM Cecil et al., PLoS, 2008, 5: 741-750

9. The Cognitive Effects of Lead

10. IQ Loss is Just the Tip of the Iceberg IQ

11. Many important aspects of language, memory, attention and executive functioning are either unmeasured or poorly measured by IQ tests.

12. How are the behavioral effects of brain damage assessed?

13. Neuropsychological Testing n Very tightly focused tests that target behavioral functions of specific brain systems (i.e. neuropsychological functions) n Objective n Valid n Reliable n Reference Baseline

14. Neuropsychological Functions n Fine motor n Attention n Memory & Learning n Executive Functions Concept Formation Planning Cognitive Flexibility

15. Examples of Lead’s Effects on Neuropsychological Test Performance

16. Complex FigureNormal ChildLead Poisoned Child Effect of Lead on Visual Memory

17. Lead’s Effect onVerbal Memory

18. Lead’s Effects on Neuropsychological Functioning n All functions are at risk (e.g. attention, memory, executive functioning) n Lead also affects social judgment n There is no signature injury n The “lag effect”

19. Why Schools Fail Lead Poisoned Children n Unaware that child had been poisoned n Unaware that lead poisoning causes brain damage n Services not provided because child’s IQ is “normal” n No access to neuopsychologists or neuropsychological testing

20. Low SES May Increase Damage From Lead Effect Modification 1. Diet: Low Calcium Low Iron High Fat 2. Schools – lack of early intervention resources 3. Stress

21. “Low” Blood Lead Levels Is There Any Safe Level of Lead?

22. Lead’s Effects on Developing Neurons Patrick & Anderson, 2000

23. Lead’s Effects on Second Messengers

24. Reduced Frontal Tissue Volume After Lead Exposure: Dose-Response KM Cecil et al., PLoS, 2008, 5: 741-750

25. Ctl ≈ 3 ≈ 6 Effects of Lead on Gene Expression Red – Increase Green - Decrease Rats: Exposed in utero 7 through day 21 Hippocampus: learning, memory & attention J.S. Schneider – TJU Univ Med School

26. Contact Information Ted Lidsky, Ph.D. Phone: (732) 851 7317 Email: tlidsky@runbox.com tlidsky@runbox.com