We need therapies to help those with Down
syndrome reach their potential.
We currently have no therapeutic inter-
ventions that can prevent or reverse the
intellectual disability or brain pathology
found in individuals with Down syndrome,
which affects about 400,000 people in the
United States alone. However, we may be
getting closer. Some researchers are working to develop drugs that could be used to
treat Down syndrome in utero (see “A
Change of Mind,” page 30). For the last
decade, my colleagues and I have been on
a similar path.
Ten years ago, we were attempting to
identify a pharmacological intervention
that might improve cognitive functioning
in mice with a condition mimicking Down
syndrome. One colleague suggested that
we look at increasing the mother’s intake
of the essential nutrient choline during
pregnancy and lactation, on the basis of
impressive cognitive benefits seen with
this intervention in normal rats during
research done at Duke. I was skeptical, but
it was worth a try. A nutritional intervention was also appealing because it could
be relatively easily tested in humans if our
studies looked promising.
We found that supplementing the
maternal diet with extra choline during pregnancy and lactation markedly
improved spatial cognition, attentional
function, and emotional reactivity in the
mouse offspring with a model of Down
syndrome. It also normalized the formation of new neurons in the hippocampus
and protected basal forebrain cholinergic neurons, which normally atrophy in
this disorder by midlife—part of the brain
changes related to the onset of Alzheimer’s.
How to explain these results? We sus-
pect the answer might be found in studies
done over the past few decades, show-
ing that choline stores become depleted
during pregnancy in both rodents and
humans. A developing fetus may need
more choline than previously realized.
Although clinical trials are needed to
determine whether similar effects are seen
in humans, anecdotal reports of women
increasing their choline intake during a
Down syndrome pregnancy are encouraging. The reports suggest that these
infants reach milestones on a schedule
more similar to that of typically developing babies than infants with Down syndrome whose mothers did not take extra
choline. There’s growing evidence to support a recommendation for all women to
increase choline intake during pregnancy
and breastfeeding—a change that could
benefit all fetuses with Down syndrome
from the earliest stages of development,
regardless of whether the mom had prenatal testing.
Today, women who learn that they are
carrying a fetus with Down syndrome are
often advised to terminate the pregnancy.
But for a variety of reasons, ethical and
otherwise, that’s not an option for all
women. Some 5,000 infants with Down
syndrome are born in the U.S. every year.
It’s imperative that we find a way to help
them achieve their highest potential.
Barbara Strupp is a professor in the division of nutritional sciences and department of psychology at Cornell University.
Computers should stop trying to act like
Everyone knows the Turing test. But
almost no one remembers Alan Turing’s
statement that to achieve true intelli-
gence, you should design a machine that AN