Neural tube disease (NTD)

Let’s start simple, what is neural tube disease; It’s a birth defect caused due to not closing the neural tube properly. There are two main types of NTDs

• Anencephaly

• Spina Bifida

Someone could ask that what the heck is a neural tube. Well, to explain that we had to go to the end of the third week of an embryo. During the end of the third week, the lateral edges of the neural plate become elevated to form neural folds (After the notochord and prechordal mesoderm appeared, inducing the overlying ectoderm to thicken and form neural plate), and the depressed mid-region forms the neural groove. Step by step the neural folds approach each other in the midline area, where they finally fuse. This process is known as Neurulation. The fusion starts in the cervical region (around the neck) and runs from cranial (in or relating to the head) towards caudally (at or near the tail or the posterior part of the body).

Ok, how does this neural tube come to play in these NTDs? Well, it’s actually simple, if the neural tube didn’t close properly, NTD would occur. The two type of NTD occurs due to the not closing of different parts of the neural tube. Anencephaly is caused due to not correctly closing the neural tube in the cranial region, whereas Spina Bifida is caused due to not closing the neural tube in the lumbosacral region.

How common are this NTDs? Let me give you some numbers, in The USA, the overall number is 1 to 1000, while in China the number is 1 to 200.

So, what are the risk factors for NTDs?

• Mother’s age

• History of abortion

• Mother’s BMI

• Nonconsumption of folic acid prior to the pregnancy

(if you need more data, please check the links I mention below.)

Before I talk about how to prevent these NTDs I need to talk about how to prevent it because prevention is more suitable than treatment. It is estimated that 50% to 70% of NTD cases can be prevented by taking 400 micrograms of Folic Acid (a type of Vitamin B) daily for at least 3 months before the pregnancy and during the pregnancy.

Now let’s look at the treatments. Unfortunately, there is no treatment for Anencephaly or Iniencephaly. Infants with these conditions usually die shortly after birth. Fortunately, Spine Bifida is treatable, but the treatments for it can differ due to the severity of the particular condition. Few of these treatments are,

• Open spina bifida. (can have surgery to close the hole in the back before birth or within the first few days after birth.)

• Tethered spinal cord. (Surgery can separate the spinal cord from surrounding tissue.)

There are thousands upon thousands of conditions people die because we don’t have the right methods to treat them, but Neural tube disease isn’t one of them. We are very fortunate to live in a time where we have treatments for this kind of disease. Be thankful.

Disclaimer: This article does not provide medical advice; it is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment.

Sources

Langman’s Medical Embryology 12th Edition.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5557146/

https://www.nichd.nih.gov/health/topics/ntds/conditioninfo/treatment