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One unusual aspect of the DA system in PFC is a relative dearth of DA transporter proteins, the best way for clearing away released DA. Long-lasting, selective visual deficits from short-term exposure to high neonatal phenylalanine levels in humans. (abstract) (pdf) Albert, M., Diamond, A., Fitch, H., Neville, H., Rapp, P., and Tallal, P.

This has many interesting and practical consequences.

Diamond hypothesized that at least part of the answer was increasing levels of dopamine in PFC. Researchers and clinicians working on inborn errors of metabolism had noticed that children well-treated for phenylketonuria (PKU) seemed to show selective EF deficits, but no one could imagine a mechanism that could explain that, so reports of such deficits were largely ignored.

Since Phe and tyrosine compete to enter the brain, a modest elevation in the Phe to tyrosine ratio in blood would result in a modest reduction in the amount of tyrosine reaching the brain a reduction sufficient to impact PFC but too small to impact other brain regions. Normal development of prefrontal cortex from birth to young adulthood: Cognitive functions, anatomy, and biochemistry.

She has made discoveries that have improved treatment for two different medical disorders and discoveries that have impacted education, improving the lives of millions of children. EFs include being able to 'think outside the box' and see things from other perspectives (cognitive flexibility), mentally relating different ideas and facts to one another (working memory), and giving a considered response rather than an impulsive one, resisting temptations, and staying focused (inhibitory control, including selective attention). In 2016, she gave 2731 addresses: many were in BC and ON but others were in the US (CA, MA, NC, NY, TX) and abroad (Israel, South Africa).

Her work has shown that executive functions can be improved even in the very young. These abilities are crucial for problem-solving, creativity, and reasoning, and for success in all life's aspects. In 2017, she gave 26 invited addresses, including in Australia, Israel, Italy, Spain, Sweden, New Zealand, and throughout North America. Groupe d’Action en Neuropsychologie Développementale (Gr AND), Quebec City, QC.

(which changed international guidelines for the age of treatment onset).

After demonstrating that maturation of PFC played a role in early cognitive development, a natural next question was, Whats changing in PFC to make these cognitive advances possible?

Even though PFC is very immature early in life and takes a very long time to develop, it can already subserve elementary versions of the highest cognitive functions during the first year of life.

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