The rubella virus affects the central nervous system in several ways and individuals with CRS may exhibit neurological and neuropsychological problems during different stages of their life.
Many of the behavioural disturbances observed in these individuals may arise from dysfunctions of the reticular activating system (arousal deficits, and disruptions of attention and concentration) and impaired executive functions, such as difficulties in suppressing response tendencies, poor impulse control, impaired judgement, perseveration and difficulties in selfregulation.
Impairment of executive functions are associated with frontal lobe damage, but the executive functions are also sensitive to damage in other parts of the brain. The executive deficits observed in individuals with CRS may not be caused by lesions within the frontal lobe per se, but may be caused by developmental dysfunction’s in reticulo- frontal projections (reticulo-frontal disconnection syndrome).
The late onset of behavioral manifestations may then be explained by the fact that a virus infection has affected the central nervous system during its foetal development, but the lesion has no physiological or psychological effect until teen or adult age.
The explanation to this is that those structures or neural connections, which are damaged during foetal development, are structures or neural connections, which mature slowly and are not fully developed until relatively high age.
