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Results for “Fetal Alcohol Spectrum Disorders”

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PubMed2005

Preventing fetal alcohol spectrum disorders. Preconception counseling and diagnosis help.

QUESTION: By the time women find out they are pregnant and see a family physician, they might have already consumed alcohol during the pregnancy and affected the development of their fetuses. How can family physicians better prevent exposure to alcohol during pregnancy? ANSWER: Women of childbearing age should be counseled about the risks associated with alcohol consumption during pregnancy before they become pregnant. Diagnosing children who have fetal alcohol spectrum disorders can help identify birth mothers who are at risk of other alcohol-exposed pregnancies and who need support to change their behaviour.

Female↗
PubMed2006

Fetal alcohol spectrum disorders in children residing in Russian orphanages: a phenotypic survey.

BACKGROUND: Alcohol use in Russia is among the highest in the world. Over 600,000 children reside in institutional care in Russia, most of them in baby homes and orphanages. The actual prevalence of fetal alcohol spectrum disorders (FASD) among these children is unknown. Therefore, we performed a systematic survey of phenotypic features associated with prenatal alcohol exposure among institutionalized Russian children and related these findings to their growth, development, medical, and social histories. METHODS: Phenotypic screening was conducted of all 234 baby home residents in the Murmansk region of Russia (mean age 21+12.6 months). Phenotypic expression scores were devised based on facial dysmorphology and other readily observable physical findings. Growth measurements from birth, time of placement in the baby home, and at present were analyzed. In addition, the charts of 64% of the children were randomly selected for retrospective review. Information collected included maternal, medical, developmental, and social histories. RESULTS: Thirteen percent of children had facial phenotype scores highly compatible with prenatal alcohol exposure and 45% had intermediate facial phenotype scores. These scores correlated with maternal gravidity and age. At least 40% of mothers in whom history was available ingested alcohol during pregnancy; some also used illicit drugs and tobacco. Z scores for growth measurements corresponded to phenotypic score, as did the degree of developmental delay. Children with no or mild delay had significantly lower phenotypic scores than those with moderate or severe delay (p = 0.04); more than 70% of children with high phenotypic scores were moderately or severely delayed. CONCLUSIONS: More than half of residents of the baby homes in Murmansk, Russia, have intermediate (45%) or high (13%) phenotypic expression scores suggesting prenatal exposure to alcohol. Despite good physical care, stable daily routine, availability of well-trained specialists, and access to medical care, these vulnerable children show significant growth and developmental delays compared with their institutionalized peers.

Anthropometry↗
PubMed2006

Neuroimaging and fetal alcohol spectrum disorders.

Heavy prenatal alcohol exposure causes permanent structural alterations to the brain and can lead to numerous cognitive and behavioral outcomes. Consistent with many of the neuropsychological and behavioral deficits that have been reported, neuroimaging studies reveal a pattern of structural abnormalities associated with prenatal alcohol exposure. This chapter systematically reviews structural anomalies by brain region, identifying cognitive and behavioral correlates when relevant. The consensus shows that in addition to the overall reduction of brain size, prominent brain shape abnormalities have been observed, with narrowing in the parietal region and reduced brain growth in portions of the frontal lobe. Commensurating with these anomalies, volumetric and tissue density findings cite disproportionate reductions in the parietal lobe, cerebellar vermis, corpus callosum, and the caudate nucleus, suggesting that certain areas of the brain may be especially vulnerable to prenatal alcohol exposure. In sum, neuroimaging techniques have greatly advanced our understanding of brain-behavior relationships in fetal alcohol spectrum disorders (FASD), and hopefully will lead to improved diagnosis and treatment options for those affected by prenatal exposure to alcohol.

Brain↗
PubMed2006

Diagnosis of fetal alcohol spectrum disorder (FASD): fatty acid ethyl esters and neonatal hair analysis.

Measuring levels of fatty acid ethyl esters (FAEE) in hair has been recently shown to discriminate between adult heavy and non-drinkers. Here, we review the potential of neonatal FAEE measurement in detecting infants exposed to alcohol in utero by outlining current progress in the development of a neonatal hair test for the diagnosis of fetal alcohol spectrum disorder (FASD). Developing a reproducible, accurate and predictable hair test for FAEE measurements in neonatal hair may prove to be a powerful tool in the detection of in utero alcohol exposure which is needed for the diagnosis of FASD. Such a neonatal hair test can revolutionize current FASD diagnostic methodology by providing early diagnosis, allowing intervention and treatment at stages where the adverse effects of alcohol can still be mitigated.

Adult↗
PubMed2006

Motor response selection in children with fetal alcohol spectrum disorders.

Previous work has reported timing delays in motor response selection in children with prenatal exposure to alcohol when the information load involved responding to two stimulus choices. The present study examined whether the delay in response selection extends to conditions in which the information load is increased to four and eight stimulus choices. Twenty children aged between 12 and 17 years with fetal alcohol spectrum disorders (FASD) were compared to 17 non-alcohol-exposed controls (NC) on a reaction time (RT) task involving 1, 2, 4 or 8 visual stimulus choices. The task demands required the participant to release a response key as fast as possible when the stimulus light electronically paired with the response key was activated. With the number of stimulus choices expressed on a logarithmic scale, there was a significant and linear increase in RT for the FASD children as predicted by information processing theory. Additionally, the increase in RT for the FASD group was comparable to that observed for the NC children at each level of stimulus choice examined. It was concluded that FASD adolescents require additional time to process increasing amount of information, but that the time required for motor response selection is not delayed relative to control group performance.

Adolescent↗
PubMed2005

Alcohol is a potent stimulant of immature neuronal networks: implications for fetal alcohol spectrum disorder.

Ethanol consumption during development affects the maturation of hippocampal circuits by mechanisms that are not fully understood. Ethanol acts as a depressant in the mature CNS and it has been assumed that this also applies to immature neurons. We investigated whether ethanol targets the neuronal network activity that is involved in the refinement of developing hippocampal synapses. This activity appears during the growth spurt period in the form of giant depolarizing potentials (GDPs). GDPs are generated by the excitatory actions of GABA and glutamate via a positive feedback circuit involving pyramidal neurons and interneurons. We found that ethanol potently increases GDP frequency in the CA3 hippocampal region of slices from neonatal rats. It also increased the frequency of GDP-driven Ca2+ transients in pyramidal neurons and increased the frequency of GABA(A) receptor-mediated spontaneous postsynaptic currents in CA3 pyramidal cells and interneurons. The ethanol-induced potentiation of GABAergic activity is probably the result of increased quantal GABA release at interneuronal synapses but not enhanced neuronal excitability. These findings demonstrate that ethanol is a potent stimulant of developing neuronal circuits, which might contribute to the abnormal hippocampal development associated with fetal alcohol syndrome and alcohol-related neurodevelopmental disorders.

Alcohol-Induced Disorders, Nervous System↗
PubMed2005

Screening for fetal alcohol spectrum disorder.

QUESTION: I have several patients whom I suspect are drinking during pregnancy. How can I find out for sure if they are? ANSWER: You can use one of the validated tools to screen for problem drinking. Motherisk uses the TWEAK test, but others are just as good. Following birth, you can test infants' meconium for metabolites of ethanol to detect whether they were exposed in utero to excessive drinking.

Alcoholism↗
PubMed2006

Brain imaging and fetal alcohol spectrum disorders.

Over thirty years of research has revealed that prenatal exposure to alcohol has a devastating impact on the structure and function of the developing central nervous system. Imaging studies over the past ten years have improved our understanding of the structural alterations related to prenatal alcohol exposure and provided researchers with potential hypotheses for brain-behavior relationships. Structural alterations associated with prenatal alcohol exposure have been found in overall brain size, shape, and symmetry, along with regional decreases in white and gray matter. In addition, abnormalities have been noted in specific structures such as the cerebellum, basal ganglia, and corpus callosum. This review demonstrates that specific areas of the brain may be more vulnerable to prenatal exposure to alcohol.

Adult↗
PubMed2006

Defining the behavioral phenotype in children with fetal alcohol spectrum disorders: a review.

While there exists a large body of literature on cognitive functions in children with prenatal alcohol exposure, it remains undetermined if these children exhibit a unique profile of cognitive-behavioral functioning or a behavioral phenotype. Researchers have consistently found that intellectual functioning, as assessed by IQ tests, of children with prenatal alcohol exposure is deficient. There is increasing evidence that prenatal alcohol exposure is associated with slow information processing and attentional problems, in particular inattentiveness. Studies examining specific cognitive abilities such as language, visual perception, and memory in alcohol-affected children have shown performance decrements associated with increased task complexity. Children with prenatal alcohol exposure have also been found to exhibit significant deficits in daily functional skills or adaptive behavior, with deficits in socialization becoming pronounced during adolescence. The above findings point to the conclusion that a generalized deficit in complex information processing constitutes the central cognitive-behavioral characteristic of children with prenatal alcohol exposure. Researchers have consistently documented that specific brain regions are more affected by alcohol than other regions. The problem of mapping focal anomalies of the brain with a generalized pattern of deficits can be solved by taking developmental processes into consideration.

Animals↗