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Ramos-Triguero A, Navarro-Tapia E, Vieiros M, Mirahi A, Astals Vizcaino M, Almela L, Martínez L, García-Algar Ó, Andreu-Fernández V. Machine learning algorithms to the early diagnosis of fetal alcohol spectrum disorders. Front Neurosci 2024; 18:1400933. [PMID: 38808031 PMCID: PMC11131948 DOI: 10.3389/fnins.2024.1400933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 04/15/2024] [Indexed: 05/30/2024] Open
Abstract
Introduction Fetal alcohol spectrum disorders include a variety of physical and neurocognitive disorders caused by prenatal alcohol exposure. Although their overall prevalence is around 0.77%, FASD remains underdiagnosed and little known, partly due to the complexity of their diagnosis, which shares some symptoms with other pathologies such as autism spectrum, depression or hyperactivity disorders. Methods This study included 73 control and 158 patients diagnosed with FASD. Variables selected were based on IOM classification from 2016, including sociodemographic, clinical, and psychological characteristics. Statistical analysis included Kruskal-Wallis test for quantitative factors, Chi-square test for qualitative variables, and Machine Learning (ML) algorithms for predictions. Results This study explores the application ML in diagnosing FASD and its subtypes: Fetal Alcohol Syndrome (FAS), partial FAS (pFAS), and Alcohol-Related Neurodevelopmental Disorder (ARND). ML constructed a profile for FASD based on socio-demographic, clinical, and psychological data from children with FASD compared to a control group. Random Forest (RF) model was the most efficient for predicting FASD, achieving the highest metrics in accuracy (0.92), precision (0.96), sensitivity (0.92), F1 Score (0.94), specificity (0.92), and AUC (0.92). For FAS, XGBoost model obtained the highest accuracy (0.94), precision (0.91), sensitivity (0.91), F1 Score (0.91), specificity (0.96), and AUC (0.93). In the case of pFAS, RF model showed its effectiveness, with high levels of accuracy (0.90), precision (0.86), sensitivity (0.96), F1 Score (0.91), specificity (0.83), and AUC (0.90). For ARND, RF model obtained the best levels of accuracy (0.87), precision (0.76), sensitivity (0.93), F1 Score (0.84), specificity (0.83), and AUC (0.88). Our study identified key variables for efficient FASD screening, including traditional clinical characteristics like maternal alcohol consumption, lip-philtrum, microcephaly, height and weight impairment, as well as neuropsychological variables such as the Working Memory Index (WMI), aggressive behavior, IQ, somatic complaints, and depressive problems. Discussion Our findings emphasize the importance of ML analyses for early diagnoses of FASD, allowing a better understanding of FASD subtypes to potentially improve clinical practice and avoid misdiagnosis.
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Affiliation(s)
- Anna Ramos-Triguero
- Grup de Recerca Infancia i Entorn (GRIE), Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department de Cirurgia i Especialitats Mèdico-Quirúrgiques, Universitat de Barcelona, Barcelona, Spain
| | - Elisabet Navarro-Tapia
- Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Hospital Universitario La Paz, Madrid, Spain
- Faculty of Health Sciences, Valencian International University (VIU), Valencia, Spain
| | - Melina Vieiros
- Grup de Recerca Infancia i Entorn (GRIE), Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Hospital Universitario La Paz, Madrid, Spain
| | - Afrooz Mirahi
- Grup de Recerca Infancia i Entorn (GRIE), Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Neonatology, Instituto Clínic de Ginecología, Obstetricia y Neonatología (ICGON), Hospital Clínic-Maternitat, BCNatal, Barcelona, Spain
| | - Marta Astals Vizcaino
- Grup de Recerca Infancia i Entorn (GRIE), Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department de Cirurgia i Especialitats Mèdico-Quirúrgiques, Universitat de Barcelona, Barcelona, Spain
| | - Lucas Almela
- Department de Cirurgia i Especialitats Mèdico-Quirúrgiques, Universitat de Barcelona, Barcelona, Spain
| | - Leopoldo Martínez
- Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Hospital Universitario La Paz, Madrid, Spain
- Department of Pediatric Surgery, Hospital Universitario La Paz, Madrid, Spain
| | - Óscar García-Algar
- Grup de Recerca Infancia i Entorn (GRIE), Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Neonatology, Instituto Clínic de Ginecología, Obstetricia y Neonatología (ICGON), Hospital Clínic-Maternitat, BCNatal, Barcelona, Spain
| | - Vicente Andreu-Fernández
- Grup de Recerca Infancia i Entorn (GRIE), Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Biosanitary Research Institute, Valencian International University (VIU), Valencia, Spain
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Goncalves-Garcia M, Hamilton DA. Unraveling the complex relationship between prenatal alcohol exposure, hippocampal LTP, and learning and memory. Front Mol Neurosci 2024; 16:1326089. [PMID: 38283699 PMCID: PMC10811250 DOI: 10.3389/fnmol.2023.1326089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 12/13/2023] [Indexed: 01/30/2024] Open
Abstract
Prenatal alcohol exposure (PAE) has been extensively studied for its profound impact on neurodevelopment, synaptic plasticity, and cognitive outcomes. While PAE, particularly at moderate levels, has long-lasting cognitive implications for the exposed individuals, there remains a substantial gap in our understanding of the precise mechanisms underlying these deficits. This review provides a framework for comprehending the neurobiological basis of learning and memory processes that are negatively impacted by PAE. Sex differences, diverse PAE protocols, and the timing of exposure are explored as potential variables influencing the diverse outcomes of PAE on long-term potentiation (LTP). Additionally, potential interventions, both pharmacological and non-pharmacological, are reviewed, offering promising avenues for mitigating the detrimental effects of PAE on cognitive processes. While significant progress has been made, further research is required to enhance our understanding of how prenatal alcohol exposure affects neural plasticity and cognitive functions and to develop effective therapeutic interventions for those impacted. Ultimately, this work aims to advance the comprehension of the consequences of PAE on the brain and cognitive functions.
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Cases-Solé R, Varillas-Delgado D, Astals-Vizcaino M, García-Algar Ó. Efficacy and Feasibility of an Osteopathic Intervention for Neurocognitive and Behavioral Symptoms Usually Associated With Fetal Alcohol Spectrum Disorder. Front Behav Neurosci 2022; 16:860223. [PMID: 35368309 PMCID: PMC8965441 DOI: 10.3389/fnbeh.2022.860223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 02/08/2022] [Indexed: 11/24/2022] Open
Abstract
The purpose of this study was to evaluate the efficacy and feasibility of a 4-week planned osteopathic manipulative treatment intervention on the improvement of neurocognitive and behavioral symptoms usually associated with fetal alcohol spectrum disorder. Thirty-two symptomatic children without fetal alcohol spectrum disorder aged 3-6 years with low level of attention from two schools and an osteopathic center were recruited in a prospective randomized pilot study in an osteopathic manipulative treatment group [osteopathic manipulative treatment (OMT)] or a control group (standard support measures). Neurocognitive maturity test results for attention (A), iconic memory (IM), spatial structuration (SS), and visual perception (VP) were recorded at baseline and post-intervention. No adverse effects were communicated and there were no dropouts. A significant increase in neurocognitive assessments was observed in children in the OMT group at post-treatment. Intergroup post-intervention statistical differences were found for A, SS, and IM were p = 0.005, p < 0.001, and p < 0.001, respectively; no differences were seen for VP (p = 0.097). This study shows that a 4-week osteopathic manipulative treatment intervention may be a feasible and effective therapeutic approach for neurocognitive and behavioral symptoms usually present in fetal alcohol spectrum disorder, justifying more studies on children affected by this condition.
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Affiliation(s)
- Ramon Cases-Solé
- Centre Osteopatia La Seu, Lleida, Spain
- Department of Surgery and Medical-Surgical Specialties, Universitat de Barcelona, Barcelona, Spain
| | | | - Marta Astals-Vizcaino
- Department of Neonatology, Hospital Clínic-Maternitat, ICGON, BCNatal, Barcelona, Spain
| | - Óscar García-Algar
- Department of Surgery and Medical-Surgical Specialties, Universitat de Barcelona, Barcelona, Spain
- Department of Neonatology, Hospital Clínic-Maternitat, ICGON, BCNatal, Barcelona, Spain
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Sessa F, Salerno M, Esposito M, Di Nunno N, Li Rosi G, Roccuzzo S, Pomara C. Understanding the Relationship between Fetal Alcohol Spectrum Disorder (FASD) and Criminal Justice: A Systematic Review. Healthcare (Basel) 2022; 10:healthcare10010084. [PMID: 35052248 PMCID: PMC8775242 DOI: 10.3390/healthcare10010084] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 12/29/2021] [Accepted: 12/29/2021] [Indexed: 12/04/2022] Open
Abstract
Prenatal alcohol exposure is considered one of the main causes of preventable birth disorders; however, it represents the main form of developmental delay in the world. Among the so-called secondary disabilities related to fetal alcohol spectrum disorder (FASD), there is a close connection with criminal behavior. This systematic review aims to provide up-to-date information about the relationship between FASD subjects and criminal justice analyzing different aspects. In light of the results of this review, a further goal is to provide several suggestions in order to reduce the public cost impact of FASD. A systematic review of the literature was conducted according to the PRISMA guidelines, producing 20 articles that met the inclusion criteria. Based on the results published in the selected studies, fetal alcohol syndrome (FAS) is a leading cause of preventable birth disorders and developmental disabilities in newborns. Moreover, these subjects seem to be more inclined to criminal acts compared to others. In conclusion, it should be pointed out that FASD entails high public health costs, both regarding the support measures provided to the affected individual and to their family, as well as the cost and social impact of any criminal offenses committed.
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Affiliation(s)
- Francesco Sessa
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy;
| | - Monica Salerno
- Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95121 Catania, Italy; (M.S.); (M.E.)
| | - Massimiliano Esposito
- Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95121 Catania, Italy; (M.S.); (M.E.)
| | - Nunzio Di Nunno
- Department of History, Society and Studies on Humanity, University of Salento, 73100 Lecce, Italy;
| | - Giuseppe Li Rosi
- Department of Law, Criminology, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy;
| | - Salvatore Roccuzzo
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98121 Messina, Italy;
| | - Cristoforo Pomara
- Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95121 Catania, Italy; (M.S.); (M.E.)
- Correspondence: ; Tel.: +39-095-3782-153 or +39-333-2466-148
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