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Vargas-Foitzick R, García-Ordenes B, Iratchet D, Acuña A, Alcayaga S, Fernández C, Toledo K, Rodríguez M, Naranjo C, Bustamante R, Haeger PA. Exercise reduces physical alterations in a rat model of fetal alcohol spectrum disorders. Biol Res 2024; 57:41. [PMID: 38907274 PMCID: PMC11193177 DOI: 10.1186/s40659-024-00520-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 06/04/2024] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND Prenatal alcohol exposure (PAE) has serious physical consequences for children such as behavioral disabilities, growth disorders, neuromuscular problems, impaired motor coordination, and decreased muscle tone. However, it is not known whether loss of muscle strength occurs, and which interventions will effectively mitigate physical PAE impairments. We aimed to investigate whether physical alteration persists during adolescence and whether exercise is an effective intervention. RESULTS Using paradigms to evaluate different physical qualities, we described that early adolescent PAE animals have significant alterations in agility and strength, without alterations in balance and coordination compared to CTRL animals. We evaluated the effectiveness of 3 different exercise protocols for 4 weeks: Enrichment environment (EE), Endurance exercise (EEX), and Resistance exercise (REX). The enriched environment significantly improved the strength in the PAE group but not in the CTRL group whose strength parameters were maintained even during exercise. Resistance exercise showed the greatest benefits in gaining strength, and endurance exercise did not. CONCLUSION PAE induced a significant decrease in strength compared to CTRL in PND21. Resistance exercise is the most effective to reverse the effects of PAE on muscular strength. Our data suggests that individualized, scheduled, and supervised training of resistance is more beneficial than endurance or enriched environment exercise for adolescents FASD.
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Affiliation(s)
- Ronald Vargas-Foitzick
- Carrera de Kinesiología, Facultad de Medicina, Universidad Católica del Norte, Coquimbo, Chile
- Departamento de Ciencias Biomédicas, Facultad de Medicina, Universidad Católica del Norte, Coquimbo, Chile
| | - Bayron García-Ordenes
- Carrera de Kinesiología, Facultad de Medicina, Universidad Católica del Norte, Coquimbo, Chile
- Núcleo de Investigación en Prevención y Tratamiento de Enfermedades Crónicas no Transmisibles (NiPTEC), Universidad Católica del Norte, Coquimbo, Chile
| | - Donovan Iratchet
- Carrera de Kinesiología, Facultad de Medicina, Universidad Católica del Norte, Coquimbo, Chile
| | - Angie Acuña
- Carrera de Kinesiología, Facultad de Medicina, Universidad Católica del Norte, Coquimbo, Chile
| | - Spencer Alcayaga
- Carrera de Kinesiología, Facultad de Medicina, Universidad Católica del Norte, Coquimbo, Chile
| | - Cristian Fernández
- Carrera de Kinesiología, Facultad de Medicina, Universidad Católica del Norte, Coquimbo, Chile
| | - Karla Toledo
- Carrera de Kinesiología, Facultad de Medicina, Universidad Católica del Norte, Coquimbo, Chile
| | - Marianela Rodríguez
- Carrera de Kinesiología, Facultad de Medicina, Universidad Católica del Norte, Coquimbo, Chile
| | - Carolina Naranjo
- Departamento de Ciencias Clínicas, Universidad Católica del Norte, Coquimbo, Chile
| | - René Bustamante
- Carrera de Kinesiología, Facultad de Medicina, Universidad Católica del Norte, Coquimbo, Chile
- Departamento de Ciencias Biomédicas, Facultad de Medicina, Universidad Católica del Norte, Coquimbo, Chile
- Núcleo de Investigación en Prevención y Tratamiento de Enfermedades Crónicas no Transmisibles (NiPTEC), Universidad Católica del Norte, Coquimbo, Chile
| | - Paola A Haeger
- Departamento de Ciencias Biomédicas, Facultad de Medicina, Universidad Católica del Norte, Coquimbo, Chile.
- Núcleo de Investigación en Prevención y Tratamiento de Enfermedades Crónicas no Transmisibles (NiPTEC), Universidad Católica del Norte, Coquimbo, Chile.
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Hilly C, Wilson PH, Lucas B, McGuckian TB, Swanton R, Froude EH. Effectiveness of interventions for school-aged-children and adolescents with fetal alcohol spectrum disorder: a systematic review and meta-analysis. Disabil Rehabil 2024; 46:1708-1733. [PMID: 37158227 DOI: 10.1080/09638288.2023.2207043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 04/20/2023] [Accepted: 04/21/2023] [Indexed: 05/10/2023]
Abstract
PURPOSE To describe allied health and educational interventions and their effectiveness for children and adolescents with fetal alcohol spectrum disorder (FASD). To appraise the quality and strength of studies. METHODS Electronic databases were searched between 2005 and March 2022, identifying non-pharmacological studies supporting function, activity, or participation for FASD participants aged 5-18 years using any quantitative research design. Outcomes were coded using International Classification of Functioning, Disability and Health, family of Participation Related Constructs and behaviour categories. Multi-level random-effects meta-analysis examined intervention effects. Study methodological quality was evaluated using Cochrane risk of bias tools, RoBiNT, AMSTAR 2 and NHMRC Hierarchy levels of evidence. Certainty of findings were synthesised using GRADE approach. RESULTS The systematic review included 25 studies with 735 participants, 10 of which were analysed by meta-analysis. Body function and structure, activity, behaviour, and sense of self outcomes were pooled. A small, positive effect favouring interventions was found (g = 0.29, 95% CI = 0.15-0.43), however the GRADE certainty was rated as low. No participation outcomes were identified. CONCLUSIONS Some interventions targeting body function and structure, activity and behaviour outcomes were effective. Evidence of interventions that support children's and adolescent's participation as an outcome is lacking.
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Affiliation(s)
- Catherine Hilly
- School of Allied Health, Australian Catholic University, Canberra, Australia
| | - Peter H Wilson
- Healthy Brain and Mind Research Centre, School of Behavioural & Health Sciences, Australian Catholic University, Melbourne, Australia
| | - Barbara Lucas
- The John Walsh Centre for Rehabilitation Research, The University of Sydney
- Physiotherapy Department, Royal North Shore Hospital, Sydney, Australia
| | - Thomas B McGuckian
- Healthy Brain and Mind Research Centre, School of Behavioural & Health Sciences, Australian Catholic University, Melbourne, Australia
| | - Ruth Swanton
- Occupational Therapy Department, Mercy University Hospital, Cork, Ireland
- Occupational Therapy Department, South Infirmary University Hospital, Cork, Ireland
| | - Elspeth H Froude
- School of Allied Health, Australian Catholic University, Sydney, Australia
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Abstract
The medical disorders of alcoholism rank among the leading public health problems worldwide and the need for predictive and prognostic risk markers for assessing alcohol use disorders (AUD) has been widely acknowledged. Early-phase detection of problem drinking and associated tissue toxicity are important prerequisites for timely initiations of appropriate treatments and improving patient's committing to the objective of reducing drinking. Recent advances in clinical chemistry have provided novel approaches for a specific detection of heavy drinking through assays of unique ethanol metabolites, phosphatidylethanol (PEth) or ethyl glucuronide (EtG). Carbohydrate-deficient transferrin (CDT) measurements can be used to indicate severe alcohol problems. Hazardous drinking frequently manifests as heavy episodic drinking or in combinations with other unfavorable lifestyle factors, such as smoking, physical inactivity, poor diet or adiposity, which aggravate the metabolic consequences of alcohol intake in a supra-additive manner. Such interactions are also reflected in multiple disease outcomes and distinct abnormalities in biomarkers of liver function, inflammation and oxidative stress. Use of predictive biomarkers either alone or as part of specifically designed biological algorithms helps to predict both hepatic and extrahepatic morbidity in individuals with such risk factors. Novel approaches for assessing progression of fibrosis, a major determinant of prognosis in AUD, have also been made available. Predictive algorithms based on the combined use of biomarkers and clinical observations may prove to have a major impact on clinical decisions to detect AUD in early pre-symptomatic stages, stratify patients according to their substantially different disease risks and predict individual responses to treatment.
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Affiliation(s)
- Onni Niemelä
- Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital and Tampere University, Seinäjoki, Finland.
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Abrishamcar S, Chen J, Feil D, Kilanowski A, Koen N, Vanker A, Wedderburn CJ, Donald KA, Zar HJ, Stein DJ, Hüls A. DNA methylation as a potential mediator of the association between prenatal tobacco and alcohol exposure and child neurodevelopment in a South African birth cohort. Transl Psychiatry 2022; 12:418. [PMID: 36180424 PMCID: PMC9525659 DOI: 10.1038/s41398-022-02195-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 09/09/2022] [Accepted: 09/20/2022] [Indexed: 01/12/2023] Open
Abstract
Prenatal tobacco exposure (PTE) and prenatal alcohol exposure (PAE) have been associated with an increased risk of delayed neurodevelopment in children as well as differential newborn DNA methylation (DNAm). However, the biological mechanisms connecting PTE and PAE, DNAm, and neurodevelopment are largely unknown. Here we aim to determine whether differential DNAm mediates the association between PTE and PAE and neurodevelopment at 6 (N = 112) and 24 months (N = 184) in children from the South African Drakenstein Child Health Study. PTE and PAE were assessed antenatally using urine cotinine measurements and the ASSIST questionnaire, respectively. Cord blood DNAm was measured using the EPIC and 450 K BeadChips. Neurodevelopment (cognitive, language, motor, adaptive behavior, socioemotional) was measured using the Bayley Scales of Infant and Toddler Development, Third Edition. We constructed methylation risk scores (MRS) for PTE and PAE and conducted causal mediation analysis (CMA) with these MRS as mediators. Next, we conducted a high-dimensional mediation analysis to identify individual CpG sites as potential mediators, followed by a CMA to estimate the average causal mediation effects (ACME) and total effect (TE). PTE and PAE were associated with neurodevelopment at 6 but not at 24 months. PTE MRS reached a prediction accuracy (R2) of 0.23 but did not significantly mediate the association between PTE and neurodevelopment. PAE MRS was not predictive of PAE (R2 = 0.006). For PTE, 31 CpG sites and eight CpG sites were identified as significant mediators (ACME and TE P < 0.05) for the cognitive and motor domains at 6 months, respectively. For PAE, 16 CpG sites and 1 CpG site were significant mediators for the motor and adaptive behavior domains at 6 months, respectively. Several of the associated genes, including MAD1L1, CAMTA1, and ALDH1A2 have been implicated in neurodevelopmental delay, suggesting that differential DNAm may partly explain the biological mechanisms underlying the relationship between PTE and PAE and child neurodevelopment.
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Affiliation(s)
- Sarina Abrishamcar
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Junyu Chen
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Dakotah Feil
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Anna Kilanowski
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
- Institute for Medical Information Processing, Biometry, and Epidemiology, Pettenkofer School of Public Health, LMU Munich, Munich, Germany
- Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, University of Munich Medical Center, Munich, Germany
| | - Nastassja Koen
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- South African Medical Research Council (SAMRC) Unit on Risk and Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Aneesa Vanker
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - Catherine J Wedderburn
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Kirsten A Donald
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - Heather J Zar
- South African Medical Research Council (SAMRC) Unit on Risk and Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - Dan J Stein
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- South African Medical Research Council (SAMRC) Unit on Risk and Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Anke Hüls
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
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Branton E, Thompson-Hodgetts S, Johnston D, Gross DP, Pritchard L. Motor skills and intelligence in children with fetal alcohol spectrum disorder. Dev Med Child Neurol 2022; 64:965-970. [PMID: 35170025 DOI: 10.1111/dmcn.15175] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 01/10/2022] [Accepted: 01/12/2022] [Indexed: 11/27/2022]
Abstract
AIM To determine the relationship between motor abilities and intelligence in children and young people with prenatal alcohol exposure (PAE) being assessed for fetal alcohol spectrum disorder (FASD). METHOD This was a cross-sectional correlational study of children and young people with PAE being assessed for FASD. The relationship between motor abilities (Movement Assessment Battery for Children, Second Edition) and intelligence (Wechsler Intelligence Scale for Children, Fourth or Fifth Edition) was calculated using correlation and regression analyses. Attention and executive function were considered as potential confounding variables. RESULTS The relationship between motor abilities and intelligence in 73 children and young people (48 males, 25 females; aged 6-17y, mean age 10y 5mo [SD 2y 9mo]) assessed for FASD was small and statistically non-significant (r=0.05, p=0.67). INTERPRETATION The findings confirm that motor abilities and intelligence should be assessed separately when investigating an FASD diagnosis. Intelligence scores should not be used to estimate motor abilities, nor should they dictate when motor testing be completed. Assessing intelligence and motor domains separately will enhance diagnostic accuracy, identify the need for strategies or interventions to address functional motor skills, and further define the role of physiotherapy and occupational therapy in FASD assessment and intervention.
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Affiliation(s)
- Erin Branton
- Alberta Health Services, Central Zone East, Children's Rehabilitation Services, Camrose, Alberta, Canada.,Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Sandy Thompson-Hodgetts
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Danielle Johnston
- Alberta Health Services, Central Zone East, Children's Rehabilitation Services, Camrose, Alberta, Canada.,Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Douglas P Gross
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Lesley Pritchard
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
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Doherty E, Wiggers J, Nathan N, Hall A, Wolfenden L, Tully B, Elliott EJ, Attia J, Dunlop AJ, Symonds I, Tsang TW, Reeves P, McFadyen T, Wynne O, Kingsland M. Iterative delivery of an implementation support package to increase and sustain the routine provision of antenatal care addressing alcohol consumption during pregnancy: study protocol for a stepped-wedge cluster trial. BMJ Open 2022; 12:e063486. [PMID: 35882461 PMCID: PMC9330336 DOI: 10.1136/bmjopen-2022-063486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 07/14/2022] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Antenatal care addressing alcohol consumption during pregnancy is not routinely delivered in maternity services. Although a number of implementation trials have reported significant increases in such care, the majority of women still did not receive all recommended care elements, and improvements dissipated over time. This study aims to assess the effectiveness of an iteratively developed and delivered implementation support package in: (1) increasing the proportion of pregnant women who receive antenatal care addressing alcohol consumption and (2) sustaining the rate of care over time. METHODS AND ANALYSIS A stepped-wedge cluster trial will be conducted as a second phase of a previous trial. All public maternity services within three sectors of a local health district in Australia will receive an implementation support package that was developed based on an assessment of outcomes and learnings following the initial trial. The package will consist of evidence-based strategies to support increases in care provision (remind clinicians; facilitation; conduct educational meetings) and sustainment (develop a formal implementation blueprint; purposely re-examine the implementation; conduct ongoing training). Measurement of outcomes will occur via surveys with women who attend antenatal appointments each week. Primary outcomes will be the proportion of women who report being asked about alcohol consumption at subsequent antenatal appointments; and receiving complete care (advice and referral) relative to alcohol risk at initial and subsequent antenatal appointments. Economic and process evaluation measures will also be reported. ETHICS AND DISSEMINATION Ethical approval was obtained through the Hunter New England (16/11/16/4.07, 16/10/19/5.15) and University of Newcastle Human Research Ethics Committees (H-2017-0032, H-2016-0422) and the Aboriginal Health and Medical Research Council (1236/16). Trial findings will be disseminated to health service decision makers to inform the feasibility of conducting additional cycles to further improve antenatal care addressing alcohol consumption as well as at scientific conferences and in peer-reviewed journals. TRIAL REGISTRATION NUMBER Australian and New Zealand Clinical Trials Registry (ACTRN12622000295741).
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Affiliation(s)
- Emma Doherty
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
- Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
| | - John Wiggers
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
- Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
| | - Nicole Nathan
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
- Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
| | - Alix Hall
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
- Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
| | - Luke Wolfenden
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
- Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
| | - Belinda Tully
- Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
| | - Elizabeth J Elliott
- Faculty of Medicine and Health and Discipline of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia
- Sydney Children's Hospital Network, Kids' Research Institute, Westmead, New South Wales, Australia
| | - John Attia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
- Clinical Research Design and Statistics, Hunter Medical Research Institute, New Lambton, New South Wales, Australia
| | - Adrian John Dunlop
- Drug and Alcohol Clinical Services Research, Hunter New England Local Health District, New Lambton, New South Wales, Australia
| | - Ian Symonds
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Tracey W Tsang
- Faculty of Medicine and Health and Discipline of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia
- Sydney Children's Hospital Network, Kids' Research Institute, Westmead, New South Wales, Australia
| | - Penny Reeves
- Health Research Economics, Hunter Medical Research Institute, New Lambton, New South Wales, Australia
| | - Tameka McFadyen
- Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
- Thurru Indigenous Health Unit, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Olivia Wynne
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
- Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
| | - Melanie Kingsland
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
- Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
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Shili I, Hamdi Y, Marouani A, Ben Lasfar Z, Ghrairi T, Lefranc B, Leprince J, Vaudry D, Olfa MK. Long-term protective effect of PACAP in a fetal alcohol syndrome (FAS) model. Peptides 2021; 146:170630. [PMID: 34481915 DOI: 10.1016/j.peptides.2021.170630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 08/13/2021] [Accepted: 08/14/2021] [Indexed: 12/29/2022]
Abstract
Prenatal ethanol exposure provokes teratogenic effects, due to oxidative stress and massive neuronal apoptosis in the developing brain that result in lifelong behavioral abnormalities. PACAP exerts anti-oxidative and neuroprotective activities on neuronal cells, and prevents ethanol neurotoxicity. The present study focused on the ability of PACAP to protect the brain of 30-day-old mice (P30) from prenatal alcohol exposure induced oxidative damage and toxicity. Pregnant mice were divided randomly into 4 groups, i.e. control group, ethanol group (1.5 g/kg ip daily injection), PACAP group (5 μg intrauterine daily injection) and an ethanol plus PACAP group. Offspring prenatally exposed to ethanol had decreased body weight and reduced cell survival. Moreover, production of ROS was sharply enhanced in the brain of prenatal ethanol-exposed animals, associated with an elevation in the activity of the antioxidant enzymes, and an increase of oxidative damages as shown by the accumulation of the lipid oxidation marker malondialdehyde and of protein carbonyl compounds. Intrauterine administration of PACAP during the gestational period restored the endogenous antioxidant system, prevented ROS overproduction and promoted the survival of dissociated cells from animals prenatally exposed to ethanol. Behavioral tests revealed that P30 animals exposed to ethanol during the prenatal period exhibited reduced motor activity, altered exploratory interest and increased anxiety. However, PACAP treatment significantly attenuated these behavioral impairments. This study demonstrates that PACAP exerts a potent neuroprotective effect against alcohol toxicity during brain development, and indicates that PACAP and/or PACAP analogs might be a useful tool for treatment of alcohol intoxication during pregnancy.
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Affiliation(s)
- Ilhem Shili
- University Tunis El Manar, Faculty of Sciences of Tunis, LR18ES03, Laboratory of Neurophysiology, Cellular Physiopathology and Biomelcules Valorisation, 2092 Tunis, Tunisia; Normandie Univ, UNIROUEN, Inserm, Laboratory of Neuronal and Neuroendocrine Communication and Differentiation, Neuropeptides, Neuronal Death and Cell Plasticity Team, 76000 Rouen, France
| | - Yosra Hamdi
- University Tunis El Manar, Faculty of Sciences of Tunis, LR18ES03, Laboratory of Neurophysiology, Cellular Physiopathology and Biomelcules Valorisation, 2092 Tunis, Tunisia
| | - Ammar Marouani
- Institut Pasteur Tunisia, Laboratory of Venins and Toxines, B.P. 74, 1002 Tunis-Belvédère, Tunisia
| | - Zakaria Ben Lasfar
- Institut Pasteur Tunisia, Laboratory of Venins and Toxines, B.P. 74, 1002 Tunis-Belvédère, Tunisia
| | - Taoufik Ghrairi
- University Tunis El Manar, Faculty of Sciences of Tunis, LR18ES03, Laboratory of Neurophysiology, Cellular Physiopathology and Biomelcules Valorisation, 2092 Tunis, Tunisia
| | - Benjamin Lefranc
- Normandie Univ, UNIROUEN, Inserm, Laboratory of Neuronal and Neuroendocrine Communication and Differentiation, Neuropeptides, Neuronal Death and Cell Plasticity Team, 76000 Rouen, France; Normandie Univ, UNIROUEN, Regional Cell Imaging Platform of Normandy (PRIMACEN), 76000 Rouen, France
| | - Jérôme Leprince
- Normandie Univ, UNIROUEN, Inserm, Laboratory of Neuronal and Neuroendocrine Communication and Differentiation, Neuropeptides, Neuronal Death and Cell Plasticity Team, 76000 Rouen, France; Normandie Univ, UNIROUEN, Regional Cell Imaging Platform of Normandy (PRIMACEN), 76000 Rouen, France
| | - David Vaudry
- Normandie Univ, UNIROUEN, Inserm, Laboratory of Neuronal and Neuroendocrine Communication and Differentiation, Neuropeptides, Neuronal Death and Cell Plasticity Team, 76000 Rouen, France; Normandie Univ, UNIROUEN, Regional Cell Imaging Platform of Normandy (PRIMACEN), 76000 Rouen, France.
| | - Masmoudi-Kouki Olfa
- University Tunis El Manar, Faculty of Sciences of Tunis, LR18ES03, Laboratory of Neurophysiology, Cellular Physiopathology and Biomelcules Valorisation, 2092 Tunis, Tunisia.
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Schaidhauer FG, Caetano HA, da Silva GP, da Silva RS. Contributions of Zebrafish Studies on the Behavioural Consequences of Early Alcohol Exposure: A Systematic Review. Curr Neuropharmacol 2021; 20:579-593. [PMID: 33913405 DOI: 10.2174/1570159x19666210428114317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/17/2021] [Accepted: 04/22/2021] [Indexed: 12/09/2022] Open
Abstract
BACKGROUND The consequences of mild to severe exposure to alcohol during brain development is still a matter of debate and scientific investigation. The long-term behavioural effects of ethanol exposure have been related to impaired social skills and cognition. Zebrafish have become a suitable animal model to investigate the effects of early ethanol exposure because it is very feasible to promote drug delivery during early development. OBJECTIVE The goal of the current report is to review existing behavioural studies addressing the impact of early alcohol exposure using zebrafish to determine whether these models resemble the behavioural effects of early alcohol exposure in humans. METHODS A comprehensive search of biomedical databases was performed using the operation order: "ZEBRAFISH AND BEHAV* AND (ETHANOL OR ALCOHOL)". The eligibility of studies was determined using the PICOS strategy, contemplating the population as zebrafish, intervention as exposure to ethanol, comparison with a non-exposed control animal, and outcomes as behavioural parameters. RESULTS The systematic search returned 29 scientific articles as eligible. The zebrafish is presented as a versatile animal model that is useful to study FASD short and long-term behaviour impairments, such as anxiety, impaired sociability, aggressiveness, learning problems, memory impairment, seizure susceptibility, sleep disorders, motivational problems, and addiction. CONCLUSION This systematic review serves to further promote the use of zebrafish as a model system to study the pathophysiological and behavioural consequences of early alcohol exposure.
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Affiliation(s)
- Flávia Gheller Schaidhauer
- Laboratório de Neuroquímica e Psicofarmacologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Higor Arruda Caetano
- Laboratório de Neuroquímica e Psicofarmacologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Guilherme Pietro da Silva
- Laboratório de Neuroquímica e Psicofarmacologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Rosane Souza da Silva
- Laboratório de Neuroquímica e Psicofarmacologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Lim YH, Licari M, Spittle AJ, Watkins RE, Zwicker JG, Downs J, Finlay-Jones A. Early Motor Function of Children With Autism Spectrum Disorder: A Systematic Review. Pediatrics 2021; 147:peds.2020-011270. [PMID: 33510035 DOI: 10.1542/peds.2020-011270] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/05/2020] [Indexed: 11/24/2022] Open
Abstract
CONTEXT Early motor impairments have been reported in children with neurodevelopmental disorders (NDD), but it is not clear if early detection of motor impairments can identify children at risk for NDD or how early such impairments might be detected. OBJECTIVE To characterize early motor function in children later diagnosed with NDD relative to typically developing children or normative data. DATA SOURCES The Cumulative Index to Nursing and Allied Health Literature, Embase, Medline, PsycINFO, and Scopus electronic databases were searched. STUDY SELECTION Eligible studies were required to include an examination of motor function in children (0-24 months) with later diagnosis of NDD by using standardized assessment tools. DATA EXTRACTION Data were extracted by 4 independent researchers. The quality of the studies was assessed by using the Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields checklist. RESULTS Twenty-five studies were included in this review; in most of the studies, the authors examined children with later autism spectrum disorder (ASD). Early motor impairments were detected in children later diagnosed with ASD. The meta-analysis results indicated that differences in fine, gross, and generalized motor functions between the later ASD and typically developing groups increased with age. Motor function across different NDD groups was found to be mixed. LIMITATIONS Results may not be applicable to children with different types of NDD not reported in this review. CONCLUSIONS Early motor impairments are evident in children later diagnosed with ASD. More research is needed to ascertain the clinical utility of motor impairment detection as an early transdiagnostic marker of NDD risk.
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Affiliation(s)
- Yi Huey Lim
- Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Melissa Licari
- Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Alicia J Spittle
- Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Neonatal Services, The Royal Women's Hospital, Parkville, Victoria, Australia.,Department of Physiotherapy, The University of Melbourne, Parkville, Victoria, Australia
| | | | - Jill G Zwicker
- British Columbia Children's Hospital Research Institute and.,Sunny Hill Health Center, British Columbia Children's Hospital, Vancouver, Canada.,Departments of Occupational Science and Occupational Therapy and.,Pediatrics, The University of British Columbia, Vancouver, Canada
| | - Jenny Downs
- Telethon Kids Institute, Nedlands, Western Australia, Australia.,The University of Western Australia, Perth, Western Australia, Australia.,Schools of Physiotherapy and Exercise Science and
| | - Amy Finlay-Jones
- Telethon Kids Institute, Nedlands, Western Australia, Australia; .,Psychology, Curtin University, Bentley, Western Australia, Australia
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Zuanetti PA, Avezum MDMDM, Ferretti MI, Pontes-Fernandes AC, Nunes MEN, Liporaci NM, Fukuda MTH, Hamad APA. Development of language and arithmetic skills: risk and protective factors. Comparative cross-sectional study. SAO PAULO MED J 2021; 139:210-217. [PMID: 33729418 PMCID: PMC9625007 DOI: 10.1590/1516-3180.2020.0280.r1.10122020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 12/10/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND In a literate society, linguistic/arithmetic performance is highly valued. Based on defined risk factors, strategies for promotion of better performance can be developed. OBJECTIVE To ascertain the risk and protective factors relating to development of language and arithmetic. DESIGN AND SETTING Observational comparative cross-sectional study at a public elementary school in Ribeirão Preto (SP), Brazil. METHODS A total of 66 children (41% females) attending first to fifth grades participated in this study. They were divided into two groups: G1, children classified as presenting language or arithmetic deficits; G2, average performance. Language (oral and written) and arithmetic skills were assessed through standardized tests. Variables relating to social skills, home environment resources and behavioral problems were assessed through standardized scales. Data on other variables (pre, peri and postnatal complications, maternal variables and others) were collected through interviews. The logistic regression technique with LASSO was used (α = 0.05). RESULTS Teenage pregnancy and consumption of psychoactive substances during pregnancy or complications during pregnancy were risk factors for performance regarding arithmetic and language. Higher schooling level for the mother was a protective factor in the development of arithmetic and language. Being female and having a history of otitis were risk factors for language. Altered social skills (responsibility and civility) and complaints of inattention were risk factor for arithmetic. Adequate linguistic development was a protective factor for the development of arithmetic. CONCLUSION The risk/protective factors included variables relating to the gestational period, mother's age when pregnant, mother's schooling, social skills, behavior and development issues.
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Affiliation(s)
- Patrícia Aparecida Zuanetti
- PhD. Speech Therapist, Department of Health Sciences, Faculty of Medicine of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto (SP), Brazil.
| | - Marina Dias Macedo de Melo Avezum
- BSc. Psychologist, Department of Neuroscience and Behavioral Sciences, Faculty of Medicine of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto (SP), Brazil.
| | - Marita Iannazzo Ferretti
- BSc. Psychologist, Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto (SP), Brazil.
| | - Angela Cristina Pontes-Fernandes
- PhD. Psychologist, Department of Neuroscience and Behavioral Sciences, Faculty of Medicine of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto (SP), Brazil.
| | - Marina Estima Neiva Nunes
- MD. Department of Neuroscience and Behavioral Sciences, Faculty of Medicine of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto (SP), Brazil.
| | - Nelson Macedo Liporaci
- MD. Department of Neuroscience and Behavioral Sciences, Faculty of Medicine of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto (SP), Brazil.
| | - Marisa Tomoe Hebihara Fukuda
- PhD. Speech Therapist, Associate Professor, Department of Health Sciences, Faculty of Medicine of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto (SP), Brazil.
| | - Ana Paula Andrade Hamad
- MD, PhD. Assistant Professor, Department of Neuroscience and Behavioral Sciences, Faculty of Medicine of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto (SP), Brazil.
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11
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Fjørtoft T, Brandal M, Brubakk AM, Adde L, Ustad T, Vågen R, Evensen KAI. Maternal alcohol and drug use during pregnancy affects the motor behaviour and general movements of infants aged 3-4 months. Early Hum Dev 2020; 151:105171. [PMID: 32977207 DOI: 10.1016/j.earlhumdev.2020.105171] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 08/24/2020] [Accepted: 08/30/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Exposure of alcohol and/or other addictive drugs in pregnancy is a documented risk factor for later neurological impairment. AIMS The aim of the study was to determine whether infants suffering from prenatal exposure to addictive drugs and alcohol develop an abnormal motor behaviour at three to four months of age. STUDY DESIGN Controlled cohort study of infants exposed to alcohol and/or other addictive drugs in pregnancy who were recruited from a hospital follow-up programme. The control group consisted of healthy, unexposed infants. SUBJECTS The study group of 108 infants exposed to alcohol and/or addictive drugs in pregnancy were enrolled based on referrals from primary health care. The control group included 106 infants who had not been exposed to the aforementioned substances. OUTCOME MEASURES We assessed the general movements (Prechtl's General-Movement-Assessment, GMA), the motor repertoire (Assessment-of-Motor-Repertoire, AMR), and the Alberta-Infant Motor-Scale (AIMS) in all infants at three to four months of age. RESULTS None of the infants in either group had absent fidgety movements (FMs). In the study group 5(5%) had exaggerated FMs and 5(5%) had sporadic FMs; and 68(63%) infants in the study group displayed an abnormal movement character, compared to 23(22%) in the control group (p<0.001). On the AIMS, 46(44%) infants in the study group scored below the 10th percentile, compared to 2(3%) controls (p< 0.001). CONCLUSION The study describes an abnormal movement character of infants exposed to alcohol and/or addictive drugs in pregnancy when their motor repertoire was assessed at three to four months of age. The AIMS also showed negative effects on their motor behaviour.
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Affiliation(s)
- T Fjørtoft
- Clinic of Clinical Services, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
| | - M Brandal
- Clinic of Clinical Services, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - A M Brubakk
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway; Department of Pediatrics, St. Olav's Hospital, Trondheim University Hospital, Norway
| | - L Adde
- Clinic of Clinical Services, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - T Ustad
- Clinic of Clinical Services, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - R Vågen
- Clinic of Clinical Services, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - K A I Evensen
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway; Department of Public Health and Nursing, Norwegian University of Science and Technology, Norway; Unit for Physiotherapy Services, Trondheim Municipality, Norway; Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
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12
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McDougall S, Finlay-Jones A, Arney F, Gordon A. A qualitative examination of the cognitive and behavioural challenges experienced by children with fetal alcohol spectrum disorder. RESEARCH IN DEVELOPMENTAL DISABILITIES 2020; 104:103683. [PMID: 32521433 DOI: 10.1016/j.ridd.2020.103683] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 05/01/2020] [Accepted: 05/01/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION At present it is unclear whether there is a consistent behavioural phenotype for children with Fetal Alcohol Spectrum Disorder (FASD) that can support screening efforts. There has been a dearth of qualitative studies exploring the behavioural phenotype from the perspective of caregivers raising children with FASD. The current study explores the cognitive and behavioural difficulties and impairments experienced by children with FASD aged between four and 12 years from the perspective of caregivers. METHODS Fourteen caregivers of children with FASD participated in telephone interviews. Caregivers were recruited until data saturation occurred. Thematic analysis was undertaken on the transcribed interviews, using NVivo 12. RESULTS Three over-arching themes were identified that consisted of subthemes 1) Self-regulation; behavioural, emotional, and attention; 2) Cognitive abilities; academic abilities and learning and memory; and 3) Adaptive functioning; social skills, communication and language skills, motor skills, and sleep concerns. Multiple subthemes were consistently identified across participants. A further two cross-cutting themes were identified; children behaving young for their age, and inconsistency in behaviour and strategies. DISCUSSION Despite the lack of a consistent behavioural phenotype for FASD, the findings suggest consistency between caregivers in their reports of the difficulties experienced by children with FASD. The implications for early identification and screening tool development are discussed.
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Affiliation(s)
- Stewart McDougall
- Australian Centre for Child Protection, University of South, GPO Box 2471, Adelaide, SA, 5001 Australia; Justice and Society, University of South Australia, SA, 5000 Australia.
| | - Amy Finlay-Jones
- Fetal Alcohol Spectrum Disorders Centre for Research Excellence, Telethon Kids Institute, WA, 6009, Australia
| | - Fiona Arney
- Australian Centre for Child Protection, University of South, GPO Box 2471, Adelaide, SA, 5001 Australia; Justice and Society, University of South Australia, SA, 5000 Australia
| | - Andrea Gordon
- Australian Centre for Child Protection, University of South, GPO Box 2471, Adelaide, SA, 5001 Australia; Justice and Society, University of South Australia, SA, 5000 Australia
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13
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Hen-Herbst L, Jirikowic T, Hsu LY, McCoy SW. Motor performance and sensory processing behaviors among children with fetal alcohol spectrum disorders compared to children with developmental coordination disorders. RESEARCH IN DEVELOPMENTAL DISABILITIES 2020; 103:103680. [PMID: 32446153 DOI: 10.1016/j.ridd.2020.103680] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 04/14/2020] [Accepted: 04/30/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Children with fetal alcohol spectrum disorders (FASD) and developmental coordination disorders (DCD) may show similar clinical sensory-motor symptoms. AIMS This study aimed to compare motor skills and sensory processing behaviors between these two groups. METHODS AND PROCEDURES In this retrospective analysis, we examined secondary data and used multivariate analysis of variance to compare the Movement Assessment Battery for Children-2 (MABC-2) and Sensory Processing Measure (SPM)-Home for 21 children with FASD and 21 with DCD without prenatal alcohol exposure, ages 5-13 years. OUTCOMES AND RESULTS No significant group differences in mean total motor or subtest scores on the MABC-2 were detected, but a higher proportion of children with DCD had more severe motor delays. Both groups had sensory processing difficulties, but the children with FASD had significantly more sensory processing difficulties on the SPM total score and visual, touch, body awareness, and planning subscales. CONCLUSIONS AND IMPLICATIONS The sensory processing symptoms in children with FASD distinguished the two groups. These group differences between children with FASD and DCD need corroboration in larger samples but haveimplications for differential diagnosis, clinical assessment, and targeted intervention.
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Affiliation(s)
- Liat Hen-Herbst
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Mount Carmel, Israel.
| | - Tracy Jirikowic
- School of Medicine, Department of Rehabilitation Medicine, Box 356490, University of Washington, Seattle, WA 98195, USA
| | - Lin-Ya Hsu
- School of Medicine, Department of Rehabilitation Medicine, Box 356490, University of Washington, Seattle, WA 98195, USA
| | - Sarah Westcott McCoy
- School of Medicine, Department of Rehabilitation Medicine, Box 356490, University of Washington, Seattle, WA 98195, USA
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14
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Single leg hopping in children with fetal alcohol spectrum disorder: Dynamic postural stability and kinematics. J Bodyw Mov Ther 2020; 24:303-315. [PMID: 33218527 DOI: 10.1016/j.jbmt.2020.06.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 05/18/2020] [Accepted: 06/13/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND This study compared dynamic postural stability (DPS) and lower limb kinematics during single leg hopping (SLH) performed by typically-developed children from urban and rural settings and children with Fetal Alcohol Spectrum Disorder (FASD) from a rural setting. METHODS Typically-developed nine-year-old children from an urban (n = 27) and rural setting (n = 14) (controls), and nine-year-old children with FASD from a rural setting (n = 14) (cases) performed SLH and landing on a pressure mat. Motion analysis systems described 1) Spatiotemporal and centre of pressure parameters (COP) and lower limb sagittal plane kinematics. Descriptive results are presented in median and ranges and differences between groups were determined by Kruskal-Wallis and Mann-Whitney U statistical tests. The level of significance was p < 0.05. RESULTS During hopping, the urban controls had longer stance and swing times (p < 0.001) than the rural groups. The urban controls remained in greater hip flexion compared to the case group (p = 0.02). The urban controls landed in more plantarflexion at initial foot contact (IFC) than the cases (p < 0.001) and the rural controls (p = 0.03). The rural groups landed with greater knee extension at IFC than the urban controls (cases p = 0.04; rural controls p < 0.001). During the landing motion, the urban controls moved into more hip flexion compared to the cases (p = 0.015) and the rural controls (p = 0.026). The cases displayed greater COP anteroposterior values during landing compared to both control groups, but the case group displayed the fastest time to stability. CONCLUSION The different hopping strategies observed provides an indication of the movement capabilities of these groups.
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15
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Sanders JL, Netelenbos N, Dei SO. Construct and factorial validity of Neurobehavioral Disorder associated with Prenatal Alcohol Exposure (ND-PAE). BMC Psychol 2020; 8:53. [PMID: 32460861 PMCID: PMC7251837 DOI: 10.1186/s40359-020-00405-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 04/12/2020] [Indexed: 11/10/2022] Open
Abstract
Background ND-PAE, as a condition needing further study, requires validation. Few studies have assessed the validity of ND-PAE with none using a prospective sample. Methods Fifty-eight children underwent multidisciplinary FASD assessments and were evaluated for ND-PAE using a prospective, clinical approach. Construct and factorial validity of ND-PAE were assessed, and associations between domains and symptoms described. Post hoc analysis assessed external validity of factors. Results ND-PAE demonstrated weak construct validity with variable convergence and divergence within and between symptoms. Factor analysis revealed one strong factor consisting of abilities associated with adaptive behavior and general cognitive ability. Relative contribution of symptoms and domains were variable. Conclusion This study provides an evidence-based approach to assessing ND-PAE symptoms and is a starting point to elucidating its neurobehavioral pattern.
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Affiliation(s)
- James Ladell Sanders
- Faculty of Health Sciences, University of Lethbridge, 4401 University Dr W, Lethbridge, Alberta, T1K 3M4, Canada.
| | - Nicole Netelenbos
- Faculty of Health Sciences, University of Lethbridge, 4401 University Dr W, Lethbridge, Alberta, T1K 3M4, Canada
| | - Samuel Ofori Dei
- Faculty of Health Sciences, University of Lethbridge, 4401 University Dr W, Lethbridge, Alberta, T1K 3M4, Canada
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16
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Blanck-Lubarsch M, Dirksen D, Feldmann R, Sauerland C, Hohoff A. Tooth Malformations, DMFT Index, Speech Impairment and Oral Habits in Patients with Fetal Alcohol Syndrome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224401. [PMID: 31717945 PMCID: PMC6888578 DOI: 10.3390/ijerph16224401] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 11/04/2019] [Accepted: 11/08/2019] [Indexed: 12/17/2022]
Abstract
Background: Fetal alcohol spectrum disorder (FASD) is a developmental disorder with severe negative lifetime consequences. Although knowledge about the harmfulness of alcohol consumption during pregnancy has spread, the prevalence of fetal alcohol spectrum disorder is very high. Our study aims at identifying fetal alcohol syndrome (FAS)-associated dental anomalies or habits, which need early attention. Methods: Sixty children (30 FAS; 30 controls) were examined prospectively. Swallowing pattern, oral habits, breastfeeding, speech therapy, ergotherapy, physiotherapy, exfoliation of teeth, DMFT (decayed, missing, filled teeth) index, modified DDE (developmental defects of enamel) index and otitis media were recorded. Results: Swallowing pattern, exfoliation of teeth, and otitis media were not significantly different. Significant differences could be found concerning mouthbreathing (p = 0.007), oral habits (p = 0.047), age at termination of habits (p = 0.009), speech treatment (p = 0.002), ergotherapy, physiotherapy, and breastfeeding (p ≤ 0.001). DMFT (p ≤ 0.001) and modified DDE (p = 0.001) index showed significantly higher values for children with fetal alcohol syndrome. Conclusions: Children with fetal alcohol syndrome have a higher need for early developmental promotion such as speech treatment, ergotherapy, and physiotherapy. Mouthbreathing, habits, and lack of breastfeeding may result in orthodontic treatment needs. High DMFT and modified DDE indexes hint at a higher treatment and prevention need in dentistry.
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Affiliation(s)
- Moritz Blanck-Lubarsch
- Department of Orthodontics, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany;
- Correspondence: ; Tel.: +49-0251-83-47100
| | - Dieter Dirksen
- Department of Prosthodontics and Biomaterials, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany;
| | - Reinhold Feldmann
- Department of Pediatrics, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany;
| | - Cristina Sauerland
- Institute of Biostatistics and Clinical Research, University of Münster, Schmeddingstraße 56, 48149 Münster, Germany;
| | - Ariane Hohoff
- Department of Orthodontics, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany;
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La Fauci V, Squeri R, Genovese C, Alessi V, Facciolà A. The 'Dangerous Cocktail': an epidemiological survey on the attitude of a population of pregnant women towards some pregnancy risk factors. J OBSTET GYNAECOL 2019; 40:330-335. [PMID: 31373265 DOI: 10.1080/01443615.2019.1621818] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Many investigations have shown the important role played by risk factors such as tobacco and alcohol and infectious agents (especially Rubella) in the development of congenital anomalies (CAs). Through the administration of a questionnaire, we evaluated the attitude of a population of pregnant women towards some risk factors in pregnancy (smoking and alcohol habit and risk of contracting one of TORCH agents). 14% of the women continued to smoke despite pregnancy; the majority of these were 34-35 years old, divorced, workers and with a high educational level. The 4.3% who identified as moderate drinkers; were mainly younger and married. Concerning the TORCH agents, it a high percentage were negative to the Rubella antibodies (62.8%). In order to improve the awareness of pregnant women on these risk factors, health education campaigns represent a public health cornerstone. Impact statementWhat is already known on this subject? Several investigations have shown an association between congenital anomalies (CAs) and various exogenous factors such as air pollutants, pesticides, metals, radiations and others present in the environmental matrices. Moreover, an important role is played by some risk factors linked to the lifestyles (i.e. tobacco and alcohol).What do the results of this study add? Our study shows that the awareness of the women about the importance of these risk factors is still rather poor, especially concerning the avoidable risks associated with smoke and alcohol and the preventable risk associated with rubella infection.What are the implications of these findings for clinical practice and/or further research? Our results highlight the importance of continuous health education both about the risk to smoke and drink during pregnancy and about the risk not to have had contract the rubella infection before the pregnancy. Particularly, about the latter issue, it appears necessary to increase the pre-conceptional diagnosis and, eventually, to vaccinate the women resulted negative in order to eliminate congenital rubella.
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Affiliation(s)
- Vincenza La Fauci
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Raffaele Squeri
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Cristina Genovese
- Postgraduate Medical School in Hygiene and Preventive Medicine, University of Messina, Messina, Italy
| | - Valeria Alessi
- Postgraduate Medical School in Hygiene and Preventive Medicine, University of Messina, Messina, Italy
| | - Alessio Facciolà
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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18
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Garrison L, Morley S, Chambers CD, Bakhireva LN. Forty Years of Assessing Neurodevelopmental and Behavioral Effects of Prenatal Alcohol Exposure in Infants: What Have We Learned? Alcohol Clin Exp Res 2019; 43:1632-1642. [PMID: 31206743 DOI: 10.1111/acer.14127] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Accepted: 06/06/2019] [Indexed: 01/01/2023]
Abstract
It has been known for over 4 decades that prenatal alcohol exposure (PAE) can adversely affect neurodevelopment and behavior (NDB). Yet, early detection of altered NDB due to PAE continues to present a major clinical challenge. Identification of altered NDB in the first 2 years of life, before higher-order cognitive processes develop, invites early interventions for affected children to improve long-term outcomes. Studies published in English from January of 1980 to July of 2018 were identified in PubMed/MEDLINE. The review focused on prospective birth cohort studies which used standardized NDB assessments in children up to 2 years of age, wherein PAE was the main exposure and NDB was the main outcome. NDB was categorized into the domains of neurocognitive, adaptive, and self-regulation based on the 2016 Updated Clinical Guidelines for Diagnosing fetal alcohol spectrum disorder. An initial search resulted in 1,867 articles for which we reviewed abstracts; 114 were selected for full-text review; and 3 additional abstracts were identified through review of references in eligible publications. Thirty-one publications met criteria and were included: of these, 24 reported neurocognitive outcomes, 24 reported adaptive behavior outcomes, and 12 reported outcomes in the domain of self-regulation. Although self-regulation was assessed in the fewest number of studies, 8/12 (75%) reported PAE-associated deficits. In contrast, results were mixed for the other 2 domains: 13/24 (54%) of the selected studies that included neurocognitive outcomes showed poorer performance following PAE, and 8/24 (33%) studies that assessed adaptive functioning found significant differences between PAE and comparison infants. There is considerable evidence to support the value of early-life assessments of infant NDB when PAE is known or suspected. More studies focusing on infant self-regulation, in particular, are needed to determine the utility of early evaluation of this critical developmental domain in infants with PAE.
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Affiliation(s)
- Laura Garrison
- Department of Pharmacy Practice and Administrative Sciences, Substance Use Research and Education Center, University of New Mexico College of Pharmacy, Albuquerque, New Mexico
| | - Sarah Morley
- Health Sciences Library and Informatics Center, University of New Mexico, Albuquerque, New Mexico
| | - Christina D Chambers
- Department of Pediatrics, University of California San Diego, La Jolla, California
| | - Ludmila N Bakhireva
- Department of Pharmacy Practice and Administrative Sciences, Substance Use Research and Education Center, University of New Mexico College of Pharmacy, Albuquerque, New Mexico.,Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico.,Division of Epidemiology, Biostatistics and Preventive Medicine, Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico
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19
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Clinical presentation, diagnosis, and management of fetal alcohol spectrum disorder. Lancet Neurol 2019; 18:760-770. [PMID: 31160204 DOI: 10.1016/s1474-4422(19)30150-4] [Citation(s) in RCA: 129] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 02/26/2019] [Accepted: 02/28/2019] [Indexed: 12/21/2022]
Abstract
Although prenatal alcohol exposure causes craniofacial anomalies, growth retardation, neurological abnormalities, cognitive impairment, and birth defects, fetal alcohol spectrum disorder is underdiagnosed. Global prevalence of fetal alcohol spectrum disorder is 0·77%, with a higher prevalence of 2-5% in Europe and North America, highlighting the need for increased diagnosis and treatment. However, diagnosis remains challenging because of the poor reliability of self-reported maternal drinking histories, an absence of sensitive biomarkers, and the infrequency of diagnostic dysmorphic facial features among individuals with fetal alcohol spectrum disorder. Different diagnostic systems and disagreements over criteria have slowed progress in the diagnosis and management of the disorder. Neuroimaging shows abnormalities in brain structure, cortical development, white matter microstructure, and functional connectivity in individuals with fetal alcohol spectrum disorder. These abnormalities modify developmental trajectories and are associated with deficits in cognition, executive function, memory, vision, hearing, motor skills, behaviour, and social adaptation. Promising trials of nutritional interventions and cognitive rehabilitation therapies are underway, with the aim of treating cognitive deficits in fetal alcohol spectrum disorders.
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Johnston D, Branton E, Rasmuson L, Schell S, Gross DP, Pritchard-Wiart L. Accuracy of motor assessment in the diagnosis of fetal alcohol spectrum disorder. BMC Pediatr 2019; 19:171. [PMID: 31138161 PMCID: PMC6537401 DOI: 10.1186/s12887-019-1542-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 05/17/2019] [Indexed: 11/10/2022] Open
Abstract
Background To evaluate the accuracy of motor assessment tools listed in Fetal alcohol spectrum disorder: a guideline for diagnosis across the lifespan (Canadian Guideline) for the purpose of fetal alcohol spectrum disorder (FASD) diagnosis. Specifically, we aimed to determine: 1) diagnostic accuracy of motor assessment tools and subtests; 2) accuracy of multiple subtests versus total scores; and 3) accuracy of alternate cut-offs. Methods Cross-sectional diagnostic study of 63 children aged 6–17 years. Diagnostic accuracy and alternate cut-offs were calculated for the Movement Assessment Battery for Children, 2nd edition (MABC-2), Bruininks-Oseretsky Test of Motor Proficiency, 2nd edition Short Form (BOT-2SF) and Beery-Buktenica Developmental Test of Visual Motor Integration, 6th edition (BeeryVMI-6). Results The MABC-2 total motor score was more sensitive (0.30; 95% CI 0.17–0.46; p < 0.01) to motor impairment in the presence of FASD than the BOT-2SF (0.02; 95% CI 0.00–0.12) at the 2nd percentile (−2SD). The MABC-2 total motor score was more accurate than any combination of subtest scores. The Motor Coordination subtest of the BeeryVMI-6 (BeeryMC) at the 5th percentile (− 1.5SD) (sensitivity 0.68, specificity 0.90) was the most accurate subtest. Conclusions The BOT-2SF was an inaccurate assessment tool for FASD diagnosis. The MABC-2 total motor score was the most accurate using current guidelines, though its sensitivity was still low. Further investigation into inclusion of single subtests and/or using a less conservative cut-off in the Canadian Guideline is warranted.
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Affiliation(s)
- Danielle Johnston
- Alberta Health Services, Central Zone East, Children's Rehabilitation Services, Professional Centre, Suite 300, 5015 50 Ave, Camrose, Alberta, T4V 3P7, Canada.
| | - Erin Branton
- Alberta Health Services, Central Zone East, Children's Rehabilitation Services, Professional Centre, Suite 300, 5015 50 Ave, Camrose, Alberta, T4V 3P7, Canada
| | - Leah Rasmuson
- Alberta Health Services, Central Zone East, Children's Rehabilitation Services, Professional Centre, Suite 300, 5015 50 Ave, Camrose, Alberta, T4V 3P7, Canada
| | - Sylvia Schell
- Alberta Health Services, Central Zone East, Children's Rehabilitation Services, Professional Centre, Suite 300, 5015 50 Ave, Camrose, Alberta, T4V 3P7, Canada
| | - Douglas P Gross
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, 2-50 Corbett Hall, Edmonton, Alberta, T6G 2G4, Canada
| | - Lesley Pritchard-Wiart
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, 2-50 Corbett Hall, Edmonton, Alberta, T6G 2G4, Canada
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21
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Hutchinson D, Youssef GJ, McCormack C, Wilson J, Allsop S, Najman J, Elliott E, Burns L, Jacobs S, Honan I, Rossen L, Fiedler H, Teague S, Ryan J, Olsson CA, Mattick RP. Prenatal alcohol exposure and infant gross motor development: a prospective cohort study. BMC Pediatr 2019; 19:149. [PMID: 31088407 PMCID: PMC6515673 DOI: 10.1186/s12887-019-1516-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 04/22/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Maternal alcohol consumption in pregnancy may have adverse effects on child gross motor (GM) development. There have been few human studies on this topic, particularly ones examining low exposure. This study examined the association between prenatal alcohol exposure (PAE) and infant GM development at 12-months of age. METHODS Participants were 1324 women recruited from antenatal clinics in Sydney and Perth, Australia. Maternal and paternal alcohol use was assessed in pregnancy via interview; offspring GM development was measured at 12-months with the Bayley Scales of Infant Development (BSID-III). RESULTS Any alcohol use in pregnancy was common: 56.1%, of pregnant women drank early in Trimester one (0-6 weeks), however this reduced to 27.9% on average thereafter and at predominantly low levels. However, infant BSID GM scale scores were not found to differ significantly as a function of PAE in the first 6-weeks (low, moderate, binge or heavy PAE), nor with low PAE across pregnancy. CONCLUSIONS We found no evidence to suggest that low PAE is associated with measurable impairment in infant GM development at 12-months. Further research is needed to examine potential PAE impacts on GM development in heavier exposure groups and through the childhood years when subtle GM deficits may be more detectable.
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Affiliation(s)
- Delyse Hutchinson
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
- Faculty of Health, School of Psychology, Centre for Social and Early Emotional Development, Deakin University, Geelong, Victoria 3125 Australia
- Murdoch Children’s Research Institute, Centre for Adolescent Health, Royal Children’s Hospital, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Royal Children’s Hospital, Melbourne, Australia
| | - George J. Youssef
- Faculty of Health, School of Psychology, Centre for Social and Early Emotional Development, Deakin University, Geelong, Victoria 3125 Australia
| | - Clare McCormack
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Judy Wilson
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Steve Allsop
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Jake Najman
- Queensland Alcohol and Drug Research and Education Centre and Schools of Public Health and Social Science, University of Queensland, Brisbane, Australia
| | - Elizabeth Elliott
- Discipline of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
- Sydney Children´s Hospitals Network, Westmead, Sydney, Australia
| | - Lucinda Burns
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Sue Jacobs
- Department of Obstetrics, Royal Prince Alfred Hospital, Sydney, Australia
| | - Ingrid Honan
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Larissa Rossen
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Hannah Fiedler
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Samantha Teague
- Faculty of Health, School of Psychology, Centre for Social and Early Emotional Development, Deakin University, Geelong, Victoria 3125 Australia
| | - Joanne Ryan
- Department of Paediatrics, University of Melbourne, Royal Children’s Hospital, Melbourne, Australia
| | - Craig A. Olsson
- Faculty of Health, School of Psychology, Centre for Social and Early Emotional Development, Deakin University, Geelong, Victoria 3125 Australia
- Murdoch Children’s Research Institute, Centre for Adolescent Health, Royal Children’s Hospital, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Royal Children’s Hospital, Melbourne, Australia
- School of Psychological Sciences, University of Melbourne, Melbourne, Victoria Australia
| | - Richard P. Mattick
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
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22
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Mattson SN, Bernes GA, Doyle LR. Fetal Alcohol Spectrum Disorders: A Review of the Neurobehavioral Deficits Associated With Prenatal Alcohol Exposure. Alcohol Clin Exp Res 2019; 43:1046-1062. [PMID: 30964197 DOI: 10.1111/acer.14040] [Citation(s) in RCA: 164] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 04/03/2019] [Indexed: 11/26/2022]
Abstract
In utero alcohol exposure can disrupt the development of the fetal brain and result in a wide range of neurobehavioral outcomes collectively known as fetal alcohol spectrum disorders (FASD). This paper provides a comprehensive review of the cognitive and behavioral outcomes of prenatal alcohol exposure, including domains of general intelligence, executive functioning, language development, learning and memory, adaptive functioning, academic performance, and concurrent psychopathology. In addition, the current status of the neurobehavioral profile of FASD and its potential as a diagnostic tool will be discussed.
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Affiliation(s)
- Sarah N Mattson
- Center for Behavioral Teratology and Department of Psychology, San Diego State University, San Diego, California
| | - Gemma A Bernes
- Center for Behavioral Teratology and Department of Psychology, San Diego State University, San Diego, California
| | - Lauren R Doyle
- Center for Behavioral Teratology and Department of Psychology, San Diego State University, San Diego, California
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23
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Prevalence of Fetal Alcohol Exposure by Analysis of Meconium Fatty Acid Ethyl Esters; A National Canadian Study. Sci Rep 2019; 9:2298. [PMID: 30783158 PMCID: PMC6381181 DOI: 10.1038/s41598-019-38856-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 01/09/2019] [Indexed: 01/02/2023] Open
Abstract
Our study aimed to estimate the prevalence of heavy fetal alcohol exposure through the analysis of meconium FAEEs as an objective biomarker of fetal exposure. We conducted a study on meconium samples collected nationwide through the Maternal-Infant Research on Environmental Chemicals (MIREC) Study Group. FAEE in meconium was quantified by an established headspace solid-phase microextraction coupled with gas chromatography-mass spectrometry (SPME GC-MS). Out of 1315 samples collected in 10 Canadian obstetric units coast to coast between 2008-2011, the estimated prevalence of positive meconium FAEE ranged between 1.16% and 2.40%, translating into at least 1800 new cases of FASD in Canada each year. Positive maternal self- reports of heavy alcohol use were tenfold lower (0.24%). Use of meconium FAEE revealed tenfold more cases of heavy exposure to maternal drinking than did maternal reports. The use of objective measures of maternal alcohol exposure is critical in accurately estimating risks and in monitoring effective prevention of FASD.
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24
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Zhu J, Zhao W, Zhang C, Wang H, Cheng W, Li Z, Qian Y, Li X, Yu Y. Disrupted topological organization of the motor execution network in alcohol dependence. Psychiatry Res Neuroimaging 2018; 280:1-8. [PMID: 30121335 DOI: 10.1016/j.pscychresns.2018.08.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 08/06/2018] [Accepted: 08/09/2018] [Indexed: 11/16/2022]
Abstract
Motor function damage is one of the most common symptoms in patients with alcohol dependence (AD). However, relatively little is known about the neuropathology of the motor impairments in AD. The aim of this study was to identify changes in the topological organization of the motor execution network in AD. Here, a total of 39 male individuals, including 19 AD patients and 20 age-matched healthy controls, underwent resting-state functional magnetic resonance imaging (fMRI). The motor execution network was constructed and analyzed using graph theoretical approaches. Topological properties (including global, nodal and edge measures) were compared between the two groups. At the global level, AD patients exhibited increased local specialization (indexed by increased clustering coefficient and local efficiency) relative to healthy controls, indicating that the motor execution network of AD patients shifts toward regularization. At the node level, nodal degree was higher in AD patients in the cerebellum. At the edge level, we observed a cerebello-thalamo-striato-cortical circuit with altered functional connectivity strength in AD patients. These findings suggest that topological architecture of the motor execution network is disrupted in AD patients, which may provide important insights into the neurobiology of the AD-related motor impairments.
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Affiliation(s)
- Jiajia Zhu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, No. 218, Jixi Road, Shushan District, Hefei 230022, China
| | - Wenming Zhao
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, No. 218, Jixi Road, Shushan District, Hefei 230022, China
| | - Cun Zhang
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, No. 218, Jixi Road, Shushan District, Hefei 230022, China
| | - Haibao Wang
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, No. 218, Jixi Road, Shushan District, Hefei 230022, China
| | - Wenwen Cheng
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, No. 218, Jixi Road, Shushan District, Hefei 230022, China
| | - Zipeng Li
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, No. 218, Jixi Road, Shushan District, Hefei 230022, China
| | - Yinfeng Qian
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, No. 218, Jixi Road, Shushan District, Hefei 230022, China
| | - Xiaohu Li
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, No. 218, Jixi Road, Shushan District, Hefei 230022, China
| | - Yongqiang Yu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, No. 218, Jixi Road, Shushan District, Hefei 230022, China.
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25
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Long X, Little G, Beaulieu C, Lebel C. Sensorimotor network alterations in children and youth with prenatal alcohol exposure. Hum Brain Mapp 2018; 39:2258-2268. [PMID: 29436054 PMCID: PMC6866525 DOI: 10.1002/hbm.24004] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 01/30/2018] [Accepted: 02/05/2018] [Indexed: 01/06/2023] Open
Abstract
Children with prenatal alcohol exposure (PAE) often have impaired sensorimotor function. While altered brain structure has been noted in sensorimotor areas, the functional brain alterations remain unclear. This study aims to investigate sensorimotor brain networks in children and youth with PAE using resting-state functional magnetic resonance imaging (rs-fMRI). A parcellation-based network analysis was performed to identify brain networks related to hand/lower limb and face/upper limb function in 59 children and youth with PAE and 50 typically developing controls. Participants with PAE and controls had similar organization of the hand and face areas within the primary sensorimotor cortex, but participants with PAE had altered functional connectivity (FC) between the sensorimotor regions and the rest of the brain. The sensorimotor regions in the PAE group showed less connectivity to certain hubs of the default mode network and more connectivity to areas of the salience network. Overall, our results show that despite similar patterns of organization in the sensorimotor network, subjects with PAE have increased FC between this network and other brain areas, perhaps suggesting overcompensation. These alterations in the sensorimotor network lay the foundation for future studies to evaluate interventions and treatments to improve motor function in children with PAE.
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Affiliation(s)
- Xiangyu Long
- Department of Radiology, and Alberta Children's Hospital Research InstituteUniversity of CalgaryCalgaryAlbertaCanada
| | - Graham Little
- Department of Biomedical EngineeringUniversity of AlbertaEdmontonAlbertaCanada
| | - Christian Beaulieu
- Department of Biomedical EngineeringUniversity of AlbertaEdmontonAlbertaCanada
| | - Catherine Lebel
- Department of Radiology, and Alberta Children's Hospital Research InstituteUniversity of CalgaryCalgaryAlbertaCanada
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26
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Cantacorps L, Alfonso-Loeches S, Moscoso-Castro M, Cuitavi J, Gracia-Rubio I, López-Arnau R, Escubedo E, Guerri C, Valverde O. Maternal alcohol binge drinking induces persistent neuroinflammation associated with myelin damage and behavioural dysfunctions in offspring mice. Neuropharmacology 2017; 123:368-384. [DOI: 10.1016/j.neuropharm.2017.05.034] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 05/30/2017] [Accepted: 05/31/2017] [Indexed: 01/08/2023]
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27
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Fitzpatrick JP, Latimer J, Olson HC, Carter M, Oscar J, Lucas BR, Doney R, Salter C, Try J, Hawkes G, Fitzpatrick E, Hand M, Watkins RE, Tsang TW, Bower C, Ferreira ML, Boulton J, Elliott EJ. Prevalence and profile of Neurodevelopment and Fetal Alcohol Spectrum Disorder (FASD) amongst Australian Aboriginal children living in remote communities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 65:114-126. [PMID: 28499185 DOI: 10.1016/j.ridd.2017.04.001] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 02/23/2017] [Accepted: 04/01/2017] [Indexed: 05/24/2023]
Abstract
BACKGROUND Despite multiple risk factors for neurodevelopmental vulnerability, few studies have assessed neurodevelopmental performance of Australian Aboriginal children. An important risk factor for neurodevelopmental vulnerability is prenatal alcohol exposure (PAE), which places children at risk for Fetal Alcohol Spectrum Disorder (FASD). AIMS This study assesses neurodevelopment outcomes in a population of Australian Aboriginal children with and without PAE. METHODS AND PROCEDURES Children born in 2002/2003, and living in the Fitzroy Valley, Western Australia between April 2010 and November 2011, were eligible (N=134). Sociodemographic and antenatal data, including PAE, were collected by interview with 127/134 (95%) consenting parents/caregivers. Maternal/child medical records were reviewed. Neurodevelopment was assessed by clinicians blinded to PAE in 108/134 (81%) children and diagnoses on the FASD spectrum were assigned. OUTCOMES AND RESULTS Neurodevelopmental disorder was documented in 34/108 children (314.8 per 1000). Any diagnosis on the FASD spectrum was made in 21/108 (194.4 per 1000) children (95% CI=131.0-279.0). CONCLUSIONS AND IMPLICATIONS Neurodevelopmental impairment with or without PAE is highly prevalent among children in the Fitzroy Valley. Rates of diagnoses on the FASD spectrum are among the highest worldwide. Early intervention services are needed to support developmentally vulnerable children in remote communities.
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Affiliation(s)
- James P Fitzpatrick
- Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Australia; Telethon Kids Institute, The University of Western Australia, Perth, Australia.
| | - Jane Latimer
- The George Institute for Global Health, Sydney Medical School, University of Sydney, Australia.
| | - Heather Carmichael Olson
- The University of Washington School of Medicine, Seattle, Washington, USA; Seattle Children's Research Institute, Seattle, Washington, USA.
| | - Maureen Carter
- Nindilingarri Cultural Health Services, Fitzroy Crossing, Australia.
| | - June Oscar
- Marninwarntikura Women's Resource Centre, Fitzroy Crossing, Australia; University of Notre Dame, Broome, Australia.
| | - Barbara R Lucas
- Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Australia; The George Institute for Global Health, Sydney Medical School, University of Sydney, Australia.
| | - Robyn Doney
- School of Public Health, Curtin University, Perth, Australia.
| | - Claire Salter
- Derby Allied Health Service, Western Australian Country Health Services, Derby, Australia.
| | - Julianne Try
- Department of Education and Early Childhood Development, Government of Victoria, Australia.
| | - Genevieve Hawkes
- Derby Allied Health Service, Western Australian Country Health Services, Derby, Australia.
| | - Emily Fitzpatrick
- Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Australia.
| | | | - Rochelle E Watkins
- Telethon Kids Institute, The University of Western Australia, Perth, Australia.
| | - Tracey W Tsang
- Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Australia.
| | - Carol Bower
- Telethon Kids Institute, The University of Western Australia, Perth, Australia.
| | - Manuela L Ferreira
- The George Institute for Global Health, Sydney Medical School, University of Sydney, Australia.
| | - John Boulton
- Telethon Kids Institute, The University of Western Australia, Perth, Australia.
| | - Elizabeth J Elliott
- Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Australia; The George Institute for Global Health, Sydney Medical School, University of Sydney, Australia.
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28
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Donald KAM, Fernandez A, Claborn K, Kuo C, Koen N, Zar H, Stein DJ. The developmental effects of HIV and alcohol: a comparison of gestational outcomes among babies from South African communities with high prevalence of HIV and alcohol use. AIDS Res Ther 2017; 14:28. [PMID: 28482927 PMCID: PMC5422965 DOI: 10.1186/s12981-017-0153-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 04/26/2017] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND There is growing evidence of the negative impact of alcohol on morbidity and mortality of individuals living with HIV but limited evidence of in utero effects of HIV and alcohol on exposure on infants. METHODS We conducted a population-based birth cohort study (N = 667 mother-infant dyads) in South Africa to investigate whether maternal alcohol use and HIV affected gestational outcomes. Descriptive data analysis was conducted for all variables using frequency distributions, measures of central tendency, and estimates of variance. Hierarchical multiple regression was conducted to determine whether maternal alcohol use, maternal HIV status and other risk factors (socioeconomic status, smoking, depression) predicted infant outcomes. RESULTS Our results showed severity of recent alcohol use and lifetime alcohol use predicted low birth weight. Similarly lifetime alcohol use predicted shorter infant length, smaller head length, smaller head circumference, and early gestational age. However, HIV status was not a significant predictor of gestational outcomes. CONCLUSIONS The unexpected finding that maternal HIV status did not predict any of the gestational outcomes may be due to high rates of ART usage among HIV-infected mothers. The potentially negative effects of HIV on gestational outcomes may have been attenuated by improved maternal health due to high coverage of antiretroviral treatment in South Africa. Interventions are needed to reduce alcohol consumption among pregnant mothers and to support healthy growth and psychosocial development of infants.
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Affiliation(s)
- Kirsten A. M. Donald
- Department of Paediatrics and Child Health, Institute of Child Health Building, Red Cross War Memorial Children’s Hospital, 5th Floor, Klipfontein Road, Rondebosch, Cape Town, 7700 South Africa
| | - Anne Fernandez
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI USA
| | - Kasey Claborn
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI USA
- Department of Medicine, Rhode Island Hospital, Providence, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, USA
| | - Caroline Kuo
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI USA
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Nastassja Koen
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Heather Zar
- Department of Paediatrics and Child Health, Institute of Child Health Building, Red Cross War Memorial Children’s Hospital, 5th Floor, Klipfontein Road, Rondebosch, Cape Town, 7700 South Africa
- South African Medical Research Council Unit on Child & Adolescent Health, Cape Town, South Africa
| | - Dan J. Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- South African Medical Research Council Unit on Risk and Resilience in Mental Disorders, Cape Town, South Africa
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Lucas BR, Elliott EJ, Coggan S, Pinto RZ, Jirikowic T, McCoy SW, Latimer J. Interventions to improve gross motor performance in children with neurodevelopmental disorders: a meta-analysis. BMC Pediatr 2016; 16:193. [PMID: 27899082 PMCID: PMC5129231 DOI: 10.1186/s12887-016-0731-6] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 11/15/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Gross motor skills are fundamental to childhood development. The effectiveness of current physical therapy options for children with mild to moderate gross motor disorders is unknown. The aim of this study was to systematically review the literature to investigate the effectiveness of conservative interventions to improve gross motor performance in children with a range of neurodevelopmental disorders. METHODS A systematic review with meta-analysis was conducted. MEDLINE, EMBASE, AMED, CINAHL, PsycINFO, PEDro, Cochrane Collaboration, Google Scholar databases and clinical trial registries were searched. Published randomised controlled trials including children 3 to ≤18 years with (i) Developmental Coordination Disorder (DCD) or Cerebral Palsy (CP) (Gross Motor Function Classification System Level 1) or Developmental Delay or Minimal Acquired Brain Injury or Prematurity (<30 weeks gestational age) or Fetal Alcohol Spectrum Disorders; and (ii) receiving non-pharmacological or non-surgical interventions from a health professional and (iii) gross motor outcomes obtained using a standardised assessment tool. Meta-analysis was performed to determine the pooled effect of intervention on gross motor function. Methodological quality and strength of meta-analysis recommendations were evaluated using PEDro and the GRADE approach respectively. RESULTS Of 2513 papers, 9 met inclusion criteria including children with CP (n = 2) or DCD (n = 7) receiving 11 different interventions. Only two of 9 trials showed an effect for treatment. Using the least conservative trial outcomes a large beneficial effect of intervention was shown (SMD:-0.8; 95% CI:-1.1 to -0.5) with "very low quality" GRADE ratings. Using the most conservative trial outcomes there is no treatment effect (SMD:-0.1; 95% CI:-0.3 to 0.2) with "low quality" GRADE ratings. Study limitations included the small number and poor quality of the available trials. CONCLUSION Although we found that some interventions with a task-orientated framework can improve gross motor outcomes in children with DCD or CP, these findings are limited by the very low quality of the available evidence. High quality intervention trials are urgently needed.
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Affiliation(s)
- Barbara R Lucas
- Discipline of Paediatrics and Child Health, The University of Sydney, The Children's Hospital at Westmead, Clinical School, Locked Bag 4001, Westmead, Sydney, NSW, 2145, Australia.
- The George Institute for Global Health, Sydney Medical School, University of Sydney, PO Box M201, , Missenden Rd, Sydney, NSW, 2050, Australia.
- Poche Centre for Indigenous Health, Sydney School of Public Health, The University of Sydney, Sydney, NSW, 2006, Australia.
- Physiotherapy Department, Royal North Shore Hospital, St Leonards, Sydney, NSW, 2065, Australia.
| | - Elizabeth J Elliott
- Discipline of Paediatrics and Child Health, The University of Sydney, The Children's Hospital at Westmead, Clinical School, Locked Bag 4001, Westmead, Sydney, NSW, 2145, Australia
- The George Institute for Global Health, Sydney Medical School, University of Sydney, PO Box M201, , Missenden Rd, Sydney, NSW, 2050, Australia
- The Sydney Children's Hospital Networks (Westmead), Locked Bag 4001, Westmead, Sydney, NSW, 2145, Australia
| | - Sarah Coggan
- The George Institute for Global Health, Sydney Medical School, University of Sydney, PO Box M201, , Missenden Rd, Sydney, NSW, 2050, Australia
- School of Public Health, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia
| | - Rafael Z Pinto
- Pain Management Research Institute, University of Sydney at Royal North Shore Hospital, St Leonards, Sydney, NSW, 2065, Australia
- Departamento de Fisioterapia, Faculdade de Ciências e Tecnologia, UNESP-Univ Estadual Paulista, Presidente Prudente, SP, 19060-900, Brazil
| | - Tracy Jirikowic
- Division of Occupational Therapy, Department of Rehabilitation Medicine, University of Washington, Seattle, WA, 98195, USA
| | - Sarah Westcott McCoy
- Division of Physical Therapy, Department of Rehabilitation Medicine, University of Washington, Seattle, WA, 98195, USA
| | - Jane Latimer
- The George Institute for Global Health, Sydney Medical School, University of Sydney, PO Box M201, , Missenden Rd, Sydney, NSW, 2050, Australia
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Niemelä O, Niemelä S, Ritvanen A, Gissler M, Bloigu A, Vääräsmäki M, Kajantie E, Werler MM, Surcel HM. Assays of Gamma-Glutamyl Transferase and Carbohydrate-Deficient Transferrin Combination from Maternal Serum Improve the Detection of Prenatal Alcohol Exposure. Alcohol Clin Exp Res 2016; 40:2385-2393. [PMID: 27650665 DOI: 10.1111/acer.13207] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 08/02/2016] [Indexed: 12/01/2022]
Abstract
BACKGROUND Alcohol use during pregnancy leads to detrimental effects on fetal development. As self-reports by mothers are known to be unreliable for assessing prenatal alcohol exposure, there is a need for sensitive and specific biomarkers for identifying those at risk for alcohol-affected offspring. METHODS We measured serum gamma-glutamyl transferase (GGT), carbohydrate-deficient transferrin (CDT), a mathematically formulated combination of GGT and CDT (GGT-CDT), and ethylglucuronide (EtG) concentrations from 1,936 mothers with a positive (n = 480) or negative (n = 1,456) history of alcohol use at the time of pregnancy. The material included 385 alcohol-abusing mothers who subsequently gave birth to children with fetal alcohol syndrome (FAS) and 1,551 mothers without FAS children including 95 women who reported a median of 1.0 standard drinks of alcohol per day during pregnancy and 1,456 nondrinking controls. Among those without FAS outcome, there were 405 mothers with gestational diabetes mellitus (GDM) and 745 mothers representing lifelong abstainers. RESULTS Mothers of FAS children had higher mean GGT, CDT, GGT-CDT, and EtG levels than abstainers (p < 0.001 for all comparisons) or mothers reporting some alcohol consumption but whose children were not diagnosed with FAS (p < 0.001 for all comparisons). In receiver operating characteristic analyses using cutoffs based on abstainers, the area under the curves (AUCs) for GGT-CDT (0.873) were higher than those of GGT (0.824), CDT (0.776), or EtG (0.584) for differentiating the mothers of FAS children and abstainers. Unlike CDT, this combination marker also differed significantly between drinking mothers without FAS outcome and abstainers (AUC = 0.730, p < 0.001). In comparisons adjusted for GDM and body mass index, the group of mothers who had reported a median of 1.0 standard drinks of alcohol per day during pregnancy also differed from the group reporting no current alcohol intake in GGT (p < 0.02) and GGT-CDT (p < 0.01) levels. CONCLUSIONS Combination of GGT and CDT improves the identification of prenatal alcohol exposure and associated high-risk pregnancies. A more systematic use of biomarkers may help intervention efforts to prevent alcohol-induced adverse effects on fetal development.
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Affiliation(s)
- Onni Niemelä
- Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital, University of Tampere, Seinäjoki, Finland.
| | - Solja Niemelä
- Research Unit of Clinical Neuroscience, Faculty of Medicine, University of Oulu, Oulu, Finland.,Department of Psychiatry, Lapland Hospital District, Rovaniemi, Finland
| | - Annukka Ritvanen
- Information Services Department, Finnish Register of Congenital Malformations, National Institute for Health and Welfare, Helsinki, Finland
| | - Mika Gissler
- Information Services Department, National Institute for Health and Welfare, Helsinki, Finland.,Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Aini Bloigu
- The Impact Assessment Unit, National Institute of Health and Welfare, Oulu, Finland
| | - Marja Vääräsmäki
- The Children, Adolescents and Families Unit, National Institute for Health and Welfare, Oulu, Finland.,PEDEGO Research Unit, Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Eero Kajantie
- PEDEGO Research Unit, Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland.,Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki and Oulu, Finland.,Children's Hospital, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland
| | - Martha M Werler
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - Heljä-Marja Surcel
- The Impact Assessment Unit, National Institute of Health and Welfare, Oulu, Finland
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Muggli E, O'Leary C, Donath S, Orsini F, Forster D, Anderson PJ, Lewis S, Nagle C, Craig JM, Elliott E, Halliday J. "Did you ever drink more?" A detailed description of pregnant women's drinking patterns. BMC Public Health 2016; 16:683. [PMID: 27485120 PMCID: PMC4969642 DOI: 10.1186/s12889-016-3354-9] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 07/22/2016] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND This paper presents drinking patterns in a prospective study of a population-based cohort of 1570 pregnant women using a combination of dose and timing to give best estimates of prenatal alcohol exposure (PAE). Novel assessments include women's special occasion drinking and alcohol use prior to pregnancy recognition. METHODS Information on up to nine types of alcoholic drink, with separate frequencies and volumes, including drinking on special occasions outside a 'usual' pattern, was collected for the periconceptional period and at four pregnancy time points. Weekly total and maximum alcohol consumption on any one occasion was calculated and categorised. Drinking patterns are described in the context of predictive maternal characteristics. RESULTS 41.3 % of women did not drink during pregnancy, 27 % drank in first trimester only; most of whom stopped once they realised they were pregnant (87 %). When compared to women who abstained from alcohol when pregnant, those who drank in the first trimester only were more likely to have an unplanned pregnancy and not feel the effects of alcohol quickly. Almost a third of women continued to drink alcohol at some level throughout pregnancy (27 %), around half of whom never drank more than at low or moderate levels. When compared with abstainers and to women who only drank in trimester one, those who drank throughout pregnancy tended to be in their early to mid-thirties, smoke, have a higher income and educational attainment. Overall, almost one in five women (18.5 %) binge drank prior to pregnancy recognition, a third of whom were identified with a question about 'special occasion' drinking. Women whose age at first intoxication was less than 18 years (the legal drinking age in Australia), were significantly more likely to drink in pregnancy and at binge levels prior to pregnancy recognition. CONCLUSIONS We have identified characteristics of pregnant women who either abstain, drink until pregnancy awareness or drink throughout pregnancy. These may assist in targeting strategies to enhance adherence to an abstinence policy and ultimately allow for appropriate follow-up and interpretation of adverse child outcomes. Our methodology also produced important information to reduce misclassification of occasional binge drinking episodes and ensure clearly defined comparison groups.
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Affiliation(s)
- Evelyne Muggli
- Murdoch Childrens Research Institute, Parkville, 3052, VIC, Australia. .,Department of Paediatrics, The University of Melbourne, Parkville, 3052, VIC, Australia.
| | | | - Susan Donath
- Murdoch Childrens Research Institute, Parkville, 3052, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, 3052, VIC, Australia
| | - Francesca Orsini
- Murdoch Childrens Research Institute, Parkville, 3052, VIC, Australia
| | - Della Forster
- Judith Lumley Centre, School of Nursing and Midwifery, SHE College, La Trobe University, Melbourne, 3000, VIC, Australia.,The Royal Women's Hospital, Parkville, 3052, VIC, Australia
| | - Peter J Anderson
- Murdoch Childrens Research Institute, Parkville, 3052, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, 3052, VIC, Australia
| | - Sharon Lewis
- Murdoch Childrens Research Institute, Parkville, 3052, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, 3052, VIC, Australia
| | - Catherine Nagle
- Quality and Patient Safety Strategic Research Centre, Deakin University, Geelong, 3220, VIC, Australia.,Women's and Children's Division, Western Health, St Albans, 3021, VIC, Australia
| | - Jeffrey M Craig
- Murdoch Childrens Research Institute, Parkville, 3052, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, 3052, VIC, Australia
| | - Elizabeth Elliott
- Paediatrics & Child Health, Children's Hospital Westmead, The University of Sydney, Sydney, 2006, NSW, Australia
| | - Jane Halliday
- Murdoch Childrens Research Institute, Parkville, 3052, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, 3052, VIC, Australia
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Lucas BR, Latimer J, Doney R, Watkins RE, Tsang TW, Hawkes G, Fitzpatrick JP, Oscar J, Carter M, Elliott EJ. Gross motor performance in children prenatally exposed to alcohol and living in remote Australia. J Paediatr Child Health 2016; 52:814-24. [PMID: 27439995 DOI: 10.1111/jpc.13240] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/06/2016] [Indexed: 11/27/2022]
Abstract
AIM This study aimed to determine the gross motor (GM) performance of Aboriginal children living in remote Australia. The relationship between GM skills, prenatal alcohol exposure (PAE) and fetal alcohol spectrum disorders (FASD) was explored. METHODS A population-based observation study was conducted in 2011 to assess motor performance in children living in the Fitzroy Valley, Western Australia, using the Bruininks-Oseretsky Test of Motor Proficiency (BOT-2). BOT-2 data were retrospectively analysed using recently developed software enabling separation of fine and GM outcomes. RESULTS A total of 108 children (98.1% Aboriginal; 53% male, mean age: 8.7 years) were assessed. Half (52.2%) were exposed to at least 'risky' levels of PAE, and 21 (19%) were diagnosed with an FASD. The mean GM composite score of the cohort (47.0 ± 8.4) approached the BOT-2 normative mean (50.0 ± 10) and was similar between children with and without PAE (P = 0.27). This mean score, however, was significantly lower in children with FASD than without (mean difference: -5.5 ± 20.6; P = 0.006). Compared with children without FASD, children with FASD had significant impairment in subtests for running speed and agility (mean difference ± standard deviation (SD): -2.4 ± 8.1; P = 0.003) and strength (mean difference ± SD:-2.8 ± 9.9; P = 0.004) and (ii) a higher proportion than expected had overall GM impairment (≤2 SD: 9.5%; ≤1 SD: 23.8%). In groups with PAE, no PAE and no FASD, GM function approached expected population norms. CONCLUSIONS A higher than expected proportion of children with FASD had GM scores that indicated impairment and need for therapy. Evaluation of GM performance should routinely be included in FASD assessment to determine strategies to optimise child development.
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Affiliation(s)
- Barbara R Lucas
- Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,The George Institute for Global Health, Musculoskeletal Division, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,Poche Centre for Indigenous Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,Physiotherapy Department, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Jane Latimer
- The George Institute for Global Health, Musculoskeletal Division, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Robyn Doney
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Rochelle E Watkins
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Tracey W Tsang
- Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,The George Institute for Global Health, Musculoskeletal Division, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Genevieve Hawkes
- Derby Allied Health Service, Western Australian Country Health Services, Perth, Western Australia, Australia
| | - James P Fitzpatrick
- Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,The George Institute for Global Health, Musculoskeletal Division, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - June Oscar
- Marninwarntikura Women's Resource Centre, Perth, Western Australia, Australia.,University of Notre Dame, Broome, Western Australia, Australia
| | - Maureen Carter
- Nindilingarri Cultural Health Services, Kimberley, Western Australia, Australia
| | - Elizabeth J Elliott
- Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,The George Institute for Global Health, Musculoskeletal Division, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,University of Notre Dame, Broome, Western Australia, Australia.,The Sydney Children's Hospital Networks (Westmead), Sydney, New South Wales, Australia
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33
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Niemelä S, Niemelä O, Ritvanen A, Gissler M, Bloigu A, Werler M, Surcel HM. Fetal Alcohol Syndrome and Maternal Alcohol Biomarkers in Sera: A Register-Based Case-Control Study. Alcohol Clin Exp Res 2016; 40:1507-14. [DOI: 10.1111/acer.13101] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 04/11/2016] [Indexed: 12/13/2022]
Affiliation(s)
- Solja Niemelä
- Research Unit of Clinical Neuroscience; Faculty of Medicine; University of Oulu; Oulu Finland
- Department of Psychiatry; Lapland Hospital District; Rovaniemi Finland
| | - Onni Niemelä
- Department of Laboratory Medicine and Medical Research Unit; Seinäjoki Central Hospital; Seinäjoki Finland
- University of Tampere; Seinäjoki Finland
| | - Annukka Ritvanen
- Finnish Register of Congenital Malformations; National Institute for Health and Welfare; Helsinki Finland
| | - Mika Gissler
- National Institute for Health and Welfare; Helsinki Finland
- Nordic School of Public Health; Gothenburg Sweden
| | - Aini Bloigu
- Department of Health Protection; National Institute of Health and Welfare; Oulu Finland
| | - Martha Werler
- Department of Epidemiology; Boston University School of Public Health; Boston Massachusetts
| | - Heljä-Marja Surcel
- Department of Health Protection; National Institute of Health and Welfare; Oulu Finland
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34
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Kable JA, O'Connor MJ, Olson HC, Paley B, Mattson SN, Anderson SM, Riley EP. Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure (ND-PAE): Proposed DSM-5 Diagnosis. Child Psychiatry Hum Dev 2016. [PMID: 26202432 DOI: 10.1007/s10578-015-0566-7] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Over the past 40 years, a significant body of animal and human research has documented the teratogenic effects of prenatal alcohol exposure (PAE). Neurobehavioral Disorder associated with PAE is proposed as a new clarifying term, intended to encompass the neurodevelopmental and mental health symptoms associated with PAE. Defining this disorder is a necessary step to adequately characterize these symptoms and allow clinical assessment not possible using existing physically-based diagnostic schemes. Without appropriate diagnostic guidelines, affected individuals are frequently misdiagnosed and treated inappropriately (often to their considerable detriment) by mental health, educational, and criminal justice systems. Three core areas of deficits identified from the available research, including neurocognitive, self-regulation, and adaptive functioning impairments, are discussed and information regarding associated features and disorders, prevalence, course, familial patterns, differential diagnosis, and treatment of the proposed disorder are also provided.
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Affiliation(s)
- Julie A Kable
- Departments of Psychiatry and Behavioral Sciences and Pediatrics, Emory University School of Medicine, Atlanta, GA, 30329, USA.
| | - Mary J O'Connor
- Department of Psychiatry and Behavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Heather Carmichael Olson
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Blair Paley
- Department of Psychiatry and Behavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Sarah N Mattson
- Department of Psychology, Center for Behavioral Teratology, San Diego State University, San Diego, CA, 92120, USA
| | - Sally M Anderson
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MA, USA
| | - Edward P Riley
- Department of Psychology, Center for Behavioral Teratology, San Diego State University, San Diego, CA, 92120, USA
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35
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Valenzuela CF, Jotty K. Mini-Review: Effects of Ethanol on GABAA Receptor-Mediated Neurotransmission in the Cerebellar Cortex--Recent Advances. THE CEREBELLUM 2016; 14:438-46. [PMID: 25575727 DOI: 10.1007/s12311-014-0639-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Studies from several laboratories have shown that ethanol impairs cerebellar function, in part, by altering GABAergic transmission. Here, we discuss recent advances in our understanding of the acute effects of ethanol on GABA(A) receptor-mediated neurotransmission at cerebellar cortical circuits, mainly focusing on electrophysiological studies with slices from laboratory animals. These studies have shown that acute ethanol exposure increases GABA release at molecular layer interneuron-to-Purkinje cell synapses and also at reciprocal synapses between molecular layer interneurons. In granule cells, studies with rat cerebellar slices have consistently shown that acute ethanol exposure both potentiates tonic currents mediated by extrasynaptic GABA(A) receptors and also increases the frequency of spontaneous inhibitory postsynaptic currents mediated by synaptic GABA(A) receptors. These effects have been also documented in some granule cells from mice and nonhuman primates. Currently, there are two distinct models on how ethanol produces these effects. In one model, ethanol primarily acts by directly potentiating extrasynaptic GABA(A) receptors, including a population that excites granule cell axons and stimulates glutamate release onto Golgi cells. In the other model, ethanol acts indirectly by increasing spontaneous Golgi cell firing via inhibition of the Na(+)/K(+) ATPase, a quinidine-sensitive K(+) channel, and neuronal nitric oxide synthase. It was also demonstrated that a direct inhibitory effect of ethanol on tonic currents can be unmasked under conditions of low protein kinase C activity. In the last section, we briefly discuss studies on the chronic effect of ethanol on cerebellar GABA(A) receptor-mediated transmission and highlight potential areas where future research is needed.
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Affiliation(s)
- C Fernando Valenzuela
- Department of Neurosciences, School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, 87131, USA,
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36
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Lucas BR, Doney R, Latimer J, Watkins RE, Tsang TW, Hawkes G, Fitzpatrick JP, Oscar J, Carter M, Elliott EJ. Impairment of motor skills in children with fetal alcohol spectrum disorders in remote Australia: The Lililwan Project. Drug Alcohol Rev 2016; 35:719-727. [DOI: 10.1111/dar.12375] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2015] [Revised: 11/15/2015] [Accepted: 11/22/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Barbara R. Lucas
- Discipline of Paediatrics and Child Health; The University of Sydney, The Children's Hospital at Westmead, Clinical School; Sydney Australia
- The George Institute for Global Health, Sydney Medical School; The University of Sydney; Sydney Australia
- Poche Centre for Indigenous Health, Sydney Medical School; The University of Sydney; Sydney Australia
- Physiotherapy Department; Royal North Shore Hospital; Sydney Australia
| | - Robyn Doney
- School of Public Health; Curtin University; Perth Australia
| | - Jane Latimer
- The George Institute for Global Health, Sydney Medical School; The University of Sydney; Sydney Australia
| | - Rochelle E. Watkins
- Discipline of Paediatrics and Child Health; The University of Sydney, The Children's Hospital at Westmead, Clinical School; Sydney Australia
- Telethon Kids Institute, The University of Western Australia; Perth Australia
| | - Tracey W. Tsang
- Discipline of Paediatrics and Child Health; The University of Sydney, The Children's Hospital at Westmead, Clinical School; Sydney Australia
| | - Genevieve Hawkes
- Derby Allied Health Service; Western Australian Country Health Services; Derby Australia
| | - James P. Fitzpatrick
- Discipline of Paediatrics and Child Health; The University of Sydney, The Children's Hospital at Westmead, Clinical School; Sydney Australia
- The George Institute for Global Health, Sydney Medical School; The University of Sydney; Sydney Australia
- Telethon Kids Institute, The University of Western Australia; Perth Australia
| | - June Oscar
- Marninwarntikura Women's Resource Centre; Fitzroy Crossing Australia
- University of Notre Dame; Broome Australia
| | - Maureen Carter
- Nindilingarri Cultural Health Services; Fitzroy Crossing Australia
| | - Elizabeth J. Elliott
- Discipline of Paediatrics and Child Health; The University of Sydney, The Children's Hospital at Westmead, Clinical School; Sydney Australia
- The George Institute for Global Health, Sydney Medical School; The University of Sydney; Sydney Australia
- The Sydney Children's Hospital Networks (Westmead); Sydney Australia
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37
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Ingber SZ, Pohl HR. Windows of sensitivity to toxic chemicals in the motor effects development. Regul Toxicol Pharmacol 2016; 74:93-104. [PMID: 26686904 PMCID: PMC5599107 DOI: 10.1016/j.yrtph.2015.11.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 11/25/2015] [Accepted: 11/26/2015] [Indexed: 11/26/2022]
Abstract
Many chemicals currently used are known to elicit nervous system effects. In addition, approximately 2000 new chemicals introduced annually have not yet undergone neurotoxicity testing. This review concentrated on motor development effects associated with exposure to environmental neurotoxicants to help identify critical windows of exposure and begin to assess data needs based on a subset of chemicals thoroughly reviewed by the Agency for Toxic Substances and Disease Registry (ATSDR) in Toxicological Profiles and Addenda. Multiple windows of sensitivity were identified that differed based on the maturity level of the neurological system at the time of exposure, as well as dose and exposure duration. Similar but distinct windows were found for both motor activity (GD 8-17 [rats], GD 12-14 and PND 3-10 [mice]) and motor function performance (insufficient data for rats, GD 12-17 [mice]). Identifying specific windows of sensitivity in animal studies was hampered by study designs oriented towards detection of neurotoxicity that occurred at any time throughout the developmental process. In conclusion, while this investigation identified some critical exposure windows for motor development effects, it demonstrates a need for more acute duration exposure studies based on neurodevelopmental windows, particularly during the exposure periods identified in this review.
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Affiliation(s)
- Susan Z Ingber
- Agency for Toxic Substances and Disease Registry, US Department of Health and Human Services, Atlanta, GA, USA
| | - Hana R Pohl
- Agency for Toxic Substances and Disease Registry, US Department of Health and Human Services, Atlanta, GA, USA.
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38
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Virtual Sensorimotor Training for Balance: Pilot Study Results for Children With Fetal Alcohol Spectrum Disorders. Pediatr Phys Ther 2016; 28:460-8. [PMID: 27661243 DOI: 10.1097/pep.0000000000000300] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To examine the effects of Sensorimotor Training to Affect Balance, Engagement, and Learning (STABEL), a virtual reality system to train sensory adaptation for balance control, for children with fetal alcohol spectrum disorders (FASDs). METHODS Twenty-three children with FASDs received STABEL training in a university laboratory, or home, or were controls. The Movement Assessment Battery for Children-2nd edition (MABC-2) and Pediatric Clinical Test of Sensory Interaction for Balance-2 (P-CTSIB-2) were analyzed by group (lab, home, and control), session (pre-STABEL, 1 week post-STABEL, and 1 month post-STABEL), and group-by-session interaction. RESULTS Significant effects were group and session for MABC-2 Balance and interaction for MABC-2 Total Motor and P-CTSIB-2. CONCLUSION Preliminary results support improved sensory adaptation, balance, and motor performance post-STABEL, which warrant further study with a larger, randomized sample.
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39
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Løhaugen GCC, Flak MM, Gerstner T, Sundberg C, Lerdal B, Skranes J. Establishment of the South-Eastern Norway Regional Health Authority Resource Center for Children with Prenatal Alcohol/Drug Exposure. Subst Abuse 2015; 9:67-75. [PMID: 26692762 PMCID: PMC4671549 DOI: 10.4137/sart.s23542] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 09/29/2015] [Accepted: 10/07/2015] [Indexed: 11/24/2022]
Abstract
This paper presents a new initiative in the South-Eastern Health Region of Norway to establish a regional resource center focusing on services for children and adolescents aged 2–18 years with prenatal exposure to alcohol or other drugs. In Norway, the prevalence of fetal alcohol spectrum (FAS) is not known but has been estimated to be between 1 and 2 children per 1000 births, while the prevalence of prenatal exposure to illicit drugs is unknown. The resource center is the first of its kind in Scandinavia and will have three main objectives: (1) provide hospital staff, community health and child welfare personnel, and special educators with information, educational courses, and seminars focused on the identification, diagnosis, and treatment of children with a history of prenatal alcohol/drug exposure; (2) provide specialized health services, such as diagnostic services and intervention planning, for children referred from hospitals in the South-Eastern Health Region of Norway; and (3) initiate multicenter studies focusing on the diagnostic process and evaluation of interventions.
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Affiliation(s)
- Gro C C Løhaugen
- Department of Child Neurology and Rehabilitation (HABU-A), Sørlandet Hospital HF, HABU, Arendal, Norway. ; Department of Laboratory Medicine, Children's and Women's Health (LBK), Faculty of Medicine, Norwegian University of Science and Technology, MTFS, Trondheim, Norway
| | - Marianne Møretrø Flak
- Department of Child Neurology and Rehabilitation (HABU-A), Sørlandet Hospital HF, HABU, Arendal, Norway. ; Addiction Unit (ARA-K), Sørlandet Sykehus HF, Kristiansand, Norway
| | - Thorsten Gerstner
- Department of Child Neurology and Rehabilitation (HABU-A), Sørlandet Hospital HF, HABU, Arendal, Norway
| | - Cato Sundberg
- Department of Child Neurology and Rehabilitation (HABU-A), Sørlandet Hospital HF, HABU, Arendal, Norway
| | - Bjørn Lerdal
- Department of Child Neurology and Rehabilitation (HABU-K), Sørlandet Hospital HF, HABU, Kristiansand, Norway
| | - Jon Skranes
- Department of Child Neurology and Rehabilitation (HABU-A), Sørlandet Hospital HF, HABU, Arendal, Norway. ; Department of Laboratory Medicine, Children's and Women's Health (LBK), Faculty of Medicine, Norwegian University of Science and Technology, MTFS, Trondheim, Norway
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40
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Virtual Sensorimotor Balance Training for Children With Fetal Alcohol Spectrum Disorders: Feasibility Study. Phys Ther 2015; 95:1569-81. [PMID: 26112255 PMCID: PMC4625061 DOI: 10.2522/ptj.20150124] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 06/11/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND Diminished sensory adaptation has been associated with poor balance control for children with fetal alcohol spectrum disorders (FASD). A virtual reality system, Sensorimotor Training to Affect Balance, Engagement and Learning (STABEL), was developed to train sensory control for balance. OBJECTIVES The purpose of this study was to examine the STABEL system in children with FASD and children with typical development (TD) to (1) determine the feasibility of the STABEL system and (2) explore the immediate effects of the STABEL system on sensory attention and postural control. DESIGN This is a technical report with observational study data. METHODS Eleven children with FASD and 11 children with TD, aged 8 to 16 years, completed 30 minutes of STABEL training. The children answered questions about their experience using STABEL. Sensory attention and postural control were measured pre- and post-STABEL training with the Multimodal Balance Entrainment Response system and compared using repeated-measures analysis of variance. RESULTS All children engaged in game play and tolerated controlled sensory input during the STABEL protocol. Immediate effects post-STABEL training in both groups were increased postural sway velocity and some changes in entrainment gain. Children with FASD showed higher entrainment gain to vestibular stimuli. There were no significant changes in sensory attention fractions. LIMITATIONS The small sample size, dose of STABEL training, and exploratory statistical analyses are study limitations, but findings warrant larger systematic study to examine therapeutic effects. CONCLUSIONS Children completed the training protocol, demonstrating the feasibility of the STABEL system. Differences in postural sway velocity post-STABEL training may have been affected by fatigue, warranting further investigation. Limited immediate effects suggest more practice is needed to affect sensory attention; however, entrainment gain changes suggest the STABEL system provoked vestibular responses during balance practice.
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Vakhtin AA, Kodituwakku PW, Garcia CM, Tesche CD. Aberrant development of post-movement beta rebound in adolescents and young adults with fetal alcohol spectrum disorders. NEUROIMAGE-CLINICAL 2015; 9:392-400. [PMID: 26594621 PMCID: PMC4589820 DOI: 10.1016/j.nicl.2015.09.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 08/24/2015] [Accepted: 09/09/2015] [Indexed: 12/14/2022]
Abstract
Dependent on maternal (e.g. genetic, age) and exposure (frequency, quantity, and timing) variables, the effects of prenatal alcohol exposure on the developing fetus are known to vary widely, producing a broad range of morphological anomalies and neurocognitive deficits in offspring, referred to as fetal alcohol spectrum disorders (FASD). Maternal drinking during pregnancy remains a leading risk factor for the development of intellectual disabilities in the US. While few functional findings exist today that shed light on the mechanisms responsible for the observed impairments in individuals with FASD, animal models consistently report deleterious effects of early alcohol exposure on GABA-ergic inhibitory pathways. The post-motor beta rebound (PMBR), a transient increase of 15-30 Hz beta power in the motor cortex that follows the termination of movement, has been implicated as a neural signature of GABA-ergic inhibitory activity. Further, PMBR has been shown to be a reliable predictor of age in adolescents. The present study sought to investigate any differences in the development of PMBR between FASD and control groups. Beta event-related de-synchronization (ERD) and movement-related gamma synchronization (MRGS), although not clearly linked to brain maturation, were also examined. Twenty-two participants with FASD and 22 age and sex-matched controls (12-22 years old) underwent magnetoencephalography scans while performing an auditory oddball task, which required a button press in response to select target stimuli. The data surrounding the button presses were localized to the participants' motor cortices, and the time courses from the locations of the maximally evoked PMBR were subjected to wavelet analyses. The subsequent analysis of PMBR, ERD, and MRGS revealed a significant interaction between group and age in their effects on PMBR. While age had a significant effect on PMBR in the controls, no simple effects of age were detected in the FASD group. The FASD group additionally displayed decreased overall ERD levels. No group or age effects on MRGS were detected. The described findings provide further evidence for broad impairments in inhibitory processes in adolescents with FASD, possibly related to aberrant development of GABA-ergic pathways.
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Affiliation(s)
- Andrei A Vakhtin
- Department of Psychology, University of New Mexico, Albuquerque, NM 87131, USA
| | - Piyadasa W Kodituwakku
- Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, NM 87131, USA
| | | | - Claudia D Tesche
- Department of Psychology, University of New Mexico, Albuquerque, NM 87131, USA
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Safety assessment for ethanol-based topical antiseptic use by health care workers: Evaluation of developmental toxicity potential. Regul Toxicol Pharmacol 2015. [PMID: 26212636 DOI: 10.1016/j.yrtph.2015.07.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Ethanol-based topical antiseptic hand rubs, commonly referred to as alcohol-based hand sanitizers (ABHS), are routinely used as the standard of care to reduce the presence of viable bacteria on the skin and are an important element of infection control procedures in the healthcare industry. There are no reported indications of safety concerns associated with the use of these products in the workplace. However, the prevalence of such alcohol-based products in healthcare facilities and safety questions raised by the U.S. FDA led us to assess the potential for developmental toxicity under relevant product-use scenarios. Estimates from a physiologically based pharmacokinetic modeling approach suggest that occupational use of alcohol-based topical antiseptics in the healthcare industry can generate low, detectable concentrations of ethanol in blood. This unintended systemic dose probably reflects contributions from both dermal absorption and inhalation of volatilized product. The resulting internal dose is low, even under hypothetical, worst case intensive use assumptions. A significant margin of exposure (MOE) exists compared to demonstrated effect levels for developmental toxicity under worst case use scenarios, and the MOE is even more significant for typical anticipated occupational use patterns. The estimated internal doses of ethanol from topical application of alcohol-based hand sanitizers are also in the range of those associated with consumption of non-alcoholic beverages (i.e., non-alcoholic beer, flavored water, and orange juice), which are considered safe for consumers. Additionally, the estimated internal doses associated with expected exposure scenarios are below or in the range of the expected internal doses associated with the current occupational exposure limit for ethanol set by the Occupational Safety and Health Administration. These results support the conclusion that there is no significant risk of developmental or reproductive toxicity from repeated occupational exposures and high frequency use of ABHSs or surgical scrubs. Overall, the data support the conclusion that alcohol-based hand sanitizer products are safe for their intended use in hand hygiene as a critical infection prevention strategy in healthcare settings.
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O'Keeffe LM, Kearney PM, McCarthy FP, Khashan AS, Greene RA, North RA, Poston L, McCowan LME, Baker PN, Dekker GA, Walker JJ, Taylor R, Kenny LC. Prevalence and predictors of alcohol use during pregnancy: findings from international multicentre cohort studies. BMJ Open 2015; 5:e006323. [PMID: 26152324 PMCID: PMC4499685 DOI: 10.1136/bmjopen-2014-006323] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To compare the prevalence and predictors of alcohol use in multiple cohorts. DESIGN Cross-cohort comparison of retrospective and prospective studies. SETTING Population-based studies in Ireland, the UK, Australia and New Zealand. PARTICIPANTS 17,244 women of predominantly Caucasian origin from two Irish retrospective studies (Growing up in Ireland (GUI) and Pregnancy Risk Assessment Monitoring System Ireland (PRAMS Ireland)), and one multicentre prospective international cohort, Screening for Pregnancy Endpoints (SCOPE) study. PRIMARY AND SECONDARY OUTCOME MEASURES Prevalence of alcohol use pre-pregnancy and during pregnancy across cohorts. Sociodemographic factors associated with alcohol consumption in each cohort. RESULTS Alcohol consumption during pregnancy in Ireland ranged from 20% in GUI to 80% in SCOPE, and from 40% to 80% in Australia, New Zealand and the UK. Levels of exposure also varied substantially among drinkers in each cohort ranging from 70% consuming more than 1-2 units/week in the first trimester in SCOPE Ireland, to 46% and 15% in the retrospective studies. Smoking during pregnancy was the most consistent predictor of gestational alcohol use in all three cohorts, and smokers were 17% more likely to drink during pregnancy in SCOPE, relative risk (RR)=1.17 (95% CI 1.12 to 1.22), 50% more likely to drink during pregnancy in GUI, RR=1.50 (95% CI 1.36 to 1.65), and 42% more likely to drink in PRAMS, RR=1.42 (95% CI 1.18 to 1.70). CONCLUSIONS Our data suggest that alcohol use during pregnancy is prevalent and socially pervasive in the UK, Ireland, New Zealand and Australia. New policy and interventions are required to reduce alcohol prevalence both prior to and during pregnancy. Further research on biological markers and conventions for measuring alcohol use in pregnancy is required to improve the validity and reliability of prevalence estimates.
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Affiliation(s)
- Linda M O'Keeffe
- National Perinatal Epidemiology Centre, Cork University Maternity Hospital, Wilton, Cork, Ireland
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
| | - Patricia M Kearney
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
| | - Fergus P McCarthy
- The Irish Centre for Foetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland
- Department of Obstetrics and Gynecology, University College Cork, Cork, Ireland
| | - Ali S Khashan
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
- The Irish Centre for Foetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland
| | - Richard A Greene
- National Perinatal Epidemiology Centre, Cork University Maternity Hospital, Wilton, Cork, Ireland
| | - Robyn A North
- Division of Women's Health, Women's Health Academic Centre, King's College London, and King's Health Partners, London, UK
| | - Lucilla Poston
- Division of Women's Health, Women's Health Academic Centre, King's College London, and King's Health Partners, London, UK
| | - Lesley M E McCowan
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, South Auckland Clinical School, University of Auckland, Auckland, New Zealand
| | - Philip N Baker
- National Centre for Growth & Development and Maternal and Fetal Health, Liggins Institute, University of Auckland, Auckland District Health Board and Counties Manukau District Health Board, Auckland, New Zealand
| | - Gus A Dekker
- Women's and Children's Division Lyell McEwin Hospital, University of Adelaide, Adelaide, South Australia
| | | | - Rennae Taylor
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Louise C Kenny
- The Irish Centre for Foetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland
- Department of Obstetrics and Gynecology, University College Cork, Cork, Ireland
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Kingsbury AM, Hayatbakhsh R, Gibbons K, Flenady V, Najman JM. Women's frequency of alcohol consumption prior to pregnancy and at their pregnancy-booking visit 2001–2006: A cohort study. Women Birth 2015; 28:160-5. [DOI: 10.1016/j.wombi.2014.11.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Revised: 11/07/2014] [Accepted: 11/14/2014] [Indexed: 11/25/2022]
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Abstract
OBJECTIVE Prenatal alcohol exposure (PAE) can cause fetal alcohol spectrum disorders (FASD) and associated neurodevelopmental impairments. It is uncertain which types of fine motor skills are most likely to be affected after PAE or which assessment tools are most appropriate to use in FASD diagnostic assessments. This systematic review examined which types of fine motor skills are impaired in children with PAE or FASD; which fine motor assessments are appropriate for FASD diagnosis; and whether fine motor impairments are evident at both "low" and "high" PAE levels. METHODS A systematic review of relevant databases was undertaken using key terms. Relevant studies were extracted using a standardized form, and methodological quality was rated using a critical appraisal tool. RESULTS Twenty-four studies met inclusion criteria. Complex fine motor skills, such as visual-motor integration, were more frequently impaired than basic fine motor skills, such as grip strength. Assessment tools that specifically assessed fine motor skills more consistently identified impairments than those which assessed fine motor skills as part of a generalized neurodevelopmental assessment. Fine motor impairments were associated with "moderate" to "high" PAE levels. Few studies reported fine motor skills of children with "low" PAE levels, so the effect of lower PAE levels on fine motor skills remains uncertain. CONCLUSIONS Comprehensive assessment of a range of fine motor skills in children with PAE is important to ensure an accurate FASD diagnosis and develop appropriate therapeutic interventions for children with PAE-related fine motor impairments.
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