Magnitude comparison and automaticity in number processing in adolescents with prenatal alcohol exposure: An event-related potentials study

BACKGROUND

Individuals with fetal alcohol spectrum disorders may exhibit a distinct pattern of dysmorphic facial features, growth restriction, and cognitive deficits, particularly in arithmetic. Magnitude comparison, a fundamental element of numerical cognition, is modulated by the numerical distance effect, with numbers closer in value more difficult to compare than those further apart, and by the automaticity of the association of numerical values with their symbolic representations (Arabic numerals).

METHODS

We examined event-related potentials acquired during the Numerical Stroop numerical and physical tasks administered to 24 alcohol-exposed adolescents (eight fetal alcohol syndrome (FAS), eight partial FAS (PFAS), eight heavily exposed (HE) nonsyndromal) and 23 typically developing (TD), same- age controls. The distance effect was assessed on the numerical task to examine differences in reaction time (RT) and accuracy when two numbers are close in value (e.g., 1 vs. 2) compared to when the numbers are less close (e.g., 1 vs. 6). Automaticity was assessed in the physical task by examining the degree to which RT and accuracy are reduced when the relative physical size of two numerals is incongruent with their numerical values (e.g., 1 vs. 6).

RESULTS

Adolescents in all four groups performed behaviorally as expected on these relatively simple magnitude comparison tasks, but accuracy was poorer and RT was slower on both tasks in the FAS and PFAS than the HE and TD groups. At the neurophysiological level, in the numerical task, a higher level of prenatal alcohol exposure was associated with smaller P2p amplitude. In the physical task, only the TD and nonsyndromal HE groups exhibited the expected smaller P300 amplitude in the incongruent than the congruent condition.

CONCLUSIONS

These findings suggest that magnitude comparison in alcohol-exposed individuals may be mediated by recruitment of alternative neural pathways that are likely to be inefficient when number processing becomes more challenging.

"My Brain Can Stop": An ERP Study of Longitudinal Prediction of Inhibitory Control in Adolescence

We examined the longitudinal predictors of electrophysiological and behavioral markers of inhibitory control in adolescence. Participants were 63 adolescent boys who have been followed since birth as part of a prospective longitudinal study on the developmental pathways to attention-deficit hyperactivity disorder (ADHD). At 17 years of age, they completed the stop-signal task (SST) while electroencephalography (EEG) was continuously recorded. Inhibitory control was evaluated by the stop-signal reaction time (SSRT) as well as by the amplitude of the event-related potential (ERP) component of N2 during successful inhibition. We found that higher inattention symptoms throughout childhood predicted reduced amplitude (i.e., less negative) of the N2 in adolescence. Furthermore, the N2 amplitude was longitudinally predicted by the early precursors of child familial risk for ADHD and early childhood temperament. Specifically, father's inattention symptoms (measured in the child's early infancy) and child's effortful control at 36 months of age directly predicted the N2 amplitude in adolescence, even beyond the consistency of inattention symptoms throughout development. The SSRT was predicted by ADHD symptoms throughout childhood but not by the early precursors. Our findings emphasize the relevance of early familial and temperamental risk for ADHD to the prediction of a later dysfunction in inhibitory control.

Prenatal Alcohol Exposure Alters Error Detection During Simple Arithmetic Processing: An Electroencephalography Study

BACKGROUND

Arithmetic is the domain of academic achievement most consistently related to prenatal alcohol exposure (PAE). Error detection, an important aspect of arithmetic processing, can be examined in a mathematical verification task. Electroencephalographic (EEG) studies using such tasks have shown bursts of synchronized theta-band activity in response to errors. We assessed this activity for error detection in adolescents with PAE and typically developing (TD) matched controls. We predicted that the PAE group would show smaller theta bursts during error detection and weaker responses depending on the size of the error discrepancy.

METHODS

Participants' mothers were recruited during pregnancy and interviewed about their alcohol consumption using a timeline follow-back interview. Participants were followed from infancy and diagnosed for fetal alcohol syndrome (FAS) or partial FAS (PFAS) by expert dysmorphologists. EEGs were recorded for 48 adolescents during a verification task, which required differentiation between correct/incorrect solutions to simple equations; incorrect solutions had small or large deviations from correct solutions.

RESULTS

Performance was good-excellent. The PAE group showed lower accuracy than the TD group: Accuracy was inversely related to diagnosis severity. The TD and heavily exposed (HE) nonsyndromal groups showed the expected differentiation in theta-burst activity between correct/incorrect equations, but the FAS/PFAS groups did not. Degree of impairment in brain response to errors reflected severity of diagnosis: The HE group showed the same differentiation between correct/incorrect solutions as TD but failed to differentiate between levels of discrepancy; PFAS showed theta reactions only in response to large error discrepancies; and FAS did not respond to small or large discrepancies.

CONCLUSIONS

Arithmetical error-related theta activity is altered by PAE and can be used to distinguish between exposed and nonexposed individuals and within diagnostic groups, supporting the use of numerical and quantitative processing patterns to derive a neurocognitive profile that could facilitate diagnosis and treatment of fetal alcohol spectrum disorders.

Deficits in arithmetic error detection in infants with prenatal alcohol exposure: An ERP study

Prenatal alcohol exposure (PAE) is associated with a range of physical, cognitive, and behavioral problems, particularly in arithmetic. We report ERP data collected from 32 infants (mean age = 6.8 mo; SD = 0.6; range = 6.1–8.1; 16 typically developing [TD]; 16 prenatally alcohol-exposed) during a task designed to assess error detection. Evidence of error monitoring at this early age suggests that precursors of the onset of executive control can already be detected in infancy. As predicted, the ERPs of the TD infants, time-locked to the presentation of the solution to simple arithmetic equations, showed greater negative activity for the incorrect solution condition at middle-frontal scalp areas. Spectral analysis indicated specificity to the 6–7 Hz frequency range. By contrast, the alcohol-exposed infants did not show the increased middle-frontal negativity seen in the TD group nor the increased power in the 6–7 Hz frequency, suggesting a marked developmental delay in error detection and/or early impairment in information processing of small quantities. Overall, our research demonstrates that (a) the brain network involved in error detection can be identified and highly specified in TD young infants, and (b) this effect is replicable and can be utilized for studying developmental psychopathology at very early ages.

Can life be evaluated? The Jewish Halachic approach vs. the quality of life approach in medical ethics: a critical view

In recent years there has been an increase in the number of requests for "mercy killings" by patients and their relatives. Under certain conditions, the patient may prefer death to a life devoid of quality. In contrast to those who uphold this "quality of life" approach, those who hold the "sanctity of life" approach claim that life has intrinsic value and must be preserved regardless of its quality. This essay describes these two approaches, examines their flaws, and offers a "golden path" between the two extreme positions. We discuss the halachic and the secular views, arguing for a balance between the sanctity of life and the quality of life. We argue that, indeed, such a balance exists in practice, and that life is important, but it is not sacred. Life can be evaluated, but quality of life is not the sole criterion.

The physiological state of captive and migrating Great White Pelicans (Pelecanus onocrotalus) revealed by their blood chemistry

The Great White Pelican Pelecanus onocrotalus is an endangered migratory bird, threatened by diminishing natural feeding sites and by persecution by fishermen. The majority of the migrating White Pelican (71000) stop-over in Israel during their autumn migration to Africa. As part of a larger study, aimed to assess the necessity of feeding during the stop-over in Israel, we examined the blood chemistry of captive and migrating White Pelicans. Blood was sampled from captive birds maintained on a fish diet, after food deprivation for 48 h and from wild birds brought from the field during migration. Food deprivation resulted in increased plasma levels of triglycerides and in lower levels of urea, potassium and calcium. In migrating birds, increased plasma levels of urea and CPK and lower levels of creatinine were revealed. In general, the coefficient of variation in the blood chemistry of migrating pelicans was higher than in the captive birds, that is to say, that these birds were in a variable physiological condition. The blood profile of migrating and wintering pelicans did not indicate a state of dehydration but did indicate energy deficiency. The less extreme changes in blood chemistry of the 48 h food-deprived compared to migrating pelicans suggest that the former did not reach a state of starvation. We conclude that for White Pelicans the stop-over in Israel is a must in order to rest and replenish their fuel reserves for completion of their autumn migration to Africa.

Absorption of nursing students: new immigrants in the general academic nursing programme in Israel

Two years after upgrading its nursing programme to university level, Israel experienced a massive wave of immigration from the former Soviet Union. Previous studies have shown that Russian immigrants in general, and in nursing in particular, have several unique characteristics that need to be taken into consideration in planning curricula and absorption programmes. The aim of the present work was to update these data, focusing on the reasons new immigrants choose nursing as a career, their image of the profession and their satisfaction with it. The study population consisted of 302 students attending five major academic schools of nursing in Israel. Students were divided into two groups: new immigrants (less than 4 years in Israel) and long-time Israelis (more than 4 years in Israel). All completed a 30-item questionnaire of proven validity and reliability. Findings were analysed by length of time in Israel and year of study. Using a series of statistical tests, we found that compared with the long-time Israelis, the new immigrants came from a higher socio-economic/professional stratum (in their mother country), had a less 'technical' perception of nursing, and were attracted to the profession primarily for extrinsic reasons ('close to medicine', economics). Both groups showed highest satisfaction in the clinical domain; however, the difference was significant only in the long-time Israeli group, even though the new immigrants had rated this domain highest in importance. The new immigrants showed least satisfaction in the academic domain. These results could be explained by several factors: the financial and housing problems that accompany immigration; the higher proportion of married students in the new immigrant group; and especially language difficulties, which are multiplied in Israel, where mastery in both Hebrew and English is necessary. Of particular interest was the fact that many of the immigrant students had already begun or completed medical school in their old country but were forced to compromise their dreams on immigration. This affected both their image of nursing and their reasons for choosing it as a career. We believe these findings will help nurse educators identify areas in which they can help ease the absorption process for maximal benefit to both the students and the profession.