Direct and indirect effects of prenatal alcohol damage on executive function
Direct and indirect effects of prenatal alcohol damage on executive function
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DOI：
10.1207/s1532694204connor
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发表时间：
2000-01-01
影响因子：
1.5
通讯作者：
Streissguth, AP
中科院分区：
文献类型：
--
作者：
Connor, PD;Sampson, PD;Streissguth, AP
患有胎儿酒精综合症(FAS)和胎儿酒精效应(FAE)的患者通常在日常生活中难以正常运作，而且似乎采用了糟糕的解决问题的策略。执行功能测试与量化与产前酒精暴露相关的功能缺陷和潜在的现实问题有关。本研究认为，产前酒精对执行功能的影响有两条途径：直接影响和通过酒精对智商的影响间接影响。我们比较了30名被诊断患有Fas或FAE的男性与参与一项纵向前瞻性研究(n=419)的年轻人和15名对照组参与者。这项研究在分析同一组执行功能评估方面是独一无二的，既有大的低剂量纵向研究样本，也有临床诊断组。对受试者进行了9项执行功能测试(包括58分)的评估。对于这种执行功能电池中的一些但不是全部测试，酒精暴露组的降幅大于从他们的智商分数预测的降幅。我们发现，6个Stroop分数中的3个、4个Trails分数中的2个、16个威斯康星卡片分类分数中的9个、2个Ruff图形流利性分数中的1个和4个辅音Trigram分数中的2个似乎对Fas和FAE患者产前酒精损伤的直接影响特别敏感。这些发现表明，这些执行功能测试在对疑似胎儿酒精损伤的人进行临床评估时特别有用，因为它们不会简单地反映智商或面部污点的缺陷。
Patients with Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Effects (FAE) often have difficulty functioning appropriately in everyday life and seem to employ poor problem-solving strategies. Tests of executive function are relevant for quantifying the functional deficits and underlying real-life problems associated with prenatal alcohol exposure. This study considers two pathways for the effects of prenatal alcohol on executive function: a direct effect and an indirect effect through prenatal alcohol's effect on IQ. We compared 30 men who had been diagnosed with FAS or FAE with young adults participating in a longitudinal prospective study (n = 419)and 15 control participants that comprised a comparison group. This study is unique in its analysis of the same battery of assessments of executive function in both a large low dose longitudinal study sample and a clinically diagnosed group. Participants were evaluated on 9 tests (including 58 scores) of executive function. For some but not all of the tests in this executive function battery, the decrement in the alcohol exposure group is greater than would be predicted from their IQ scores. We found that 3 of 6 Stroop scores, 2 of 4 Trails scores, 9 of 16 Wisconsin Card Sorting scores, 1 of 2 Ruffs Figural Fluency scores, and 2 of 4 Consonant Trigrams scores appear to be particularly sensitive to the direct effects of prenatal alcohol damage for patients with FAS and FAE. The findings suggest that these executive function tests would be particularly useful in clinical evaluations of persons suspected of fetal alcohol damage because they would not simply reflect deficits in IQ or facial stigmata.