Contribution of Sleep Disruption to Memory Impairment and Emotion Dysregulation in Fetal Alcohol Spectrum Disorders

摘要 产前酒精暴露(PAE)与一系列不良和持久的后果有关， 包括学习和记忆受损以及对充满情绪的事件(即情绪)的反应改变 监管失调)。虽然睡眠问题经常在流行病学研究和临床病例中被注意到 关于胎儿酒精谱系障碍(FASD)的报道，它们还没有被很好地描述为 客观方法学，如多导睡眠图(PSG)。此外，还没有研究探索可能的 FASD患者的睡眠问题与记忆和情绪调节障碍之间的关系。 有必要对这些关联进行研究，因为众所周知，健康的睡眠在 巩固新获得的陈述性记忆，并减弱情感反应- 有效的刺激。这项拟议的研究将首次调查睡眠结构及其与睡眠的关系 FASD中的记忆巩固和情绪调节。90名青壮年(18-21岁；30名胎儿酒精 综合征(Fas)或部分Fas(Pfas)，30例非综合征重度暴露组和30例非暴露组对照) 将从Pi Sandra Jacobson和Co-I Joseph Jacobson的开普敦招募， 南非，FASD队列，从婴儿时期起就被纵向跟踪。数据将被收集起来 在开普敦大学的皮托马斯睡眠科学实验室。开普敦是一个极好的 考虑到大量患有重度PAE和Fas的患者可在 单一地点，并提供最先进的PSG设备实验室。将获得睡眠数据 连续三个晚上。第一个(适应)夜将允许参与者适应睡眠 实验室的环境和与监测设备连接的睡眠。第二天晚上的睡眠将会是 在此之前是对标准陈述性记忆测试的学习试验，已发现这些试验受到 PAE，并将在上午随后进行延迟召回试验。这一程序将允许我们检查 睡眠中断和记忆巩固之间的联系。第三天晚上的睡眠将会提前 通过最初观看配价的图片，并将在上午之后观看相同的刺激。 睡前和睡后观看时的心理生理测量将使我们能够检查 睡眠障碍与情绪唤醒/情绪调节之间的关系。目标是(1) 描述患有FASD的年轻人的睡眠结构；(2)检验以下假设 慢波睡眠(SWS)百分比将在记忆巩固中调节与PAE相关的干扰；以及(3) 为了检验快速眼动(REM)睡眠百分比的减少将调节PAE的假设- 与之前观看过的有情感价值的图片的情绪反应相关的变化。如果 预测的关联被观察到，基于睡眠的干预可能提供重要的和新的途径 解决FASD在陈述性记忆和情绪调节方面的缺陷。

ABSTRACT Prenatal alcohol exposure (PAE) is associated with a broad range of adverse and enduring consequences, including impaired learning and memory and altered responses to emotion-laden events (i.e., emotion dysregulation). Although sleep problems are often noted in epidemiological studies and clinical case reports relating to fetal alcohol spectrum disorders (FASD), they have not been well characterized using objective methodologies, such as polysomnography (PSG). Moreover, no studies have explored possible associations between sleep problems and memory and emotional regulation impairments in FASD. Investigation of these associations is warranted because healthy sleep is known to play a critical role in the consolidation of newly-acquired declarative memories and to attenuate emotional reactivity to affectively- valenced stimuli. The proposed study will be the first to investigate sleep architecture and its relation to memory consolidation and emotional regulation in FASD. 90 young adults (18-21 yr of age; 30 fetal alcohol syndrome (FAS) or partial FAS (PFAS), 30 non-syndromal heavily-exposed, and 30 non-exposed controls) will be recruited from PI Sandra Jacobson’s and Co-I Joseph Jacobson’s well-characterized Cape Town, South Africa, FASD cohort, which has been followed longitudinally since infancy. The data will be collected in PI Thomas’s Sleep Sciences Laboratory at the University of Cape Town. Cape Town is an excellent venue for this study given the unusually large number of individuals with heavy PAE and FAS available at a single site and the availability of a state-of-the-art PSG-equipped laboratory. Sleep data will be obtained over three consecutive nights. The 1st (adaptation) night will allow participants to acclimate to the sleep laboratory’s environment and to sleeping with monitoring equipment attached. Sleep on the 2nd night will be preceded by learning trials of standard declarative memory tests, which have been found to be affected by PAE, and will be followed in the morning by delayed recall trials. This procedure will allow us to examine associations between sleep disruption and memory consolidation. Sleep on the 3rd night will be preceded by initial viewing of valenced pictures and will be followed in the morning by viewing of the same stimuli. Psychophysiological measurement during both pre- and post-sleep viewing will allow us to examine associations between sleep disruption and affective arousal/emotion regulation. The aims are (1) to characterize sleep architecture of young adults with FASD; (2) to test the hypothesis that reductions in slow-wave sleep (SWS) percentage will mediate PAE-related disruptions in memory consolidation; and (3) to test the hypothesis that reductions in rapid eye movement (REM) sleep percentage will mediate PAE- related alterations in emotional reactivity to previously-viewed emotionally-valenced pictures. If the predicted associations are observed, sleep-based interventions may offer important and novel pathways for addressing deficits in declarative memory and emotion regulation in FASD.