A Multisite Neurobehavioral Assessment of Fetal Alcohol Spectrum Disorders

描述（由申请人提供）：本申请是“胎儿酒精谱系障碍合作倡议（CIFASD）”（通知RFA-AA-03-004）竞争性更新的一部分，以继续和扩展当前的多学科CIFASD。该RFA呼吁，在某种程度上，针对胎儿酒精谱系障碍（FASD）的“改进诊断”和“加强对神经行为损害领域的理解”进行研究。尽管30年的研究已经确定了FASD患者的无数缺陷，但大多数神经心理学研究都受到全面功能障碍与相对保留和功能受损模式的问题的困扰。神经心理学侧面的描绘一直是最近争论的主题。有限的研究，包括目前的CIFASD联盟，已经检查了产前酒精暴露是否会导致一般功能障碍或更具体的优势和劣势神经行为特征。本项目的主要目的是确定胎儿酒精综合征患儿是否存在神经行为表型，无面部畸形的FASD患儿是否存在相同表型，以及该表型是否可用于鉴别诊断。次要目标，包括与其他CIFASD项目和核心的合作，是确定脑畸形、面部畸形和神经行为功能之间的关系。这些目标与CIFASD的总体目标保持一致，包括加强对FASD神经行为表型的理解和建立标准化的诊断标准和评估方法。标准的神经行为协议将在六个地点对四组儿童实施，并将解决执行功能，工作记忆，语言功能和心理症状学的功能领域。除了FASD患儿和未暴露对照组外，低智商或ADHD患儿也将被纳入对照样本。使用这种异质样本和多元统计方法，将寻求FASD特有的神经行为特征。此外，参与者将使用Dysmorphology Core和CIFASD面部和脑成像项目规定的方法进行评估。来自三个广泛领域（神经行为学、畸形学和脑形态学和功能）的数据将分别和共同分析，以解决CIFASD的主要目标：改进FASD的诊断标准。该项目与围绕产前大量酒精暴露影响的公共卫生问题直接相关，改善酒精影响个体的诊断，并确定FASD特有的神经行为影响的轮廓。改进对这些特征的识别和描述将最终导致改进治疗。

DESCRIPTION (provided by applicant): This application is part of the competitive renewal for the "Collaborative Initiative on Fetal Alcohol Spectrum Disorders (CIFASD)" (Notice RFA-AA-03-004) to continue and expand the current multidisciplinary CIFASD. This RFA calls for, in part, research aimed at "improved diagnosis" and "enhanced understanding of the domains of neurobehavioral impairment" of fetal alcohol spectrum disorders (FASD). Although 30 years of research have identified myriad deficits in individuals with FASD, most neuropsychological studies are plagued by the question of global dysfunction vs. a pattern of relative sparing and impaired function. Delineation of a neuropsychological profile has been the subject of much recent debate. Limited research, including the current CIFASD consortium, has examined if prenatal alcohol exposure results in general dysfunction or a more specific neurobehavioral profile of strengths and weaknesses. The primary aim of this project is to determine whether a neurobehavioral phenotype exists in children with fetal alcohol syndrome, whether the same phenotype exists in children with FASD who lack facial dysmorphology, and whether the phenotype can be used for differential diagnosis. Secondary aims, involving collaboration with other CIFASD projects and cores, are to determine the relationship between brain dysmorphology, facial dysmorphology, and neurobehavioral function. These aims are in keeping with the overall aims of the CIFASD, including enhanced understanding of the neurobehavioral phenotype and establishment of standardized diagnostic criteria and methods of assessment of FASD. A standard neurobehavioral protocol will be administered to four groups of children at six sites and will address the functional domains of executive function, working memory, verbal function, and psychological symptomatology. In addition to children with FASD and nonexposed controls, children with low IQ scores or ADHD will be included as contrast samples. Using this heterogeneous sample and multivariate statistical methods, neurobehavioral profile specific to FASD will be sought. In addition, participants will be assessed using methodology prescribed by the Dysmorphology Core and the facial and brain imaging projects of the CIFASD. Data from three broad domains (neurobehavior, dysmorphology, and brain morphology and function) will be analyzed both separately and together to address the main aim of the CIFASD: improving the diagnostic criteria for FASD. This project is directly relevant to public health concerns surrounding the effects of heavy prenatal alcohol exposure, improving diagnosis of alcohol-affected individuals, and defining the profile of neurobehavioral effects that are specific to FASD. Improved identification and delineation of these features will ultimately lead to improved treatment.