1/5 The Cumulative Risk of Substance Exposure and Early Life Adversity on Child Health Development and Outcomes

1/5 物质暴露和早年不幸对儿童健康发展和结果的累积风险

• 批准号: 10078664
• 负责人: STEPHEN L BUKA
• 金额: $ 51.37万
• 依托单位: RHODE ISLAND HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-30 至 2022-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10078664
• 关键词: Cumulative; Risk; Substance; Exposure; Early

PROJECT SUMMARY / DESCRIPTION How do in utero opioid exposure and early adversity affect a child's neurodevelopmental and health outcomes? The simplicity of this question masks the complex and multifaceted nature of human neurodevelopment, and the variety of environmental influences that can exacerbate or moderate the effects of in utero substance exposure. From conception to age 10, our brain undergoes remarkable structural and functional change. Processes including myelination and synaptogenesis are at their peak throughout this age span, contributing to the emergence of nearly all cognitive and behavioral skills, and responsive to both early substance exposures and environmental stimuli. In the context of fetal opioid exposure, this often co-occurs with other maternal substance use (alcohol, tobacco, marijuana), as well as related pre- and post-natal factors including maternal mental health concerns, supportive or adverse family environments, low socioeconomic status (SES), inter-partner violence, and caregiving quality and quantity. Despite increased efforts to understand the neurodevelopmental sequela of in utero opioid and other substance exposure on long-term behavioral, cognitive, and societal outcomes, important questions remain, specifically, 1. How is brain growth is disrupted by fetal substance and related pre and post-natal exposures; and 2. How are these disrupted growth patterns causally related to later cognitive and behavioral outcomes? This proposal seeks to formulate our approach to addressing these key questions, and decipher the individual and cumulative effect of these intertwined pre- and post-natal exposures on child neurodevelopment. By bringing together leading experts in child development and adversity, pediatric neuroimaging, maternal, fetal, and child abuse medicine, longitudinal and functional statistics, and public health, strategically located US states and counties hardest hit by the current opioid crisis, we will articulate our vision of the larger HEALthy Brain & Child Development study, and lay the foundation for our participation in three incremental steps. First, we will address the legal, ethical, and mother-child care and support concerns implicit in this study by leveraging our team's past experience in family adversity, child abuse, and fetal substance exposure research. Next, we will integrate across our areas of neuroimaging expertise to develop, implement, and harmonize a multi-modal MRI and EEG protocol to assess maturing brain structure, function, and connectivity. This neuroimaging protocol will be paired with extensive neurocognitive, sociodemographic, physical health, family and medical history, anthropometric, and biospecimen data collection to quantify the individual, cumulative, and interactive effects of a child's substance and environment on their overall health and neurodevelopment. Finally, we will develop and test advanced statistical approaches to model and analyze this multidimensional and longitudinal data, taking into account the likely sparse and unbalanced nature of the measurements. Together, these steps lay the foundation for a broad and large-scale study to examine the impact of exposure to substances and early adversity on a child's neural, physical, and behavioral development.

项目摘要 /描述 在子宫内阿片类药物的暴露和早期逆境如何影响儿童的神经发育和健康成果？ 这个问题的简单性掩盖了人类神经发育的复杂而多方面的性质， 各种环境影响会加剧或减轻子宫内物质暴露的影响。 从概念到10岁，我们的大脑经历了显着的结构和功能变化。过程 包括髓鞘形成和突触发生在整个年龄跨度上都达到了高峰，有助于 几乎所有认知和行为技巧的出现，以及对早期物质暴露和 环境刺激。在胎儿阿片类药物暴露的背景下，这通常与其他母体物质同时发生 使用（酒精，烟草，大麻）以及相关的产前和后因素，包括孕产妇的心理健康 关注，支持性或不利的家庭环境，低社会经济地位（SES），伴侣暴力， 以及护理质量和数量。尽管努力越来越了解神经发育的后遗症 在子宫阿片类药物和其他有关长期行为，认知和社会结局的暴露中， 具体来说，重要的问题仍然存在。 和产后暴露；和2。这些破坏的增长模式与后来的认知和 行为结果？该建议旨在提出我们解决这些关键问题的方法，并 解读这些相互交织的产前和产后暴露对儿童的个体和累积效应 神经发育。通过汇集儿童发展和逆境领域的主要专家，儿科 神经影像学，产妇，胎儿和虐待儿童医学，纵向和功能统计以及公共卫生， 在当前的阿片类药物危机中，战略性地位于美国州和县最严重的打击，我们将阐明我们的愿景 大型健康的大脑和儿童发展研究，并为我们参与三个 增量步骤。首先，我们将解决法律，道德和母子护理和支持关注的隐含 在这项研究中，通过利用我们团队过去在家庭逆境，虐待儿童和胎儿物质方面的经验 暴露研究。接下来，我们将在我们的神经影像专业知识领域融合以开发，实施， 并协调多模式MRI和EEG方案，以评估成熟的大脑结构，功能和 连接性。该神经影像学方案将与广泛的神经认知，社会人口统计学， 身体健康，家庭和病史，人体测量学和生物测定数据收集，以量化 儿童的物质和环境对他们的整体健康以及 神经发育。最后，我们将开发和测试高级统计方法，以建模和分析 考虑到多维和纵向数据，考虑到可能的稀疏和不平衡的性质 测量。这些步骤共同为一项广泛而大规模的研究奠定了基础，以检查 暴露于物质和早期逆境对儿童神经，身体和行为发展的影响。