Prenatal Alcohol Exposure: Adult Neurocognition

描述（由申请人提供）：胎儿酒精综合征（FAS）及其相关疾病是导致终身发育和行为障碍的主要原因。孕妇在妊娠期间饮酒会产生畸形、生长缺陷，并以尚未完全了解的方式影响神经系统。尽管需要关于这种致畸物的长期影响的准确、有数据库的信息，但对酒精暴露和受影响的成年人的适应功能和神经认知的实证研究仍然非常有限。拟议的研究将跟踪一个特征良好的样本（N=275），该样本是1980年至1986年间根据孕妇孕期饮酒情况在产前确定的队列的一部分，直至成年早期，以描述其当前功能并评估神经认知状态。这些结果将与显示产前暴露行为影响的个体亚样本（n=120）的神经影像学结果相关。先前对低社会经济地位（SES），主要是非裔美国人的研究表明，一种神经发育缺陷模式与酒精暴露可能在宏观结构和微观结构水平上影响大脑白质束的假设一致，并且与这种改变相关的缺陷可能与特定的神经行为结果有关。使用结构和功能MRI协议和弥散张量成像（DTI），我们将评估一系列假设，即产前暴露的个体表现出相对于对照组的神经心理缺陷，与SES和残疾状态相匹配，将显示出大脑结构和白质完整性指数的可测量差异。该研究的纵向随访部分将检查酒精暴露和受影响的年轻人的社会、适应性和神经心理学结果，并将结果与那些也被纵向跟踪的社会经济地位匹配的对照组以及在青春期招募的特殊教育对照组的成员进行比较。将选择酒精影响个体和对照的子样本在3T进行神经成像，以评估产前酒精暴露对宏观结构，微观结构和功能的影响。我们预计这些技术将为酒精暴露对发育的致畸作用以及这种疾病中白质完整性和神经心理功能之间的关系提供见解。

DESCRIPTION (provided by applicant): Fetal Alcohol Syndrome (FAS) and associated disorders are a major cause of lifelong developmental and behavioral disabilities. Maternal alcohol use during gestation produces dysmorphology, growth deficits and impacts the nervous system in ways that are not yet fully understood. Despite the need for accurate, databased information on the long-term effects of this teratogen, empirical research on adaptive functioning and neurocognition in alcohol-exposed and affected adults is still very limited. The proposed research will follow a well-characterized sample (N=275), part of a cohort identified prenatally between 1980 and 1986 based on maternal alcohol use during pregnancy, into early adulthood in order to describe their current functioning and to evaluate neurocognitive status. These outcomes will be correlated with the results of neuroimaging in a subsample (n=120) of individuals demonstrating behavioral effects of prenatal exposure. Previous research with this low socioeconomic status (SES), predominantly African-American cohort has demonstrated a pattern of neurodevelopmental deficits consistent with the hypothesis that alcohol exposure may have affected white matter tracts in the brain at both macrostructural and microstructural levels and that deficits related to such alterations may be associated with specific neurobehavioral outcomes. Using structural and functional MRI protocols and Diffusion Tensor Imaging (DTI), we will evaluate a series of hypotheses that prenatally exposed individuals demonstrating neuropsychological deficits relative to controls, matched for SES and disability status, will show measurable differences in brain structure and in indices of white matter integrity. A longitudinal follow-up portion of the study will examine social, adaptive and neuropsychological outcomes in alcohol-exposed and affected young adults and compare results to those of SES matched controls who have also been followed longitudinally and to members of a special education contrast group recruited during adolescence. A subsample of alcohol-affected individuals and controls will be selected for neuroimaging at 3T to evaluate effects of prenatal alcohol exposure on macrostructure, microstructure and function. We anticipate that these techniques will provide insight into the teratogenic effects of alcohol exposure on development as well as the relationship between white matter integrity and neuropsychological functioning in this disorder.