Fetal AlcoholSpectrum Disorders
Dina E. Hill, Ph.D. ([email protected])
Andrea Sherwood, PhD, ABPP-CN([email protected])
UNM Center for Neuropsychological Services, Department of Psychiatry
Disclosures
• Dr. Hill has a contract with IHS for neuropsychological assessment of children through her private practice.
• Dr. Sherwood has no financial relationships or conflicts of interest related to this presentation. She is not involved in any clinical drug trials.
Overview of FASD Series
• Session 1: Overview and Introduction
• Session 2: Screening and Diagnosis
• Session 3: Assessment of FASD
• Session 4: Therapeutic Interventions
• Session 5: FASD Over the Lifespan
• Session 6:Special Topics-Neuroimaging
Session 6: Special Topics-Neuroimaging
Goals/Objectives
• Identify Two Neuroimaging Techniques utilized in FASD research
• Identify Two Neuroanatomical Structures affected by In-Utero Alcohol Exposure
• Describe Two Behavioral Results found in Neuroimaging Studies of FASD
Neuroimaging Methods: Structural & Functional
New neuroimaging methods allow visualizing brain structures in detail (MRI, DTI)
Some other imaging methods allow looking at what is happening in the brain (function) while someone doing a task (fMRI, EEG, MEG)
Structural MRI: Cortical
• Overall Brain Size
• Cerebral Cortex
• Frontal Lobes
• Parietal Lobes
• Temporal Lobes
Structural MRI: Subcortical
• Basal Ganglia
• Caudate Nucleus
• Corpus Callosum
• Hippocampus
• Cerebellum
Basal Ganglia: Caudate Nucleus
• Basal Ganglia: motor control and learning
• Caudate Nucleus: associated with learning, mental flexibility, and behavioral inhibition
• Basal ganglia structures are significantly smaller even when controlling for overall brain size
Normal FAS
Caudate Nucleus in Two 18-Year Olds
Corpus Callosum
• The corpus callosum is the fiber tract that connects the two hemispheres
• Anomalies in the corpus callosum can range from thinning in some regions to the total absence called agenesis
• The integrity of corpus callosum is critical to the integration of information from two hemispheres
Hippocampus
• The hippocampus is a structure located inside the medial temporal lobe
• The hippocampus plays a critical role in learning and memory
• It is a part of the limbic system
• Equivocal findings in hippocampal volume
Cerebellum
• Important for attention, executive functions, and movement
• Differences seen in cerebellar structures for individuals with FASD
Other Structural Neuroimaging Techniques
• MR Spectroscopy
• Diffusion Tensor Imaging (DTI)
• Summary Structural and Brain-Behavior Findings
Functional Brain Imaging
• Magnetoencephalography (MEG)
• Functional Magnetic Resonance Imaging (fMRI)
Magnetoencephalography
Delayed neural responses to stimuli as revealed by magnetoencephalography; Stephen et al. (in press)
Functional Magnetic Resonance Imaging (fMRI)
• Spatial Working Memory
• Inhibitory Control
• Verbal Learning & Working Memory
• Visual Working Memory
• Summary fMRI Findings
Summary
• At a behavioral level children with FASD show slow information processing and increased inattentiveness.
• At a neurocognitive level children with FASD display impaired performance on tasks that involve the integration and manipulation of information.
• At a neuronal level children with FASD show both structural and functional differences.
Research Challenges & Opportunities
• Mechanisms of Alcohol’s Prenatal Effects
• Preventing Potentially Harmful Alcohol Consumption
• Combination Drug Use and FASD
• Biomarkers of FASD
• Animal Models
FASD Resources
• State-specific waiver plans
• www.medicaid.gov
• Substance Abuse and Mental Health Services Administration (SAMHSA)
• https://store.samhsa.gov/shin/content/SMA13-4803/SMA13-4803.pdf
• National Institute on Alcohol Abuse and Alcoholism
• http://pubs.niaaa.nih.gov/publications/arh341/toc34_1.htm
• American Academy of Pediatrics FASD Toolkit
• https://www.aap.org/
