Fetal Alcohol Spectrum Disorders: An Overview

Department of Psychology, Center for Behavioral Teratology, San Diego State University, San Diego, CA 92120, USA.
Neuropsychology Review (Impact Factor: 4.59). 06/2011; 21(2):73-80. DOI: 10.1007/s11065-011-9166-x
Source: PubMed


When fetal alcohol syndrome (FAS) was initially described, diagnosis was based upon physical parameters including facial anomalies and growth retardation, with evidence of developmental delay or mental deficiency. Forty years of research has shown that FAS lies towards the extreme end of what are now termed fetal alcohol spectrum disorders (FASD). The most profound effects of prenatal alcohol exposure are on the developing brain and the cognitive and behavioral effects that ensue. Alcohol exposure affects brain development via numerous pathways at all stages from neurogenesis to myelination. For example, the same processes that give rise to the facial characteristics of FAS also cause abnormal brain development. Behaviors as diverse as executive functioning to motor control are affected. This special issue of Neuropsychology Review addresses these changes in brain and behavior highlighting the relationship between the two. A diagnostic goal is to recognize FAS as a disorder of brain rather than one of physical characteristics.

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    • "These cases are referred to as alcoholrelated neurodevelopmental disorders (ARND) and are often difficult to identify because they lack the characteristic facial features and growth retardation seen in FAS. In fact, an ARND diagnosis requires confirmation of prenatal alcohol exposure, which often is unavailable or unreliable (see Riley et al. 2011 for a comparison of various diagnostic schemas for FAS and ARND). Finding novel ways to identify at-risk individuals for disabilities along the spectrum is critical, as is identifying effective interventions to mitigate these cognitive and behavioral effects. "
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    ABSTRACT: Prenatal alcohol exposure can cause a number of physical, behavioral, cognitive, and neural impairments, collectively known as fetal alcohol spectrum disorders (FASD). This article examines basic research that has been or could be translated into practical applications for the diagnosis or treatment of FASD. Diagnosing FASD continues to be a challenge, but advances are being made at both basic science and clinical levels. These include identification of biomarkers, recognition of subtle facial characteristics of exposure, and examination of the relation between face, brain, and behavior. Basic research also is pointing toward potential new interventions for FASD involving pharmacotherapies, nutritional therapies, and exercise interventions. Although researchers have assessed the majority of these treatments in animal models of FASD, a limited number of recent clinical studies exist. An assessment of this literature suggests that targeted interventions can improve some impairments resulting from developmental alcohol exposure. However, combining interventions may prove more efficacious. Ultimately, advances in basic and clinical sciences may translate to clinical care, improving both diagnosis and treatment.
    Alcohol research : current reviews 09/2015; 37(1):97-108.
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    • "The range of effects that can be caused by prenatal ethanol exposure is denoted as fetal alcohol spectrum disorder (FASD), whose severity depends on several factors, such as the timing, pattern and dose of ethanol consumed, as well as environmental and genetic factors (Jones, 2011). The central nervous system alterations are among the most severe manifestations of FASD, which significantly decrease quality of life and involve a wide range of processes such as learning, memory, attention, fine motor coordination, judgment, social interaction, and emotional behavior (Riley et al., 2011). Regarding the latter, several studies have demonstrated an association between prenatal ethanol exposure and anxiety disorders (O'Connor and Paley, 2009; Hellemans et al., 2010). "
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    ABSTRACT: Ethanol consumption during pregnancy produces a wide range of morphological and behavioral alterations known as Fetal Alcohol Spectrum Disorder (FASD). Among the behavioral deficits associated with FASD is an increased probability of developing anxiety disorders. Studies with animal models of FASD have demonstrated that ethanol exposure during the equivalent to the 1st and 2nd trimesters of human pregnancy increases anxiety-like behavior. Here, we examined the impact on this type of behavior of exposure to high doses of ethanol in vapor inhalation chambers during the rat equivalent to the human 3rd trimester of pregnancy (i.e., neonatal period in these animals). We evaluated anxiety-like behavior with the elevated plus maze. Using whole-cell patch-clamp electrophysiological techniques in brain slices, we also characterized glutamatergic and GABAergic synaptic transmission in the basolateral amygdala, a brain region that has been implicated to play a role in emotional behavior. We found that ethanol-exposed adolescent offspring preferred the closed arms over the open arms in the elevated plus maze and displayed lower head dipping activity than controls. Electrophysiological measurements showed an increase in the frequency of spontaneous and miniature excitatory postsynaptic currents in pyramidal neurons from the ethanol group. These findings suggest that high-dose ethanol exposure during the equivalent to the last trimester of human pregnancy can persistently increase excitatory synaptic inputs to principal neurons in the basolateral amygdala, leading to an increase in anxiety-like behaviors. Copyright © 2015. Published by Elsevier Inc.
    Pharmacology Biochemistry and Behavior 08/2015; 137. DOI:10.1016/j.pbb.2015.08.009 · 2.78 Impact Factor
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    • "Fetal Alcohol Spectrum Disorders are a major cause of non-genetic physical, mental, behavioral and learning disabilities (Riley et al., 2011; Warren et al., 2011). From a public health perspective, preventing the harmful effects of prenatal alcohol exposure is considered a priority (Anderson and Baumberg, 2006; European Commission, 2007; World Health Organization, 2011). "
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    ABSTRACT: To evaluate a multilevel program to raise awareness of the risks of prenatal exposure to alcohol in the area of Treviso (Italy). The program started in 2008 and consists of an action-research experience involving health professionals of maternal-child services, and in the campaign 'Mamma Beve Bimbo Beve', targeted to the childbearing-aged population. A comparative study was carried out in 2013. Surveys using semi-structured self-report questionnaires were carried out among professionals and pregnant women in Treviso, and among control groups belonging to another local area of Italy (Verona). The questionnaires investigated awareness and opinions about alcohol and pregnancy, as well as sources and kind of information provided and received. Health professionals in Treviso, who had been exposed both to the action-research experience and to the campaign, showed a more rational approach to alcohol than colleagues in the control group, and were more aware and sensitized about the risks of alcohol consumption during pregnancy. Physicians and midwives had a higher probability of having advised pregnant women to abstain from alcohol in Treviso. Pregnant women in Treviso, who had received information through the campaign and from professionals, had a higher probability of having received only correct advice about the issue of alcohol and pregnancy, but did not hold perceptions different to women in Verona. The multilevel program carried out in the Treviso area was effective in increasing awareness and improving attitudes towards the risks of alcohol use during pregnancy among local healthcare professionals, compared with the control group. © The Author 2015. Medical Council on Alcohol and Oxford University Press. All rights reserved.
    Alcohol and Alcoholism 05/2015; DOI:10.1093/alcalc/agv051 · 2.89 Impact Factor
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