MRI/S in Children with Prenatal Alcoholic Exposure

产前酒精暴露儿童的 MRI/S

基本信息

批准号：
6711643
负责人：
SUSAN J ASTLEY
金额：
$ 28.46万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
财政年份：
2002
资助国家：
美国
起止时间：
2002-03-01 至 2006-02-28
项目状态：
已结题

项目摘要

DESCRIPTION (provided by applicant): Fetal alcohol syndrome (FAS) is a permanent birth defect syndrome caused by maternal drinking during pregnancy. FAS is characterized by growth deficiency, a unique facial phenotype and central nervous system (CNS) dysfunction. The cognitive/behavioral problems in this condition stem from prenatal organic brain damage. Not all individuals with prenatal alcohol exposure suffer brain damage and not all who do suffer brain damage have FAS. The degree of brain damage among individuals with prenatal alcohol exposure may vary from microcellular and neurochemical aberrations to gross structural anomalies. Similarly, cognitive/behavioral dysfunction varies considerably. Teratogenic physical findings in individuals with FAS lend credence to the clinical judgment that their cognitive and behavioral dysfunction is due, in part, to organic brain damage. But without the physical features of FAS or at least a severe expression of brain damage, the injury often goes undiagnosed and unserved. This project proposes to use (magnetic resonance spectroscopy (MRS), magnetic resonance imaging (MM), and functional MM (fMRI)) to determine if prenatally alcohol-exposed children, with and without FAS, who present along the full continuum of mild to severe CNS dysfunction, have irrefutable evidence of organic brain damage in the form of chemical and structural alterations. An MRS pilot study of prenatally alcohol-exposed monkeys with moderate CNS dysfunction found that levels of choline/creatine in the brain, a marker of cell membrane breakdown, rose with increasing alcohol exposure and increasing neuropsychological dysfunction. An MRS pilot study in children with FAS also showed that choline/creatine increased with increasing neuropsychological dysfunction. These findings are consistent with MRS outcomes in individuals with organic brain damage associated with other disease states. MRI studies in small numbers of people with FAS and in alcohol-exposed monkeys with moderate CNS dysfunction demonstrate significant size alterations of selected brain regions. Together, these studies demonstrate the utility and sensitivity of MM/S in better understanding alcohol teratogenesis. Neuropsychological dysfunction will be measured using a global index of impairment generated from psychometric measures-and with experimental measures of discrete, clinically meaningful cognitive skills subserved by brain regions that prior literature suggests may be affected by alcohol teratogenesis. A pilot feasibility study will also be conducted to determine if fMRI can be effectively administered to this population.

描述（由申请人提供）：胎儿酒精综合征（FAS）是由孕产妇饮酒引起的永久性先天缺陷综合征。 FA的特征是生长不足，独特的面部表型和中枢神经系统（CNS）功能障碍。认知/行为问题这种情况源于产前有机脑损伤。并非所有人随着产前酒精暴露遭受脑部损害，并不是所有遭受痛苦的人脑损伤具有FAS。患者的大脑损害程度产前酒精暴露可能因微细胞和神经化学而异总体结构异常的畸变。同样，认知/行为功能障碍差异很大。个体的致化身体发现 FAS对临床判断的认知能力表示认知和行为功能障碍部分归因于有机脑损伤。但是没有 FAS的物理特征或至少严重表达脑损伤，伤害常常无法诊断和未被诊断。该项目建议使用（磁共振光谱（MRS），磁共振成像（MM）和功能毫米（fMRI））确定是否有产前酒精暴露的儿童没有FA，他们沿着轻度至重度中心的完整连续体呈现功能障碍，有无可辩驳的证据表明有机脑损伤的形式化学和结构改变。产前的夫人试点研究酒精暴露的猴子患有中度中枢神经系统功能障碍发现水平大脑中的胆碱/肌酸是细胞膜破裂的标志物，与增加酒精暴露并增加神经心理功能障碍。一个 FAS儿童的Pilot夫人研究还表明胆碱/肌酸随着神经心理功能障碍的增加而增加。这些发现是与有机脑损伤的个体的MRS结局一致与其他疾病状态相关。少数人的MRI研究与FAS和酒精暴露的猴子中的中等中枢神经系统功能障碍证明选定的大脑区域的显着尺寸改变。一起，这些研究证明了mm/s的效用和灵敏度了解酒精致畸作用。神经心理功能障碍将是使用心理测量产生的全球障碍指数测量措施与通过离散，临床意义的实验措施先前文献表明的大脑区域提供的认知能力可能受到酒精畸胎发生的影响。飞行员可行性研究也将是进行以确定是否可以有效地给予fMRI 人口。