Choline Intervention in Children with Fetal Alcohol Spectrum Disorders

胎儿酒精谱系障碍儿童的胆碱干预

• 批准号: 8720636
• 负责人: Tanya T Nguyen
• 金额: $ 3.18万
• 依托单位: SAN DIEGO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-10 至 2016-09-09
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8720636
• 关键词: Adolescence; Adverse effects; Aftercare; Alcohol consumption; Alcohols; Animal Model; Animals; Area; Attention; Attention deficit hyperactivity disorder; Attenuated; Behavioral; Blinking; Brain; Brain Injuries; Child; Childhood; Choline; Clinical; Clinical Research; Clinical Trials; Cognitive; Cognitive deficits; Communities; Congenital Abnormality; Data; Development; Diagnosis; Dietary Intervention; Disease; Dysmorphology; Economic Burden; Effectiveness; Face; Family; Fetal Alcohol Exposure; Fetal Alcohol Spectrum Disorder; Fetus; Functional disorder; Goals; Hippocampus (Brain); Hyperactive behavior; Impaired cognition; Impairment; Individual; Intellectual functioning disability; Intervention; Learning; Length; Measures; Memory; Memory impairment; Movement; Names; Neurodevelopmental Disorder; Nutrient; Nutritional; Paired-Associate Learning; Pattern; Pattern Recognition; Placebo Control; Population; Prefrontal Cortex; Pregnancy; Prevalence; Prevention; Prevention Measures; Public Health; Research; Response Latencies; Risk; Sampling; School-Age Population; Schools; Severities; Short-Term Memory; Supplementation; System; Task Performances; Therapeutic; Time; Translating; Variant; Visuospatial; Woman; Work; adverse outcome; alcohol consumption during pregnancy; alcohol exposure; animal data; behavioral impairment; cognitive enhancement; cognitive function; conditioned fear; design; dietary supplements; early childhood; effective intervention; effective therapy; executive function; fetal; high risk; improved; interest; neuropsychological; object recognition; postnatal; pre-clinical; pre-clinical research; preclinical study; prenatal; prenatal exposure; response; selective attention; skills; social; treatment program; young adult

DESCRIPTION (provided by applicant): Prenatal alcohol exposure represents a major public health concern, resulting in a spectrum of disorders associated with a wide range of physical abnormalities, facial dysmorphology, and neuropsychological impairments. Alcohol's adverse effects on brain development and cognitive abilities are among the most devastating consequences. Prenatal exposure to alcohol is one of the leading preventable causes of birth defects, intellectual disability, and neurodevelopmental disorders. However, despite extensive public health warnings and prevention efforts, women continue to consume alcohol during pregnancy, particularly in patterns known to be of high risk to the developing fetus. The prevalence of fetal alcohol spectrum disorders (FASD) is estimated to be as high as 2-5% of young school children in the U.S., placing considerable social and economic burdens on the individual, families, and community. These significant ramifications call for the development of comprehensive treatment programs to ameliorate the adverse consequences of prenatal alcohol exposure. Choline, an essential nutrient, is critical for fetal brain development and studies have shown that early supplementation leads to long-lasting cognitive enhancement. Animal models of FASD have also revealed that choline supplementation can reduce the severity of alcohol-related cognitive impairments, even when given postnatally after alcohol damage has occurred. Given this preclinical evidence, the goal of the current proposal is to translate these findings toa clinical population and determine if choline can effectively reduce neuropsychological impairments in children with FASD. Currently, two clinical studies are examining the effects of prenatal choline supplementation in women drinking alcohol during pregnancy as well as early postnatal supplementation in young children. However, as many children with FASD are not diagnosed until they enter school, it is essential to examine treatment options that can be effective throughout middle and later childhood. Animal data suggest that choline may still be effective even when administered during this later period of development. Thus, this study will determine whether choline can improve cognitive functioning in school age children. The specific aims of the proposal are to investigate whether choline supplementation can reduce the severity of learning and memory, executive function, and attention deficits in children with FASD.

描述（由申请人提供）：产前酒精暴露是一个主要的公共卫生问题，会导致一系列与广泛的身体异常、面部畸形和神经心理损伤相关的疾病。酒精对大脑发育和认知能力的不利影响是最具破坏性的后果之一。产前接触酒精是导致出生缺陷、智力障碍和神经发育障碍的主要可预防原因之一。然而，尽管采取了广泛的公共卫生警告和预防措施，妇女在怀孕期间仍然继续饮酒，特别是已知对发育中的胎儿具有高风险的饮酒方式。据估计，美国学童中胎儿酒精谱系障碍 (FASD) 的患病率高达 2-5%，给个人、家庭和社区带来了相当大的社会和经济负担。这些重大影响要求制定综合治疗方案，以减轻产前酒精暴露的不良后果。胆碱是一种必需营养素，对胎儿大脑发育至关重要，研究表明，早期补充可带来持久的认知增强。 FASD 动物模型还表明，补充胆碱可以减轻与酒精相关的认知障碍的严重程度，即使是在出生后发生酒精损害后补充胆碱也是如此。鉴于这些临床前证据，当前提案的目标是将这些发现转化为临床人群，并确定胆碱是否可以有效减少 FASD 儿童的神经心理障碍。目前，两项临床研究正在研究产前补充胆碱对怀孕期间饮酒的女性以及产后早期补充胆碱对幼儿的影响。然而，由于许多患有 FASD 的儿童直到进入学校才被诊断出来，因此有必要检查在整个童年中期和后期有效的治疗方案。动物数据表明，即使在发育后期施用，胆碱可能仍然有效。因此，这项研究将确定胆碱是否可以改善学龄儿童的认知功能。该提案的具体目的是调查补充胆碱是否可以减轻 FASD 儿童的学习和记忆、执行功能和注意力缺陷的严重程度。