The synchrony study: A randomized controlled trial of music training for children with FASD

同步研究：针对 FASD 儿童的音乐训练的随机对照试验

基本信息

批准号：
10649003
负责人：
JULIA MARIE STEPHEN
金额：
$ 31.17万
依托单位：
LOVELACE BIOMEDICAL RESEARCH INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-08-05 至 2025-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10649003
关键词：
16 year old Academic skills Active Listening Address Adult Age Attention Auditory Auditory Perception Behavior Behavior Therapy Behavioral Blinded Brain Child Code Cognition Cognitive Complex Cross-Over Studies Crossover Design Diffusion Magnetic Resonance Imaging Disease Dose Educational Intervention Electroencephalography Environment Evidence based intervention Exhibits Family Fetal Alcohol Exposure Fetal Alcohol Spectrum Disorder Fetal alcohol effects Future High Prevalence Individual Intervention Lifestyle-related condition Longevity Magnetic Resonance Imaging Magnetoencephalography Measurable Measures Modeling Motor Motor Skills Music National Institute on Alcohol Abuse and Alcoholism Neuronal Plasticity Neuropsychology Outcome Outcome Assessment Outcome Measure Parents Participant Perception Performance Phase Pilot Projects Play Procedures Qualifying Quality of life Questionnaires Randomized Randomized, Controlled Trials Regulation Role Sampling Schools Sensory Short-Term Memory Strategic Planning Structure Structure of supramarginal gyrus Testing Time Training United States United States National Institutes of Health Visual Perception active control age effect age group auditory discrimination behavior measurement cognitive benefits cognitive function cognitive skill cognitive training efficacy evaluation emotion regulation executive function experience frontal lobe function improved improved outcome inattention indexing innovation instrument multidisciplinary multisensory neural neuroimaging neurophysiology primary outcome reduce symptoms response sensory integration skills sound trial comparing

项目摘要

Abstract Recent estimates indicate that, conservatively, up to 5% of children in the United States have sufficient behavioral and cognitive effects due to prenatal alcohol exposure that they qualify for a fetal alcohol spectrum disorder (FASD). Children with an FASD experience a range of effects, including deficits in sensory, motor, and executive functions, which are in turn related to poor long-term outcomes. However, few evidence-based interventions are available for children with an FASD and, of these, only two target academic or cognitive skills. Music training (MT) targets a complex array of skills including auditory and visual perception, multisensory integration, attention, and working memory. These MT targets align well with the deficits experienced by children with FASD and, therefore, MT may be well-suited for improving outcomes for these children. In this project, we hypothesize that MT improves brain function and targeted skills via improvement in predictive coding. The predictive coding framework posits that a primary role of the brain is to predict the environment and optimize outcomes through identifying and correcting prediction errors. MT provides direct practice of predictive coding when participants regularly produce sounds (environment) and adjust their behavior to correct any errors (fix incorrect notes/timing). We further posit that this bottom-up training will help optimize sensory, motor, and cognitive function relative to top-down strategies, leading to better outcomes. Our pilot MT intervention in children with an FASD provided exciting evidence for acceptance of MT by children and parents and for the occurrence of pre-/post-MT changes at the neural and behavioral level in children with MT vs. those without MT. In the R61 phase, we will conduct a randomized cross-over study of a 12-week MT intervention relative to a music listening (ML) control period in a larger sample to examine neurophysiological changes in predictive coding and behavioral effects due to MT in FASD in children 8-16 years of age. We will assess changes in 1) brain function using magnetoencephalography and electroencephalography, 2) brain structure using structural magnetic resonance imaging and diffusion tensor imaging, and 3) cognition and behavior using neuropsychological assessment and questionnaires at three time points (pre-trial (week 1), cross-over (week 13), and post-trial (week 28)). In the R33 phase, we will again implement a randomized cross-over design in 8-16 year-olds with an FASD to: a) compare MT effects relative to a cognitive training (CT) control and b) evaluate dose effects by comparing 12- vs. 24-weeks of intervention. We hypothesize that the bottom-up approach of MT, which improves sensory (auditory) and motor functioning, will lead to changes in brain connectivity, which in turn will improve cognitive functioning relative to the top- down approach of CT. We have assembled a strong multidisciplinary team to implement a music training intervention and assess the outcomes using objective neuroimaging, cognitive, and behavioral measures. Future studies will explore how MT can contribute to a strengths-based intervention approach for FASD.

抽象的最近的估计表明，保守地说，美国多达 5% 的儿童拥有足够的资源由于产前酒精暴露而导致的行为和认知影响，他们符合胎儿酒精谱精神障碍（FASD）。患有 FASD 的儿童会经历一系列影响，包括感觉、运动、和执行功能，而这又与不良的长期结果有关。然而，缺乏证据支持患有 FASD 的儿童可以采取干预措施，其中只有两项针对学业或认知技能。音乐训练（MT）针对一系列复杂的技能，包括听觉和视觉感知、多感官整合、注意力和工作记忆。这些 MT 目标与所经历的赤字非常吻合患有 FASD 的儿童，因此 MT 可能非常适合改善这些儿童的治疗结果。在这个项目中，我们假设 MT 通过提高预测能力来改善大脑功能和目标技能编码。预测编码框架假设大脑的主要作用是预测环境并通过识别和纠正预测错误来优化结果。 MT 提供直接练习当参与者定期发出声音（环境）并调整他们的行为以进行预测编码时纠正任何错误（修正不正确的音符/时间）。我们进一步认为这种自下而上的培训将有助于优化与自上而下的策略相关的感觉、运动和认知功能，可以带来更好的结果。我们对 FASD 儿童进行的试点 MT 干预为儿童接受 MT 提供了令人兴奋的证据儿童和父母以及 MT 前后神经和行为水平发生的变化患有 MT 的儿童与没有 MT 的儿童。在R61阶段，我们将进行一项随机交叉研究 12 周 MT 干预相对于音乐聆听 (ML) 控制期，在更大的样本中进行检查 MT 对 8-16 岁儿童 FASD 造成的预测编码和行为影响的神经生理学变化岁数。我们将使用脑磁图评估 1) 大脑功能的变化，以及脑电图，2）使用结构磁共振成像和扩散张量的大脑结构成像，3) 使用神经心理学评估和问卷调查进行三次认知和行为点（试验前（第 1 周）、交叉（第 13 周）和试验后（第 28 周））。在R33阶段，我们将再次在患有 FASD 的 8-16 岁儿童中实施随机交叉设计，以： a) 比较 MT 效应相对值 b) 通过比较 12 周与 24 周的干预来评估剂量效应。我们假设机器翻译的自下而上方法可以改善感觉（听觉）和运动功能，将导致大脑连接的变化，这反过来又会改善相对于顶级的认知功能 CT 向下接近。我们组建了一支强大的多学科团队来实施音乐培训使用客观的神经影像、认知和行为测量进行干预并评估结果。未来的研究将探讨机器翻译如何为 FASD 提供基于优势的干预方法。