THE CUMULATIVE RISK OF SUBSTANCE EXPOSURE AND EARLY LIFE ADVERSITY ON CHILD HEALTH DEVELOPMENT AND OUTCOMES

物质暴露和早期生活逆境对儿童健康发展和结果的累积风险

• 批准号: 9900281
• 负责人: James Blair
• 金额: $ 27.62万
• 依托单位: FATHER FLANAGAN'S BOYS' HOME
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-30 至 2021-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9900281
• 关键词: Address; Affect; Age; Alcohol or Other Drugs use; Alcohols; Analgesics; Area; Behavioral; Biological Markers; Biometry; Brain; Caring; Child; Child Abuse; Child Care; Child Development; Child Health; Child Support; Childhood; Cognitive; Cohort Studies; Communities; Complex; Conceptions; County; Data; Data Collection; Development; Developmental Process; Drug Exposure; Electroencephalography; Ensure; Environment; Environmental Exposure; Environmental Risk Factor; Epidemiology; Ethics; Exposure to; Family; Family Study; Family history of; Fentanyl; Foundations; Fright; Geographic state; Government Agencies; Growth; Health; Healthcare; Heroin; Human Characteristics; Individual; Infant; Intervention; Legal; Legal system; Logistics; Magnetic Resonance Imaging; Marijuana; Masks; Measurement; Measures; Medical History; Medicine; Mental Health; Modeling; Mothers; Nature; Neonatal Abstinence Syndrome; Neurocognitive; Newborn Infant; Opioid; Outcome; Parents; Participant; Pattern; Pharmaceutical Preparations; Phenotype; Population; Positioning Attribute; Pregnant Women; Process; Protocols documentation; Psychometrics; Public Health; Research; Risk; Rural; Schools; Series; Services; Statistical Models; Stimulus; Structure; Substance abuse problem; Support Groups; Support System; System; Techniques; Testing; Tobacco; Translating; Vision; Work; behavioral outcome; caregiving; child protective service; early life adversity; early life exposure; experience; fetal; fetal opioid exposure; imaging approach; in utero; innovation; interest; interpartner violence; low socioeconomic status; multimodality; myelination; neurodevelopment; neuroimaging; opioid epidemic; opioid exposure; opioid use; physical conditioning; recruit; relating to nervous system; response; skills; sociodemographics; statistics; study population; synaptogenesis

PROJECT SUMMARY/ABSTRACT How do in utero opioid exposure and early adversity affect a child's neurodevelopmental and health outcomes? The simplicity of this question masks the complex and multifaceted nature of human neurodevelopment, and the variety of environmental influences that can exacerbate or moderate the effects of in utero substance exposure. From conception to age 10, our brain undergoes remarkable structural and functional change. Processes including myelination and synaptogenesis are at their peak throughout this age span, contributing to the emergence of nearly all cognitive and behavioral skills, and responsive to both early substance exposures and environmental stimuli. In the context of fetal opioid exposure, this often co-occurs with other maternal substance use (alcohol, tobacco, marijuana), as well as related pre- and post-natal factors including maternal mental health concerns, supportive or adverse family environments, low socioeconomic status (SES), inter-partner violence, and caregiving quality and quantity. Despite increased efforts to understand the neurodevelopmental sequela of in utero opioid and other substance exposure on long-term behavioral, cognitive, and societal outcomes, important questions remain, specifically, 1. How brain growth is disrupted by fetal substance and related pre and post-natal exposures; and 2. How are these disrupted growth patterns causally related to later cognitive and behavioral outcomes? This proposal seeks to formulate our approach to addressing these key questions, and decipher the individual and cumulative effect of these intertwined pre- and post-natal exposures on child neurodevelopment. By bringing together leading experts in child development and adversity, pediatric neuroimaging, maternal, fetal, and child abuse medicine, longitudinal and functional statistics, and public health, strategically located US states and counties hardest hit by the current opioid crisis, we will articulate our vision of the larger HEALthy Brain & Child Development study, and lay the foundation for our participation in three incremental steps. First, we will address the legal, ethical, and mother-child care and support concerns implicit in this study by leveraging our team's past experience in family adversity, child abuse, and fetal substance exposure research. Next, we will integrate across our areas of neuroimaging expertise to develop, implement, and harmonize a multi-modal MRI and EEG protocol to assess maturing brain structure, function, and connectivity. This neuroimaging protocol will be paired with extensive neurocognitive, sociodemographic, physical health, family and medical history, anthropometric, and biospecimen data collection to quantify the individual, cumulative, and interactive effects of a child's substance and environment on their overall health and neurodevelopment. Finally, we will develop and test advanced statistical approaches to model and analyze this multidimensional and longitudinal data, taking into account the likely sparse and unbalanced nature of the measurements. Together, these steps lay the foundation for a broad and large-scale study to examine the impact of exposure to substances and early adversity on a child's neural, physical, and behavioral development.

项目概要/摘要 子宫内阿片类药物暴露和早期逆境如何影响儿童的神经发育和健康结果？ 这个问题的简单性掩盖了人类神经发育的复杂性和多面性， 各种环境影响可能会加剧或减轻子宫内物质暴露的影响。 从受孕到 10 岁，我们的大脑经历了显着的结构和功能变化。流程 包括髓鞘形成和突触发生在这个年龄段都处于高峰，有助于 几乎所有认知和行为技能的出现，并对早期物质暴露和 环境刺激。在胎儿阿片类药物暴露的情况下，这通常与其他母体物质同时发生 使用（酒精、烟草、大麻），以及相关的产前和产后因素，包括母亲的心理 健康问题、支持性或不利的家庭环境、低社会经济地位 (SES)、伴侣间 暴力以及护理的质量和数量。尽管人们越来越努力地了解神经发育 子宫内阿片类药物和其他物质暴露对长期行为、认知和社会的后遗症 就结果而言，重要的问题仍然存在，具体来说，1.胎儿的物质和物质如何扰乱大脑的生长？ 相关的产前和产后暴露； 2. 这些被破坏的增长模式与后来的增长有何因果关系？ 认知和行为结果？该提案旨在制定我们解决这些关键问题的方法 问题，并破译这些相互交织的产前和产后暴露的个体和累积效应 关于儿童神经发育。通过汇集儿童发展和逆境方面的领先专家，儿科 神经影像学、孕产妇、胎儿和儿童虐待医学、纵向和功能统计以及公共卫生， 在美国战略上受当前阿片类药物危机打击最严重的州和县，我们将阐明我们的愿景 更广泛的健康大脑与儿童发展研究，并为我们参与三项研究奠定基础 增量步骤。首先，我们将解决隐含的法律、道德和母婴护理和支持问题 在这项研究中，我们利用了我们团队过去在家庭逆境、虐待儿童和胎儿物质方面的经验 暴露研究。接下来，我们将整合我们的神经影像专业知识领域来开发、实施、 并协调多模态 MRI 和 EEG 协议来评估成熟的大脑结构、功能和 连接性。该神经影像学方案将与广泛的神经认知、社会人口学、 身体健康、家族和病史、人体测量和生物样本数据收集，以量化 儿童的物质和环境对其整体健康和健康的个体、累积和交互影响 神经发育。最后，我们将开发和测试先进的统计方法来建模和分析这一点 多维和纵向数据，考虑到数据可能稀疏和不平衡的性质 测量。总之，这些步骤为广泛和大规模的研究奠定了基础，以检验 接触物质和早期逆境对儿童神经、身体和行为发育的影响。