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      Functional magnetic resonance imaging outcomes from a comprehensive magnetic resonance study of children with fetal alcohol spectrum disorders

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          Abstract

          A comprehensive neuropsychological/psychiatric, MR imaging, (MRI), MR spectroscopy (MRS), and functional MRI (fMRI) assessment was administered to children with fetal alcohol spectrum disorders (FASD) to determine if global and/or focal abnormalities could be identified, and distinguish diagnostic subclassifications across the spectrum. The four study groups included: 1. FAS/Partial FAS; 2. Static Encephalopathy/Alcohol Exposed (SE/AE); 3. Neurobehavioral Disorder/Alcohol Exposed (ND/AE); and 4. healthy peers with no prenatal alcohol exposure. fMRI outcomes are reported here. The neuropsychological/psychiatric, MRI, and MRS outcomes are reported separately. fMRI was used to assess activation in seven brain regions during performance of N-back working memory tasks. Children across the full spectrum of FASD exhibited significant working memory deficits and altered activation patterns in brain regions that are known to be involved in working memory. These results demonstrate the potential research and diagnostic value of this non-invasive MR tool in the field of FASD.

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          Storage and executive processes in the frontal lobes.

          The human frontal cortex helps mediate working memory, a system that is used for temporary storage and manipulation of information and that is involved in many higher cognitive functions. Working memory includes two components: short-term storage (on the order of seconds) and executive processes that operate on the contents of storage. Recently, these two components have been investigated in functional neuroimaging studies. Studies of storage indicate that different frontal regions are activated for different kinds of information: storage for verbal materials activates Broca's area and left-hemisphere supplementary and premotor areas; storage of spatial information activates the right-hemisphere premotor cortex; and storage of object information activates other areas of the prefrontal cortex. Two of the fundamental executive processes are selective attention and task management. Both processes activate the anterior cingulate and dorsolateral prefrontal cortex.
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            Errors and error correction in choice-response tasks.

            P. RABBITT (1966)
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              Fetal alcohol spectrum disorder: Canadian guidelines for diagnosis.

              The diagnosis of fetal alcohol spectrum disorder (FASD) is complex and guidelines are warranted. A subcommittee of the Public Health Agency of Canada's National Advisory Committee on Fetal Alcohol Spectrum Disorder reviewed, analysed and integrated current approaches to diagnosis to reach agreement on a standard in Canada. The purpose of this paper is to review and clarify the use of current diagnostic systems and make recommendations on their application for diagnosis of FASD-related disabilities in people of all ages. The guidelines are based on widespread consultation of expert practitioners and partners in the field. The guidelines have been organized into 7 categories: screening and referral; the physical examination and differential diagnosis; the neurobehavioural assessment; and treatment and follow-up; maternal alcohol history in pregnancy; diagnostic criteria for fetal alcohol syndrome (FAS), partial FAS and alcohol-related neurodevelopmental disorder; and harmonization of Institute of Medicine and 4-Digit Diagnostic Code approaches. The diagnosis requires a comprehensive history and physical and neurobehavioural assessments; a multidisciplinary approach is necessary. These are the first Canadian guidelines for the diagnosis of FAS and its related disabilities, developed by broad-based consultation among experts in diagnosis.
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                Author and article information

                Contributors
                +1-206-5980555 , +1-20-5987815 , astley@u.washington.edu
                Journal
                J Neurodev Disord
                Journal of neurodevelopmental disorders
                Springer US (Boston )
                1866-1947
                1866-1955
                12 March 2009
                March 2009
                : 1
                : 1
                : 61-80
                Affiliations
                [1 ]Department of Epidemiology, Center on Human Development and Disability, University of Washington, Box 357920, Seattle, WA 98195-7920 USA
                [2 ]Department of Radiology, University of Washington, Seattle, WA 98195 USA
                [3 ]Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98195 USA
                [4 ]Department of Psychology, University of Victoria, Victoria, BC V8P 5C2 Canada
                [5 ]Department of Speech and Hearing Sciences, University of Washington, Seattle, WA 98195 USA
                [6 ]Department of Pediatrics, University of Washington, Seattle, WA 98195 USA
                [7 ]Department of Rehabilitation Medicine, University of Washington, Seattle, WA 98195 USA
                Article
                9004
                10.1007/s11689-009-9004-0
                3164017
                21547622
                daf94432-485e-4488-beea-452cab0fe231
                © Springer Science+Business Media, LLC 2009
                History
                : 20 August 2008
                : 23 January 2009
                Categories
                Article
                Custom metadata
                © Springer Science+Business Media, LLC 2009

                Neurosciences
                fasd 4-digit diagnostic code,n-back,functional magnetic resonance imaging (fmri),fetal alcohol spectrum disorder (fasd),working memory

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