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胎儿酒精谱系障碍患儿的神经认知特征

Neurocognitive profile in children with fetal alcohol spectrum disorders.

作者信息

Kodituwakku Piyadasa W

机构信息

Center for Development and Disability, University of New Mexico School of Medicine, Albuquerque, New Mexico 87107, USA.

出版信息

Dev Disabil Res Rev. 2009;15(3):218-24. doi: 10.1002/ddrr.73.

Abstract

The question of whether children with fetal alcohol spectrum disorders (FASD) exhibit a unique neurocognitive profile has received considerable attention over the past three decades. The identification of a syndrome-specific neurocognitive profile would aid in diagnosing prenatally exposed children with cognitive deficits who do not exhibit clinically discernable physical anomalies. The current review of the literature, therefore, focuses on the studies of higher-order cognitive skills in children with FASDs with a view towards delineating a pattern of cognitive functioning. Researchers have documented that children with FASDs show diminished intellectual functioning, with average IQ scores falling within the borderline to low average ranges. Slow information processing and disturbances of attention have been observed from infancy through adulthood in individuals with FASDs. Clinical and experimental reports on individuals with FASD have documented marked deficits in executive functioning, particularly in tasks that involve holding and manipulating information in working memory. Studies examining specific domains of cognitive functioning such as language, visual perception, memory and learning, social functioning, and number processing in individuals with FASDs have revealed performance decrements associated with increased task complexity. The above findings converge on the conclusion that children with FASDs have a generalized deficit in the processing and integration of information. We recommend the study of developmental trajectories of both elementary and higher-order functions in future research on FASD to elucidate the development of this cognitive profile.

摘要

在过去三十年里,胎儿酒精谱系障碍(FASD)患儿是否表现出独特的神经认知特征这一问题受到了广泛关注。确定一种特定综合征的神经认知特征将有助于诊断那些未表现出临床上可辨别的身体异常但有认知缺陷的产前暴露儿童。因此,当前对文献的综述聚焦于对FASD患儿高阶认知技能的研究,旨在勾勒出一种认知功能模式。研究人员已记录表明,FASD患儿的智力功能有所减退,平均智商分数处于临界至低平均范围。从婴儿期到成年期,在FASD个体中均观察到信息处理速度缓慢和注意力障碍。关于FASD个体的临床和实验报告已记录了执行功能方面的显著缺陷,尤其是在涉及在工作记忆中保存和处理信息的任务中。对FASD个体认知功能的特定领域,如语言、视觉感知、记忆与学习、社会功能以及数字处理等进行研究后发现,随着任务复杂性增加,其表现会下降。上述研究结果都指向一个结论,即FASD患儿在信息处理和整合方面存在普遍缺陷。我们建议在未来关于FASD的研究中对基本功能和高阶功能的发展轨迹进行研究,以阐明这种认知特征的发展情况。

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