Division of Neonatology, Department of Pediatrics, The Children's Hospital of Philadelphia, PA, USA.
Neurotoxicol Teratol. 2011 Jan-Feb;33(1):36-46. doi: 10.1016/j.ntt.2010.08.004.
Preclinical studies of gestational cocaine exposure (GCE) show evidence of changes in brain function at the anatomical, physiological, and behavioral levels, to include effects on developing dopaminergic systems. In contrast, human studies have produced less consistent results, with most showing small effects or no effects on developmental outcomes. Important changes in brain structure and function occur through adolescence, therefore it is possible that prenatal cocaine exposure has latent effects on neurocognitive (NC) outcome that do not manifest until adolescence or young adulthood. We examined NC function using a set of 5 tasks designed to tap 4 different systems: inhibitory control, working memory, receptive language, and incidental memory. For each NC task, data were collected longitudinally at ages 12, 14.5 and 17 years and examined using generalized estimating equations. One hundred and nine children completed at least two of the three evaluations. Covariates included in the final model were assessment number, gender, participant age at first assessment, caregiver depression, and two composites from the Home Observation for Measurement of the Environment (HOME), Environmental Stimulation and Parental Nurturance. We found no cocaine effects on inhibitory control, working memory, or receptive language (p=0.18). GCE effects were observed on incidental face memory task (p=0.055), and GCE by assessment number interaction effects were seen on the incidental word memory task (p=0.031). Participant performance on inhibitory control, working memory, and receptive language tasks improved over time. HOME Environmental Stimulation composite was associated with better receptive language functioning. With a larger sample size smaller differences between groups may have been detected. This report shows no evidence of latent effects of GCE on inhibitory control, working memory, or receptive language. GCE effects were observed on the incidental face memory task, and GCE by assessment number interaction effects was seen on the incidental word memory task.
产前可卡因暴露（GCE）的临床前研究表明，在解剖学、生理学和行为学水平上存在大脑功能的变化，包括对发育中的多巴胺能系统的影响。相比之下，人类研究的结果则不太一致，大多数研究显示对发育结果的影响较小或没有影响。大脑结构和功能的重要变化发生在青春期，因此，产前可卡因暴露可能对神经认知（NC）结果产生潜在影响，直到青春期或成年早期才会显现。我们使用一组旨在探索 4 个不同系统的 5 项任务来检查 NC 功能：抑制控制、工作记忆、接受性语言和偶然记忆。对于每个 NC 任务，数据在 12、14.5 和 17 岁时进行纵向收集，并使用广义估计方程进行分析。有 109 名儿童至少完成了三次评估中的两次。最终模型中的协变量包括评估次数、性别、参与者首次评估时的年龄、照顾者抑郁以及家庭观察评估环境（HOME）的两个综合指标，环境刺激和父母养育。我们没有发现可卡因对抑制控制、工作记忆或接受性语言有影响（p=0.18）。在偶然面孔记忆任务上观察到 GCE 效应（p=0.055），在偶然单词记忆任务上观察到 GCE 与评估次数的交互效应（p=0.031）。参与者在抑制控制、工作记忆和接受性语言任务上的表现随时间推移而提高。HOME 环境刺激综合指标与更好的接受性语言功能相关。如果样本量更大，可能会检测到更小的组间差异。本报告没有证据表明 GCE 对抑制控制、工作记忆或接受性语言有潜在影响。在偶然面孔记忆任务上观察到 GCE 效应，在偶然单词记忆任务上观察到 GCE 与评估次数的交互效应。
