胎儿酒精谱系障碍的神经发育特征：系统评价。
Neurodevelopmental profile of Fetal Alcohol Spectrum Disorder: A systematic review.
机构信息
Institute for Mental Health Policy Research, Centre for Addiction and Mental Health , Toronto, ON, Canada.
Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
出版信息
BMC Psychol. 2017 Jun 23;5(1):22. doi: 10.1186/s40359-017-0191-2.
BACKGROUND
In an effort to improve the screening and diagnosis of individuals with Fetal Alcohol Spectrum Disorder (FASD), research has focused on the identification of a unique neurodevelopmental profile characteristic of this population. The objective of this review was to identify any existing neurodevelopmental profiles of FASD and review their classification function in order to identify gaps and limitations of the current literature.
METHODS
A systematic search for studies published up to the end of December 2016 reporting an identified neurodevelopmental profile of FASD was conducted using multiple electronic bibliographic databases. The search was not limited geographically or by language of publication. Original research published in a peer-reviewed journal that involved the evaluation of the classification function of an identified neurodevelopmental profile of FASD was included.
RESULTS
Two approaches have been taken to determine the pathognomonic neurodevelopmental features of FASD, namely the utilization of i) behavioral observations/ratings by parents/caregivers and ii) subtest scores from standardized test batteries assessing a variety of neurodevelopmental domains. Both approaches show some promise, with the former approach (which is dominated by research on the Neurobehavioral Screening Tool) having good sensitivity (63% to 98%), but varying specificity (42% to 100%), and the latter approach having good specificity (72% to 96%), but varying sensitivity (60% to 88%).
CONCLUSIONS
The current review revealed that research in this area remains limited and a definitive neurodevelopmental profile of FASD has not been established. However, the identification of a neurodevelopmental profile will aid in the accurate identification of individuals with FASD, by adding to the armamentarium of clinicians. The full review protocol is available in PROSPERO ( http://www.crd.york.ac.uk/PROSPERO/ ); registration number CRD42016039326; registered 20 May 2016.
背景
为了提高胎儿酒精谱系障碍（FASD）个体的筛查和诊断水平，研究人员专注于确定该人群特有的独特神经发育特征。本综述的目的是确定现有的 FASD 神经发育特征，并对其分类功能进行综述，以确定当前文献的差距和局限性。
方法
通过使用多个电子书目数据库，对截至 2016 年 12 月底发表的报告 FASD 已确定神经发育特征的研究进行了系统检索。检索范围不限于地理位置或出版语言。纳入了同行评议期刊上发表的原始研究，这些研究涉及对 FASD 已确定神经发育特征的分类功能进行评估。
结果
已经采取了两种方法来确定 FASD 的特征性神经发育特征，即：（i）父母/照顾者的行为观察/评分和（ii）用于评估各种神经发育领域的标准化测试组合的分测验分数。这两种方法都显示出一定的前景，前者方法（主要是基于神经行为筛查工具的研究）具有较高的敏感性（63%至 98%），但特异性差异较大（42%至 100%），后者方法具有较高的特异性（72%至 96%），但敏感性差异较大（60%至 88%）。
结论
本综述显示，该领域的研究仍然有限，尚未确定明确的 FASD 神经发育特征。然而，确定神经发育特征将有助于临床医生增加识别 FASD 个体的准确性。完整的综述方案可在 PROSPERO（http://www.crd.york.ac.uk/PROSPERO/）中获取；注册编号 CRD42016039326；注册于 2016 年 5 月 20 日。
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