Nash Kelly, Stevens Sara, Clairman Hayyah, Rovet Joanne
Psychiatry Department, The Hospital for Sick Children, Toronto, ON M5G1X8, Canada.
Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON M4G1R8, Canada.
Brain Sci. 2017 Dec 28;8(1):7. doi: 10.3390/brainsci8010007.
Children with fetal alcohol spectrum disorder (FASD) exhibit behavioral dysregulation, executive dysfunction, and atypical function in associated brain regions. Previous research shows early intervention mitigates these outcomes but corresponding brain changes were not studied. Given the Alert Program for Self-Regulation improves behavioral regulation and executive function in children with FASD, we asked if this therapy also improves their neural functioning in associated regions. Twenty-one children with FASD aged 8-12 years were randomized to the Alert-treatment (TXT; = 10) or waitlist-control (WL; = 11) conditions. They were assessed with a Go-NoGo functional magnetic resonance imaging (fMRI) paradigm before and after training or the wait-out period. Groups initially performed equivalently and showed no fMRI differences. At post-test, TXT outperformed WL on NoGo trials while fMRI in uncorrected results with a small-volume correction showed less activation in prefrontal, temporal, and cingulate regions. Groups also demonstrated different patterns of change over time reflecting reduced signal at post-test in selective prefrontal and parietal regions in TXT and increased in WL. In light of previous evidence indicating TXT at post-test perform similar to non-exposed children on the Go-NoGo fMRI paradigm, our findings suggest Alert does improve functional integrity in the neural circuitry for behavioral regulation in children with FASD.
患有胎儿酒精谱系障碍(FASD)的儿童表现出行为失调、执行功能障碍以及相关脑区的功能异常。先前的研究表明早期干预可减轻这些后果,但相应的脑变化尚未得到研究。鉴于自我调节警觉计划可改善FASD儿童的行为调节和执行功能,我们询问这种疗法是否也能改善他们相关脑区的神经功能。21名年龄在8至12岁的FASD儿童被随机分为警觉治疗组(TXT;n = 10)或等待名单对照组(WL;n = 11)。在训练前后或等待期结束后,他们接受了一项停止信号功能磁共振成像(fMRI)范式评估。两组最初表现相当,fMRI结果无差异。在测试后,TXT组在停止信号试验中的表现优于WL组,而在未校正结果并进行小体积校正的fMRI显示,前额叶、颞叶和扣带区域的激活较少。两组还表现出不同的随时间变化模式,反映出TXT组在测试后选择性前额叶和顶叶区域的信号减少,而WL组增加。鉴于先前的证据表明,在停止信号fMRI范式中,测试后的TXT组表现与未接触该疗法的儿童相似,我们的研究结果表明,警觉计划确实能改善FASD儿童行为调节神经回路的功能完整性。