University of Minnesota Twin Cities, Minneapolis, MN, USA.
Department of Psychiatry, University of Minnesota, F282 / 2A West, 2450 Riverside Ave, Minneapolis, MN, 55454, USA.
J Neurodev Disord. 2020 Mar 12;12(1):9. doi: 10.1186/s11689-020-09312-7.
Despite the high prevalence of fetal alcohol spectrum disorder (FASD), there are few interventions targeting its core neurocognitive and behavioral deficits. FASD is often conceptualized as static and permanent, but interventions that capitalize on brain plasticity and critical developmental windows are emerging. We present a long-term follow-up study evaluating the neurodevelopmental effects of choline supplementation in children with FASD 4 years after an initial efficacy trial.
The initial study was a randomized, double-blind, placebo-controlled trial of choline vs. placebo in 2-5-year-olds with FASD. Participants include 31 children (16 placebo; 15 choline) seen 4 years after trial completion. The mean age at follow-up was 8.6 years. Diagnoses were 12.9% fetal alcohol syndrome (FAS), 41.9% partial FAS, and 45.1% alcohol-related neurodevelopmental disorder. The follow-up included measures of intelligence, memory, executive functioning, and behavior.
Children who received choline had higher non-verbal intelligence, higher visual-spatial skill, higher working memory ability, better verbal memory, and fewer behavioral symptoms of attention deficit hyperactivity disorder than the placebo group. No differences were seen for verbal intelligence, visual memory, or other executive functions.
These data support choline as a potential neurodevelopmental intervention for FASD and highlight the need for long-term follow-up to capture treatment effects on neurodevelopmental trajectories.
ClinicalTrials.Gov #NCT01149538; Registered: June 23, 2010; first enrollment July 2, 2010.
尽管胎儿酒精谱系障碍（FASD）的患病率很高，但针对其核心神经认知和行为缺陷的干预措施却很少。FASD 通常被认为是静态和永久性的，但利用大脑可塑性和关键发育窗口的干预措施正在出现。我们提出了一项长期随访研究，评估了在初始疗效试验 4 年后，胆碱补充对 FASD 儿童神经发育的影响。
最初的研究是一项针对 2-5 岁 FASD 儿童的胆碱与安慰剂的随机、双盲、安慰剂对照试验。参与者包括初始试验完成后 4 年接受随访的 31 名儿童（16 名安慰剂；15 名胆碱）。随访时的平均年龄为 8.6 岁。诊断为 12.9%的胎儿酒精综合征（FAS）、41.9%的部分 FAS 和 45.1%的酒精相关神经发育障碍。随访包括智力、记忆、执行功能和行为的测量。
接受胆碱的儿童的非言语智力较高、视觉空间技能较高、工作记忆能力较高、言语记忆较好、注意力缺陷多动障碍的行为症状较少，而安慰剂组则无差异。在言语智力、视觉记忆或其他执行功能方面未见差异。
这些数据支持胆碱作为 FASD 的潜在神经发育干预措施，并强调需要长期随访以捕捉治疗对神经发育轨迹的影响。
ClinicalTrials.Gov #NCT01149538；注册日期：2010 年 6 月 23 日；首次入组日期：2010 年 7 月 2 日。
