Julie A Kable1,2, Claire D Coles1,2, Kenneth L Jones3,4, Lyubov Yevtushok5,6,7, Yaroslav Kulikovsky5,6, Natalya Zymak-Zakutnya5,8, Iryna Dubchak5,8, Diana Akhmedzhanova5,8, Wladimir Wertelecki3,5, Christina D Chambers3,4. 1. From the Department of Psychiatry and Behavioral Science (JAK, CDC), Emory University School of Medicine, Atlanta, Georgia, USA. 2. Department of and Pediatrics (JAK, CDC), Emory University School of Medicine, Atlanta, Georgia, USA. 3. Department of Pediatrics (KLJ, WW, ChDC), University of California San Diego, La Jolla, California, USA. 4. Department of Family Medicine and Public Health (KLJ, ChDC), University of California San Diego, La Jolla, California, USA. 5. OMNI-Net Ukraine Birth Defects Program (LY, YK, NZ-Z, ID, DA, WW), Rivne, Ukraine. 6. Rivne Regional Medical Diagnostic Center (LY, YK), Rivne, Ukraine. 7. Lviv National Medical University (LY), Lviv, Ukraine. 8. Khmelnytsky Perinatal Center (NZ-Z, ID, DA), Khmelnytsky, Ukraine.
Abstract
BACKGROUND: Prenatal alcohol exposure (PAE) has been identified as one of the leading preventable causes of developmental disabilities, but early identification of those impacted has been challenging. This study evaluated the use of infant cardiac orienting responses (CORs), which assess neurophysiological encoding of environmental events and are sensitive to the impact of PAE, to predict later fetal alcohol spectrum disorder (FASD) status. METHODS: Mother-infant dyads from Ukraine were recruited during pregnancy based on the mother's use of alcohol. Participants (n = 120) were then seen at 6 and 12 months when CORs were collected and in the preschool period when they were categorized as having (i) fetal alcohol syndrome (FAS), (ii) partial FAS (pFAS), (iii) alcohol-related neurodevelopmental disorder (ARND), (iv) PAE and no diagnosis, or (v) no PAE and no diagnosis. To assess CORs, stimuli (auditory tones and pictures) were presented using a fixed-trial habituation/dishabituation paradigm. Heart rate (HR) responses were aggregated across the first 3 habituation and dishabituation trials and converted to z-scores relative to the sample's mean response at each second by stimuli. Z-scores greater than 1 were then counted by condition (habituation or dishabituation) to compute a total risk index. RESULTS: Significant group differences were found on total deviation scores of the CORs elicited from visual but not auditory stimuli. Those categorized as pFAS/FAS had significantly higher total deviation scores than did those categorized as ARND or as having no alcohol-related diagnosis with or without a history of PAE. Receiver operating characteristic curve analysis of the visual response yielded an area under the curve value of 0.765 for predicting to pFAS/FAS status. CONCLUSIONS: A score reflecting total deviation from typical HR during CORs elicited using visual stimuli in infancy may be useful in identifying individuals who need early intervention as a result of their PAE.
BACKGROUND: Prenatal alcohol exposure (PAE) has been identified as one of the leading preventable causes of developmental disabilities, but early identification of those impacted has been challenging. This study evaluated the use of infant cardiac orienting responses (CORs), which assess neurophysiological encoding of environmental events and are sensitive to the impact of PAE, to predict later fetal alcohol spectrum disorder (FASD) status. METHODS: Mother-infant dyads from Ukraine were recruited during pregnancy based on the mother's use of alcohol. Participants (n = 120) were then seen at 6 and 12 months when CORs were collected and in the preschool period when they were categorized as having (i) fetal alcohol syndrome (FAS), (ii) partial FAS (pFAS), (iii) alcohol-related neurodevelopmental disorder (ARND), (iv) PAE and no diagnosis, or (v) no PAE and no diagnosis. To assess CORs, stimuli (auditory tones and pictures) were presented using a fixed-trial habituation/dishabituation paradigm. Heart rate (HR) responses were aggregated across the first 3 habituation and dishabituation trials and converted to z-scores relative to the sample's mean response at each second by stimuli. Z-scores greater than 1 were then counted by condition (habituation or dishabituation) to compute a total risk index. RESULTS: Significant group differences were found on total deviation scores of the CORs elicited from visual but not auditory stimuli. Those categorized as pFAS/FAS had significantly higher total deviation scores than did those categorized as ARND or as having no alcohol-related diagnosis with or without a history of PAE. Receiver operating characteristic curve analysis of the visual response yielded an area under the curve value of 0.765 for predicting to pFAS/FAS status. CONCLUSIONS: A score reflecting total deviation from typical HR during CORs elicited using visual stimuli in infancy may be useful in identifying individuals who need early intervention as a result of their PAE.
Authors: Eric W Fish; Laura B Murdaugh; Kathleen K Sulik; Kevin P Williams; Scott E Parnell Journal: Birth Defects Res Date: 2017-05-15 Impact factor: 2.344
Authors: H Eugene Hoyme; Wendy O Kalberg; Amy J Elliott; Jason Blankenship; David Buckley; Anna-Susan Marais; Melanie A Manning; Luther K Robinson; Margaret P Adam; Omar Abdul-Rahman; Tamison Jewett; Claire D Coles; Christina Chambers; Kenneth L Jones; Colleen M Adnams; Prachi E Shah; Edward P Riley; Michael E Charness; Kenneth R Warren; Philip A May Journal: Pediatrics Date: 2016-07-27 Impact factor: 7.124