Neurodevelopmental Outcomes Associated with Prefrontal Cortical Deoxygenation in Children with Fetal Alcohol Spectrum Disorders

“The pad contained a reusable, flexible circuit board that contained the aDiagnostic Interview Schedule for Children (DISC (Shaffer et al., 2000)); bMet criteria for an Attention-Deficit Hyperactivity Disorder; cMet criteria for an Oppositional-Defiant Disorder on the DISC; dMet criteria for a…”

“Since the original publication on Fetal Alcohol Syndrome (Jones & Smith, 1973), over 45 years have elapsed during which human and animal models have been used to identify the range of symptoms and explore the mechanisms by which PAE adversely impacts fetal development.”

“Functional near-infrared spectroscopy is an alternative to traditional neuroimaging methods that can be used to assess functional activity in the PFC (Ferrari & Quaresima, 2012).”

“Although many resources have been directed to preventing PAE, conservative estimates of the prevalence of FASDs have ranged from 1% to 5.0% (May et al., 2018) and difficulties with identifying these individuals persist (Chasnoff, Wells, & King, 2015).”

“…errors on learning tasks (McGee, Schonfeld, Roebuck-Spencer, Riley, & Mattson, 2008), having difficulty making reversal shifts while learning (Coles et al., 1997; Green et al., 2009), impairments in verbal fluency (Vaurio, Riley, & Mattson, 2008), and inhibiting impulses (Kodituwakku et al.,…”

“In our previous work (Kable & Coles, 2017), HBR levels in the Win condition generated the strongest group differences for the PAE group relative to the other two groups of children so it is not surprising that in this larger sample these responses have stronger relationships with an EF outcome commonly found to be imp…”

“, 2018) or being misclassified (Chasnoff et al., 2015) and is of concern given that there is evidence of differential treatment responsiveness (Kable et al.”

“…of children with FASD, fNIRS has the potential of being used as a tool for evaluating both psychiatric medications and behavioral interventions (Ehlis et al., 2014) to improve their habilitative care as a result of its relatively low cost and ease of use relative to other traditional…”

“Aggregation of the data across optodes may have minimized the impact of head circumference size as has been reported in other studies (Haeussinger et al., 2011; Whiteman et al., 2018).”

“These problems manifest in several ways in everyday functioning, including incorporating feedback to correct a response (Green et al., 2009), making errors on learning tasks (McGee, Schonfeld, Roebuck-Spencer, Riley, & Mattson, 2008), having difficulty making reversal shifts while learning (Coles…”

“Source-detector separation was 2.5 cm (Ayaz et al., 2011).”

“Although HBR levels in the Medial PFC, an area known to be linked to reward processing (May et al., 2004) and self-monitoring (Davidson, Fox, & Kalin, 2007), may be linked to externalizing behaviors and cognitive inhibition deficits, these relationships do not appear to be unique characteristics to prenatal alcohol te…”

“Behavioral and emotional control problems also are often reported by caregivers of children with FASD (Floyd, Weber, Denny, & O’Connor, 2009; Mattson & Riley, 2000).”

“An algorithm, the Sliding-window Motion Artifact Rejection (SMAR) (Ayaz et al., 2010, 2011), was then applied to remove motion artifacts in the signal with a window size of 10.”

“Such skills have been found to differentiate children with PAE from both typically developing children and those with other clinical conditions (Mattson et al., 2013).”

“EF executive functioning HBO oxygenated hemoglobin HBR deoxygenated hemoglobin PAE prenatal alcohol exposure PFC prefrontal cortex FASDs fetal alcohol spectrum disorders fNIRs functional near-infrared spectroscopy MBLL modified Beer-Lambert Law ADHD attention-deficit hyperactivity disorder LEDS light-emitting diodes C…”

“In our previous work (Kable & Coles, 2017), HBR levels in the Win condition generated the strongest group differences for the PAE group relative to the other two groups of children so it is not surprising that in this larger sample these responses have stronger relationships with an EF outcome commonly found to be imp…”

“Children with a history of PAE have an array of neurodevelopmental symptoms (Kable et al., 2016), including deficits in a cluster of EF skills known as executive functions (EF).”

“Criteria for the prenatal alcohol-exposed (PAE) group (n = 33) was having a history of heavy PAE (>4 drinks/occasion or >13 drinks/week during pregnancy) or when such exposure was suspected in a child with a clinical FASD diagnosis using the Emory diagnostic classification (Coles et al., 2016).”

“The infrared light used in fNIRS is only capable of being absorbed and appropriately reflecting back within a limited range into the cortex and therefore can only provide estimates of changes in blood oxygenation observed at the cortical surface level (Vanderwert & Nelson, 2014).”

“Validation studies comparing fNIRS and fMRI find good agreement between these methods (Amyot et al., 2012; Heinzel et al., 2013).”

“, 2009) and the connectivity of the PFC to other brain regions (Wozniak et al., 2013) are adversely impacted by PAE and this may play a critical role in the expression of the commonly observed neurodevelopmental impairments.”

“We are particularly interested in the changes in HBR levels of the PFC during emotional arousal as these changes seemed to be pervasive across the PFC and may be indicative of disruption to angiogenesis that has been associated with PAE in animal models, including reduced vascular tissue and disrupted organization of…”

“Children with FASD have historically been found to struggle with tasks that require cognitive inhibition (Connor, Sampson, Bookstein, Barr, & Streissguth, 2000; Ware et al., 2012) and deficits in this area have been linked to alterations in brain structure (Migliorini et al., 2015).”

“Evidence suggests that the prefrontal cortex (PFC) (O’Hare et al., 2009) and the connectivity of the PFC to other brain regions (Wozniak et al.”

“…related to measures of behavioral functioning (Perlman, Luna, Hein, & Huppert, 2014), to be sensitive to the impact of pharmacological intervention (Monden et al., 2012), and has been recommended as a promising tool for improving our understanding of neuropsychiatric disorders (Ehlis, Schneider,…”

“These tasks has been found to differentiate neuropsychological impairments found in children with FASDs (Rasmussen et al., 2013).”

“, 2009), impairments in verbal fluency (Vaurio, Riley, & Mattson, 2008), and inhibiting impulses (Kodituwakku et al., 2006).”

“Indices of brain functioning obtained from fNIRS have been found to differentiate clinical groups (Ishii-Takahashi et al., 2014; Kable & Coles, 2017; Wiley & Riccio, 2014), to be related to measures of behavioral functioning (Perlman, Luna, Hein, & Huppert, 2014), to be sensitive to the impact of…”

“The Right Lateral PFC is an area of the brain linked to emotional and behavioral inhibition or suppression (Li, Grabell, Wakschlag, Huppert, & Perlman, 2017) and to the regulation of rule-breaking behavior (Possin et al., 2009).”

“Children with FASDs often have a reduced head circumference, which has been found to be correlated to the depth of the cortex (Whiteman et al., 2018), but head size was not found to be related to the aggregate measures of PFC functioning used in this study.”

“Validation studies comparing fNIRS and fMRI find good agreement between these methods (Amyot et al., 2012; Heinzel et al., 2013).”

“, 2008) and deficits in this area have been predictive of functional communication impairments in children with FASDs (Doyle et al., 2018).”

“Higher levels of HBR may reflect less neural activation as long as the HBO levels are the same or are reduced but may also reflect changes in the total blood volume content or ratio of HBO to HBR (Villringer, 1997).”

“Indices of brain functioning obtained from fNIRS have been found to differentiate clinical groups (Ishii-Takahashi et al., 2014; Kable & Coles, 2017; Wiley & Riccio, 2014), to be related to measures of behavioral functioning (Perlman, Luna, Hein, & Huppert, 2014), to be sensitive to the impact of…”

“Using a task that assessed sustained attention and cognitive inhibitory control, PAE children were found to have reduced PFC HBO and increased HBR relative to both other groups in the inhibitory condition, suggesting reduced neural activity but increased oxygen consumption and poor replenishment (Barrett et al., 2019).”

“…efficient and parsimonious regression procedure that allows for both simultaneous and separate tests of regression slopes and intercepts across groups (Watkins & Hetrick, 1999) within one analysis as opposed to running multiple comparisons of slopes derived from estimating each group independently.”

“Indices of brain functioning obtained from fNIRS have been found to differentiate clinical groups (Ishii-Takahashi et al., 2014; Kable & Coles, 2017; Wiley & Riccio, 2014), to be related to measures of behavioral functioning (Perlman, Luna, Hein, & Huppert, 2014), to be sensitive to the impact of…”

“There is a clear correlation of children with FAS and prefrontal executive functioning [316].”

“These executive function behaviors include decision-making and inhibitory control (Connor, Sampson, Bookstein, Barr, & Streissguth, 2000; Driscoll, Streissguth, & Riley, 1990; Kable et al., 2020; Sowell et al., 2001).”

“A study on children with prenatal alcohol exposure showed high levels of deoxyhemoglobin using fNIRS and observed that such children tend to have more developmental and behavioral problems than those with normal levels of deoxyhemoglobin (Kable et al., 2020).”

“Abnormal activation of prefrontal brain areas (Kable & Coles, 2017; Kable et al., 2020) and altered prefrontal network connectivity with parietal and temporal regions (Gómez et al., 2022; O’Hare et al., 2009; Ware et al., 2021) are likely candidates for the neurobiological basis for the executive…”

“…as a key site of PAE-related neural dysregulation (M. W. Miller 1986 ; Ferrer and Galofré 1987 ; E. K. Miller and Cohen 2001 ; Allan et al. 2014 ; Marquardt et al. 2014 , 2020 ; Hamilton and Brigman 2015 ; Skorput et al. 2015 ; Skorput and Yeh 2016 ; Öztürk et al. 2017 ; Kable et al. 2020 ).”

“W każdym z badań, w któ-rych oceniano impulsywność i hamowanie (Kable et al. , 2020; Kully-Martens et al. , 2012) oraz teorię umysłu (zdol-ność przyjmowania perspektywy innych osób, rozumienia ich sposobu myślenia i stanów emocjonalnych) (Lindinger et al. , 2016; Rasmussen et al. , 2009), stosowano…”