Source: Knee Surg Sports Traumatol Arthrosc  |  Posted 10 years ago

Brain structure and brain function are both affected by heavy prenatal exposure to alcohol.

Moreover, the effect of this exposure is not global in nature but apparently has an impact on certain areas more than others in both the neuropsychological and neuroanatomical arenas.

These are the conclusions of Sarah N Mattson and colleagues from the Center for Behavioral Teratology, San Diego State University (SDSU) and the SDSU/University of California-San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, United States.

Children with a history of heavy prenatal alcohol exposure show evidence of changes in brain structure and function as well as a range of behavioural effects, presumably resulting from this insult to the brain.

Until recently, most research among these children and adolescents has focused on either the structural or behavioural effects, suggests this review of the teratogenic effects of alcohol on brain and behaviour.

Now, increasingly, the focus is on the links between the two areas. Neuropsychological studies identify deficits in learning and memory as well as in executive functioning (higher level cognitive abilities).

This is true both in children with foetal alcohol syndrome, which is the most serious outcome of prenatal exposure, and in those with less severe impairments.

Both groups of children also exhibit problem behaviours, such as alcohol and other drug use, hyperactivity, impulsivity and poor socialisation and communication skills. However, neuropsychological and behavioural deficits are real-life, and indirect, manifestations of the effects of prenatal alcohol exposure.

The advent of numerous structural and functional brain imaging techniques allows researchers to study the living brains of alcohol-affected children and in a relatively non-invasive fashion.

These techniques include, for brain structure, magnetic resonance imaging and, for brain function, electroencephalography, positron emission tomography (PET) and single photon emissions computed tomography (SPECT).

Imaging studies have identified structural changes in various brain regions of these children - including basal ganglia, corpus callosum, cerebellum and hippocampus - that may account for cognitive deficits.

Functional imaging studies also have detected changes in alcohol-exposed children indicative of deficits in information processing and memory tasks.

Increased attention to the relationship between the neuropsychological and neuroanatomical data should provide a clearer picture of the strengths and weaknesses of these children and adolescents, this review suggests.

This, in turn, should allow both researchers and clinicians to develop more targeted and effective interventions, the authors conclude.