Fetal Alc Exposure Flashcards
What is the most prevalent drinking pattern during pregnancy?
only during first month
What is the second most prevalent drinking pattern during pregnancy?
drinking throughout pregnancy (typically due to SUD)
What is the third most prevalent drinking patterns prevalence?
starting to drink during 3rd trimester (often due to psychological stress or Dr. unknowingly saying its okay)
What is the iceberg idea with FASD?
As amount x frequency decreases, you move from directly observable issues (FAS/pFAS), to unseen functional damage (ARND)
How many people out of 1000 have FAS/pFAS?
1-7:1000
How many people out of 100 have ARND?
1-5:100
What are the 4 different fetal alcohol spectrum disorders?
- FAS- fetal alcohol syndrome
- pFAS- partial fetal alcohol syndrome
- ARBD- alcohol related birth defects
- ARND- alcohol related neurodevelopmental disorder
umbrella disorders!
When was FAS termed and by who?
1973 by Kenneth Jones and Ann Streissguth
When was FASD termed?
2004
What is the US monetary burden of FASD?
$4B/year
What is the prevalence of FASD as a whole?
1-5% although likely underestimate
DSM and FASD
- Called Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure
- In DSM-V (2013)
What are the three signs of FAS?
- Facial abnormalities
- Growth Retardation
- Brain Alterations
What are the facial characteristics of FAS?
- thin upper lip
- smooth philtrum
- small head
- underdeveloped jaw
- flat midface
- short eyelid opening
- short nose
- epicanthal folds
- low nasal bridge
What are neural crest cells?
Cells in communication with the developing brain that give rise to a lot of tissue in the body
Cranial Neural Crest Cells and FAS
- stem cells, many give rise to the face
- can see and track these individuals
When are cranial neural crest cells formed?
formation of these cells is first trimester
What are the neurobehavioral consequences of prenatal alcohol?
- learning, memory, and motor deficits
- ADHD/anxiety/depression
- social behavior problems
- increased risk for SUD
often individuals have several of these- why its considered a spectrum
What NTs are altered due to prenatal alc exposure?
- 5-HT, dopamine
- Glutamate, GABA
- Opioid
- Acetylcholine
- etc.
What parts of the brain are affected due to fetal alcohol exposure?
- cerebral cortex
- striatum
- hippocampus
- cerebellum
- brain stem
- dopaminergic system
- hypothalamus
reflects the idea that alc is a dirty drug
What happens to the corpus callosum in FAS brain?
very different shape/size
How does the cerebellum appear in someone with FAS?
- more gaps
- smaller
cerebellum involved in cognitive function
How are ventricles different in someone with FAS?
much larger due to brain matter loss
What are the other known effects of prenatal alcohol?
- Impaired LTP and neurogenesis (inc stem cells)
- epigenetic changes (alterations in gene expression that can be passed down)
- Affected neuronal migration leading to disorganized brain structure
- white matter deficits (less myelin=info transferred at wrong speed)
What is the typical FASD treatment and what’s wrong with it?
- Anxiolytics, antidepressents, and stimulants
- Not great bc many drug interactions and can increase risk of drug misuse
What foods contain choline?
salmon, eggs, nuts, chicken, beef, broccoli
What is choline?
precursor to acetylcholine
Why is choline supplementation an idea for helping FASD?
- hypothesized that choline deficiency may contribute to effects of prenatal alc exposure
- lots of promise in animal models+ in human preliminary studies if given during pregnancy
Behavioral therapies for FASD
- works best when started early; however, difficult to diagnose unless confirmed exposure
- in animal models, exercise and environmental enrichment helps
- in humans, CBT and social skills intervention are used
