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Advances in Diagnosis and Treatment of Fetal Alcohol Spectrum Disorders: From Animal Models to Human Studies.

Murawski NJ, Moore EM, Thomas JD, Riley EP - Alcohol Res (2015)

Bottom Line: Diagnosing FASD continues to be a challenge, but advances are being made at both basic science and clinical levels.However, combining interventions may prove more efficacious.Ultimately, advances in basic and clinical sciences may translate to clinical care, improving both diagnosis and treatment.

View Article: PubMed Central - PubMed

Affiliation: Center for Behavioral Teratology, San Diego State University, San Diego, California.

ABSTRACT
Prenatal alcohol exposure can cause a number of physical, behavioral, cognitive, and neural impairments, collectively known as fetal alcohol spectrum disorders (FASD). This article examines basic research that has been or could be translated into practical applications for the diagnosis or treatment of FASD. Diagnosing FASD continues to be a challenge, but advances are being made at both basic science and clinical levels. These include identification of biomarkers, recognition of subtle facial characteristics of exposure, and examination of the relation between face, brain, and behavior. Basic research also is pointing toward potential new interventions for FASD involving pharmacotherapies, nutritional therapies, and exercise interventions. Although researchers have assessed the majority of these treatments in animal models of FASD, a limited number of recent clinical studies exist. An assessment of this literature suggests that targeted interventions can improve some impairments resulting from developmental alcohol exposure. However, combining interventions may prove more efficacious. Ultimately, advances in basic and clinical sciences may translate to clinical care, improving both diagnosis and treatment.

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Related in: MedlinePlus

Craniofacial anomalies associated with alcohol exposure during development. (A) An illustration of a child with facial features of fetal alcohol syndrome (FAS). (B) Left figure shows a mouse with gestational day 7 alcohol exposure: Note small head, small eyes, and lack of a cleft under the nose compared with the control mouse on the right. (C) Zebrafish with embryonic alcohol exposure on the left compared with a control on the right. Again notice the small eyes, the smaller head, and the malformed body cavity and fin displacement resulting from alcohol exposure.SOURCE: Figure 1A: Warren et al. 2011.Photos in B are courtesy of Dr. Kathleen Sulik, University of North Carolina at Chapel Hill.Photos in C were taken from Marrs et al. 2010.
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f1-arcr-37-1-97: Craniofacial anomalies associated with alcohol exposure during development. (A) An illustration of a child with facial features of fetal alcohol syndrome (FAS). (B) Left figure shows a mouse with gestational day 7 alcohol exposure: Note small head, small eyes, and lack of a cleft under the nose compared with the control mouse on the right. (C) Zebrafish with embryonic alcohol exposure on the left compared with a control on the right. Again notice the small eyes, the smaller head, and the malformed body cavity and fin displacement resulting from alcohol exposure.SOURCE: Figure 1A: Warren et al. 2011.Photos in B are courtesy of Dr. Kathleen Sulik, University of North Carolina at Chapel Hill.Photos in C were taken from Marrs et al. 2010.

Mentions: To obtain an accurate estimate of FASD prevalence and provide early intervention for affected individuals, it is critical to identify infants prenatally exposed to alcohol. Identification is less problematic on the severe end of the spectrum—where fetal alcohol syndrome (FAS) lies—because it is characterized by obvious growth retardation, central nervous system (CNS) dysfunction, and a specific pattern of craniofacial anomalies (see figure 1A). However, many, if not the majority, of individuals affected by prenatal alcohol exposure do not meet criteria for FAS (Bertrand et al. 2005), yet have significant neurobehavioral impairments (Mattson et al. 2013). These cases are referred to as alcohol-related neurodevelopmental disorders (ARND) and are often difficult to identify because they lack the characteristic facial features and growth retardation seen in FAS. In fact, an ARND diagnosis requires confirmation of prenatal alcohol exposure, which often is unavailable or unreliable (see Riley et al. 2011 for a comparison of various diagnostic schemas for FAS and ARND). Finding novel ways to identify at-risk individuals for disabilities along the spectrum is critical, as is identifying effective interventions to mitigate these cognitive and behavioral effects.


Advances in Diagnosis and Treatment of Fetal Alcohol Spectrum Disorders: From Animal Models to Human Studies.

Murawski NJ, Moore EM, Thomas JD, Riley EP - Alcohol Res (2015)

Craniofacial anomalies associated with alcohol exposure during development. (A) An illustration of a child with facial features of fetal alcohol syndrome (FAS). (B) Left figure shows a mouse with gestational day 7 alcohol exposure: Note small head, small eyes, and lack of a cleft under the nose compared with the control mouse on the right. (C) Zebrafish with embryonic alcohol exposure on the left compared with a control on the right. Again notice the small eyes, the smaller head, and the malformed body cavity and fin displacement resulting from alcohol exposure.SOURCE: Figure 1A: Warren et al. 2011.Photos in B are courtesy of Dr. Kathleen Sulik, University of North Carolina at Chapel Hill.Photos in C were taken from Marrs et al. 2010.
© Copyright Policy - public-domain
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4476607&req=5

f1-arcr-37-1-97: Craniofacial anomalies associated with alcohol exposure during development. (A) An illustration of a child with facial features of fetal alcohol syndrome (FAS). (B) Left figure shows a mouse with gestational day 7 alcohol exposure: Note small head, small eyes, and lack of a cleft under the nose compared with the control mouse on the right. (C) Zebrafish with embryonic alcohol exposure on the left compared with a control on the right. Again notice the small eyes, the smaller head, and the malformed body cavity and fin displacement resulting from alcohol exposure.SOURCE: Figure 1A: Warren et al. 2011.Photos in B are courtesy of Dr. Kathleen Sulik, University of North Carolina at Chapel Hill.Photos in C were taken from Marrs et al. 2010.
Mentions: To obtain an accurate estimate of FASD prevalence and provide early intervention for affected individuals, it is critical to identify infants prenatally exposed to alcohol. Identification is less problematic on the severe end of the spectrum—where fetal alcohol syndrome (FAS) lies—because it is characterized by obvious growth retardation, central nervous system (CNS) dysfunction, and a specific pattern of craniofacial anomalies (see figure 1A). However, many, if not the majority, of individuals affected by prenatal alcohol exposure do not meet criteria for FAS (Bertrand et al. 2005), yet have significant neurobehavioral impairments (Mattson et al. 2013). These cases are referred to as alcohol-related neurodevelopmental disorders (ARND) and are often difficult to identify because they lack the characteristic facial features and growth retardation seen in FAS. In fact, an ARND diagnosis requires confirmation of prenatal alcohol exposure, which often is unavailable or unreliable (see Riley et al. 2011 for a comparison of various diagnostic schemas for FAS and ARND). Finding novel ways to identify at-risk individuals for disabilities along the spectrum is critical, as is identifying effective interventions to mitigate these cognitive and behavioral effects.

Bottom Line: Diagnosing FASD continues to be a challenge, but advances are being made at both basic science and clinical levels.However, combining interventions may prove more efficacious.Ultimately, advances in basic and clinical sciences may translate to clinical care, improving both diagnosis and treatment.

View Article: PubMed Central - PubMed

Affiliation: Center for Behavioral Teratology, San Diego State University, San Diego, California.

ABSTRACT
Prenatal alcohol exposure can cause a number of physical, behavioral, cognitive, and neural impairments, collectively known as fetal alcohol spectrum disorders (FASD). This article examines basic research that has been or could be translated into practical applications for the diagnosis or treatment of FASD. Diagnosing FASD continues to be a challenge, but advances are being made at both basic science and clinical levels. These include identification of biomarkers, recognition of subtle facial characteristics of exposure, and examination of the relation between face, brain, and behavior. Basic research also is pointing toward potential new interventions for FASD involving pharmacotherapies, nutritional therapies, and exercise interventions. Although researchers have assessed the majority of these treatments in animal models of FASD, a limited number of recent clinical studies exist. An assessment of this literature suggests that targeted interventions can improve some impairments resulting from developmental alcohol exposure. However, combining interventions may prove more efficacious. Ultimately, advances in basic and clinical sciences may translate to clinical care, improving both diagnosis and treatment.

Show MeSH
Related in: MedlinePlus