Academic journal article Alcohol Research

Teratogenic Effects of Alcohol on Brain and Behavior

Academic journal article Alcohol Research

Teratogenic Effects of Alcohol on Brain and Behavior

Article excerpt

Children prenatally exposed to alcohol can suffer from serious cognitive deficits and behavioral problems as well as from alcohol-related changes in brain structure. Neuropsychological studies have identified deficits in learning and memory as well as in executive functioning both in children with fetal alcohol syndrome and in children with less severe impairments. Both groups of children also exhibit problem behaviors, such as alcohol and drug use, hyperactivity, impulsivity, and poor socialization and communication skills. Brain imaging studies have identified structural changes in various brain regions of these children-including the basal ganglia, corpus callosum, cerebellum, and hippocampus-that may account for the cognitive deficits. Functional brain imaging studies also have detected changes in alcohol-exposed children indicative of deficits in information processing and memory tasks. KEY WORDS: fetal alcohol syndrome; prenatal alcohol exposure; teratogenesis; brain imaging; neuropsychological assessment; cognitive and memory disorder; basal ganglia; corpus callosum; cerebellum; hippocampus; electroencephalography; magnetic resonance imaging; positron emission tomography; single photon emission computed tomography

Prenatal alcohol exposure can have serious and permanent adverse effects on children. The extent and severity of a child's condition depends on several factors, such as how much alcohol the pregnant mother consumed and how often and at what point during her pregnancy she drank. The most serious outcome is fetal alcohol syndrome (FAS), the diagnosis of which is based on three criteria: (1) growth deficiency manifested by small overall height and small head size (i.e., microcephaly); (2) central nervous system disorders; and (3) a distinctive pattern of abnormal facial features. Other children with histories of heavy prenatal alcohol exposure, however, often do not meet the diagnostic criteria of FAS. These children, who typically lack the characteristic facial features of FAS, have variously been labeled as having fetal alcohol effects (FAE), alcohol-related neurodevelopmental disorder (ARND), or prenatal exposure to alcohol (PEA). Both children with FAS and those with related disorders can be born to women known to drink in a heavy episodic fashion or more regularly during pregnancy. For the remainder of this article, children with histories of prenatal alcohol exposure who do not meet the diagnostic criteria of FAS are referred to as either having FAE or PEA. When available, data from such children are noted; otherwise, the results presented in this article refer to children diagnosed with FAS.

Children with histories of heavy prenatal alcohol exposure show evidence of changes in brain structure and function as well as a variety of behavioral effects presumably resulting from this insult to the brain. Most of the research conducted among alcohol-exposed children and adolescents has focused on either the structural or behavioral effects. Only recently have studies begun to demonstrate the relationship between the two areas-that changes in brain structure could negatively affect behavior. This article summarizes the results of neuropsychological studies analyzing alcohol's teratogenic (i.e., damaging to the developing fetus) effects on behavior and of brain imaging studies analyzing alcohol's effects on brain structure. It then highlights the existing connections between those two areas of research. For more extensive coverage of these topics, the reader is referred to review articles by Mattson and Riley (1998) and Roebuck and colleagues (1998).

RESULTS FROM

NEUROPSYCHOLOGICAL

STUDIES

Generally, heavy prenatal alcohol exposure is associated with deficits in a wide range of areas of function, including both cognitive functioning (e.g., general intellectual functioning, learning of new verbal information, and performance on visual-spatial tasks) and fine- and gross-motor performance. …

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