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. 2017 Dec 28;8(1):7.
doi: 10.3390/brainsci8010007.

Preliminary Findings that a Targeted Intervention Leads to Altered Brain Function in Children with Fetal Alcohol Spectrum Disorder

Kelly Nash  1 , Sara Stevens  2   3 , Hayyah Clairman  4 , Joanne Rovet  5   6   7
Affiliations

Preliminary Findings that a Targeted Intervention Leads to Altered Brain Function in Children with Fetal Alcohol Spectrum Disorder

Kelly Nash et al. Brain Sci. .

Abstract

Children with fetal alcohol spectrum disorder (FASD) exhibit behavioral dysregulation, executive dysfunction, and atypical function in associated brain regions. Previous research shows early intervention mitigates these outcomes but corresponding brain changes were not studied. Given the Alert® Program for Self-Regulation improves behavioral regulation and executive function in children with FASD, we asked if this therapy also improves their neural functioning in associated regions. Twenty-one children with FASD aged 8-12 years were randomized to the Alert®-treatment (TXT; n = 10) or waitlist-control (WL; n = 11) conditions. They were assessed with a Go-NoGo functional magnetic resonance imaging (fMRI) paradigm before and after training or the wait-out period. Groups initially performed equivalently and showed no fMRI differences. At post-test, TXT outperformed WL on NoGo trials while fMRI in uncorrected results with a small-volume correction showed less activation in prefrontal, temporal, and cingulate regions. Groups also demonstrated different patterns of change over time reflecting reduced signal at post-test in selective prefrontal and parietal regions in TXT and increased in WL. In light of previous evidence indicating TXT at post-test perform similar to non-exposed children on the Go-NoGo fMRI paradigm, our findings suggest Alert® does improve functional integrity in the neural circuitry for behavioral regulation in children with FASD.

Keywords: Alert® Program for Self-Regulation; executive functioning; fMRI; fetal alcohol spectrum disorder; inhibitory control; neural correlates; self-regulation training.

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Conflict of interest statement

The authors declare no conflict of interest. The founding sponsors had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, and in the decision to publish the results.

Figures

Figure 1
Figure 1
Go-NoGo Task Stimuli. Instructions were to press for all moles and not press for vegetables. Stimuli were presented for 250 ms with a jittered interstimulus index ISI averaging 1250 ms (range = 970–1530 ms).
Figure 2
Figure 2
Mean NoGo accuracy at pre-test and post-test in treatment (TXT) and Waitlist (WL) groups. * signifies p < 0.05.
Figure 3
Figure 3
Sample Group × Time interaction result from whole-brain analysis. Panel on left shows sagittal and coronal views of significant cluster in left middle frontal gyrus (Brodmann Area (BA) 46; Montreal Neurological Institute (MNI) coordinates = −48 40 16). Panel on right shows percent signal change differences between groups. Note signal decreased between pre-test and post-test in TXT and increased in WL.
Figure 4
Figure 4
Sample Group × Time interaction result from whole-brain analysis. Panel on left shows sagittal and coronal views of significant cluster in left inferior parietal lobule (Brodmann Area (BA) 40; Montreal Neurological Institute (MNI) coordinates = −56 −40 52). Panel on right shows percent signal change differences between groups. Note signal decreased between pre-test and post-test in TXT and increased in WL.
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