Diagnosis of fetal alcohol spectrum disorder (FASD) is difficult because information regarding prenatal exposure is often lacking, many affected children do not exhibit the characteristic facial anomalies, and no distinctive behavioral phenotype has been identified. Development of appropriate treatments has been hampered by limited understanding of the pathophysiology of FASD. Since 1999, we have been conducting a prospective, longitudinal study in the Cape Coloured (mixed ancestry) community in Cape Town, South Africa, where there is an exceptionally high incidence of fetal alcohol syndrome (FAS). In a 5-year follow-up of this cohort, we found a remarkably consistent effect of fetal alcohol exposure on eyeblink conditioning, a cerebellar-dependent form of learning whose neural circuitry and alcohol effects have been documented in detail in laboratory animals;not a single child with full FAS met criterion for conditioning, compared with 75% of the non-exposed controls. Thus, we have identified a potential biomarker of alcohol-related CNS impairment. Moreover, because it is well established in early infancy, short-delay EBC may provide an important tool in the early diagnosis of FASD and in the evaluation of the efficacy of intrapartum and early postpartum interventions. In this study we will follow-up our Cape Town cohort of 165 children at 8.5 years and recruit a new prospective cohort of 60 infants (30 heavy exposed, 30 controls) from the same community. The principal aims are to characterize the developmental course of alcohol-related impairment in EBC;to use selected neuroimaging techniques to examine the impact of fetal alcohol exposure on the neural circuitry mediating EBC;and to use neurobehavioral and functional MRI tasks to assess effects on cerebellar- mediated timing, a central element of EBC. Advanced neuroimaging will include high resolution structural MRI to examine the regional pattern of brain hypoplasia and the first whole brain diffusion tensor imaging (DTI) in children with FASD to assess the integrity of white matter tracts. The moderating effects of maternal age, alcohol abuse history, and variants of the ADH1B polymorphism on the child's vulnerability to FASD will also be examined. Public Health Relevance: A better understanding of the effects of fetal alcohol exposure on the EBC cerebellar circuit in childhood and infancy has the potential to advance our understanding of the neuropathology of FASD, to improve the diagnosis and treatment of this disorder, and to enable earlier identification of affected children.

National Institute of Health (NIH)
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Research Project (R01)
Project #
Application #
Study Section
Child Psychopathology and Developmental Disabilities Study Section (CPDD)
Program Officer
Matochik, John A
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Wayne State University
Schools of Medicine
United States
Zip Code
du Plessis, Lindie; Jacobson, Joseph L; Jacobson, Sandra W et al. (2014) An in vivo 1H magnetic resonance spectroscopy study of the deep cerebellar nuclei in children with fetal alcohol spectrum disorders. Alcohol Clin Exp Res 38:1330-8
Carter, R C; Jacobson, J L; Jacobson, S W (2014) Fertility treatments, maternal intelligence, and child cognition. BJOG 121:1652
Molteno, Christopher D; Jacobson, Joseph L; Carter, R Colin et al. (2014) Infant emotional withdrawal: a precursor of affective and cognitive disturbance in fetal alcohol spectrum disorders. Alcohol Clin Exp Res 38:479-88
Jacobson, Sandra W; Carter, R Colin; Jacobson, Joseph L (2014) Breastfeeding as a proxy for benefits of parenting skills for later reading readiness and cognitive competence. J Pediatr 164:440-2
Hess, Aaron T; Jacobson, Sandra W; Jacobson, Joseph L et al. (2014) A comparison of spectral quality in magnetic resonance spectroscopy data acquired with and without a novel EPI-navigated PRESS sequence in school-aged children with fetal alcohol spectrum disorders. Metab Brain Dis 29:323-32
De Guio, Francois; Mangin, Jean-Francois; Riviere, Denis et al. (2014) A study of cortical morphology in children with fetal alcohol spectrum disorders. Hum Brain Mapp 35:2285-96
Suttie, Michael; Foroud, Tatiana; Wetherill, Leah et al. (2013) Facial dysmorphism across the fetal alcohol spectrum. Pediatrics 131:e779-88
Jacobson, Sandra W; Carter, R Colin; Jacobson, Joseph L (2013) Commentary on Day and colleagues : the association between prenatal alcohol exposure and behavior at 22 years of age--adverse effects of risky patterns of drinking among low to moderate alcohol-using pregnant women. Alcohol Clin Exp Res 37:1069-73
Jacobson, Sandra W; Jacobson, Joseph L; Stanton, Mark E et al. (2011) Biobehavioral markers of adverse effect in fetal alcohol spectrum disorders. Neuropsychol Rev 21:148-66