Fetal alcohol syndrome (FAS) encompasses a broad range of disabilities involving both structural and functional changes. Among the most devastating effects are those caused by alterations in the central nervous system (CMS). These CMS changes result in the cognitive and behavioral deficits reported in most studies of FAS. In addition, it is recognized that brain and behavioral changes can occur in the absence of the facial features required for an FAS diagnosis. In our studies, children with heavy prenatal exposure to alcohol (PEA), who do not have the obvious physical features of FAS, show changes in both brain and behavior similar to those seen in FAS. The term fetal alcohol spectrum disorders (FASD) is now being used to describe the range of effects resulting from prenatal alcohol exposure and to reflect that these effects can occur in both dysmorphic and nondysmorphic individuals. Our structural magnetic resonance imaging (MRI) studies have indicated that white matter in the brain may be particularly sensitive to the effects of prenatal alcohol exposure. At the same time we have noticed a similarity between the behavioral effects of prenatal alcohol exposure and those resulting from white matter damage. The proposed project is multidisciplinary in nature, including neuropsychological assessment and brain imaging studies. We plan to continue our structural MRI studies, and in addition, we are proposing two new imaging techniques: diffusion tensor imaging (DTI) to assess white matter damage and functional MRI (fMRI) to assess changes in brain function while performing a task known to be sensitive to prenatal alcohol exposure. This proposal represents a continuation of work that we have been conducting over the last 10 years. Our behavioral assessments will stress tasks hypothesized to be sensitive to white matter changes and our imaging studies will complement these behavioral investigations and allow us to correlate changes in brain with our behavioral findings. Furthermore, we will conduct these investigations in both dysmorphic and nondysmorphic individuals with FASD. We believe that our approach has been successful thus far, and that this multidisciplinary project will expand our understanding of the devastating effects of prenatal alcohol exposure, hopefully informing us sufficiently that we might begin to propose reasonable intervention strategies
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