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

Kelly Nash; Sara Stevens; Hayyah Clairman; Joanne Rovet

doi:10.3390/brainsci8010007

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

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

Authors

Kelly Nash¹, Sara Stevens^{2

3}, Hayyah Clairman⁴, Joanne Rovet^{5

6

7}

Affiliations

¹ Psychiatry Department, The Hospital for Sick Children, Toronto, ON M5G1X8, Canada. 2kellynash@gmail.com.
² Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON M4G1R8, Canada. sstevens@hollandbloorview.ca.
³ Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON M4G1R8, Canada. sstevens@hollandbloorview.ca.
⁴ Neurosciences and Mental Health Program, The Hospital for Sick Children, Toronto, ON M5G1A0, Canada. hayyah.clairman@sickkids.ca.
⁵ Neurosciences and Mental Health Program, The Hospital for Sick Children, Toronto, ON M5G1A0, Canada. joanne.rovet@sickkids.ca.
⁶ Department of Pediatrics, University of Toronto, Toronto, ON M5G1X8, Canada. joanne.rovet@sickkids.ca.
⁷ Psychology Department, University of Toronto, Toronto, ON M5S3G3, Canada. joanne.rovet@sickkids.ca.

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.