Health, social and legal outcomes of individuals with diagnosed or at risk for fetal alcohol spectrum disorder: Canadian example

Popova, Svetlana; Temple, Valerie; Dozet, Danijela; O'Hanlon, Graham; Toews, Caitlin; Rehm, Jürgen

doi:10.1016/j.drugalcdep.2020.108487

Cited by 23 publications

(24 citation statements)

References 23 publications

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“…In a comparison of economic costs between the United States, Canada, Sweden, and New Zealand, the annual mean cost per person is from $12,000 to $68,000 US dollars per individual per year (Greenmyer et al, 2018 ). Individuals with FASD have high rates of physical and mental health comorbidities, and high rates of substance use (Popova et al, 2021 ). FASD diagnosis is challenging as there are no reliable biomarkers nor effective treatments.…”

Section: Neurodevelopment and Fetal Alcohol Spectrum Disorders (Fasd)mentioning

confidence: 99%

“…Children with FASD have high rates of early life adversity and are less likely to live with both biological parents compared to children without FASD (Flannigan et al, 2021 ). Specifically, in a recent cross-sectional study, 75% of individuals with FASD were involved with the child welfare system, and these individuals are more than four times more lately to also have an anxiety disorder (Popova et al, 2021 ). Unfortunately, children with PAE often have comorbid prenatal and postnatal risk factors, including drug exposures and nutritional deficiencies.…”

Section: Neurodevelopment and Fetal Alcohol Spectrum Disorders (Fasd)mentioning

confidence: 99%

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Epigenetic Impacts of Early Life Stress in Fetal Alcohol Spectrum Disorders Shape the Neurodevelopmental Continuum

Alberry

Laufer

Chater‐Diehl

et al. 2021

Front. Mol. Neurosci.

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Neurodevelopment in humans is a long, elaborate, and highly coordinated process involving three trimesters of prenatal development followed by decades of postnatal development and maturation. Throughout this period, the brain is highly sensitive and responsive to the external environment, which may provide a range of inputs leading to positive or negative outcomes. Fetal alcohol spectrum disorders (FASD) result from prenatal alcohol exposure (PAE). Although the molecular mechanisms of FASD are not fully characterized, they involve alterations to the regulation of gene expression via epigenetic marks. As in the prenatal stages, the postnatal period of neurodevelopment is also sensitive to environmental inputs. Often this sensitivity is reflected in children facing adverse conditions, such as maternal separation. This exposure to early life stress (ELS) is implicated in the manifestation of various behavioral abnormalities. Most FASD research has focused exclusively on the effect of prenatal ethanol exposure in isolation. Here, we review the research into the effect of prenatal ethanol exposure and ELS, with a focus on the continuum of epigenomic and transcriptomic alterations. Interestingly, a select few experiments have assessed the cumulative effect of prenatal alcohol and postnatal maternal separation stress. Regulatory regions of different sets of genes are affected by both treatments independently, and a unique set of genes are affected by the combination of treatments. Notably, epigenetic and gene expression changes converge at the clustered protocadherin locus and oxidative stress pathway. Functional studies using epigenetic editing may elucidate individual contributions of regulatory regions for hub genes and further profiling efforts may lead to the development of non-invasive methods to identify children at risk. Taken together, the results favor the potential to improve neurodevelopmental outcomes by epigenetic management of children born with FASD using favorable postnatal conditions with or without therapeutic interventions.

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Section: Neurodevelopment and Fetal Alcohol Spectrum Disorders (Fasd)mentioning

confidence: 99%

Section: Neurodevelopment and Fetal Alcohol Spectrum Disorders (Fasd)mentioning

confidence: 99%

Epigenetic Impacts of Early Life Stress in Fetal Alcohol Spectrum Disorders Shape the Neurodevelopmental Continuum

Alberry

Laufer

Chater‐Diehl

et al. 2021

Front. Mol. Neurosci.

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“…Although cognitive deficits are the major outcome of prenatal ethanol exposure, increased anxiety behavior has also been observed in many FASDs [ 131 , 132 , 133 , 134 ] and animal studies [ 78 , 135 , 136 , 137 , 138 ]. However, some studies reported increased or decreased anxiety-like behaviors, depending on sex, following prenatal ethanol exposure [ 50 , 51 , 126 , 139 , 140 , 141 , 142 ].…”

Section: Discussionmentioning

confidence: 99%

Binge-like Prenatal Ethanol Exposure Causes Impaired Cellular Differentiation in the Embryonic Forebrain and Synaptic and Behavioral Defects in Adult Mice

Subbanna

Basavarajappa

2022

Brain Sciences

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An embryo’s in-utero exposure to ethanol due to a mother’s alcohol drinking results in a range of deficits in the child that are collectively termed fetal alcohol spectrum disorders (FASDs). Prenatal ethanol exposure is one of the leading causes of preventable intellectual disability. Its neurobehavioral underpinnings warrant systematic research. We investigated the immediate effects on embryos of acute prenatal ethanol exposure during gestational days (GDs) and the influence of such exposure on persistent neurobehavioral deficits in adult offspring. We administered pregnant C57BL/6J mice with ethanol (1.75 g/kg) (GDE) or saline (GDS) intraperitoneally (i.p.) at 0 h and again at 2 h intervals on GD 8 and GD 12. Subsequently, we assessed apoptosis, differentiation, and signaling events in embryo forebrains (E13.5; GD13.5). Long-lasting effects of GDE were evaluated via a behavioral test battery. We also determined the long-term potentiation and synaptic plasticity-related protein expression in adult hippocampal tissue. GDE caused apoptosis, inhibited differentiation, and reduced pERK and pCREB signaling and the expression of transcription factors Pax6 and Lhx2. GDE caused persistent spatial and social investigation memory deficits compared with saline controls, regardless of sex. Interestingly, GDE adult mice exhibited enhanced repetitive and anxiety-like behavior, irrespective of sex. GDE reduced synaptic plasticity-related protein expression and caused hippocampal synaptic plasticity (LTP and LTD) deficits in adult offspring. These findings demonstrate that binge-like ethanol exposure at the GD8 and GD12 developmental stages causes defects in pERK–pCREB signaling and reduces the expression of Pax6 and Lhx2, leading to impaired cellular differentiation during the embryonic stage. In the adult stage, binge-like ethanol exposure caused persistent synaptic and behavioral abnormalities in adult mice. Furthermore, the findings suggest that combining ethanol exposure at two sensitive stages (GD8 and GD12) causes deficits in synaptic plasticity-associated proteins (Arc, Egr1, Fgf1, GluR1, and GluN1), leading to persistent FASD-like neurobehavioral deficits in mice.

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“…Individuals with FASD experience complex, lifelong deficits in functioning as a result of prenatal alcohol exposure (Cook et al., 2016; Gagnier et al., 2011; Mattson et al., 2019; May et al., 2014; Popova et al., 2021). These multi‐faceted deficits in domains such as cognition, language, executive functioning, attention, memory and adaptive functioning, including social functioning, combined with other secondary issues such as mental health challenges, drug or alcohol misuse, which place individuals with FASD at greater risk of becoming involved in the criminal justice system for a range of illegal activities (Gagnier et al., 2011; O’Connor & Paley, 2009; O’Connor, Shah, et al., 2002; Pei et al., 2011; Popova et al., 2021; Streissguth et al., 2004), including firesetting in some cases. Many of these difficulties share remarkable similarities to the known risk factors for youth firesetting.…”

Section: Discussionmentioning

confidence: 99%

Fetal alcohol spectrum disorders (FASD) and youth firesetting: A call on criminal justice, emergency responder, and fire prevention specialists to become informed

Brown

Spiller²,

Carter

et al. 2021

Behavioral Sci & The Law

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Central nervous system damage resulting from prenatal exposure to alcohol, often referred to as fetal alcohol spectrum disorders (FASD), commonly manifests as lacking cognitive functioning, problem solving, impulsivity, memory, executive functioning, and social skill deficits. For individuals with FASD, these brain‐based deficits translate into impulsive behaviors and poorly thought‐out decision‐making, coupled with an inability to anticipate and recognize the sometimes very severe consequences of their behaviors. Not unexpectedly, individuals with FASD frequently find themselves disproportionately involved in the criminal justice system and mental health services. For some individuals with FASD, these behaviors can also include firesetting. First responders, like other health and legal professionals, are often unable to recognize the behavioral indicators of FASD, primarily due to a lack of training. As a result, firesetting behaviors are often attributed to deliberate, willful acts of delinquency, a desire to damage property, thrill seeking, or as attempts for personal gain, rather than being viewed as maladaptive attempts to solve problems by individuals who lack the tools to do this in more appropriate ways. These same skill deficits also present when individuals with FASD are interviewed about their involvement in such behaviors, sometimes resulting in confabulation, suggestibility, and false confessions. Further education and training in FASD are vital for first responders if they are to better support individuals with FASD and minimize their chances of becoming involved in firesetting behaviors. Furthermore, this training and education will help ensure that first responders can intervene in more appropriately when crisis situations do occur. This article will outline key behavioral symptoms of FASD as well as provide first responders with suggestions as to how to best support individuals when FASD is suspected. The brief quote that follows highlights some of the key challenges facing individuals with FASD and how poor decision‐making and impulsiveness can result in severe consequences for the individual and those around them.

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Health, social and legal outcomes of individuals with diagnosed or at risk for fetal alcohol spectrum disorder: Canadian example

Cited by 23 publications

References 23 publications

Epigenetic Impacts of Early Life Stress in Fetal Alcohol Spectrum Disorders Shape the Neurodevelopmental Continuum

Epigenetic Impacts of Early Life Stress in Fetal Alcohol Spectrum Disorders Shape the Neurodevelopmental Continuum

Binge-like Prenatal Ethanol Exposure Causes Impaired Cellular Differentiation in the Embryonic Forebrain and Synaptic and Behavioral Defects in Adult Mice

Fetal alcohol spectrum disorders (FASD) and youth firesetting: A call on criminal justice, emergency responder, and fire prevention specialists to become informed

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