The Prevalence of Epilepsy and Seizures in Subjects with Fetal Alcohol Spectrum Disorders. MSc Thesis, Queen’s University, Kingston, Ontario, Canada, May 2009. OBJECTIVE: Fetal alcohol spectrum disorders (FASD) is the umbrella term that describes the range of adverse developmental outcomes that occur in offspring as a consequence of maternal drinking during pregnancy. FASD has been associated with a large number of co-morbidities, including neurological disorders such as epilepsy. Epilepsy occurs in 0.6% of the population in Canada. The aim of this study was to evaluate the prevalence of epilepsy or seizure disorders in people who have been diagnosed with Fetal Alcohol Syndrome (FAS), partial Fetal Alcohol Syndrome (pFAS) or Alcohol Related Neurodevelopmental Disorder (ARND). METHODS: A retrospective chart review was conducted on all active charts (N=1063) at St. Michael’s Hospital (Toronto) and Glenrose Rehabilitation Hospital (Edmonton) FASD clinics. A total of 425 subjects between the ages of 2 to 49 were included in the analysis. The relationship between FASD diagnosis and other risk factors for co-occurrence of epilepsy and seizures (e.g. extent of exposure to alcohol and other drugs, type of birth, maternal history, and trauma) in subjects with FASD was also examined. Chi-square tests and multivariate multinomial logistic regression were used. RESULTS: Twenty-five (5.9%) individuals with FASD had a confirmed diagnosis of epilepsy, and 50 (11.8%) had at least one documented seizure episode, yielding an overall prevalence of 17.7% with a history of seizures in this population. Those with epilepsy or seizures were two times (Odds Ratio=2.27, 95% Confidence Interval=1.14-4.51, p<0.05) more likely to have an unnatural birth and those with epilepsy were three times (OR=3.41, 95% CI 1.11-10.5, p<0.05) more likely to have had an unnatural type of birth (breech, caesarean, forceps or vacuum) than those subjects with no history of seizures. None of the other risk factors examined were associated with a greater prevalence of epilepsy or seizures in subjects with FASD. These results indicate a remarkably high prevalence of epilepsy/seizures in the FASD population of two specialized FASD clinics compared with the general population. / Thesis (Master, Neuroscience Studies) -- Queen's University, 2009-07-23 16:38:17.17

This research explores the experiences and needs of five young people with FASD in care. Data was gathered through personal interviews with youth in care, guided by an anti-oppressive research philosophy. The findings suggest that youth in care with FASD experience a myriad of challenges throughout their journeys in care with regard to placements, caregivers, and the transition to adulthood for which the impact for young people was difficult to understand. The high degree of secondary disabilities of FASD was found to be alarming in this group of young people. The study also found that those with more of an awareness of their disability had the capacity to speak to some of their support needs. All of the youth revealed strengths within themselves and reported having goals and dreams for their futures. A number of recommendations, which include input from participants, are highlighted, with the intention of providing some suggestions for best practice with our young people with FASD in care and policy changes within the systems working with this population.

This research explores the experiences and needs of five young people with FASD in care. Data was gathered through personal interviews with youth in care, guided by an anti-oppressive research philosophy. The findings suggest that youth in care with FASD experience a myriad of challenges throughout their journeys in care with regard to placements, caregivers, and the transition to adulthood for which the impact for young people was difficult to understand. The high degree of secondary disabilities of FASD was found to be alarming in this group of young people. The study also found that those with more of an awareness of their disability had the capacity to speak to some of their support needs. All of the youth revealed strengths within themselves and reported having goals and dreams for their futures. A number of recommendations, which include input from participants, are highlighted, with the intention of providing some suggestions for best practice with our young people with FASD in care and policy changes within the systems working with this population.

It is well documented that children with Fetal Alcohol Spectrum Disorders (FASD) experience difficulties in several domains of social functioning. Despite this evidence, there are very few interventions that target underlying components of social behaviour. The current study aimed to add to this literature by implementing a mindfulness-based training program for adolescents with FASD. The goals of the study were to analyze the influence of mindfulness training on several aspects of social functioning including perspective taking, emotion regulation, and social problem solving. The study used a pre-post-test design that included 10 children with FASD (ages 12- to17-years). Participants were assessed using experimental measures of social cognition at baseline and 8-week follow-up. In addition, caregivers completed measures that assessed children’s emotionality and social skills at both time points. Analyses revealed that mindfulness training may be effective for improving perspective taking skills in children with FASD. No significant treatment effects were observed for emotion regulation, social skills or social problem solving. Overall, results from this study suggest that mindfulness training is a feasible intervention for children with FASD. / Graduate / 0622

One percent of children in North America may be affected by fetal alcohol spectrum disorder (FASD). FASD remains difficult to diagnose because confirmation of maternal alcohol use is a diagnostic criterion, and women consuming alcohol during pregnancy are reluctant to divulge this information for fear of stigmatization and losing custody of the child. Consequently, using a biomarker to assess alcohol exposure would provide a tremendous advantage. Recently, the measurement of fatty acid ethyl ester (FAEE) in hair has provided a powerful tool for assessing alcohol exposure. My thesis fills a translational gap of research between the development of the FAEE hair test and its application in the context of FASD. The guinea pig has been a critical model for FASD research, in which FAEE hair analysis has previously distinguished ethanol-exposed dams/offspring from controls. My first study, reports a positive dose-concentration relationship between alcohol exposure and hair FAEE, in the human, and the guinea pig. Humans also displayed over an order of magnitude higher FAEE incorporation per equivalent alcohol exporsure, suggesting that the test will be a sensitive clinical marker of fetal alcohol exposure. My second study utilized multi-coloured rats to investigate the potential of a hair-colour bias, as has been reported for other clinical hair assays; no evidence of bias is reported here. My third study is the first to examine the clinical use of the FAEE hair test in parents at high risk of having children with FASD. Over one third of parents tested positive for excessive alcohol use. Parents were investigated by social workers working for child protection services, and my fourth study reports that hair FAEE results agree with social worker reports. Individuals highly suspected of abusing alcohol were at a significantly greater risk of testing positive, whereas individuals tested based on other reasons (such as to cover all bases) were negatively associated with testing positive. The last study of my thesis, confirmed an association between alcohol and drug use by parents at high risk for having children with FASD, posing an added risk to children. This work helps bridge a gap in translational research, suggesting that the FAEE hair test has potential for use in FASD diagnosis and research.

No description available.

One percent of children in North America may be affected by fetal alcohol spectrum disorder (FASD). FASD remains difficult to diagnose because confirmation of maternal alcohol use is a diagnostic criterion, and women consuming alcohol during pregnancy are reluctant to divulge this information for fear of stigmatization and losing custody of the child. Consequently, using a biomarker to assess alcohol exposure would provide a tremendous advantage. Recently, the measurement of fatty acid ethyl ester (FAEE) in hair has provided a powerful tool for assessing alcohol exposure. My thesis fills a translational gap of research between the development of the FAEE hair test and its application in the context of FASD. The guinea pig has been a critical model for FASD research, in which FAEE hair analysis has previously distinguished ethanol-exposed dams/offspring from controls. My first study, reports a positive dose-concentration relationship between alcohol exposure and hair FAEE, in the human, and the guinea pig. Humans also displayed over an order of magnitude higher FAEE incorporation per equivalent alcohol exporsure, suggesting that the test will be a sensitive clinical marker of fetal alcohol exposure. My second study utilized multi-coloured rats to investigate the potential of a hair-colour bias, as has been reported for other clinical hair assays; no evidence of bias is reported here. My third study is the first to examine the clinical use of the FAEE hair test in parents at high risk of having children with FASD. Over one third of parents tested positive for excessive alcohol use. Parents were investigated by social workers working for child protection services, and my fourth study reports that hair FAEE results agree with social worker reports. Individuals highly suspected of abusing alcohol were at a significantly greater risk of testing positive, whereas individuals tested based on other reasons (such as to cover all bases) were negatively associated with testing positive. The last study of my thesis, confirmed an association between alcohol and drug use by parents at high risk for having children with FASD, posing an added risk to children. This work helps bridge a gap in translational research, suggesting that the FAEE hair test has potential for use in FASD diagnosis and research.

South Africa has the highest reported prevalence of Fetal Alcohol Spectrum Disorder (FASD) worldwide. The high prevalence is aggravated by limited remedial and rehabilitative services in the rural Northern Cape. Parents requested guidance to facilitate the development of their children with FASD. Understanding their needs and strengths will inform intervention programmes to create the stable environments children with FASD require for optimal life outcomes. The aim of the study is to explore the way that mothers facilitate the occupational engagement of their children with FASD as well as the challenges they face. Using a qualitative descriptive study design, the author purposively selected mothers to reveal three turning points in the lives of their children. Semi structured- and photo-elicitation interviews highlighted mothers’ experiences. Interviews were transcribed verbatim and inductively analysed with content analysis. Two themes emerged, namely, “Doing together” and “Varying access to engagement”. The findings of this study highlight the important role mothers play to facilitate the occupational engagement of children with FASD. Recognising mothers as agents of change and including them in intervention will enhance occupational therapy practice in the area of FASD.

One of the most frequently reported deficits seen in individuals with Fetal Alcohol Spectrum Disorder (FASD) is impairments in learning and memory, which is likely attributed to the teratogenic effects of ethanol on the developing hippocampus. TGF-β (transforming growth factor-β), hedgehog and Wnt signaling pathways have been identified as high probability candidate pathways associated with brain deficits seen in FASD. Increasing evidence indicates that ethanol may induce changes in DNA methylation that could alter transcription regulating factors within signaling pathways critical in brain development. The purpose of this study was to test the hypotheses that prenatal ethanol exposure during i) the first trimester-equivalent period, or ii) throughout the entire gestational period induces changes in DNA methylation and alters the transcription/translation of TGF-β1, SHH (sonic hedgehog) and Wnt3a within the developing hippocampus. Pregnant Dunkin-Hartley-strain guinea pigs were assigned to one of three groups: ethanol (4 g/kg maternal body weight), isocaloric-sucrose/pair-feeding, or no treatment. Embryonic telencephalon tissue (which gives rise to the hippocampus) and fetal hippocampus were collected at gestational day (GD) 23 or GD 65, respectively. GD 23 ethanol-exposed and nutritional control embryos exhibited decreased crown-rump and head lengths. GD 65 ethanol-exposed fetuses exhibited decreased body and brain weights compared with the control groups. Ethanol exposure during the first trimester-equivalent period, but not during the entire gestational period, resulted in an increase in global DNA methylation. First trimester-equivalent ethanol exposure did not alter TGF-β1, SHH and Wnt3a gene expression within the GD 23 telencephalon. However, ethanol exposure throughout the entire pregnancy led to an increase in the expression of all three genes within the GD 65 hippocampus. No change in TGF-β1 protein was seen in the hippocampus of ethanol-treated fetuses. Post-translationally modified (ptm) SHH, but not unmodified SHH protein, was decreased in the hippocampus of ethanol-exposed fetuses. A decrease in unmodified, but not ptm Wnt3a protein, was observed in both ethanol-exposed and nutritional control hippocampus. These results suggest that prenatal ethanol exposure may affect hippocampal development through alterations in i) DNA methylation as shown at early gestation and ii) the expression of transcription regulating factors, especially SHH, as shown at term. / Thesis (Master, Pharmacology & Toxicology) -- Queen's University, 2012-12-03 12:36:33.035

Individuals with Alcohol Related Neurodevelopmental Disorder (ARND) and Attention-Deficit/Hyperactivity Disorder (ADHD) display similar deficits in behavioural, cognitive, and executive dysfunction symptoms; however, the underlying impairment in brain function and attention pathways is thought to be different. This study compared these two clinical groups, and healthy controls, using psychological assessments and functional magnetic resonance imaging (fMRI). The two clinical groups had significantly different scores on measures of overall intellectual functioning, working memory, and the conjunction trials on the fMRI assessment but could not be differentiated on other measures from rating scales, standardized psychological assessments, and performance data from fMRI tasks. The fMRI task accuracy variables were strongly correlated with related standardized psychological measures. All groups demonstrated difficulties with response inhibition compared to attention, and the clinical groups demonstrated more difficulties with attention and variability compared to the control group on a computer-paced Go/No-Go task. The comparison of a self-paced and a computer-paced Go/No-Go task indicated that the computer-paced task would be more appropriate to use with fMRI to assess cortical activation in response inhibition. It was found that the ADHD group had higher levels of cortical activation (indicating that more cognitive effort was require to reach the same level of behavioural performance) compared to the ARND group during the visual-spatial attention tasks, whereas the ARND group had higher levels of activation during the response inhibition and working memory tasks. Despite no significant differences in behavioural performance, the fMRI tasks helped to demonstrate different activation patterns that could help distinguish and differentially diagnose these two similar groups. / October 2016