NIAAA Spectrum, Vol. 3, Issue 3, September 2011

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niaaa Spectrum

Volume 3, Issue 3   |   September 2011   |   http://www.spectrum.niaaa.nih.gov

U.S.DEPARTMENTOFHEALTHANDHUMANSERVICES•NationalInstitutesofHealth•NationalInstituteonAlcoholAbuseandAlcoholism

INTHISISSUE

FEATURES

1NIAAAAdvances

ResearchonFetalAlcohol

SpectrumDisorders

2ImagingHelps

ResearchersSeeInto

Alcohol-ExposedBrains

PHOTOESSAY

2BrainScansRevealthe

DamageofFetalAlcohol

Exposure

CHARTICLE

4OneinEightPregnant

WomenDrinks

NEWSFROMTHEFIELD

5ReceptorMayHelp

ExplainSusceptibilityto

Addiction

5

HeavilyAdvertisedAlcohol

BrandsMayAttractMore

UnderageDrinkers



ResearchShowstheValue

ofaMinimumLegal

DrinkingAgeof21

6EvidenceMountsThat

BingeDrinkingHarms

AdolescentBrain

Development

5QUESTIONSWITH...

7KennethWarren,Ph.D.

FEATURE

NIAAAADVANCESRESEARCHONFETAL

ALCOHOLSPECTRUMDISORDERS

In1967,whenFrenchpediatricianPaul

Lemoinerstrecognizedthatchildren

withalcoholicmothersshareda

patternofabnormalfacialfeaturesand

behaviorproblems,hedidnotgetmuch

attention.Backthen,conventional

wisdomheldtherewasnothingwrong

withdrinkingduringpregnancy.Most

doctorsneverevenraisedtheissue.

Buttodayweknowdifferently.

That’sinpartbecause,in1973,

pediatricianDavidSmithand

researcherKennethLyonsJones

uncoveredthesamerelationshipthat

Dr.Lemoinedid.Dr.Smithhopedto



bringmoreattentiontotheproblematic

patternbygivingitaname:fetal

alcoholsyndrome(FAS).

Thenameworked.Doctors,

researchers,andthepublicingeneral

begantopaymoreattentionto

FAS.Today,wehaveamuchbetter

understandingofthewiderangeof

braindamageanddevelopmental,

cognitive,andbehavioralproblems

causedbyfetalalcoholexposure.

Researchonthisrangeofproblems,

whichwenowcallfetalalcohol

spectrumdisorders(FASD),isatop

priorityforNIAAA.Withoursupport,

FASDresearchhasalreadycomea

longway.

“Initially,somepeoplethoughtthat

thisproblemonlyaffectedneglected

childrenofpooralcoholicwomen

whogrewupinunfavorablepostnatal

environments—andthat’swhythekids

didnotlookorbehavelikenormal

children.ButNIAAAfundedcritical

animalresearchstudiesthatshowed

thatalcoholisabletodisturbthe

growthanddevelopmentofanembryo

orfetus,”explainedSallyAnderson,

Ph.D.,NIAAA.

Today,NIAAAsupportsresearchers

aroundtheworldwhoaremaking

tremendousstrides.Inparticular,current

researchisadvancingmoreaccurate

diagnosesofFASD,distinguishing

FASDfromotherdisorders,and

determiningtheprevalenceofFASD

withgreaterprecision.

Accurate Diagnosis

SmithandJones’originaldescriptionof

FAShasnotchangedverymuch.People

withthefollowingthreefeaturesreceive

adiagnosisoffullFAS:

Continued on page 3

1 IN 8

PREGNANT

WOMEN

DRINKS

http://www.spectrum.niaaa.nih.gov

Volume3,Issue3|September2011

Continued on page 4

Continued from page 1

BRAINSCANSREVEALTHEDAMAGEOFFETALALCOHOLEXPOSURE

Theseimagesprovideacloserlook

athowprenatalalcoholexposurecan

damagethebrain.Magneticresonance

imaging(MRI)scansweretakenof

miceandhumanswithcomparable

amountsofalcoholexposureprior

tobirth.Thescansrevealdamageto

structuresthathelpthebrainfunction

properly(indicatedbywhiteand

blackarrows).Oneofthesestructures

isthecorpuscallosum,whichaids

communicationbetweenthebrain’s

twosides.

Fortheimagesontheleft,researchers

scannedthebrainsofmicethat

receiveddifferentlevelsofalcohol

duringgestation.OntherightareMRI

brainscansofchildrenknowntohave

prenatalalcoholexposurecomparable

tothoseofthemiceontheleft.



Therstmouse(a)wasnotexposed

toalcohol,anditscorpuscallosum

appearsnormal.Achildwithoutfetal

alcoholsyndrome(b)alsohasanormal

corpuscallosum.

Thesecondmouse(c)received

amoderatedoseofalcoholon

gestationalday7,whichcorresponds

tolateinweek3ofhumanprenatal

development.Thismousehasdamage

tothecorpuscallosum,particularly

evidentinathinner

middlesection.A

childwithmildFAS

(d)hascomparable

defectsinthecorpus

callosum.

Thethirdmouse(e)

receivedalarger

doseofalcoholon

gestationalday7,

anditshowsamore

severelyreduced

corpuscallosum.

Thismousealso

hasdamageto

thehippocampal

commissure(yellow

arrows),another

structureimportant

tocommunication

betweentheleftand

rightsidesofthe

brain.Inachildwith

severeFAS(f),the

corpuscallosumis

dramaticallyreduced

insize.

PHOTOESSAY

MRI scans that show comparable amounts of brain damage associated with

prenatal alcohol exposure. Mouse brains are shown on the left, and human

brains are on the right.

Sources:

O’Leary-MooreSK,ParnellSE,LipinskiRJ,SulikKK.Magneticresonance-basedimagingin

animalmodelsoffetalalcoholspectrumdisorder.Neuropsychology Review,2011Jun;21(2):167–85.

HumanMRIimagesarecourtesyofDr.S.Mattson.

FEATURE

IMAGINGHELPSRESEARCHERSSEEINTOALCOHOL-EXPOSEDBRAINS

Whenitcomestounderstandingthe

effectsofprenatalalcoholexposure

onthebrain,seeingisbelieving.

Advancesinimagingtechniquesare

allowingresearcherstogetafuller

pictureofhowalcoholcanaffectthe

developmentofthebrain’sstructure

and,consequently,itsfunctioning.

Theimagingtechniqueresearchersuse

mostoftenisMRI.Ingeneral,MRI

usesaverystrongmagnettocreate

animageofanypartofaperson’s

body.Butthereareveryspecictypes

ofMRItechnologythatarehelping

researchersshedlightondifferent

aspectsofabnormalitiescausedby

prenatalalcoholexposure,suchasthe

following:

Structural MRI (sMRI)usesastrong

magneticeldtodistinguishbetween

differenttypesofbraintissuesuch

asgraymatterandwhitematter.By

creatingacontrastbetweentissues,

sMRIallowsresearcherstomeasure

thevolumeofbrainstructuresand

thicknessofcorticaltissueand

comparemeasurementsbetween

differentgroupsofpeople.

Diffusion tensor imaging (DTI) uses

MRItechnologytocreateanimageof

braintissuebymeasuringthediffusion,

orthedirectionofmovement,ofwater

moleculesthroughbraintissues.In

particular,DTIishelpingresearchers

visualizeandunderstandthechanges

thataffectthestructureofwhitematter

bertractsduringbraindevelopment.

Magnetic resonance spectroscopy

(MRS)usesastrongmagneticeldto

measuretheconcentrationofchemicals

inthebrain.Thishelpsresearchers

understandthemetabolicchangesthat

takeplaceinthebrain.Researchers

useMRStocomparehealthybrainsto

brainsexposedtoalcoholprenatally.

niaaa Spectrum

IMAGINGHELPSRESEARCHERSSEEINTOALCOHOL-EXPOSEDBRAINS

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NIAAA ADVANCES RESEARCH...Continued from page 1

•



Characteristicpatternoffacial

abnormalities;

•



Growthdecits,eitherprenatallyor

postnatally;and

• Centralnervoussystemdysfunction.



Butfetalalcoholexposuredoesnot

alwaysresultinallthreecharacteristics,

meaningthatsomepeoplewouldnot

receiveanFASdiagnosisalthoughthey

wereadverselyaffected.

“Initially,clinicianswereonlyable

toidentifyindividualswithFAS,”

explainedKennethWarren,Ph.D.,

actingdirectorofNIAAA,anda

leadingexpertonFASandFASD.

“Ifyoudidn’thavethedistinctive

facialfeatures,youweren’tdiagnosed

withFAS.Ifyoudidn’thaveagrowth

decit,youweren’tdiagnosedwith

FAS.Fortunately,ourabilityto

understandanddescribeotherareas

hasbeenenhancedandcontinuesto

improve,”Dr.Warrensaid.

Wenowincludeabroaderrangeof

effectsthatresultfromprenatalalcohol

exposureundertheumbrellatermof

FASD.InadditiontofullFAS,FASD

includes:

• Partial FAS,whichdescribespeople

withsomesignsandsymptomsof

fullFAS,butnotallthree.

• Alcohol-related birth defects,which

includeprenatalalcohol-induced

physicalabnormalitieswhich

affectvision,hearing,ortheheart,

kidneys,orskeletalstructure.

• Alcohol-related neurodevelopmental

disorder(ARND),whichdescribes

fetalalcohol-inducedimpairments

tothegrowthanddevelopmentof

thebrainorcentralnervoussystem,

and/orthecognitiveandbehavioral

problemsofFASwithoutfacialor

growthabnormalities.

Distinguishing FASD From Other

Disorders

TreatingFASDeffectivelydependson

anaccuratediagnosis.Unfortunately,

FASDarechronicallyunder-diagnosed.

Theproblemisthat“distinguishing

FASDfromotherdevelopmental

disordersistricky,andevolving

diagnosticstandardsarenotyet

acceptedbyeveryone,”explains 

Dr.Anderson.

Often,peoplewithFASDare

mistakenlydiagnosedwithconditions

likeattentiondecithyperactivity

disorder(ADHD),whichalsocauses

learningandbehaviorproblems.

Currentresearchismakingthe

differencesbetweenFASDandother

disorderslikeADHDmuchclearer.

Forexample,wenowunderstand

thedifferenceinabehaviorcalled

perseveration.

“Perseverationisanimpairedability

toshiftfromonetasktoanother.Many

peoplewithADHDoftenswitchfrom

tasktotaskconstantly,butifyouask

someonewithintheFASDspectrum

toswitchfromoneactivitytoanother

veryquickly,theywilllikelybevery

resistant,”explainsDr.Warren.

Arecentreviewofresearchstudies

comparingchildrenwithFASDto

childrenwithADHDconcludedthat

childrenwithADHDhaveaharder

timefocusingandsustainingattention

whilechildrenwithFASDhavea

hardertimeshiftingattentionfromone

tasktoanotherandsolvingproblems

withexibility.Inaddition,children

withADHDhavetroubleretrieving

informationtheylearnverbally.By

contrast,childrenwithFASDhave

troubleencodingandremembering

verballylearnedinformation.Other

researchsuggeststhatstimulant

medication,whichoftenreduces

inattentionsymptomsinchildrenwith

ADHD,isnoteffectiveforchildren

withFASD.

Prevalence

WeknowthatFASDarethemost

common,preventabledevelopmental

disordersintheUnitedStates.Now,

NIAAAisfundinganewresearchstudy

thatwillimproveourknowledgeofjust

howmanypeopleareaffectedbyFASD.

NIAAAisdevelopinganetworkand

infrastructurecalledCollaborationon

FASDPrevalence(CoFASP)totest

kindergartenandrst-gradestudents

forsignsofFASD.Testingwillbegin

withstudentsinSanDiego,California;

GreatFalls,Montana;SiouxFalls,

NorthDakota;andseveralcommunities

inNorthCarolina.

“Thenewstudywillhelpdetermine

theprevalenceofFAS,partialFAS,

andARND,andalsohelpthechildren

inthosecommunitiesgetthespecial

educationservicestheyneedtothrive,”

saidDr.Warren.

Other Areas of Research

Clearly,researchhascomealong

waysinceDr.Lemoine’sdays.YetDr.

Warrenacknowledgesthereisstilla

lotwedonotyetfullyunderstand.The

breadthofresearchcontinuestogrow.

OtherareasofsignicantNIAAA-

fundedresearchonFASDinclude

demonstratingstructuralbraindamage

causedbyprenatalalcoholexposure

usingadvancedimaging,mitigatingthe

extentofalcohol-relatedbraindamage

throughnutrition,andunderstanding

theeffectofprenatalalcoholexposure

ongeneexpression.

“Ofcourse,ourhopeisthattherewill

beadaywhenpeoplenolongerhave

FASD.Butuntilthattime,wewill

continuetotrytounderstandthese

disordersasbestwecan.Themorewe

know,themorewecanimprovethelives

ofindividualswhostrugglewiththese

difcultieseveryday,”saidDr.Warren.

Sources:

Coles,CD.Discriminatingthe

effectsofprenatalalcoholexposure

fromotherbehavioralandlearning

disorders.Alcohol Research & Health,

Vol.34(1),p.47–48.

MattsonSN,CrockerN,NguyenTT.

Fetalalcoholspectrumdisorders:

neuropsychologicalandbehavioral

features.Neuropsychology Review,

2011,Vol.21,p.81.

Volume3,Issue3|September2011

http://www.spectrum.niaaa.nih.gov

IMAGING HELPS RESEARCHERS...Continued from page 2

Functional magnetic resonance

imaging (fMRI)usesastrongmagnetic

eldtoshowhowbloodowsinthe

brain.Generally,morebloodows

towardsanactivatedbrainstructure.

Researcherscantrackthisowof

bloodtodeterminewhatpartofthe

brainrespondstoparticularstimuli

andhowdifferentpartsofthebrain

function.fMRIalsoallowsresearchers

totrackmagneticallylabeledblood,

whichfollowsaspeciccoursewithin

thebrain.

MRIstudieshavehelpedscientists

matchupstructuralandfunctional

braindecits.Forexample,MRI

helpedEdwardRiley,Ph.D.,director

oftheCenterforBehavioralTeratology

andprofessorofpsychologyatSan

DiegoStateUniversity,realizethat

childrenwithFAShavesignicant

decitsinthecorpuscallosum.This

structurepromotescommunication

betweentheleftandrightsidesofthe

brain.

“UsingMRIstudies,wetrackeda

simpletask,”explainedDr.Riley.

“Weputkids’handsinaboxsothey

couldn’tseethem.Then,wetouched

theirngersandaskedthemtotellus

whichngerswetouched.”

Thechildrencouldverballyidentify

thetouchedngersonthehandthe

researchersactuallytouched.Butwhen

askedtopointtothengersthatwere

touchedontheoppositehand,“there

werealotmoremistakes,”saidDr.Riley.

Bytrackingthebrainactivityand

resultingfunctionwithMRI,Riley’s

studyshowed“that[kidswithFAS]have

difcultyintransferringinformation

fromonehemispheretoanother.”

Thisadvancedlevelofimaginghas

tremendouspotentialforhelping

researchersdevelopeffective

interventionandeducationstrategies.

Source:RoussotteF,SoderbergL,

SowellE.Structural,metabolic,and

functionalbrainabnormalitiesasa

resultofprenatalexposuretodrugsof

abuse:Evidencefromneuroimaging.

Neuropsychological Review,2010

Dec;20(4):376–97.Epub2010Oct28.

CHARTICLE

ONEINEIGHTPREGNANTWOMENDRINKS

Onaverage,about12percentof

pregnantwomendrinkandabout2

percentbingedrink(denedas5or

moredrinksononeoccasioninthepast

30days).Theserateshavechanged

verylittleovertime,accordingtoa

2009studybytheCentersforDisease

ControlandPreventionthatanalyzed

datafrom1991to2005.Perhaps

surprisingly,womenwhoareolderand

moreeducatedweremorelikelyto

drinkduringpregnancythanyounger,

lesseducatedwomen.About18

percentofpregnantwomenaged35–44

reporteddrinking,comparedwithabout

9percentofpregnantwomenaged

18–24.About14percentofpregnant

womenwithatleastonecollege

degreereporteddrinking,compared

withabout8percentofpregnant

womenwithahighschooldiploma

orless.Theresearchersspeculate

thatthepopulation

ofolderwomenmay

includemorewhoare

dependentonalcohol,

andthatwomenwith

moreeducationhave

morediscretionary

moneytospendon

alcohol.



Sources:

Centersfor

DiseaseControl

andPrevention.

Alcoholuse

amongpregnant

andnonpregnant

womenof

childbearingage:

UnitedStates,

1991–2005.

Morbidityand

Mortality Weekly

Report,2009May

22;58(19):529–32.

1 IN 8

PREGNANT

WOMEN

DRINKS

niaaa Spectrum

Continued on page 6

NEWSFROMTHEFIELD

RECEPTORMAYHELPEXPLAINSUSCEPTIBILITYTOADDICTION

Dopamine,abrainchemicalthat

playsimportantrolesinthecontrol

ofnormalmovementandinpleasure,

reward,andmotivation,alsoplaysa

centralroleinsubstanceabuseand

addiction.Inanewstudyconducted

inanimals,scientistsfoundthata

specicdopaminereceptor,called

D2,controlsanorganism’sactivity

levelandcontributestomotivation

forreward-seekingaswellastothe

rewardingeffectsofcocaine.Areport

ofthendings,byNIAAAresearchers,

appearsonlineinNature Neuroscience.

Inthestudy,scientistsinNIAAA’s

LaboratoryforIntegrative

NeuroscienceworkedwithArgentinean

researcherstodevelopgenetically

engineeredmiceinwhichexpressionof

D2receptorswasselectivelyprevented

innervecellsthatusedopamineas

theirneurotransmitter.Thereceptors

normallypresentonthesecellsare

knownasD2autoreceptors.

TheresearchersfoundthatlossofD2

autoreceptorsinthemiceprevented

thenormalfeedbackeffectbywhich

dopaminealreadypresentinbrain

synapsesreducessubsequentactivity

ofdopamine-containingneuronsand

dopaminerelease.Thiscontrolsystem

preventstheneurotransmitterfrom

reachingconcentrationsthatproduce

excessivelevelsofmovementand

otherbehaviors.Micethatlacked

D2autoreceptorsweremoreactive

thanmicewithnormalautoreceptor

levels.Wheninvestigatorsexamined

behaviorsrelatedtobrainmechanisms

ofrewardandaddiction,theyfound

thatmicelackingD2autoreceptors

workedlongerandhardertoobtain

foodandshowedincreasedsensitivity

totherewardingeffectsofcocaine,

comparedtonormalmice.Cocaine

increasedactivityinmice,andthe

micelackingD2autoreceptorswere

alsomoresensitivetothiseffectofthe

drug.Thestudymayhelpexplainwhy

alteredlevelsofD2receptorsinhuman

Thearticleabstractcanbefound

here:

Cocaine supersensitivity and

enhanced motivation for reward

in mice lacking dopamine D2

autoreceptors.

http://www.ncbi.nlm.nih.gov/

pubmed/21743470

midbrainandstriatumareassociated

withsusceptibilitytoaddiction.

NEWSFROMTHEFIELD

HEAVILYADVERTISEDALCOHOLBRANDSMAYATTRACTMORE

UNDERAGEDRINKERS

Underagealcoholuseisapervasive

andpersistentproblemintheUnited

Statesandmanyothercountries,with

serioushealthandsafetyconsequences.

Giventhesignicantamountofalcohol

advertisingtowhichyoungpeopleare

exposedinvirtuallyalltypesofmedia,

scientistshavesoughttolearnwhether

andhowsuchadvertisinginuences

underagedrinking.

InastudypublishedintheArchives of

Pediatrics and Adolescent Medicine,

NIAAA-supportedresearchers

asked2,699youthaged16–20about

theiralcoholuseandalcoholbrand

preferenceaspartofalong-term

telephonesurveyofU.S.adolescents

andmediause.Theresearchersreport

thatamajorityofunderagedrinkersin

thestudyidentiedapreferencefora

specicbrandofalcoholicbeverage,

thatthemost-preferredbrandsincluded

bothdistilledspiritsandbeer,and

thatbrandpreferencescorrelatedwith

levelsofbrand-specicadvertising

expenditures.Thiscorrelationsuggests

thatalcoholicbeveragemarketing

effortsmaybereachingandinuencing

underageaudiences.

Theresearchersalsofoundthatyoung

drinkerswhoidentiedapreferred

brandalsoweremorelikelytoengage

Volume3,Issue3|September2011

http://www.spectrum.niaaa.nih.gov

inbingedrinking.Thisnding

highlightstheneedforfurtherresearch

toidentifyanycausalconnections

betweenalcoholadvertising,brand

preferences,andbingedrinkingamong

underageyouths.

HEAVILY ADVERTISED ALCOHOL BRANDS . . . Continued from page 5

Source:

Alcohol brand preference and binge drinking among adolescents. Archives of

Pediatrics and Adolescent Medicine. 2011 Jul;165(7):675-6.

NEWSFROMTHEFIELD

RESEARCHSHOWSTHEECONOMICVALUEOFAMINIMUMLEGAL

DRINKINGAGE

Alcoholconsumptionanditsharms

arecommonamongyoungpeople,

includingthosewhoarebelow

theminimumlegaldrinkingage

(MLDA)of21.Researchersrecently

conductedeconomicanalysesto

estimatetheeffectsoftheMLDAon

deaths,injuries,crime,andalcohol

consumption,andtoidentifythecosts

andbenetsofloweringtheMLDA

to18.TheyreportintheJournal of

Economic Perspectivesthatalarge

bodyofevidenceshowsthatsettingthe

MLDAat21clearlyreducesalcohol

consumptionanditsmajorharms.

Theresearchersestimatethatlowering

theMLDAto18wouldresultinan

additional8deathsper100,000person

yearsforthe18–20agegroup.Using

acommonestimateofthevalueofa

statisticallifeof$8.72million,this

suggeststhatforevery100,000young

adultsallowedtodrinklegallyduring

ayear,theannualcostintermsof

increasedmortalitywouldbeabout$70

million.Theresearchersalsoestimate

thatloweringtheMLDAwouldimpose

additionalcostsonothersforcrime,

healthcare,anddeathsofnondrinking

driversandpassengersofatleast

$12millionannuallyforevery100,000

newlylegaldrinkers.Theseestimates

suggestthateachdrinkconsumedas

aresultofloweringtheMLDAwould

generateharmsvaluedatmorethan

$15tothedrinkerplusatleastan

additional$2.63inharmsimposedon

others,allinadditiontothepurchase

priceofthedrink.

Accordingtotheresearchers,“…the

evidencestronglysuggeststhatsetting

theminimumlegaldrinkingageat

21isbetterfromacostandbenet

perspectivethansettingitat18andthat

anyproposaltoreducethedrinking

ageshouldfaceaveryhighburdenof

proof.”

Thearticleabstractcanbefoundhere:

The minimum legal drinking age

and public health.

http://www.ncbi.nlm.nih.gov/

pubmed/21595328

NEWSFROMTHEFIELD

EVIDENCEMOUNTSTHATBINGEDRINKINGHARMSADOLESCENT

BRAINDEVELOPMENT

Adolescentswhodrinkalcoholoften

bingedrink.Whilethereisample

evidencethatadolescentbingedrinking

increasesriskybehaviorsandoften

resultsinnegativeconsequences,we

knowlessabouttheeffectsofalcohol

onadolescentbraindevelopment.

Nowresearchershaveshownthatthe

adolescentbrainexposedtobinge

drinkingrespondsdifferentlywhen

performingtestsofworkingmemory

andspatialfunctioningcomparedto

thoseofadolescentswhodonotbinge

drink.Previousresearchhaslinked

impairmentsinmemoryandspatial

functioningtoalcoholdependencein

adults.

Continued on page 7

5QUESTIONSWITH...

niaaa Spectrum

Inthecurrentstudy,theresearchers

examinedasampleof40adolescents

betweenages16and19whoreported

bingedrinkingatleastonceinthe

previous3months(bingedrinking

wasdenedasveormoredrinksfor

malesandfourormoreforfemaleson

atleastoneoccasion).UsingfMRI,the

researchersexaminedbloodowto

severalbrainregionsasameasureof

brainactivationwhiletheadolescents

performedspatialworkingmemory

tests.ThefMRIshowedthatadolescents

whoreportedbingedrinkingexhibited

differentlevelsofregionalbrain

activationcomparedtocontrolsubjects,

suggestingalcohol-relateddifferences

inbrainfunction.

Whencomparedtothesamegender

controls,femaleadolescentbinge

drinkersexhibitedreducedregional

brainactivation,whilemaleadolescent

bingedrinkersexhibitedequalor

elevatedregionalactivation.The

reducedactivationobservedin

femaleswascorrelatedwithpoorer

performanceinsustainedattentionand

workingmemory,whiletheincreased

activationinmaleswascorrelated

withimprovedperformanceinspatial

functioning.Thesedatasuggestthere

maybeimportantgenderdifferencesin

theimpactofalcoholontheadolescent

brain.

Overall,thendingssuggestthat

theregionsoftheadolescentbrain

responsibleforworkingmemoryand

spatialfunctioningmaybevulnerable

tothephysiologicaleffectsofbinge

drinking,withfemalespotentially

beingmoreatriskthanmales.These

effectscouldhaveimplicationsfor

futurebehaviorsextendinginto

adulthood.

Thearticleabstractcanbefound

here:

Adolescent binge drinking linked

to abnormal spatial working

memory brain activation:

Differential gender effects.

http://www.ncbi.nlm.nih.gov/

pubmed/21762178

5QUESTIONSWITH...

KENNETHWARREN,PH.D.

Dr. Warren is the acting director of NIAAA.



WhyisFASDsuch

animportant

researchareaforNIAAA?

Prenatalalcoholexposure

istheleadingpreventable

causeofbirthdefects

anddevelopmental

disordersintheUnitedStates.The

disabilitiesassociatedwithFASD

canpersistthroughoutlifeandplace

heavyemotionalandnancialburdens

onindividuals,families,andsociety.

Sofromapublichealthperspective,

thisisaseriousandentrenched

problem.Meanwhile,fromaresearch

opportunitiesperspective,studies

continuetoprovidenewinsightsinto

thenatureofthediseaseandpotential

interventionandtreatmentstrategies.

Giventhepublichealthneedandthe

potentialofourresearch,FASDisan

obviouspriorityareaforus.



Whatimportantresearch

advanceshaveoccurredsince

therstformaldescriptionofFASwas

introducedin1973?



Ithinkwehavemadesignicant

progressinthreedistinctareas.

First,wehavedevelopedamuch

morecomprehensiveandnuanced

understandingoftheeffectsofprenatal

alcoholconsumption,andhave

renedourterminologytoreectthis

evolution.Whileweoncehadonly

arelativelysimpleunderstandingof

FAS,wenowrecognizethatdrinking

duringpregnancycanleadtoFASD,

afullspectrumofneurobehavioral

effectsthatrangefromintellectual

andlearningdisabilities,poor



executivefunction,andspeechand

languagedelaystobehavioraland

emotionaldifculties,poorsocial

skills,andmotordecits.Thisnuanced

understandinghelpsresearcherspaint

anaccurateandrealisticpictureofthe

subtlecomplexitiesofthesedisorders

astheysearchforbetterintervention

strategies.

Second,researchershavemade

progressinunderstandinghowalcohol

damagesthefetus(includingepigenetic

inuences)andinthepotentialof

preventingsuchdamagethrough

pharmacotherapeuticinterventions

duringpregnancy.Andnally,

researchersareexploringnewways

touseeducational,behavioral,and

nutritionalinterventionstoimproveor

EVIDENCE MOUNTS THAT . . . Continued from page 6

Continued on page 8

Volume3,Issue3|September2011

fullyrestorebehavioralandcognitive

functionsinFASDpatients.

Takentogether,theseresearch

developmentsholdgreatpromisefor

effectiveinterventionsthatcanhelp

reducetheheavyburdensofFASDfor

patientsandtheirfamilies.

3.

 Whataresomeoftheongoing

 challengesweface?

Despitethegrowingbodyofresearch

evidence,toomanypregnantwomen

continuetodrink,andmanypeoplestill

questionwhetheralcoholconsumption

duringpregnancyisariskybehaviorat

all.Sondingeffectiveandculturally

relevantpreventionandintervention

strategiesremainsanelusivegoal.

Wealsoneedtocontinuetoimprove

ourknowledgeinareaswherewe

havebeenmakingprogress,suchas

developingtoolstobetteridentifyall

affectedindividualsandtheirunique

patternsofalcohol-induceddecits.

Newtechnologiesareprovingtobe

extremelypromising,suchasthenew

three-dimensionalimagingtoolsfor

detectingsubtlefacialcharacteristics

associatedwithprenatalalcohol

exposure.Yetweneedtomaintainour

researchfocusandbuilduponthese

advances.Thatway,wecandevelop

arangeoftoolstoidentifyalcohol-

relatedconditionsquicklyandprovide

appropriatemedicalandsocialservices

promptly.

Wemustalsounderstandmore

fullyhowthequantity,frequency,

andtimingofalcoholexposureand

maternalfactorssuchasthemother’s

age,numberofpriorpregnancies,

nutrition,andmetabolisminuencethe

developmentofFASD.Understanding

themechanismsunderlyingalcohol’s

detrimentaleffects,aswellasthe

geneticandsocioeconomicfactors

contributingtotheriskforFASD,

willallowresearchersandclinicians

toidentifyalcohol-relatedconditions

moreefcientlyanddevelopmore

targetedandeffectivepreventionand

treatmentstrategies.





AsourunderstandingofFASD

difculttokeepstakeholdersandthe

continuestoevolve,hasitbeen

publicapprisedofalltheresearch

developments?

Perceptionscanbedifculttochange.

Butwearefortunatethatanumber

ofadvocacyorganizations,bothin

theUnitedStatesandabroad,are

dedicatedtohelpingusbringresearch

informationtoFASDstakeholders

andthepublic.Theseorganizations

havebeenvitaltotheprogressof

FASDresearchandeducation.For

example,intheUnitedStates,the

NationalOrganizationonFetalAlcohol

Syndrome(NOFAS)andtheFAS

CommunityResourceCenterhave

doneagreatjobofincreasingpublic

awareness,mobilizinggrassroots

action,andservingasliaisons

amongthemanyFASDstakeholder

communities.Theseorganizationsalso

educatepatients,healthcareproviders,

andpolicymakers.Andmostofall,

groupsliketheseprovideimportant

feedbackfromthefamiliesofaffected

individuals,helpingtoimproveour

clinicalandpreventioneffortsandthe

communityprogramsweserve.



After35years,youhave

certainlymadeyourmarkinthe

alcoholeld.Lookingback,whatother

careerscapturedyourimagination?

AsayoungmanintheBronx,I

workedasamusician.Thinking

back,continuingtoplaymusicin

clubswouldhavealsomadeforan

interestingprofessionallife.

ABOUT US

NIAAA SpectrumisNIAAA’srst-ever

webzine.Withengagingfeaturearticles,

shortnewsupdates,andcolorful

graphics,NIAAA Spectrumoffers

accessibleandrelevantinformationon

NIAAAandthealcoholresearcheld

forawiderangeofaudiences.Each

issueincludesfeature-lengthstories,

newsupdatesfromtheeld,charticles

andphotoessays,andaninterviewwith

anNIAAAstaffmemberoralcohol

researcher.NIAAA Spectrum is

publishedthreetimesayear.

National Institute on Alcohol

Abuse and Alcoholism (NIAAA)

5635FishersLane,MSC9304

Bethesda,MD20892-9304

Communications/PublicInfo:

301–443–3860 

http://www.spectrum.niaaa.nih.gov

LearnmoreaboutcurrentFASDresearch

inthemostrecentissueofAlcohol

Research & Health,theNIAAAjournal.

Adownloadablecopyisavailableathttp://

pubs.niaaa.nih.gov/publications/arh341/

toc34_1.htm.