July 2014
(Submitted as part of the Coursera Course:
“Understanding the Brain”)
 A number of years ago, our neighbours elected to take care
of a foster child.
 The young boy was prone to screaming fit...
 Alcohol is a toxin to the developing brains of fetuses.
 The fetus brain is the most sensitive organ to alcohol damage....
1. In the first trimester, alcohol interferes with the migration
and organization of brain cells, which can create structu...
Palpebral Fissures: Eyelid openings Microcephaly: Small head
Philtrum: Groove on upper lip Epicanthal Folds: Upper eyelid ...
 The brain of an FAS-affected individual has an overall
smaller and less-developed brain.
 The FAS-affected brain has fe...
Affected Brain
•Smoother
•Has hole
Healthy
Brain
National Organisation on FAS
 The cerebrum (telencephalon) is ~6% smaller for an
individual who has had prenatal exposure to alcohol (PEA)
and ~13% sm...
Gray Matter = Density Increase White Matter = Density Decrease
Sowell et al., 2001
• White matter (contains the axons that...
Frontal Lobes - This area controls impulses and
judgment.The most obvious damage to the brain
occurs in the prefrontal cor...
Corpus Callosum - Passes information from
the left brain (rules, logic) to the right brain
(impulse, feelings) and vice ve...
Basal Ganglia - Affects spatial memory and
behaviors like perseveration and the inability to
switch modes, work toward goa...
Normally developing “brain
circuits” (symbolically shown
as the six arrows on the left)
Drinking during pregnancy
causes t...
Inhibition
Problem solving
Sexual urges
Planning
Time perception
Internal ordering
Working memory
Self-monitoring
...
 Socially inappropriate behavior (as if inebriated)
 Inability to control sexual impulses,
esp. in social situations
 I...
 Mental health problems prevalent among 90% of the group;
 Disrupted schooling for 60% of the clients (suspension or
exp...
 An FAS-affected individual often looks
normal, but the permanent brain injury
results in unexpected, inconsistent, and
u...
 In 1987, fetal alcohol exposure was the leading
known cause of intellectual disability in the
Western world
 FAS preval...
There is no cure for FAS, because the
central nervous system damage creates a
permanent disability, but treatment is
poss...
 The only certain way to prevent FAS is to simply
avoid drinking alcohol during pregnancy.
Photo: www.mommyish.com
 In t...
Alaska Republican State Senator Pete Kelly
proposed putting
pregnancy tests in
bars as a solution to
the state’s fetal alc...
Fetal Alcohol Syndrome is a preventable medical
condition that is caused by the excessive consumption
of alcohol by pregna...
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Understanding the brain final project - fas

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Coursera Course : Understanding the Brain
Final Project
Title : Fetal Alcohol Syndrome and the Brain

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Understanding the brain final project - fas

  1. 1. July 2014 (Submitted as part of the Coursera Course: “Understanding the Brain”)
  2. 2.  A number of years ago, our neighbours elected to take care of a foster child.  The young boy was prone to screaming fits, making inappropriate comments and had the habit of repeating the same question over and over, even when his question was answered.  I was told that his birth mother was an alcoholic and he had fetal alcohol syndrome (FAS). It was mentioned that the FAS left “holes”in his brain and this affected his behaviour.  This presentation will examine FAS and its effect on the brain.
  3. 3.  Alcohol is a toxin to the developing brains of fetuses.  The fetus brain is the most sensitive organ to alcohol damage.  Fetal Alcohol Spectrum Disorders (FASD) is a condition which describes a continuum of permanent birth defects caused by maternal consumption of alcohol during pregnancy.  Fetal Alcohol Syndrome (FAS) and Alcohol Related Neurodevelopmental Disorder (ARND) represent different degrees of FASD.  FAS is the most severe and is characterized by growth deficiency, central nervous system disorders, and a pattern of distinct facial features.
  4. 4. 1. In the first trimester, alcohol interferes with the migration and organization of brain cells, which can create structural deformities or deficits in the brain. [Journal of Pediatrics, 92(1):64-67] 2. Heavy drinking during the second trimester, (the 10th to 20th week after conception), causes more clinical features of FAS than at other times during pregnancy. [Early-Human-Development; 1983 Jul Vol. 8(2) 99-111] 3. During the third trimester, the hippocampus is significantly affected.This leads to problems with encoding visual and auditory information (reading and math). [Neurotoxicology And Teratology, 13:357-367, 1991] From the College of Cognitive and Linguistic Sciences at Brown University, Providence, RI.
  5. 5. Palpebral Fissures: Eyelid openings Microcephaly: Small head Philtrum: Groove on upper lip Epicanthal Folds: Upper eyelid folds Vermillion: Upper lip Micrognathia: Undersized jaw FAS facial features: smooth philtrum, thin vermilion and small palpebral fissures
  6. 6.  The brain of an FAS-affected individual has an overall smaller and less-developed brain.  The FAS-affected brain has fewer gyri and sulci and appears smoother.  In some brain scans of FAS-affected individual show actual holes in the brain.  Alcohol exposure appears to damage some parts of the brain, while leaving other parts unaffected.  Not all damage from alcohol is seen on brain scans, as the lesions can be too small to be detected with current technology. (Examples on next 3 slides)
  7. 7. Affected Brain •Smoother •Has hole Healthy Brain National Organisation on FAS
  8. 8.  The cerebrum (telencephalon) is ~6% smaller for an individual who has had prenatal exposure to alcohol (PEA) and ~13% smaller for someone with FAS.  The cerebellum is ~4% smaller for PEA and ~17% for FAS.
  9. 9. Gray Matter = Density Increase White Matter = Density Decrease Sowell et al., 2001 • White matter (contains the axons that connect nerve cells with each other) decreases in density. • Gray matter (contains the nerve cell bodies) increases in density. • The parietal lobe (involved in visual-spatial processing and in the integration of sensory information) is especially susceptible to alcohol: Its white matter is significantly reduced and its gray matter density is significantly increased.
  10. 10. Frontal Lobes - This area controls impulses and judgment.The most obvious damage to the brain occurs in the prefrontal cortex, which controls the Executive Functions. Hippocampus - Plays a fundamental role in memory, learning, and emotion. Hypothalamus - Controls appetite, emotions, temperature, and pain sensation. - Location in the brain
  11. 11. Corpus Callosum - Passes information from the left brain (rules, logic) to the right brain (impulse, feelings) and vice versa.The Corpus Callosum in an individual with FAS might be smaller than normal, and in some cases it is almost nonexistent. Cerebellum - Controls coordination and movement, behavior and memory. - Location in the brain
  12. 12. Basal Ganglia - Affects spatial memory and behaviors like perseveration and the inability to switch modes, work toward goals, and predict behavioral outcomes, and the perception of time. Amygdala –Central part of emotional circuitry, senses danger, fear and anxiety; plays major role in recognizing faces and facial expressions, social behavior, aggression, and emotional memory; critical for stimulus-reinforcement association learning. The hypothalamus, amygdala, and hippocampus are part of the limbic system, which regulates emotions, social and sexual behavior, the “fight or flight”response, and empathy, all areas of concern for individuals with prenatal alcohol exposure. - Location in the brain
  13. 13. Normally developing “brain circuits” (symbolically shown as the six arrows on the left) Drinking during pregnancy causes the “brain circuits” to become pruned, garbled, impaired or missing.www.fasdwheel.com
  14. 14. Inhibition Problem solving Sexual urges Planning Time perception Internal ordering Working memory Self-monitoring Verbal self- regulation Empathy Regulation of emotion Motivation Judgment
  15. 15.  Socially inappropriate behavior (as if inebriated)  Inability to control sexual impulses, esp. in social situations  Inability to learn from past actions  Storing and/or retrieving information  Diminished sense of remorse, inability to understand others  Needs frequent cues, requires policing by others  Needs to talk to self out loud; needs feedback  Moody and exaggerated roller-coaster emotions  Inability to weigh pros and cons when making decisions Artist: Moriz89
  16. 16.  Mental health problems prevalent among 90% of the group;  Disrupted schooling for 60% of the clients (suspension or expulsion from school or dropping out of school)  Trouble with the law by ~ 50% of the group (having been in trouble with authorities, charged, or convicted of a crime)  Confinement was experienced by about 50% of the clients; (includes treatment for mental health problems, alcohol /drug problems or incarceration for a crime)  Inappropriate sexual behavior noted by 50% of the group;  Alcohol/drug problems registered by ~30% of the clients;  Problems with employment experienced by 80% of group.
  17. 17.  An FAS-affected individual often looks normal, but the permanent brain injury results in unexpected, inconsistent, and unpredictable behaviors.  Too frequently it is assumed that someone with FASD is not trying hard enough or does not want to cooperate.These children disproportionately receive diagnoses of • Attention Deficit Hyperactivity Disorder (ADHD), • Oppositional Defiant Disorder, • Pervasive Developmental Disorder, or • Conduct Disorder (Coles, 2001).  It is the brain damage that is creating problems and their behavior problems is organic in origin.To better understand FAS behavior issues, shift the perspective from thinking the child “won't”to “can't”.
  18. 18.  In 1987, fetal alcohol exposure was the leading known cause of intellectual disability in the Western world  FAS prevalence in the US and Europe is estimated to be between 0.2-2 in every 1,000 live births  The lifetime medical and social costs of FAS are about US$800,000 per child  Surveys in the US report that 10-15% of pregnant women having recently drunk alcohol and up to 30% drink alcohol sometime during pregnancy Wikipedia
  19. 19. There is no cure for FAS, because the central nervous system damage creates a permanent disability, but treatment is possible. As the damage can vary from individual to individual, there is no one treatment type that works for everyone. Photo: www.iamsleep.com
  20. 20.  The only certain way to prevent FAS is to simply avoid drinking alcohol during pregnancy. Photo: www.mommyish.com  In the United States, the Surgeon General recommended in 1981, and again in 2005, that women abstain from alcohol use while pregnant or while planning a pregnancy, the latter to avoid damage in the earliest stages of a pregnancy, as the woman may not be aware that she has conceived.
  21. 21. Alaska Republican State Senator Pete Kelly proposed putting pregnancy tests in bars as a solution to the state’s fetal alcohol syndrome epidemic. www.msnbc.com/the-last-word/birth-control-irresponsible-people
  22. 22. Fetal Alcohol Syndrome is a preventable medical condition that is caused by the excessive consumption of alcohol by pregnant women. The resulting brain damage affects many different parts of the brain and resulting in children that:  Have attachment issues,  Display inappropriate sexual behaviours,  Show poor judgment,  Have difficulty controlling their impulses,  Are emotionally immature, and  Need frequent reminders of rules. As a result, many will require the protection of close supervision for the rest of their lives.

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