Saccadic eye movements and executive function in children with Fetal Alcohol Spectrum Disorders (FASD): Results from a multi-centered study
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A serious consequence of maternal consumption of alcohol during pregnancy is the fetal alcohol syndrome (FAS): characterized by growth deficiency (both pre- and post-natal), craniofacial dysmorphology and central nervous system (CNS) dysfunction. However, in the absence of the characteristic facial features, and without confirmed history of alcohol exposure, clinical diagnosis remains a significant challenge. Recently, the term fetal alcohol spectrum disorders (FASD) has been adopted to encompass all diagnoses relating to a history of prenatal alcohol exposure. The purpose of this study was to test the following three general hypotheses: Children with FASD 1) demonstrate specific deficits in oculomotor control that can be measured using saccadic eye movement tasks, 2) display specific deficiencies in multiple domains of executive function that can be determined using standardized neuropsychological tasks, and 3) reveal deficits in oculomotor control that correlate with deficiencies in executive function as measured using standardized neuropsychological tasks. A preliminary study revealed significant deficits in saccadic eye movement tasks and provided the foundation for a large, multi-centered study assessing oculomotor control and neuropsychological function in children with FASD. A mobile laboratory was created, which facilitated recruitment of 92 control subjects and 89 subjects with FASD. We found significant evidence for oculomotor deficits across multiple outcome measures following the saccadic eye movement experiments, especially for oculomotor tasks that probe aspects of executive function. Additionally, children with FASD exhibited performance deficits in neuropsychological tasks that assess planning, attention, spatial working memory and strategy; cognitive skills also included within the domain of executive function. Finally, significant correlations between these two objective measures were found for children with FASD, which were not evident in the control sample. These findings are consistent with significant frontal lobe dysfunction. This is an exciting area of research that may hold promise in developing effective screening tools that can assist in the diagnosis of individuals with a history of prenatal alcohol exposure.