Neuromodulation augmented cognitive remediation to improve executive dysfunction in fetal alcohol spectrum disorder
Jeffrey R. Wozniak, Ph.D., L.P. (Department of Psychiatry)
Christopher J. Boys, Ph.D. (Department of Pediatrics), Kelvin Lim, MD (Department of Psychiatry)
Prenatal alcohol exposure (PAE) has profound detrimental effects on brain development and, as a result, has permanent consequences for cognition, learning, and behavior. Individuals with Fetal Alcohol Spectrum Disorders (FASD) commonly have a range of neurocognitive impairments that directly lead to practical problems with learning, attention, working memory, task planning/execution, and decision making, among other areas of functioning. Despite the profound public health burden posed by FASD, there have been very few treatment studies of any sort in this population. Our group conducted the first randomized controlled trials of the nutrient choline as a neurodevelopmental intervention in 2-5 year old children with FASD, in which we demonstrated effects on sequential memory. For older children, a very different neurodevelopmental target is needed, and for this we have narrowed our focus to “plasticity” (the brain’s ability to adapt). We propose to conduct a novel pilot study to examine the effects of cognitive remediation training augmented with tDCS in children and adolescents with FASD. Functional magnetic resonance imaging will be collected to provide preliminary data of brain circuitry changes created by this intervention.
Perinatal Stroke: Understanding Brain Reorganization through Infant Neuroimaging and Neuromodulation
Bernadette Gillick, PhD, MSPT, PT (Department of Rehabilitation Medicine)
Michael Georgieff, MD (Department of Neonatology), Raghavendra Rao, MD (Department of Neonatology)
The purpose of this study is to use MRI/DTI TMS and electroencephalography (EEG) to comprehensively examine both the CST integrity and cortical excitability in infants following perinatal stroke, and to identify association with sensorimotor outcome as evaluated by clinical behavioral assessments of infants. The results of this study will provide fundamental information as to the feasibility and safety of applying non-sedative/natural sleeping MRI/DTI scanning and TMS in infants. This study will also investigate the relationship between modeled electric field and measured motor threshold across hemispheres. This may help identify anatomical markers that can predict electric field strength and thus could be used for dosing considerations for future neuromodulation interventions. Additionally, sensory stimulation evoked event related potential amplitude will be compared between infants with stroke and typical development to identify whether infants with stroke demonstrate early sensory processing differences compared to typically developing peers.
The development of attentional orienting to semantic salience in infancy: Concurrent associations between visual orienting and white matter development
Jed Elison, PhD (Institute of Child Development)
Robin Sifre, Graduate Student (Institute of Child Development)
While a large body of work has charted the emergence of selective attention, less is known about the role that orienting to semantic salience plays in selective attention. Specifically, to what extent can experience with a stimulus modify its semantic salience, and how does the developing brain integrate these modifications into attentional biases? We intend to assess the extent to which reward-modulated semantic salience captures attention in infancy, and how structural brain development supports these abilities. We will focus on 7 to 9 months for two reasons: First, this period marks an important transition toward more sophisticated selective attention; thus, there should be high variability in orienting to semantic salience during this transition. Structural variability in neural circuitry could function as one source of this variance. Second, there is growing evidence suggesting that the social deficits observed in individuals with autism spectrum disorder (ASD) may be traced back to early differences in attention orienting and its relation to white matter microstructure at this age. This project will provide the first normative developmental trajectory of 1) infants’ attentional orienting to semantic salience, and 2) the white matter fiber bundles supporting this orienting ability, as a key first step toward studying this construct in infants considered at high-risk for ASD.