Study suggests that adolescent exposure to alcohol can negatively affect learning, memory and behavior in adulthood

A study at Duke University suggests that repeated exposure to alcohol during adolescence causes long-lasting changes in the part of the brain that controls learning and memory. The study, published in the journal Alcoholism: Clinical & Experimental Research, helped explain how exposure to alcohol before the brain has fully developed can cause cellular and synaptic abnormalities and negatively affect behavior. Kentucky is ranked 9th in the nation for the percentage of children who drank alcohol before age 13 (25.1 percent), according to the state Department for Public Health.

"In the eyes of the law, once people reach the age of 18, they are considered adult, but the brain continues to mature and refine all the way into the mid-20s," said lead author Mary-Louise Risher, a post-doctoral researcher in Duke's Department of Psychiatry and Behavioral Sciences. "It's important for young people to know that when they drink heavily during this period of development, there could be changes occurring that have a lasting impact on memory and other cognitive functions.

Studies had shown that animals exposed to alcohol at an early age do not perform as well in memory tasks as those not exposed to it. The new study, which involved exposing young rodents to alcohol and waiting for them to grow into adulthood, found that the exposure also affects the hippocampus, the area of the brain that controls memory and learning. The researchers measured a cellular mechanism called long-term potentiation, which involves the strengthening of brain synapses being used to learn new tasks or bring up memories. Ideally, LTP should be high, especially in young people. The researchers found that the adult rodents exposed to the alcohol during adolescence had higher levels of LTP, which may seem to be a positive outcome but is actually not.

"If you produce too much LTP in one of these circuits, there is a period of time where you can't produce any more," said senior author Scott Swartzwelder, a Duke professor. "The circuit is saturated, and the animal stops learning. For learning to be efficient, your brain needs a delicate balance of excitation and inhibition—too much in either direction, and the circuits do not work optimally."

The researchers also observed a structural change in individual nerve cells: those exposed to alcohol at a young age have brain cells that appear immature, even in adulthood. "It's quite possible that alcohol disrupts the maturation process, which can affect these cognitive functions later on," Risher said. She also noted that the immature appearance of the cells might be associated with behavioral immaturity.

Fragile X Syndrome, a little known disorder, is the leading inherited cause of intellectual disabilities; U of L has only clinic for it in Ky.

A common but little-known genetic disorder called Fragile X Syndrome is the leading inherited cause of intellectual disability, autism and developmental delay, and the University of Louisville is home to the only Fragile X clinic in Kentucky, the university said in a press release.

Varying levels of disability are associated with the syndrome, depending on whether the FMR1 gene associated with the condition is fully mutated or merely changed but not fully mutated, according to the release.

The federal Centers for Disease Control and Prevention explains that the FMR1 gene is responsible for making a protein that is needed for normal brain development. Those with the syndrome don't make this protein, and those with altered genes don't make enough of it.

Infants born with the fully mutated gene may have intellectual disability, autism and/or delays in development, speech and language. Those with altered genes are more likely to have milder problems in childhood, such as a learning disability or issues with anxiety and social difficulty, which can occur both in childhood and adulthood, says the release. They can also develop infertility and neurological problems such as tremors, imbalance and dementia. Some carriers of the altered genes have no symptoms.

Fragile X Syndrome affects one in approximately 4,000 men and 6,000 women, according to the release. Carriers of the altered gene, who pass it along to later generations, are much more common, with approximately one in 250 women and 800 men.

The Weisskopf Child Evaluation Center at U of L is home to one of 27 clinics affiliated with the National Fragile X Foundation.

John and Shannon Casasfranco had their 2-year-old son John, who had been diagnosed with autism, genetically tested at the center on their doctor's recommendation. They learned that he had Fragile X, and that they were both carriers of the altered gene.

They encourage families to speak to their doctor about genetic testing if they are concerned about children not meeting milestones or suspect that Fragile X is an issue in their family. “If we hadn’t have gotten John tested, we wouldn’t know anything. There is no blood test for autism but there is for Fragile X. Now we know there’s a biological reason for his disability. It’s a hard thing to swallow but you’ve got to plan,” Shannon said.

“Because of our affiliation with the Fragile X Clinical & Research Consortium, we can provide care to patients and families like the Casasfrancos that is based on the most up-to-date knowledge and recommendations of clinicians across the United States who have expertise in Fragile X,” Lisa Craft, ;medical director of the WCEC Fragile X clinic, said.

According to Craft, Fragile X genetic testing should be considered for:

• A child with autism or developmental delays
• Adults with autism or developmental disabilities with no known cause
• Adults with a tremor or balance problem, even if no family members have been diagnosed with Fragile X.
• Women with fertility problems, even if no family members have been diagnosed with Fragile X.

“With knowledge comes power. Knowing that a child or adult has Fragile X provides the family with a ‘road map’ to help them understand the individual’s needs, challenges and strengths,” Craft said. “A diagnosis helps families find the most appropriate services and connect to other families and professionals who can help them on their journey across the lifespan.”

July 22 is National Fragile X Day.

Childhood obesity is linked to more immediate health problems than doctors formerly realized

While a plethora of research on childhood obesity has linked it to long-term health problems, a new UCLA study focuses on the condition's more proximate consequences, showing that obese children are at a greater risk for immediate health problems than previously thought. That's important for Kentucky, which ranks poorly in many health measures and is third highest in child obesity. (Photo by Tara Kaprowy)

"This study paints a comprehensive picture of childhood obesity, and we were surprised to see just how many conditions were associated with childhood obesity," said lead author Dr. Neal Halfon, a professor of pediatrics, public health and public policy at UCLA.

Compared to kids who are not overweight, the study found that obese children have nearly twice the risk of having three or more reported medical, mental or developmental conditions. Specific medical conditions included bone, joint and muscle problems; asthma; allergies; headaches; and ear infections. Obese children also reported a greater tendency toward emotional and behavioral problems, higher rates of grade repetition, missed school days and other school problems, ADHD, conduct disorder, depression, learning disabilities, and developmental delays.

The study provides the first comprehensive national profile of associations between weight status and a broad set of associated health conditions, a UCLA release said. Halfon said these findings should serve as a wake-up call to physicians, parents and teachers, who should be better informed of the risk for health conditions associated with childhood obesity. (Read more)

Georgia doctor prescribes pills to help in school -- whether or not the ADHD shoe fits -- to level the playing field for the poor

Amanda Rocafort and her son, Quintn,
who takes Adderall for his ADHD.
(NYT photo by Bryan Meltz)

In light of last week's news that the number of poor children on Medicaid in Kentucky are being prescribed anti-psychotic drugs at alarming rates for such diagnoses as attention-deficit and hyperactivity disorder and depression, the New York Times reports that some doctors are making "no excuses" for prescribing psychostimulants in other locales for children of the poor.  Dr. Michael Anderson, a pediatrician in a poor county north of Atlanta, Ga., said he thinks ADHD is "made up" and "an excuse" to prescribe pills to treat what he "considers the children’s true ill -- poor academic performance in inadequate schools." Still, "I don’t have a whole lot of choice,' said Anderson. “We’ve decided as a society that it’s too expensive to modify the kid’s environment. So we have to modify the kid.'"

Dr. Anderson is one of the more outspoken proponents of an idea that is gaining some ground: Prescribe drugs to struggling students in schools not to treat ADHD, necessarily, but to boost their focus and impulse control.  Alan Schwarz reports that Anderson figures that he is arming them with the only tool he has because these children can't afford family therapy or tutoring or behavior-based counseling or any of those other tools that other children might have at their disposal to help them learn.

Of course, Anderson is not without his critics. Many doctors, writes Schwarz, warn of the dangers of exposing children to the unwarranted physical and psychological risks of powerful drugs on everything from mood to blood pressure to the suppression of growth. (Read more)