title: Neuropyschological and behavioral outcomes from a comprehensive magnetic resonance study of children with fetal alcohol spectrum disorders.
abstract: BACKGROUND
  Clinical and research advancements in the field of fetal alcohol spectrum disorders (FASD) require accurate and valid identification of FASD clinical subgroups.
  
  
  OBJECTIVE
  A comprehensive neuropsychological battery, coupled with magnetic resonance imaging, (MRI), MR spectroscopy (MRS), and functional MRI (fMRI) were administered to children with fetal alcohol spectrum disorders (FASD) to determine if global and/or focal abnormalities could be identified across the spectrum, and distinguish diagnostic subclassifications within the spectrum. The neuropsychological outcomes of the comprehensive neuroimaging study are presented here.
  
  
  METHODS
  The study groups included: 1) FAS/Partial FAS; 2) Static Encephalopathy/Alcohol Exposed (SE/AE); 3) Neurobehavioral Disorder/Alcohol Exposed (ND/AE) as diagnosed by an interdisciplinary team using the FASD 4-Digit Code; and 4) healthy peers with no prenatal alcohol. A standardized neuropsychological battery was administered to each child and their primary caregiver by a psychologist.
  
  
  RESULTS
  Use of the 4-Digit Code produced three clinically and statistically distinct FASD clinical subgroups. The three subgroups (ND/AE, SE/AE and FAS/PFAS) reflected a linear continuum of increasing neuropsychological impairment and physical abnormality, representing the full continuum of FASD. Behavioral and psychiatric disorders were comparably prevalent across the three FASD groups, and significantly more prevalent than among the Controls. All three FASD subgroups had comparably high levels of prenatal alcohol exposure.
  
  
  CONCLUSIONS
  Although ND/AE, SE/AE, and FAS/PFAS are distinct FASD subgroups, these groups are not distinguishable solely by their neuropsychological profiles. While all children within a group shared the same magnitude of neuropsychological impairment, the patterns of impairment showed considerable individual variability. MRI, MRS and fMRI further distinguished these FASD subgroups.
authors.affiliation: Department of Epidemiology, University of Washington, Seattle, USA. astley@u.washington.edu
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Astley
authors.forename: Heather Carmichael
authors.initials: HC
authors.lastname: Olson
authors.forename: Kimberly
authors.initials: K
authors.lastname: Kerns
authors.forename: Allison
authors.initials: A
authors.lastname: Brooks
authors.forename: Elizabeth H
authors.initials: EH
authors.lastname: Aylward
authors.forename: Truman E
authors.initials: TE
authors.lastname: Coggins
authors.forename: Julian
authors.initials: J
authors.lastname: Davies
authors.forename: Susan
authors.initials: S
authors.lastname: Dorn
authors.forename: Beth
authors.initials: B
authors.lastname: Gendler
authors.forename: Tracy
authors.initials: T
authors.lastname: Jirikowic
authors.forename: Paul
authors.initials: P
authors.lastname: Kraegel
authors.forename: Kenneth
authors.initials: K
authors.lastname: Maravilla
authors.forename: Todd
authors.initials: T
authors.lastname: Richards