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RUSMIDDEL-Rusmiddelforskning

Neurocognitive development in children born to mothers with substance abuse and psychiatric disorders: biological-social interaction effects

Awarded: NOK 6.0 mill.

Project Number:

190411

Application Type:

Project Period:

2009 - 2014

Funding received from:

Location:

Substantial time and resources in the project have been devoted to recruitment and testing of participants. This is a special group of children, and it takes a lot of effort to get in touch with these. Still, recruitment and testing were completed as planned. The main aim of the project is to establish a database of brain measures, cognitive measures and social/ relational measures. Thus database will be used to investigate neurocognitive development in children born to mothers using drugs or suffering from psychiatric problems. These children will then be compared to children without such risk factors. An important part of the project is also to compare neurocognitive development in a group of children exposed to opioid and poly-substance use during pregnancy, but where the mother has were detoxified, to a group of exposed children we previously have studied where the mothers were not detoxified. In the latter group, we have previously seen neurocognitive differences compared to a group of control children. We have analyzed data during the project, and preliminary analyses have yielded very interesting results. We are now working on several manuscripts based on these results alone. Two of the first three completed manuscripts are now accepted for publication, while a third is currently under review. We cannot describe the results of this paper since it has not yet been accepted for publication. Of results published so far, we have found that the mothers mental health problems seem to be associated with brain development and cognitive development in 4.5 year old children. The children born to mothers with psychiatric problems also had lower birth weight and gestational age. Further, we have found that infants born to mothers in residential detoxification treatment, who experience less prenatal drug exposure, show better perinatal outcomes on gestational age and head circumference, as well as no NAS, compared to the infants in the earlier cohort whose mothers did not receive residential treatment. No miscarriages, complications, or morbidities were associated with residential detoxification treatment in this cohort.

Maternal substance abuse has biological and social effects on children, often interacting in determining developmental outcome. Prenatal substance exposure can alter brain development and effects can be worsened by concomitant parental psychopathology pre ceding or following substance abuse. This project will identify mechanisms that mediate and moderate effects of maternal substance abuse on developmental difficulties. Five hypotheses will be tested: (1) Cerebral markers of developmental state, including morphometric and fiber tract characteristics, can be identified by magnetic resonance imaging (MRI). These brain characteristics are part of the basis for, and may precede, cognitive and behavioral expression. Attention/hyperactivity difficulties in many children exposed to substances involve brain-changes in frontal-striatal circuitry in terms of gray matter reductions and possibly altered fiber connections (2) Such markers can be used to identify children at risk for cognitively aberrant development, an d inform diagnosis, treatment and intervention. (3) Continuity can to some extent be identified in cognitive skills and quality of interaction from 2 to 4 yrs of age. We hypothesize that the quality of early mother child interaction will mediate the relat ion between earlier and later cognitive skills. (4) Biological and social vulnerability variables may interact with gender in determination of developmental outcome with a vulnerability for lower cognitive functioning in boys. (5) Children who live in a p oor care environment as measured by the quality of mother-child interaction, will show an atypical cortisol extraction cyclus, or less cortisol variation during the course of a day-night cycle. To test this, optimal behavioral and MRI protocols, including MRI real-time motion correction, will be developed and implemented in a collaborative inter-disciplinary international network, fostering research translation to clinical application in diagnosis and intervention.

Funding scheme:

RUSMIDDEL-Rusmiddelforskning