The Use of Cardiac Orienting Responses as an Early and Scalable Biomarker of Alcohol-Related Neurodevelopmental Impairment

• Type of Material: Article
• Authors: Diego A. Mesa, University of California, San Diego; Julie Kable, Emory University; Claire Coles, Emory University; Kenneth Lyons Jones, University of California, San Diego; Lyubov Yevtushok, Rivne Regional Medical Diagnostic Center; Yaroslav Kulikovsky, Rivne Regional Medical Diagnostic Center; Wladimir Wertelecki, University of California, San Diego; Todd P. Coleman, University of California, San Diego; Christina D. Chambers, University of California, San Diego
• Language: English
• Date: 2016-11-24
• Publisher: Wiley: 12 months
• Publication Version: Final Published Version
• Copyright Statement: © 2016 Research Society on Alcoholism.
• Final Published Version (URL): http://dx.doi.org/10.1111/acer.13261
• Title of Journal or Parent Work: Alcoholism: Clinical and Experimental Research
• Volume: 41
• Issue: 1
• Start Page: 128
• End Page: 138
• Grant/Funding Information: All cardiac orienting response (COR) work was done in conjunction with the Collaborative Initiative on Fetal Alcohol Spectrum Disorders (CIFASD), which is funded by grants from the NIAAA.; Additional support was provided by USDA Agricultural Research Service Intramural Projects (5306-51530-019- 00D).; This research was funded by support from NIH Research Grant #U01AA014835 and Diversity Supplement 3U01-AA014835-1251, funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the NIH Office of Dietary Supplements (ODS)—Christina Chambers, PI.
• Keywords: alcohol; pregnancy; prenatal alcohol; cardiac orienting; Fetal alcohol spectrum disorders
• Research Categories: Health Sciences, Toxicology; Health Sciences, Human Development; Psychology, Developmental

Abstract

Background: Considered the leading cause of developmental disabilities worldwide, fetal alcohol spectrum disorders (FASD) are a global health problem. To take advantage of neural plasticity, early identification of affected infants is critical. The cardiac orienting response (COR) has been shown to be sensitive to the effects of prenatal alcohol exposure and is an inexpensive, easy to administer assessment tool. The purpose of this study was to evaluate the COR effectiveness in assessing individual risk of developmental delay. Methods: As part of an ongoing longitudinal cohort study in Ukraine, live-born infants of women with some to heavy amounts of alcohol consumption in pregnancy were recruited and compared to infants of women who consumed low or no alcohol. At 6 and 12 months, infants were evaluated with the Bayley Scales of Infant Development-II. CORs were also collected during a habituation/dishabituation learning paradigm. Using a supervised logistic regression classifier, we compared the predictive utility of the COR indices to that of the 6-month Bayley scores for identification of developmental delay based on 12-month Bayley scores. Heart rate collected at each second (Standard COR) was compared to key features (Key COR) extracted from the response. Results: Negative predictive values (NPV) were 85% for Standard COR, 82% for Key COR, and 77% for the Bayley, and positive predictive values (PPV) were 66% for Standard COR, 62% for Key COR, and 43% for the Bayley. Conclusions: Predictive analysis based on the COR resulted in better NPV and PPV than the 6-month Bayley score. As the resources required to obtain a Bayley score are substantially more than in a COR-based paradigm, the findings are suggestive of its utility as an early scalable screening tool based on the COR. Further work is needed to test its long-term predictive accuracy.