It’s possible that I shall make an ass of myself. But in that case one can always get out of it with a little dialectic. I have, of course, so worded my proposition as to be right either way (K.Marx, Letter to F.Engels on the Indian Mutiny)
New approach to FASD in N.W.T. focuses on accommodation, not behaviour CBC March 6, 2020 A new wave of thinking on how to work with those who live with Fetal Alcohol Spectrum Disorder (FASD) has arrived in the Northwest Territories.
It aims to recognize FASD as a brain-based physical disability, with symptoms or effects expressed through undesired behaviour. But instead of a focus on correcting the behaviour, this "brain-based" approach is focused on accommodating the disability before the bad behaviour happens.
A three-day workshop in Yellowknife this week presented the approach to more than 150 parents, and front-line social, mental health, and justice workers in the N.W.T.
"Until recently … FASD has been understood as a condition," said Nathalie Brassard, the FASD consultant and facilitator with FASCETS Canada West who led the workshop.
"We knew what caused it, but we didn't really know quite what to do for the individuals…. We focused on … behaviours, not realizing that behaviours are only a sign for the root cause, which is a brain that functions differently."
It's estimated by the Centre for Addiction and Mental Health (CAMH) that one out of every 13 women who consume alcohol during pregnancy will deliver a child with FASD — a disorder with a range of mental, physical and behavioural effects that result from neurochemical and structural brain damage in the mother's womb. It can interfere with a person's ability to successfully function in daily life.
In Canada, the CAMH estimates that eight out of every 1,000 children have FASD, although rates are generally acknowledged to be higher in special populations, such as the child welfare system or the justice system. According to the Northwest Territories Health and Social Services Authority, there are no statistics on the prevalence of FASD in the territory, but between one and four per cent of the Canadian population is affected by the disorder.
A paradigm shift
Brassard described the change in focus — from behaviour correction to disability accommodation — as a paradigm shift.
Kate Kyle/CBC
"The importance is to realize who we have in front of us — to ask ourselves, who is this person? What do they need? How do they function or function differently? What's hard for them?" Brassard said.
"By providing accommodation and support, those behaviours that we've been focusing on reduce on their own, and diminish and disappear."
But accommodation will vary from person to person, said Shawna Pound, the territory's adult FASD program co-ordinator with the Northwest Territories Health and Social Services Authority. The trick is to identify what a person needs in order to overcome undesired behaviour, and then to put mechanisms in place to account for those needs.
As an example, she describes a person with FASD who is chronically late for work. That person may, through disability, lack the capacity to understand what is going wrong every day. For the rest of us, it might be obvious that the person needs to set alarms as reminders to get to work on time. What may be unique about the person with FASD is the inability to make that judgment call, to recognize there is a problem, and to set an alarm.
"They need someone to set the reminders up in their phone, or maybe they need a phone call," Pound said. "It'll look different for everybody."
Pound said that the three-day workshop this week qualified participants for formal facilitator training in the method. She said a few people have shown interest in the year-long training process, and her department would like to see the approach expand in the North.
Alcohol harm reduction experts are calling on the Government to urgently act on recommendations from nine witnesses who have detailed the multiple, serious and systemic failures by successive Governments to address the unequal harms to Māori from the lifelong disability of Fetal Alcohol Spectrum Disorder (FASD).
The witnesses will be heard by the Waitangi Tribunal on Monday and Tuesday, in support of a claim (WAI2624) submitted by Raawiri (David) Ratuu (Ngaati te Ata Waiohua, Waikato-Tainui, Ngaati Maniapoto) of Kookiri ki Taamakimakaurau Trust and member of The Health Coalition Aotearoa’s Roopuu Apaarangi Waipiro, Alcohol Expert Panel.
First, caregivers will describe the devastating, life-changing and on-going challenges and distress they face raising their loved ones with FASD, often with little to no Government support. Clinical practitioners and researchers will then present compelling evidence on the Crown’s breaches of Te Tiriti o Waitangi by failing to respond to the serious harm of FASD. This includes failures to measure the prevalence of FASD as well as providing specific and adequate funding for diagnosis and wrap-around disability support services for individuals and whānau.
Fellow Health Coalition Aotearoa Panel member and clinical neuropsychologist, Dr Valerie McGinn, is one of the witnesses presenting evidence next week. She says "the evidence to be presented will be upsetting to many - the implications of alcohol exposure in pregnancy have devastating, intergenerational effects. With an estimated one-half of all pregnancies being exposed to alcohol, as many as 1800 or more babies are born with FASD in our country each year. The damage to the brain from prenatal alcohol exposure leads to outcomes such as low educational achievement, mental health and substance abuse issues, early contact with the justice system, benefit dependence and premature death - including through suicide. With the right funding and support, these outcomes can be greatly reduced and persons with FASD and their whānau can thrive. FASD must be recognised as a stand-alone disability, eligible for disability support services. Other countries are leading the way, and Aotearoa New Zealand must follow suit."
"The Waitangi Tribunal claim and witnesses present clear solutions for change. Proper regulation of alcohol is also imperative to reduce the number of babies born with FASD each year. Weak regulation has resulted in the oversaturation of alcohol outlets across many communities, low alcohol prices, and sophisticated advertising to target young people and those of child-bearing age" says Panel member Dr Nicki Jackson.
"The persistent lack of regulation of alcohol has enormous, lifelong consequences. Our pro-drinking environment drives inequities in alcohol use and harm, including the lifelong disability of FASD. We, as the Health Coalition Aotearoa Alcohol Expert Panel, urge the Government to implement effective regulation of our most harmful drug. They have a duty to create healthy environments that support alcohol-free pregnancies. We want every child to have the opportunity to reach their full potential", ends Dr Nicki Jackson.
First experimental study to propose a therapy to correct memory deficit caused by disorders in the fetal alcohol spectrum
Research conducted in a mouse model identifies the neurobiological mechanism responsible for alterations in the memory of young individuals exposed to alcohol during pregnancy and lactation. This study proposes a therapy that can reverse the deficit
IMAGE: FROM LEFT TO RIGHT: INÉS GALLEGO, ANTONI PASTOR, ALBA GARCIA-BAOS, OLGA VALVERDE AND RAFAEL DE LA TORRE. CREDIT: UPF.view more
CREDIT: UPF
A research team of the Department of Medicine and Life Sciences (MELIS) at Pompeu Fabra University (UPF) involving the Hospital del Mar Research Institute has for the first time, in mice, identified and validated the neurobiological mechanism and therapy to correct memory deficit in individuals with fetal alcohol spectrum disorders (FASD). These results pave the way for studying whether the mechanism is the same in humans, which would enable improving the diagnosis and treatment of affected individuals.
Fetal Alcohol Spectrum Disorder (FASD) includes a number of conditions suffered by infants who have been exposed to alcohol during pregnancy. The effects of FASD range from craniofacial morphological malformations or growth problems, in the most severe cases, to hyperactivity, emotional and motivational difficulties or defects in learning and memory, in the mildest cases.
“In children of normal appearance, FASD is underdiagnosed and is often mistaken for hyperactivity or ADD”, explains Rafael de la Torre, coordinator of the Integrated Pharmacology and Systems Neuroscience Research Group at the Hospital del Mar Research Institute. “Since there is no diagnosis, there is no treatment, and symptomatic therapy is given to alleviate hyperactivity or other disorders such as anxiety”.
The results of the study published in the journal Molecular Psychiatry, have allowed the researchers to observe that “exposure to alcohol need not be chronic for FASD to occur. Sporadic consumption ending in intoxication - getting drunk- is enough to observe alterations in memory, in mice”, explains Olga Valverde, study coordinator and director of the Research Group in Behavioural Neurobiology at the MELIS-UPF.
The study shows that mice born to mothers that have consumed alcohol sporadically during pregnancy and lactation have a memory deficit that persists into adulthood. One of the reasons for this deficit is that alcohol affects the function of the endocannabinoid system, reducing the expression of the PPAR-𝛄 receptor.
“The endocannabinoid system is greatly involved in learning and memory processes”, de la Torre explains. “That is why it is especially relevant that this decrease occurs during infancy, when the mice, male and female, are of learning age”. However, the reduction in PPAR-𝛄 does not occur throughout the brain. It is limited to the hippocampal astrocytes -cells that support neurons controlling functions such as their metabolism or the inflammation to which they are subjected- of the hippocampus.
After confirming the neurobiological mechanism by three different routes, the study also proposes an effective treatment with the drugpioglitazone, commonly used to control sugar and which stimulates PPAR receptors. According to the first author of the study, AlbaGarcia-Baos, “manages to alleviate the cognitive memory deficitsof individuals with FASD in infancy”.
Optimism regarding studies in humans
The results of this study pave the way for studying the effects of other cognitive impairments caused by alcohol exposure during pregnancy. “In this work we have only studied alterations in memory, but there may be emotional, motivational or behavioural alterations related to FASD”, points out Valverde, who is also a full professor of Psychobiology at UPF.
Although this study has been conducted in mice, the researcher is optimistic about confirming that this mechanism is replicated in humans “because we are two species of mammals that share many similarities”. In addition, if confirmed, “it would be relatively simple to carry out a study to validate whether the therapy we propose works in humans, since there are drugs that have similar effects to the ones we have used that are approved for use in children”.
Thanks to his Gladue report, Blaine Hotomanie is now serving a reduced six month sentence in jail after being found guilty of impaired driving. He's seen here in Carry the Kettle Nakoda Nation, Sask., in early January, before he started his sentence (Richard Agecoutay/CBC News)
Blaine Hotomanie's Gladue report did more than reduce the time he'll spend behind bars.
"It changed my life, the way I look at things," he said. "I've got a big family and I want to show my grandchildren not to drink and drive. I talk to them about it."
Gladue reports present circumstances of a self-identified Indigenous accused's life for a judge to consider while deciding on a sentence. These can include personal and community histories, and traumas such as colonialism and its ongoing impacts.
Even though Gladue reports are a right for every Indigenous person who appears in court — thanks to two court decisions from 1999 and 2012 — not everyone is aware of their right to them, or has access to Gladue report writers. Saskatchewan in particular ranks near the bottom of the country for the use of Gladue reports, according to data from the Aboriginal Legal Society, which intervened in the landmark 1999 court case.
Gladue reports are time-consuming and resource-intensive, but in late 2020 the Integrated Justice Program (IJP), which is funded by Public Safety Canada, created a team of legal experts and people who study and work with people with fetal alcohol spectrum disorder (FASD), entirely focused on writing the reports for Saskatchewan trials.
WATCH| What are Gladue reports?
What are Gladue reports?
9 hours ago
Duration2:51
Gladue reports explain an Indigenous person’s history, their families history and their community's history to the courts to take the individual’s unique circumstances and challenges into consideration. 2:51
Advocates say the writing team is allowing more people to get the Gladue reports they are entitled to.
Michelle Stewart and Robyn Pitawanakwat, members of the Integrated Justice Program, seen here working on laptops at the University of Regina, are part of a team that writes Gladue reports for people with fetal alcohol spectrum disorder. (Bryan Eneas/CBC)
Hotomanie, 57, from Carry the Kettle Nakoda Nation — roughly 80 kilometres east of Regina — had at one point been facing 18 months for impaired driving last spring. After his Gladue report, which presented factors including his FASD, Hotomanie's sentence was reduced to six months.
Over the course of three days of three-hour interviews for his Gladue report, Hotomanie shared the pains he faced growing up. He experienced a lot of violence as a child in a home where both his parents drank. He lost loved ones — particularly his parents — and was in the residential school system.
It wasn't until his interviews with the IJP that Hotomanie learned how these traumas impacted him.
Now, with a large support network consisting of his wife, his six children, 25 grandchildren, friends and leaders in Carry the Kettle, he's more worried about his future than his sentence.
"I've got all that stuff out and I'm doing better. I've got a job. I've never had a job for a long time," he said.
"I'm kinda hoping that I can save my job, but time will tell."
Representing the most marginalized
The IJP was launched in 2019. It is a joint initiative run by the Fetal Alcohol Spectrum Disorder Network and File Hills Tribal Council. The program focuses on comprehensive support for Indigenous people with FASD in Saskatchewan.
IJP launched the team focused on writing in-depth Gladue reports in fall 2020.
Hotomanie said he didn't know what a Gladue report was until he met Michelle Stewart and Robyn Pitawanakwat from the IJP.
Stewart, an expert on FASD, is the IJP's project lead and Gladue project coordinator, while Pitawanakwat is the program's coordinator, runs the organization's frontline services and conducts Gladue interviews.
"These are often the most marginalized people within the justice system," Pitawanakwat said.
"We work with them because their disability [FASD] isn't understood, and their disability often makes them more vulnerable to charges, where someone else who presents differently would probably not be charged."
Stewart, an associate professor at the University of Regina, said the initial goal was to work directly with people with FASD to ensure their complex needs were being met.
"Our goal is to expand that circle of support for them, because we're talking about individuals that experience compounding forms of marginalization and alienation," Stewart said.
Stewart and Pitawanakwat said their work — building relationships to learn about someone's traumas, personal and familial history, taking the time to understand those subjects, then preparing the reports — is an effort toward reconciliation within Saskatchewan's justice system.
Pitawanakwat, the Integrated Justice Program's lead interviewer, seen here at the University of Regina, said those involved feel supported in what they do and those who've participated felt the process was good for them. (Bryan Eneas/CBC )
The Truth and Reconciliation Commission's 34th call to action calls on governments, "to make changes to the criminal justice system to improve outcomes for offenders with Fetal Alcohol Spectrum Disorder (FASD)."
Pitawanakwat said IJP writers provide courts with important context. Many of the interviewees have been separated from their families and peers, Pitawanakwat said.
"One of the strongest ways that we can push back against colonialism is to bring families back together; to bring people home and keep them home whenever possible," Pitawanakwat said.
Hotomanie's report did just that, allowing him to stay in Carry the Kettle a bit longer before he was incarcerated. He will also be able to reconnect with his family sooner, due to the reduction in his sentence the judge granted after reading the report.
Program's work greatly needed
The IJP team has completed more than 30 Gladue or pre-sentencing reports in Saskatchewan as of January 2022, Stewart and Pitawanakwat said.
Gladue reports can take weeks to months to complete, due to resource constraints within the justice system. The IJP's team-based approach has dramatically reduced turnaround times in Saskatchewan, where the need for the program is great.
The province ranks near the bottom when it comes to using Gladue reports in court, said Jonathan Rudin, the program director for Aboriginal Legal Services.
Jonathan Rudin, Aboriginal Legal Service's program director, said most Gladue reports completed in Saskatchewan are privately funded. He's seen here speaking at a lectern at Lakehead University. (Amy Hadley/CBC)
"In most parts of Canada where there are Gladue reports, the provincial government in particular, or the provincial legal aid plan, steps up with funding," Rudin said.
"In Saskatchewan the provincial government does not seem inclined to provide that funding at all."
Data provided by the Ministry of Justice showed that the provincial government paid a combined $78,080 for 24 Gladue reports over the past five years. That data doesn't include reports by independent agencies like the IJP.
In the 2019-2020 reporting year — the last time the province covered the costs for Gladue reports — the government paid for two reports. In the 2018-2019 reporting year it paid for 10, the most in the five years of data provided.
In the 2020-2021 reporting year, it paid for none.
Rudin said that, aside from IJP reports, the few cases where Gladue reports were completed in the province were primarily privately funded. In just a few instances, courts were asked to provide the money or ordered the government to provide the money.
Government support needed, expert says
Jane Dickson, who trained Stewart in Gladue writing and is currently a professor of law at Carleton University, said there shouldn't need to be independent agencies doing Gladue reports, as the Supreme Court of Canada has ruled every Indigenous person should be granted one.
"If government stepped up and adequately funded Gladue we wouldn't need to find these creative solutions to secure funding," Dickson said.
She said in Saskatchewan and many other parts of Canada, courts take it upon themselves to decide whether or not they have the right amount of information to determine someone's fate.
Stewart, left, the Integrated Justice Program's lead, seen here at the University of Regina, said a variety of different people participate in the practicum program offered through the IJP, which in turn spreads the knowledge and style of Gladue writing the team offers. (Bryan Eneas/CBC)
In Saskatchewan, the Ministry of Justice said courts were committed to using "relevant Gladue information" in pre-sentencing reports completed by community corrections staff like parole officers.
"Community corrections has made a concerted effort to heighten awareness of Gladue factors and provide Gladue information in pre-sentence reports," the ministry's statement said.
Dickson said legal professionals would rather see full Gladue reports like those being done by the IJP, but there is too much demand. She's working with organizations across Canada on a team-based approach like what the IJP is doing in Regina.
"The model is absolutely generalizable across the country," Dickson said.
A success, so far
Pitawanakwat said while some of the reports the IJP did were more beneficial than others, the program was successful so far because the people involved feel supported in their work.
Most importantly, Pitawanakwat said the clients involved in the program seemed to feel the process was good for them and judges seem to be recognizing the reports are well researched and well written.
Hotomanie says he was a bit nervous about his six month sentence, though he was mostly more worried about being able to return to his job in Carry the Kettle when he comes home. (Richard Agecoutay / CBC News)
Hotomanie said he felt comfortable during the interview process. When things got tough and he became emotional, the group pressed pause and agreed to continue the next day when he felt better.
He also felt as though he got to know Pitawanakwat and Stewart through the process as much as they got to know him.
The final report made him feel understood by the courts in a way the justice system never had.
"I wasn't just a person who was getting caught for impaired [driving], I felt good about myself," Hotomanie said.
Bryan Eneas is a journalist from the Penticton Indian Band currently based in Regina, Saskatchewan. Before joining CBC, he reported in central and northern Saskatchewan. Send news tips to Bryan.Eneas@cbc.ca.
Wednesday, October 29, 2025
Mayo Clinic study finds majority of midlife women with menopause symptoms do not seek care
ROCHESTER, Minn. — A new study from Mayo Clinic underscores the widespread impact of menopause symptoms on midlife women — and raises concern that most are navigating this stage of life without medical care to help manage those challenges.
The study, published in Mayo Clinic Proceedings, was based on responses from nearly 5,000 women ages 45-60 who were surveyed across four Mayo Clinic primary care locations. More than 3 out of 4 respondents experienced menopause symptoms, with many reporting substantial effects on daily life, work productivity and overall well-being.
Despite the availability of safe and effective treatment options, Mayo Clinic researchers found that menopause symptoms remain underrecognized, undertreated and inadequately addressed in the health care system.
Severe symptoms affect daily life, yet few women seek care or receive treatment
More than one-third (34%) of women who were surveyed reported moderate to very severe symptoms. Sleep disturbances and weight gain were among the most common issues reported by more than half of participants.
The most striking finding was that more than 80% of the women who responded to the survey did not seek medical care for their menopause symptoms. While many women said they preferred to manage symptoms on their own, others said that they were too busy or unaware that effective treatments exist. Only about 1 in 4 women were receiving any treatment for menopause symptoms at the time of the survey.
"Menopause is universal for women at midlife, the symptoms are common and disruptive, and yet, few women are receiving care that could help them," says lead author Ekta Kapoor, M.B.B.S., an endocrinologist and menopause specialist at Mayo Clinic in Rochester. "This gap has real consequences for women's health and quality of life, and it's time we address it more proactively."
Without proper treatment, menopause symptoms can negatively affect sleep, mood, cognition, and productivity at work and at home. The findings underscore the importance of healthcare professionals proactively identifying and managing menopause symptoms in patients who may be struggling with them, the authors said.
Researchers call for proactive care strategies and new tools to close the treatment gap
The study noted that women often do not voluntarily mention concerns about menopause symptoms to their healthcare professional. Mayo Clinic researchers emphasize the need for strategies that destigmatize menopause care and make it more visible and accessible. Efforts are underway to develop questionnaires, digital tools and smartphone apps that help women identify symptoms, learn about treatment options and have more productive discussions with their primary care professionals.
"Our goal is to educate women and healthcare professionals about menopause," Dr. Kapoor says. "By making it easier to recognize and understand symptoms, we can close the gap between need and care — and help midlife women live healthier, more fulfilling lives."
Review the study for a complete list of authors, disclosures and funding. A video of Dr. Kapoor discussing the findings is available.
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About Mayo Clinic Proceedings
One of the premier peer-reviewed clinical journals in general and internal medicine, Mayo Clinic Proceedings is among the most widely read and highly cited scientific publications for physicians. Continuously published since 1926 and celebrating its centennial next year, Mayo Clinic Proceedings is sponsored by Mayo Clinic, guided by its Bold. Forward. vision to transform medicine as the global authority in the care of serious or complex disease. The journal publishes original research, articles and commentary from authors worldwide and has an Impact Factor of 6.7, placing it in the top 10% among general and internal medicine journals.
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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.
Addressing Menopause Symptoms: Barriers and Opportunities for Improvement
Article Publication Date
29-Oct-2025
COI Statement
Dr Kapoor has received consulting fees from Mithra Pharmaceuticals, Astellas Pharmaceuticals, and Womaness; and has received grant support from Mithra Pharmaceuticals. Dr Kling has received consulting fees from Everday Health as a medical editor; and has received fees or honoraria for lectures, presentations, speaker bureaus, manuscript writing, or educational events from Pri-Med and AiCME. The remaining authors report no potential competing interests. Dr Faubion has received honoraria for lectures for PriMed, AiCME, Medscape and consulting fees from Era Women’s Health Platform and Weight Watchers.
Houseplant inspires textured surfaces to mitigate copper IUD corrosion
Laser-engraved microstructure patterns inspired by the golden pothos mitigate the burst release of copper ions, paving the way for safer IUDs
A golden pothos plant (Epipremnum aureum) and a scanning electron microscope image of its surface microstructures. Researchers are taking inspiration from its surface patterns to make a safer copper IUD.
Credit: A golden pothos plant (Epipremnum aureum) and a scanning electron microscope image of its surface microstructures. Researchers are taking inspiration from its surface patterns to make a safer copper IUD. Credit: Liu et al.
WASHINGTON, Oct. 28, 2025 – Copper intrauterine devices are a common contraceptive due to their long-acting effects and affordability. However, the first few months of use are associated with several side effects.
When a copper IUD is first implanted in the uterus, it undergoes a chemical reaction with uterine fluid. This reaction corrodes its surface, causing a burst of copper ions, which can lead to symptoms such as menstrual irregularity, increased menstrual cramps, and pelvic inflammatory disease.
In Biointerphases, an AVS journal published by AIP Publishing, researchers from Changchun University and Northeast Normal University took inspiration from a common houseplant to develop a better, safer copper IUD.
The researchers noticed that pothos leaves are hydrophobic — a distinctive microstructure on the leaf’s surface causes water droplets to ball up and slide off.
The team realized that mimicking this pattern on the surface of a copper IUD might repel uterine fluid. Less contact between the surface and fluid would decrease corrosion, releasing fewer copper ions and mitigatingside effects.
Under a scanning electron microscope, the researchers observed that the dried pothos leaf was covered with a system of ridges and hexagonal valleys. Researchers quantified this pattern by calculating the average diameter of the ridges, the depths of the valleys, and the angle between each ridge and valley. Then, the simplified, bioinspired pattern was engraved onto the surface of the IUD using lasers.
“The pothos structure offered a balance of simplicity, stability, and effectiveness, making it well suited for our goal of improving copper IUDs,” said author Junbo Liu.
The researchers saw the engraved surface repelled water significantly better than the traditional IUD. After testing the corrosion of the IUD, researchers found that it released fewer copper ions into simulated uterine fluid. Cell viability and cytotoxicity tests determined potential tissue responses to cells in contact with the IUD.
Compared to a traditional copper IUD, the plant-inspired device is more hydrophobic and more corrosion-resistant, releases fewer copper ions, causes less cell death, and increases cell viability. The laser texturing technique is scalable and avoids supply-chain risks associated with the creation of mixed-metal IUDs and the degradation of polymer IUD coatings.
The team plans to optimize their prototype for larger-scale laser patterning and efficient production and to conduct in vivo studies to measure the long-term behavior of their IUD.
“On a broader level, this study demonstrates how surface engineering inspired by natural structures can provide innovative solutions to biomedical challenges, bridging materials science with women’s health care,” said Liu.
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The article “A femtosecond laser-textured copper surface for reducing initial copper ion burst release in intrauterine devices” is authored by Junbo Liu, Lili Zhou, Li Liu, and Yuwei Li. It will appear in Biointerphases on Oct. 28, 2025 (DOI: 10.1116/6.0004923). After that date, it can be accessed at https://doi.org/10.1116/6.0004923.
ABOUT THE JOURNAL
Biointerphases, an AVS journal published by AIP Publishing, emphasizes quantitative characterization of biomaterials and biological interfaces. As an interdisciplinary journal, a strong foundation of chemistry, physics, biology, engineering, theory, and/or modelling is incorporated into originated articles, reviews, and opinionated essays. See https://pubs.aip.org/avs/bip.
ABOUT AVS
AVS is an interdisciplinary, professional society with some 4,500 members worldwide. Founded in 1953, AVS hosts local and international meetings, publishes five journals, serves members through awards, training and career services programs, and supports networking among academic, industrial, government, and consulting professionals. Its members come from across the fields of chemistry, physics, biology, mathematics, engineering, and business and share a common interest in basic science, technology development and commercialization related to materials, interfaces, and processing.
Credit: Texas A&M University Naresh K. Vashisht College of Medicine
Fetal Alcohol Spectrum Disorders (FASD), a leading cause of neurodevelopmental disorders, may affect as many as 1 in 20 school-aged children in the United States. Despite its prevalence, the exact brain circuit responsible for FASD’s hallmark symptom — cognitive inflexibility, or the inability to adjust thoughts and behaviors to new environments — has largely remained a mystery.
A new study led by Dr. Jun Wang and co-authored by Dr. Rajesh Miranda, professors at Texas A&M University’s Naresh K. Vashisht College of Medicine, observed that alcohol consumption both during pregnancy and around the time of birth significantly impairs an offspring’s brain development — particularly in regions that govern decision-making — while also increasing the risk of compulsive alcohol use later in life.
“It’s exciting,” Wang said. “We’ve identified a specific brain cell in offspring affected by early alcohol exposure that’s directly linked to problems with flexible thinking and impulse control, and this gives us a clear target for better understanding and eventually developing more effective treatments of FASD.”
Targeted treatments and a call for awareness
By pinpointing the exact brain circuits affected by prenatal alcohol exposure, the study opens possibilities for targeted therapies aimed at restoring normal cognitive and behavioral flexibility in individuals with FASD.
"Our findings represent a major step forward in FASD research. By uncovering how early alcohol exposure changes brain chemistry, we’re able to move from describing symptoms to transitioning into treating root causes," Wang said.
The findings also reinforce longstanding public health messages about the risks of drinking alcohol during pregnancy or around the time of birth.
“Even limited alcohol consumption during sensitive developmental windows can have profound and lifelong consequences,” Wang said.
Neuron damage in key brain regions
Published in Neuropharmacology and supported by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the study explored the impact of early alcohol exposure on a specific type of brain cell known as cholinergic interneurons, or CINs — important regulators of learning, behavioral flexibility and impulse control within the brain’s decision-making hub, the striatum
“CINs are like the conductors of the brain’s decision-making orchestra,” Wang explained. “They are largely responsible for the decision-making network in the brain.”
Using high-resolution imaging techniques, the team not only discovered a sharp reduction in the number of CINs in prenatal alcohol-exposed offspring, but they also observed a marked decrease in their firing activity and release of acetylcholine, an essential chemical for learning and adaptive behavior.
“Alcohol exposure during pregnancy or around the time of birth disrupts these conductors,” Wang said. “This impairs the brain’s ability to make critical decisions, learn from feedback and adjust to change.”
These disruptions and deficits help explain why individuals with FASD struggle with cognitive flexibility.
“Cognitive flexibility is our mental ability to learn, adapt and adjust to new or unexpected situations,” Wang said. “It can be significantly impaired in FASD groups.”
The lack of cognitive flexibility was clearly demonstrated in behavioral experiments when the researchers trained and compared two groups—one prenatal alcohol-exposed offspring, one control — to press two distinct levers, each associated with a different food reward.
When the levers were reversed, the prenatal alcohol-exposed group struggled to adjust their responses, continuing to press the old lever despite the change.
“This highlights how prenatal alcohol exposure can have lasting effects on a brain’s flexibility and adaptability to new environments,” Wang said.
From brain chemistry to real-world behavior
Beyond brain changes, the researchers explored how early alcohol exposure might influence behavior later in life — specifically compulsive alcohol drinking, a known risk factor for FASD populations.
Strikingly, they found that the prenatal alcohol-exposed offspring showed compulsive drinking in adulthood, continuing to drink alcohol even when it was mixed with a bitter substance designed to make it unpalatable.
"When key decision-making brain cells are compromised, they don’t just stop at brain chemistry. They manifest in real-world behaviors, like addiction and compulsive behavior," Wang said.
Urgency for prevention, emphasis on intervention
By identifying specific brain circuits disrupted by early alcohol exposure, the research highlights the importance of early prevention, intervention and education of alcohol use during pregnancy and the perinatal period.
“This is a preventable disorder,” Wang emphasized. “There is no safe amount, no safe time, to consume alcohol during pregnancy.”
As the research team continues to uncover brain mechanisms behind FASD, the message is clear: alcohol and pregnancy don’t mix.
For more information about Wang, visit his faculty page.
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