The brain impacts nearly every aspect of our lives. But if it is compromised by disability or disease, activities we take for granted can become a struggle, leading to issues as serious as not finishing school or being unable to live independently. These challenges are all too familiar for young people with fetal alcohol spectrum disorders (FASDs), which develop in utero and have lasting effects on everything from attention span, to memory and learning, to planning and organizing.
Currently, there is no proven intervention for cognitive issues experienced by those with FASD. But Jeffrey Wozniak, Ph.D., L.P., part of the U’s psychiatry faculty, and Christopher Boys, Ph.D., L.P., part of its pediatrics department, are aiming to change this.
Increasing brain plasticity
With Masonic support, Wozniak and Boys have developed and are now testing a new intervention that could give those with FASD an increased chance to thrive.
Their approach, which combines computerized cognitive training with mild electrical stimulation to the scalp, is to train the brain to become more flexible and adaptive to new information and situations.
While the work that they’re doing is serious, they’ve added an element of fun to keep their study participants, who range from 10 to 16 years old, engaged.
“Our cognitive training is designed to increase attention and working memory—things like keeping track of what you’re doing or remembering how objects are distributed across the screen, for example,” says Wozniak. “But to the child or teen, it looks like a video game. It’s progressive and gets more difficult the better you do.”
The participants complete six sessions of computerized games wearing an electrode cap and, during each session, half receive mild stimulation to the brain. Their results, which are measured with “before” and “after” MRI scans and cognitive testing, will be compared to the results for those who do not receive stimulation.
“When we provide electrical stimulation like this, we think it makes the brain a little more responsive to what’s happening at the moment,” Wozniak explains. “We’re essentially waking up the brain, saying the task at hand is important to pay attention to and be recorded.”
“We describe this as plasticity, the brain is always adapting. We’re not necessarily doing repair work, what we’re doing is training. Just like any experience in life, this experience is changing the brain. We’re enhancing it so the new learning sticks a little more and the brain is more ready to learn new tasks.”
As of March 2019, 30 children and teens had completed Wozniak and Boys’ study, with only 10 left to go.
The team’s next big step will be to analyze the data they’ve collected to see if the intervention is making a difference and, specifically, if those who receive electrical stimulation fare better than those who do not.
If the results show promise, Wozniak and Boys plan to apply for new support from the National Institutes of Health (NIH) to test the intervention in significantly more participants.
Eventually, says Wozniak, the hope is that cognitive function will improve so that the study participants will no longer need electrical stimulation or cognitive training.
Breaking new ground, while helping people on the ground
When it comes to understanding and treating FASD, researchers like Wozniak and Boys keep the U on the leading edge of discovery. Support from Minnesota Masonic Charities, which funded their latest study, has played a crucial role along the way.
“No one else in the world is doing this kind of study, which combines computerized cognitive training with electrode stimulation,” Wozniak says.
This innovative research has captured the attention of FASD experts nationally and internationally, including the person who discovered FASD more than 40 years ago. “He discovered fetal alcohol syndrome in 1973 and is still very active in the field. In fact, he comes to Minnesota twice a year to see the kids in our studies,” Wozniak says.
Boys has also developed a reputation locally and nationally for the care he provides to patients and families affected by FASD.
He was recently invited to speak at an NIH event about his team’s approach to clinical care and how to promote recognition of FASD in community and child welfare systems. And both he and Wozniak work on an ongoing basis with support groups, public awareness associations, and government agencies that develop and advocate for policies that raise awareness of and help people with FASD.
But in the end, they say, the most rewarding part of the job is working directly with people with FASD to make their lives better.
“The families, and especially the individuals affected by these disorders, are extremely appreciative of the work we’re doing on their behalf. They’re so thankful that this work is funded and that it’s moving toward an intervention,” Wozniak says. “And that’s what matters most.”