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Distúrbios do espectro da síndrome fetal alcoólica (DSFA) : alterações no SNC e perturbações associadas
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Resumo(s)
Nos últimos 40 anos tem sido claro que as consequências da exposição pré-natal ao álcool resultam num conjunto de características, atualmente designadas por Distúrbios do Espectro da Síndrome Fetal Alcoólica (DSFA). Este espectro inclui desde as alterações físicas, a nível do neuro-desenvolvimento, até cognitivas e comportamentais. Nesta revisão as alterações no SNC e as perturbações secundárias associadas são discutidas. O reconhecimento do perfil cognitivo e comportamental é fundamental para o correto e rápido diagnóstico, bem como ajuda os clínicos na distinção entre os DSFA e outras perturbações mentais. As características fenotípicas da exposição alcoólica são relacionadas com os efeitos do álcool no SNC, como no corpo caloso, cerebelo, gânglios da base e substância cinzenta-branca. Assim, há a necessidade de uma intervenção e de um tratamento efetivo para as crianças com DSFA. Neste artigo revemos as principais estratégias e terapêuticas que têm como respetivos alvos os mecanismos moleculares envolvidos nos danos do álcool no cérebro, os fatores protetores e de agravamento dos défices encontrados nos indivíduos com DSFA e outras intervenções que podem melhorar a plasticidade do Sistema Nervoso Central, quer durante a exposição alcoólica, quer muito tempo após esta ter ocorrido.
In the last 40 years it has become clear that the prenatal alcohol exposure results in the development of a set of features, now is referred to as Fetal Alcohol Spectrum Disorder (FASD). This spectrum includes overall abnormalities, such as, physical, neurodevelopmental, cognititive and even behaviour and learning problems. In this review the changes within the Central Nervous System and its associated secondary disabilities are discussed. It is essential to be able to recognise the behaviour and cognitive profile which then leads to a rapid and correct diagnose, on the other hand it helps to distinguish this pathology, FASD, from other mental dysfunctions. The phenotype of alcohol exposure is directly related to the effect that alcohol has on some parts of the nervous system, like corpus callosum, cerebellum, basal ganglia and grey matter. Therefore, there is a necessity to intervene and treat children with FASD. In this article the major therapeutically strategies are reviewed. These strategies target the molecular mechanisms involved with the damage alcohol does to the brain and the protective and aggravating factors of some deficits these individuals show. Also to be reviewed are other interventions that have the potential to improve the plasticity of the CNS, during alcohol exposure as well as long after it has occurred.
In the last 40 years it has become clear that the prenatal alcohol exposure results in the development of a set of features, now is referred to as Fetal Alcohol Spectrum Disorder (FASD). This spectrum includes overall abnormalities, such as, physical, neurodevelopmental, cognititive and even behaviour and learning problems. In this review the changes within the Central Nervous System and its associated secondary disabilities are discussed. It is essential to be able to recognise the behaviour and cognitive profile which then leads to a rapid and correct diagnose, on the other hand it helps to distinguish this pathology, FASD, from other mental dysfunctions. The phenotype of alcohol exposure is directly related to the effect that alcohol has on some parts of the nervous system, like corpus callosum, cerebellum, basal ganglia and grey matter. Therefore, there is a necessity to intervene and treat children with FASD. In this article the major therapeutically strategies are reviewed. These strategies target the molecular mechanisms involved with the damage alcohol does to the brain and the protective and aggravating factors of some deficits these individuals show. Also to be reviewed are other interventions that have the potential to improve the plasticity of the CNS, during alcohol exposure as well as long after it has occurred.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2016
Palavras-chave
Distúrbios do espectro da síndrome fetal alcoólica Exposição pré-natal ao álcool Efeitos teratogénicos Técnicas de neuroimagem Gestação Sistema nervoso central