An important element of designing research studies is the selection of appropriate outcome measur... more An important element of designing research studies is the selection of appropriate outcome measures to ensure that the question posed is properly answered given the evidence. The selection of outcome measures is especially important when tackling complex, interdisciplinary problems, where appropriate outcome measures may not be as simple as a blood test or a laboratory value. One such area of study is the research into neurodevelopmental outcomes after early exposure to anesthetic agents. Concern has arisen recently that certain anesthetic agents may be toxic to the developing brain; a public-private partnership, SmartTots, was formed in conjunction with the Food and Drug Administration and various stakeholders to develop safe anesthetic regimens for neonates and infants who require surgery. However, as research has progressed, questions have arisen regarding the best outcome measures to use in order to detect a true effect, as well as the optimal window in which to measure. These issues were discussed in a round table meeting during the SmartTots meeting in September 2017, and a summary of the discussion is presented here.
Anesthetic agents disrupt neurodevelopment in animal models, but evidence in humans is mixed. The... more Anesthetic agents disrupt neurodevelopment in animal models, but evidence in humans is mixed. The morphologic and behavioral changes observed across many species predicted that deficits should be seen in humans, but identifying a phenotype of injury in children has been challenging. It is increasingly clear that in children, a brief or single early anesthetic exposure is not associated with deficits in a range of neurodevelopmental outcomes including broad measures of intelligence. Deficits in other domains including behavior, however, are more consistently reported in humans and also reflect findings from nonhuman primates. The possibility that behavioral deficits are a phenotype, as well as the entire concept of anesthetic neurotoxicity in children, remains a source of intense debate. The purpose of this report is to describe consensus and disagreement among experts, summarize preclinical and clinical evidence, suggest pathways for future clinical research, and compare studies of anesthetic agents to other suspected neurotoxins.
Background. Airborne polycyclic aromatic hydrocarbons (PAH) are widespread urban pollutants from ... more Background. Airborne polycyclic aromatic hydrocarbons (PAH) are widespread urban pollutants from fossil fuel burning and other combustion sources that can bind to DNA to form PAH-DNA adducts. Prena...
Polluting Developing Brains When the Environmental Protection Agency scrapped a plan to ban chlor... more Polluting Developing Brains When the Environmental Protection Agency scrapped a plan to ban chlorpyrifos, it violated its duty to protect human health, ignoring child health policy that requires all national public health standards to address the special vulnerability of infants and children.
Children from economically disadvantaged communities have a disproportionate risk of exposure to ... more Children from economically disadvantaged communities have a disproportionate risk of exposure to chemicals, social stress, and learning difficulties. Although animal models and epidemiologic studies link exposures and neurodevelopment, little focus has been paid to academic outcomes in environmental health studies. Similarly, in the educational literature, environmental chemical exposures are overlooked as potential etiologic factors in learning difficulties. We propose a theoretical framework for the etiology of learning difficulties that focuses on these understudied exogenous factors. We discuss findings from animal models and longitudinal, prospective birth cohort studies that support this theoretical framework. Studies reviewed point to the effects of prenatal exposure to polycyclic aromatic hydrocarbons on reading comprehension and math skills via effects on inhibitory control processes. Long term, this work will help close the achievement gap in the United States by identifyi...
Objective: To test if an adolescent population with prenatal chlorpyrifos (CPF) exposure is more ... more Objective: To test if an adolescent population with prenatal chlorpyrifos (CPF) exposure is more likely to manifest non-motor symptoms, which may precede Parkinson’s disease (PD). Background: Individuals exposed to CPF are at higher risk to develop PD. We measured CPF umbilical cord plasma levels in 350 newborns who are now 18–20 years old. Individuals in this cohort with high CPF levels had reduced birth weight, cognitive deficits, poor dexterity, and tremor. Dysautonomia, hyposmia, and REM Behavior Disorder (RBD) can precede the motor symptoms of PD by several years, and these signs have not been studied in this cohort. Design/Methods: In this study we will evaluate individuals with the composite autonomic symptom scale 31 (COMPASS-31), the University of Pennsylvania Smell Identification Testing (UPSIT), and the RBD Questionnaire. We dichotomized CPF exposure (upper quartile versus all others, limit of 6.17 g/pg) and will test the association between CPF levels, dysuautonomia, hyp...
Although severe early life stress has been shown to accelerate the development of frontolimbic re... more Although severe early life stress has been shown to accelerate the development of frontolimbic resting-state functional connectivity (RSFC), less is known about the effects of socioeconomic disadvantage, a prolonged and multifaceted stressor. In a cross-sectional study of 127 participants aged 5–25, we examined whether lower neighborhood socioeconomic status (SES; measured by Area Deprivation Index and neighborhood poverty and educational attainment) was associated with prematurely reduced amygdala-ventromedial prefrontal cortex (vmPFC) RSFC. We further tested whether neighborhood SES was more predictive than household SES and whether SES effects on connectivity were associated with anxiety symptoms. We found reduced basolateral amygdala-vmPFC RSFC at earlier ages in participants from more disadvantaged neighborhoods; this effect was unique to neighborhood SES and absent for household SES. Furthermore, this reduced connectivity in more disadvantaged youth and increased connectivity ...
APA PsycNET Our Apologies! - The following features are not available with your current Browser c... more APA PsycNET Our Apologies! - The following features are not available with your current Browser configuration. - alerts user that their session is about to expire - display, print, save, export, and email selected records - get My ...
BACKGROUND: Polycyclic aromatic hydrocarbons (PAHs) are ubiquitous air pollutants generated by co... more BACKGROUND: Polycyclic aromatic hydrocarbons (PAHs) are ubiquitous air pollutants generated by combustion of organic material, including fossil fuel. OBJECTIVES: It has been an open question whether prenatal exposure to air pollution in general and PAHs in particular significantly increases the risk of intrauterine growth restriction, including small size for gestational age (SGA), and preterm delivery. Here, we have examined this hypothesis in a cohort of mothers and newborns in New York City. METHODS: Subjects were young, nonsmoking, healthy African-American (n = 224) and Dominican (n = 392) mother-newborn pairs residing in New York City whose prenatal PAH exposures were estimated by personal air monitoring. Questionnaire and medical record data were obtained. RESULTS: A 1 natural-log (ln)-unit increase in prenatal PAH exposure was associated with a 2-fold increase in risk of symmetric intrauterine growth restriction (i.e., SGA and fetal growth ratio < 85%) among full-term African Americans (p < 0.05). Preterm delivery risk was 5-fold greater among African Americans per ln-unit increase in prenatal PAH exposure. The same unit increase in exposure significantly increased the ratio of head circumference to birth weight by 0.04% in African Americans. These effects were not observed in Dominicans. CONCLUSION: Prenatal PAH exposure is likely to contribute to the occurrence of SGA as well as preterm births among African Americans. The lack of an association in Dominicans might reflect modification of the risk by healthful cultural practices among recent Dominican immigrants. Given that PAHs are globally generated and distributed pollutants, our observations have potential implications for environmental health and energy policies.
An important element of designing research studies is the selection of appropriate outcome measur... more An important element of designing research studies is the selection of appropriate outcome measures to ensure that the question posed is properly answered given the evidence. The selection of outcome measures is especially important when tackling complex, interdisciplinary problems, where appropriate outcome measures may not be as simple as a blood test or a laboratory value. One such area of study is the research into neurodevelopmental outcomes after early exposure to anesthetic agents. Concern has arisen recently that certain anesthetic agents may be toxic to the developing brain; a public-private partnership, SmartTots, was formed in conjunction with the Food and Drug Administration and various stakeholders to develop safe anesthetic regimens for neonates and infants who require surgery. However, as research has progressed, questions have arisen regarding the best outcome measures to use in order to detect a true effect, as well as the optimal window in which to measure. These issues were discussed in a round table meeting during the SmartTots meeting in September 2017, and a summary of the discussion is presented here.
Anesthetic agents disrupt neurodevelopment in animal models, but evidence in humans is mixed. The... more Anesthetic agents disrupt neurodevelopment in animal models, but evidence in humans is mixed. The morphologic and behavioral changes observed across many species predicted that deficits should be seen in humans, but identifying a phenotype of injury in children has been challenging. It is increasingly clear that in children, a brief or single early anesthetic exposure is not associated with deficits in a range of neurodevelopmental outcomes including broad measures of intelligence. Deficits in other domains including behavior, however, are more consistently reported in humans and also reflect findings from nonhuman primates. The possibility that behavioral deficits are a phenotype, as well as the entire concept of anesthetic neurotoxicity in children, remains a source of intense debate. The purpose of this report is to describe consensus and disagreement among experts, summarize preclinical and clinical evidence, suggest pathways for future clinical research, and compare studies of anesthetic agents to other suspected neurotoxins.
Background. Airborne polycyclic aromatic hydrocarbons (PAH) are widespread urban pollutants from ... more Background. Airborne polycyclic aromatic hydrocarbons (PAH) are widespread urban pollutants from fossil fuel burning and other combustion sources that can bind to DNA to form PAH-DNA adducts. Prena...
Polluting Developing Brains When the Environmental Protection Agency scrapped a plan to ban chlor... more Polluting Developing Brains When the Environmental Protection Agency scrapped a plan to ban chlorpyrifos, it violated its duty to protect human health, ignoring child health policy that requires all national public health standards to address the special vulnerability of infants and children.
Children from economically disadvantaged communities have a disproportionate risk of exposure to ... more Children from economically disadvantaged communities have a disproportionate risk of exposure to chemicals, social stress, and learning difficulties. Although animal models and epidemiologic studies link exposures and neurodevelopment, little focus has been paid to academic outcomes in environmental health studies. Similarly, in the educational literature, environmental chemical exposures are overlooked as potential etiologic factors in learning difficulties. We propose a theoretical framework for the etiology of learning difficulties that focuses on these understudied exogenous factors. We discuss findings from animal models and longitudinal, prospective birth cohort studies that support this theoretical framework. Studies reviewed point to the effects of prenatal exposure to polycyclic aromatic hydrocarbons on reading comprehension and math skills via effects on inhibitory control processes. Long term, this work will help close the achievement gap in the United States by identifyi...
Objective: To test if an adolescent population with prenatal chlorpyrifos (CPF) exposure is more ... more Objective: To test if an adolescent population with prenatal chlorpyrifos (CPF) exposure is more likely to manifest non-motor symptoms, which may precede Parkinson’s disease (PD). Background: Individuals exposed to CPF are at higher risk to develop PD. We measured CPF umbilical cord plasma levels in 350 newborns who are now 18–20 years old. Individuals in this cohort with high CPF levels had reduced birth weight, cognitive deficits, poor dexterity, and tremor. Dysautonomia, hyposmia, and REM Behavior Disorder (RBD) can precede the motor symptoms of PD by several years, and these signs have not been studied in this cohort. Design/Methods: In this study we will evaluate individuals with the composite autonomic symptom scale 31 (COMPASS-31), the University of Pennsylvania Smell Identification Testing (UPSIT), and the RBD Questionnaire. We dichotomized CPF exposure (upper quartile versus all others, limit of 6.17 g/pg) and will test the association between CPF levels, dysuautonomia, hyp...
Although severe early life stress has been shown to accelerate the development of frontolimbic re... more Although severe early life stress has been shown to accelerate the development of frontolimbic resting-state functional connectivity (RSFC), less is known about the effects of socioeconomic disadvantage, a prolonged and multifaceted stressor. In a cross-sectional study of 127 participants aged 5–25, we examined whether lower neighborhood socioeconomic status (SES; measured by Area Deprivation Index and neighborhood poverty and educational attainment) was associated with prematurely reduced amygdala-ventromedial prefrontal cortex (vmPFC) RSFC. We further tested whether neighborhood SES was more predictive than household SES and whether SES effects on connectivity were associated with anxiety symptoms. We found reduced basolateral amygdala-vmPFC RSFC at earlier ages in participants from more disadvantaged neighborhoods; this effect was unique to neighborhood SES and absent for household SES. Furthermore, this reduced connectivity in more disadvantaged youth and increased connectivity ...
APA PsycNET Our Apologies! - The following features are not available with your current Browser c... more APA PsycNET Our Apologies! - The following features are not available with your current Browser configuration. - alerts user that their session is about to expire - display, print, save, export, and email selected records - get My ...
BACKGROUND: Polycyclic aromatic hydrocarbons (PAHs) are ubiquitous air pollutants generated by co... more BACKGROUND: Polycyclic aromatic hydrocarbons (PAHs) are ubiquitous air pollutants generated by combustion of organic material, including fossil fuel. OBJECTIVES: It has been an open question whether prenatal exposure to air pollution in general and PAHs in particular significantly increases the risk of intrauterine growth restriction, including small size for gestational age (SGA), and preterm delivery. Here, we have examined this hypothesis in a cohort of mothers and newborns in New York City. METHODS: Subjects were young, nonsmoking, healthy African-American (n = 224) and Dominican (n = 392) mother-newborn pairs residing in New York City whose prenatal PAH exposures were estimated by personal air monitoring. Questionnaire and medical record data were obtained. RESULTS: A 1 natural-log (ln)-unit increase in prenatal PAH exposure was associated with a 2-fold increase in risk of symmetric intrauterine growth restriction (i.e., SGA and fetal growth ratio < 85%) among full-term African Americans (p < 0.05). Preterm delivery risk was 5-fold greater among African Americans per ln-unit increase in prenatal PAH exposure. The same unit increase in exposure significantly increased the ratio of head circumference to birth weight by 0.04% in African Americans. These effects were not observed in Dominicans. CONCLUSION: Prenatal PAH exposure is likely to contribute to the occurrence of SGA as well as preterm births among African Americans. The lack of an association in Dominicans might reflect modification of the risk by healthful cultural practices among recent Dominican immigrants. Given that PAHs are globally generated and distributed pollutants, our observations have potential implications for environmental health and energy policies.
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Papers by Virginia Rauh