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USDTL Assisted Research

Impact of Prenatal Cocaine Exposure on Attention and Response Inhibition as Assessed by Continuous Performance Tests

Veronica H. Accornero Ph.D., Alfred J. Amado Ph.D., Connie E. Morrow Ph.D., Lihua Xue MS, James C. Anthony Ph.D., Emmalee S. Bandstra MD

First Published: 28 June 2007 DIO: 10.1097/01.DBP.0000268560.72580.f9

Department of Pediatrics, Perinatal CARE Program, University of Miami Miller School of Medicine, Miami, FL 33101, USA.


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This study examined the influence of prenatal cocaine exposure on attention and response inhibition measured by continuous performance tests (CPTs) at ages 5 and 7 years.


The baseline sample consisted of 253 cocaine-exposed and 223 non-cocaine-exposed children enrolled prospectively at birth and assessed comprehensively through age 7 years in the longitudinal Miami Prenatal Cocaine Study. This report includes a subsample of 415 children (219 cocaine-exposed, 196 non-cocaine-exposed) who completed at least one CPT assessment at ages 5 and/or 7 years. Prenatal cocaine exposure was measured by maternal self-report and maternal and infant bioassays. Deficits in attention and response inhibition are estimated in relation to prenatal cocaine exposure using generalized estimating equations within the general linear model.


Results indicate cocaine-associated increases in omission errors at ages 5 and 7 as well as increases in response times for target tasks (i.e., slower reaction times) and decreased consistency in performance at age 7. There were no demonstrable cocaine-associated deficits in commission errors. Estimates did not change markedly with statistical adjustment for selected prenatal and postnatal covariates.


Evidence supports cocaine-associated deficits in attention processing through age 7 years.


Accumulating evidence suggests that prenatal cocaine exposure disrupts arousal and attention regulation in offspring. In animal models, in utero, cocaine exposure has been shown to alter the developing monoaminergic system, resulting in structural and functional changes to circuitry subserving functions such as arousal and attention. Moreover, gestational cocaine exposure produces behavioral responses in animals consistent with altered attention processing, including impairments in selective and sustained attention. Difficulties with arousal and emotional regulation have also been reported. Several studies showed deficits in adulthood, demonstrating the potential for long-lasting impairment following in-utero cocaine exposure.

Key terms: prenatal cocaine co-exposure, sustained attention, response inhibition, continuous performance test, prenatal cocaine influence, cocaine-exposure

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