Central white matter integrity alterations in 2-3-year-old children following prenatal alcohol exposure - PubMed (original) (raw)

Central white matter integrity alterations in 2-3-year-old children following prenatal alcohol exposure

Annerine Roos et al. Drug Alcohol Depend. 2021.

Abstract

Background: Prenatal alcohol exposure (PAE) remains a potentially preventable, but pervasive risk factor to neurodevelopment. Yet, evidence is lacking on the impact of alcohol on brain development in toddlers. This study aimed to investigate the impact of PAE on brain white matter integrity in 2-3-year-old children.

Methods: Children (n = 83, 30-37 months old) of the Drakenstein Child Health Study birth cohort, underwent diffusion MRI on a 3 T Siemens scanner during natural sleep. Parameters were extracted in children with PAE (n = 25, 56 % boys) and unexposed controls (n = 58, 62 % boys) using Tract-based Spatial Statistics, and compared by group. The contribution of maternal tobacco smoking to white matter differences was also explored.

Results: Children with PAE had altered fractional anisotropy, radial diffusivity and axial diffusivity in brain stem, limbic and association tracts compared to unexposed controls. Notably lower fractional anisotropy was found in the uncinate fasciculus, and lower mean and radial diffusivity were found in the fornix stria terminalis and corticospinal tract (FDR corrected p < 0.05). There was a significant interaction effect of PAE and prenatal tobacco exposure which lowered mean, radial and axial diffusivity in the corticospinal tract significantly in the PAE group but not controls.

Conclusion: Widespread altered white matter microstructural integrity at 2-3 years of age is consistent with findings in neonates in the same and other cohorts, indicating persistence of effects of PAE through early life. Findings also highlight that prenatal tobacco exposure impacts the association of PAE on white matter alterations, amplifying effects in tracts underlying motor function.

Keywords: Development; Prenatal alcohol exposure; Prenatal tobacco exposure; White matter integrity.

Copyright © 2021 The Author(s). Published by Elsevier B.V. All rights reserved.

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Conflict of interest statement

No conflict declared.

Figures

Fig. 1

Fig. 1

Flowchart outlining participation in the DCHS. Of the children for whom diffusion tensor imaging (DTI) was successful, 83 children were included in the final analysis.

Fig. 2

Fig. 2

Boxplots of group effects (uncorrected). Patterns of effect were similar across tracts except for the uncinate fasciculus that had differences in the opposite direction. As indicated in the bottom right box, boxplots denote the mean parameter value with indication of the standard error (SE) and 0.95 confidence interval from the mean.

Fig. 3

Fig. 3

Interaction effect of alcohol and tobacco smoking on mean diffusivity in the corticospinal tract. Prenatal tobacco exposure lowered MD in the PAE group but not in controls. Vertical bars denote 0.95 confidence intervals.

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