Brain perfusion SPECT and MRI in foetal alcohol syndrome

Abstract

Six boys and five girls with a mean age of 8.6 (range 3 to 13) years with foetal alcohol syndrome (FAS) were studied by MRI and single photon emission computed tomography (SPECT) to find specific areas of vulnerability. Morphological anomalies shown in six of 11 patients by MRI were situated both cortically and subcortically: cortical atrophy (N = 2), dilated ventricle (N = 1), corpus callosum hypoplasia (N = 1), cerebellar atrophy (N = 2), one of the latter with Arnold-Chiari malformation (N = 1). Delayed myelination of the white matter was seen in two patients. Volumetric studies of the hippocampus showed morphological left-right asymmetry in five of eight patients. However, SPECT showed mild hypoperfusion of the left hemisphere in all 10 subjects. The negative left-right index was located especially in the left parietooccipital region, i.e. in the brain areas implicated in arithmetical and logical-grammatical functions, which are known to be affected in FAS. Normal left-right dominance was also lacking in the frontal area, i.e. the brain area affected in attention-deficit-hyperactivity disorder (ADHD). Detection of these abnormalities, although they are not unique to FAS, may be helpful in the diagnosis and any attempts at rehabilitation. Diverse morphological and functional abnormalities are more frequent than has usually been believed even in less impaired children with FAS.

Radiological studies of fetal alcohol spectrum disorders in humans and animal models: An updated comprehensive review

“…Similar to cortical gray matter changes, reductions in white matter volume were observed globally [18;26], as well as around the occipital horns [48], in the left parietal…”

“…A large reduction of blood flow in the temporal region relative to the cerebellum was observed in three subjects with FAS, while such reduction was smaller in two healthy subjects [23]. A SPECT study A C C E P T E D M A N U S C R I P T 22 using Tc-99m hexamethylpropyleneamine oxime in children with FAS reported mild hypoperfusion in the left parietooccipital and right frontal region [48]. In another SPECT study using 123 I-nor-β-CIT tracer, children with FASD were reported to have lower serotonin in the medial frontal cortex and higher levels of dopamine transporters in the striatum compared to healthy peers [129].…”

Effects of prenatal alcohol exposure on hippocampal volume, verbal learning, and verbal and spatial recall in late childhood

“…However, these reductions in hippocampal volume were Alcohol-related effects on the hippocampus 1023 proportional to reductions in overall brain size (Archibald et al, 2001). Additional differences in hippocampal architecture between children with PAE and controls were found by Riikonen et al (1999Riikonen et al ( , 2005, who reported reduced hippocampal volumes and greater hippocampal asymmetry (i.e., left smaller than right) in children with PAE relative to controls, as well as by Autti-Rämö et al (2002), who found left hippocampal thinning in three children with varying levels of PAE. Several studies of PAE in children have used structural MRI to investigate the structure-function correlations between verbal learning and recall and the corpus callosum (Sowell et al, 2001), cerebellum (O'Hare et al, 2005), as well as overall cortical thickness (Sowell et al, 2008).…”

“…We hypothesized that the FASD group would show impaired verbal learning, as well as poor verbal and spatial recall. Given earlier findings of left-right hippocampal asymmetries (i.e., smaller left than right volume, Riikonen et al, 1999Riikonen et al, , 2005 and left hippocampal thinning (Autti-Rämö et al, 2002) in children with PAE, we hypothesized that any reductions found in hippocampal volume may be greater in the left than the right hippocampus in children with FASDs. We further hypothesized that spatial recall deficits found in children with FASDs would be more strongly associated with right than left hippocampal volume reductions, based on studies relating poor spatial recall to right hippocampal damage (Bohbot et al, 1998;Uecker & Nadel, 1996).…”

Occipital-temporal Reduction and Sustained Visual Attention Deficit in Prenatal Alcohol Exposed Adults

“…More specifically, volume and density abnormalities in both the white matter and gray matter have been noted in various brain regions including the corpus callosum, the temporoparietal area, the frontal area, and the basal ganglia. (Archibald et al 2001;Riikonen et al 1999;Sowell et al 2001b;Sowell et al 2002). By using the diffusion tensor imaging (DTI) technique, we recently also found significant difference in the diffusion fractional anisotropy and apparent diffusion coefficient in the corpus callosum of alcohol-affected young adults compared with the non-exposed controls (Ma et al 2005).…”