Proton magnetic resonance spectroscopy in children with fetal alcohol spectrum disorders

Abstract

-Objective: To analyze the metabolic constitution of brain areas through proton magnetic resonance spectroscopy in children affected with fetal alcohol spectrum disorder compared with normal children. Method: The sample of this case-control study included eight boys with epidemiologic history of in utero exposure to alcohol (median age 13.6±3.8 years) who were diagnosed with fetal alcohol spectrum disorder, and eight controls (median age 12.1±3,4 years). An 8 cm 3 single voxel approach was used, with echo time 30 ms, repetition time 1500 ms, and 128 acquisitions in a 1.5T scanner, and four brain areas were analyzed: anterior cingulate, left frontal lobe, left striatum, and left cerebellar hemisphere. Peaks and ratios of metabolites N-acetylaspartate, choline, creatine, and myo-inositol were measured. Results: Children with fetal alcohol spectrum disorder showed a decrease in choline/creatine ratio (p=0.020) in left striatum and an increase in myo-inositol/creatine ratio (p=0.048) in left cerebellum compared with controls. There was no statistically significant difference in all peaks and ratios from the anterior cingulate and frontal lobe between the two groups. Conclusion: This study found evidence that the left striatum and left cerebellum are affected by intrauterine exposure to alcohol. Additional studies with larger samples are necessary to expand our knowledge of the effects of fetal exposure to alcohol.Key words: fetal alcohol syndrome, alcohol-induced disorders of the nervous system, ethanol, fetal development, magnetic resonance spectroscopy. espectroscopia por ressonância magnética de prótons em crianças com transtornos do espectro alcoólico fetal resumo -Objetivo: Analisar a composição metabólica de áreas encefálicas através da espectroscopia de prótons por ressonância magnética em crianças com transtornos do espectro alcoólico fetal e crianças normais. Método: A amostra deste estudo de casos-controles incluiu 8 meninos com história epidemiológica de exposição fetal ao álcool (idade mediana 13,6±3,8 anos), diagnosticados com transtorno do espectro alcoólico fetal, e 8 controles (idade mediana 12,1±3,4 anos). Utilizou-se voxel único de 8 cm³, tempo de eco 30 ms, tempo de repetição 1.500 ms, 128 aquisições, em scanner de 1,5T para as seguintes áreas: cíngulo anterior, lobo frontal esquerdo, estriado esquerdo e hemisfério cerebelar esquerdo. estudaram-se os picos e as razões dos metabólitos N-acetilaspartato, colina, creatina e o mio-inositol. Resultados: As crianças acometidas apresentaram diminuição da razão colina/creatina (p=0,020) no estriado esquerdo, e aumento da razão mio-inositol/creatina (p=0,048) no cerebelo esquerdo. Não houve diferença estatisticamente significativa nos valores encontrados no cíngulo anterior e lobo frontal entre os dois grupos. Conclusão: este estudo encontrou evidências de que o estriado e o cerebelo esquerdos são acometidos pela exposição intra-uterina ao álcool. estudos adicionais com amostras maiores são essenciais para expandir nosso conhecimento dos efeitos d...

Extensive Deep Gray Matter Volume Reductions in Children and Adolescents with Fetal Alcohol Spectrum Disorders

“…Volume is not the sole attribute that can be measured of deep gray matter structures by using a variety of imaging methods. Magnetic resonance spectroscopy studies have reported altered brain metabolism in the thalamus (Fagerlund et al., 2006), striatum (Goncalves Rde et al., 2009), and caudate (Cortese et al., 2006) in FASD. Positron emission tomography revealed decreases in regional cerebral metabolic rates in bilateral thalamus and basal ganglia, which includes the caudate, putamen, and globus pallidus, in individuals with FAS (Clark et al., 2000) and single‐photon emission computed tomography has shown reductions of dopamine transporter binding in the striatum (Riikonen et al., 2005).…”

Reduced glutamate in white matter of male neonates exposed to alcohol in utero: a 1H-magnetic resonance spectroscopy study

“…A third 1 H-MRS study reported decreased choline, a marker of phospholipid membrane turnover and myelination, in frontal/parietal white matter of preadolescent children with diagnosed FASD ( n = 20) compared with non-impaired children ( n = 61; Astley et al 2009). A second study reported decreased choline in the left striatum of children with FASD ( n = 8) when compared to controls (Goncalves Rde et al 2009). Finally, a more recent study which assessed young children with heavy alcohol exposure ( n = 37) and non- or minimally exposed controls ( n = 17), found several 1 H-MRS relationships within the cerebellum; decreased NAA was related to increased maternal use of alcohol around time of conception, decreased choline was related to higher levels of alcohol consumption during pregnancy, and alcohol consumption around time of conception and during pregnancy were related to increased glutamate with glutamine (Glx) (du Plessis et al 2014).…”

Differential neuroimaging indices in prefrontal white matter in prenatal alcohol‐associated ADHD versus idiopathic ADHD

“…As reported among Astley et al's secondary findings, Cho also decreased with increasing amount of PAE across subjects. Gonçalves et al () found a below‐normal ratio of Cho to creatine + phosphocreatine (“Cho/Cr + PCr”) in an MRS acquisition volume (“voxel”) containing the internal capsule—the ventral extension of the corona radiata—as well as the putamen and caudate. Thus, there are indications of a possible role of ACR Cho in FASD.…”