Trajectories of brain white matter development in young children with prenatal alcohol exposure

Kar, Preeti; Reynolds, Jess E.; Gibbard, W. Ben; McMorris, Carly A.; Tortorelli, Christina; Lebel, Catherine

doi:10.1002/hbm.25944

Cited by 18 publications

(13 citation statements)

References 83 publications

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“…There was no inflexion point in the dose-response curves to suggest a cut-off for PAE effects, and significant effects were observed with as little as 1.1 US standard drinks per week throughout pregnancy. Increased brain volume was attributed to impairment of synaptic pruning in the preadolescent brain, consistent with research demonstrating the effect of PAE on trajectories of brain development 70,71 .…”

Section: Mechanisms/pathophysiologysupporting

confidence: 80%

Fetal alcohol spectrum disorders

Popova

Charness

Burd

et al. 2023

Nat Rev Dis Primers

116

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Alcohol readily crosses the placenta and may disrupt fetal development. Harm from prenatal alcohol exposure (PAE) is determined by the dose, pattern, timing and duration of exposure, fetal and maternal genetics, maternal nutrition, concurrent substance use, and epigenetic responses. A safe dose of alcohol use during pregnancy has not been established. PAE can cause fetal alcohol spectrum disorders (FASD), which are characterized by neurodevelopmental impairment with or without facial dysmorphology, congenital anomalies and poor growth. FASD are a leading preventable cause of birth defects and developmental disability. The prevalence of FASD in 76 countries is >1% and is high in individuals living in out-of-home care or engaged in justice and mental health systems. The social and economic effects of FASD are profound, but the diagnosis is often missed or delayed and receives little public recognition. Future research should be informed Nature Reviews Disease Primers | (2023) 9:11 2 0123456789();: PrimerFASD occur in all socioeconomic and ethnic groups 15 and are complex, chronic conditions that affect health and family functioning 16 . Individuals with FASD usually require lifelong health care as well as social and vocational support. Some require remedial education and others interact with the justice system. Early diagnosis and a strength-based management approach will optimize health outcomes.FASD are the most common of the potentially preventable conditions associated with birth anomalies and neurodevelopmental problems 13 , and their global effects, including huge social and economic costs, are substantial 17 . For example, in Canada, the annual cost associated with FASD is an estimated ~CAD$ 1.8 billion (CAD$ 1.3 billion to CAD$ 2.3 billion) 17 , which is attributable in part to productivity loss (41%), correction services (29%) and health care (10%). In North America, the lifetime cost of supporting an individual with FASD is estimated at >CAD$ 1 million 18 . Addressing and preventing alcohol use in pregnancy is a public-health imperative.This Primer presents the epidemiology of FASD and the latest understanding of its pathophysiology as well as approaches to diagnosis, screening and prevention. The Primer also describes outcomes across the lifespan, management and quality of life (QOL) of people living with FASD, and highlights important areas for future research and clinical practice. Epidemiology Alcohol use during pregnancyNo safe level of PAE has been established 19 , and international guidelines advise against any amount or type of alcohol use during pregnancy [20][21][22][23] . Nevertheless, ~10% of pregnant women worldwide consume alcohol 24,25 . The highest prevalence of alcohol use during pregnancy is in the WHO European Region (25.2% 24 ; Fig. 1), consistent with the prevalence of heavy alcohol use, heavy episodic drinking and alcohol use disorders in this region 26 . 0123456789();: PrimerIn 40% of the 162 countries evaluated, >25% of women who consumed any alcohol during pregnancy drank at 'bing...

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Section: Mechanisms/pathophysiologysupporting

confidence: 80%

Fetal alcohol spectrum disorders

Popova

Charness

Burd

et al. 2023

Nat Rev Dis Primers

116

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“…The white matter structural differences often are present in long‐range tracts such as the lateral splenium of corpus callosum (Sowell et al, 2008), bilateral superior longitudinal fasciculus (Lebel et al, 2008), left inferior longitudinal fasciculus (Fan et al, 2016), right inferior longitudinal fasciculus (Green et al, 2013), corticospinal tract (Paolozza et al, 2015), and corticothalamic tracts such as anterior and posterior internal capsule (Stephen et al, 2021). When examined longitudinally, young children with PAE 2–8 years of age showed slower white matter development in frontal and temporal tracts specifically the genu of the corpus callosum, inferior fronto‐occipital fasciculus, inferior longitudinal fascicular, and uncinate fasciculus (Kar et al, 2022), while older children with PAE between 5 and 15 years of age showed faster white matter development with greater change (steeper decreases) in mean diffusivity of the inferior longitudinal fasciculus and superior fronto‐occipital fasciculus (Treit et al, 2013). Given the number of white matter tracts impacted and dynamic changes during development, prenatal alcohol exposure may affect white matter globally.…”

Section: Discussionmentioning

confidence: 99%

Disrupted dynamic functional network connectivity in fetal alcohol spectrum disorders

Candelaria‐Cook

Flynn

Cerros

et al. 2023

Alcohol: Clinical and Experimental Research

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Background: Prenatal alcohol exposure (PAE) can result in harmful and long-lasting neurodevelopmental changes. Children with PAE or a fetal alcohol spectrum disorder (FASD) have decreased white matter volume and resting-state spectral power compared to typically developing controls (TDC) and impaired resting-state static functional connectivity. The impact of PAE on resting-state dynamic functional network connectivity (dFNC) is unknown. Methods: Using eyes-closed and eyes-open magnetoencephalography (MEG) restingstate data, global dFNC statistics and meta-states were examined in 89 children aged 6-16 years (51 TDC, 38 with FASD). Source analyzed MEG data were used as input to group spatial independent component analysis to derive functional networks from which the dFNC was calculated. Results: During eyes-closed, relative to TDC, participants with FASD spent a significantly longer time in state 2, typified by anticorrelation (i.e., decreased connectivity) within and between default mode network (DMN) and visual network (VN), and state 4, typified by stronger internetwork correlation. The FASD group exhibited greater dynamic fluidity and dynamic range (i.e., entered more states, changed from one meta-state to another more often, and traveled greater distances) than TDC. During eyes-open, TDC spent significantly more time in state 1, typified by positive intra-and interdomain connectivity with modest correlation within the frontal network (FN), while participants with FASD spent a larger fraction of time in state 2, typified by anticorrelation within and between DMN and VN and strong correlation within and between FN, attention network, and sensorimotor network. Conclusions: There are important resting-state dFNC differences between children with FASD and TDC. Participants with FASD exhibited greater dynamic fluidity and dynamic range and spent more time in states typified by anticorrelation within and between DMN and VN, and more time in a state typified by high internetwork connectivity. Taken together, these network aberrations indicate that prenatal alcohol exposure has a global effect on resting-state connectivity.

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“…The impacts of PAE are lifelong and manifest in patterns where deficits vary with age and become comparatively more pronounced as the child ages (Crocker et al, 2009; Pyszczynski & Greenberg, 1987; Rasmussen & Bisanz, 2009; Thomas et al, 1998). The trajectory of brain development appears to be altered by PAE (Kar et al, 2022; Treit et al, 2013). A diagnosis encourages the specific assessments that might be most appropriate for the characteristic array of deficits that can be seen with FASD, and those that can be expected and monitored as the child grows.…”

Section: Discussionmentioning

confidence: 99%

Fetal alcohol spectrum disorders and access to regional center services in San Diego County

Montag

Jones

Campo

et al. 2022

Alcoholism Clin & Exp Res

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Background: Fetal alcohol spectrum disorders (FASD) are developmental disabilities that are estimated to occur in 2-5% of elementary school children and that negatively impact a child's ability to function without support. Timely diagnosis-informed interventions are crucial to optimizing the developmental trajectory of children with FASD.The true prevalence of FASD among children receiving services for developmental disabilities is unknown.Methods: An FASD prevalence study was carried out between 2011 and 2014 among a sample of 5-to 7-year-old children who were receiving services provided by the California State Regional Center for Developmental Disabilities in San Diego County.Children whose parent or caregiver consented were evaluated using the Collaboration on Fetal Alcohol Spectrum Disorders Prevalence study assessment protocol and classification criteria.Results: Among 216 eligible caregiver-child dyads, 44 completed assessments that were sufficient to obtain a classification for FASD, including fetal alcohol syndrome (FAS), partial FAS, alcohol-related neurodevelopmental disorder, or no fetal alcohol spectrum disorder. Fifteen children were classified as meeting the criteria for an FASD. A minimum FASD prevalence rate of 69.4 per 1000 (6.9%) among all eligible children was estimated. None of the children classified as FASD were receiving services because of an FASD diagnosis, and none had previously been diagnosed with FASD. Autism was the most common qualifying diagnosis for which children classified as FASD were receiving services.Conclusions: The 6.9% prevalence estimate among Regional Center clients was higher than the prevalence estimate of 2.3% in the same community among 5-to 7-year-old children in the general population, though the estimate was based on only 20% of eligible dyads. All children in the sample were receiving Regional Center services for another diagnosis. Barriers to eligibility for services for children with FASD may lead to less than optimum care for these children. Study findings support the facilitation of access to developmental services for children with FASD.

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Trajectories of brain white matter development in young children with prenatal alcohol exposure

Cited by 18 publications

References 83 publications

Fetal alcohol spectrum disorders

Fetal alcohol spectrum disorders

Disrupted dynamic functional network connectivity in fetal alcohol spectrum disorders

Fetal alcohol spectrum disorders and access to regional center services in San Diego County

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