White matter microstructure in fetal alcohol spectrum disorders: A systematic review of diffusion tensor imaging studies

Sherbaf, Farzaneh Ghazi; Aarabi, Mohammad Hadi; Yazdi, Meisam Hosein; Haghshomar, Maryam

doi:10.1002/hbm.24409

Cited by 50 publications

(56 citation statements)

References 110 publications

(207 reference statements)

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“…Higher FA and lower MD were noted in young children with PAE, which differs from previous findings in older children and adolescents (Donald et al, 2015a;Fan et al, 2016;Ghazi Sherbaf et al, 2018;Nguyen et al, 2017;Wozniak et al, 2011), though limited previous research in newborns has shown lower AD (Donald et al, 2015b;Taylor et al, 2016). Throughout childhood, FA increases and MD decreases with age across the brain (Lebel et al, 2011;Lebel et al, 2008b;Reynolds et al, 2019); thus, higher FA and lower MD may reflect premature development of white matter.…”

Section: Discussioncontrasting

confidence: 80%

“…Throughout childhood, FA increases and MD decreases with age across the brain (Lebel et al, 2011;Lebel et al, 2008b;Reynolds et al, 2019); thus, higher FA and lower MD may reflect premature development of white matter. Because previous studies consistently show lower FA and higher MD in older children and adolescents with PAE (Donald et al, 2015a;Ghazi Sherbaf et al, 2018;Nguyen et al, 2017), it is likely that premature development is then followed by early plateaus in developmental trajectories of white matter.…”

Section: Discussionmentioning

confidence: 97%

“…Magnetic resonance imaging (MRI) has been used to study brain structure in newborns, schoolaged children, adolescents, and adults with PAE, demonstrating widespread alterations such as reduced total brain volume and alterations to cortical and subcortical regional volumes, cortical thickness, and functional activation (Donald et al, 2015a;Nguyen et al, 2017). White matter appears to be particularly affected by PAE, with volume studies suggesting disproportionate reductions to white matter (Archibald et al, 2001;Jacobson et al, 2017;Nardelli et al, 2011) and diffusion tensor imaging (DTI) studies reporting extensive alterations to microstructure (Donald et al, 2015a;Ghazi Sherbaf et al, 2018;Lebel et al, 2008a). Measures of white matter microstructure, such as fractional anisotropy (FA) and mean, axial and radial diffusivity (MD, AD, RD), reflect properties such as myelination, axon diameter, and/or axon packing density.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, altered cerebellar white matter in newborns with PAE has been associated with neurobehavioral outcomes (Donald et al, 2015b). In school-aged children, adolescents and adults with PAE/FASD, lower FA and/or higher MD have been consistently noted throughout the brain (Donald et al, 2015a;Ghazi Sherbaf et al, 2018;Lebel et al, 2008a). Some studies have associated lower FA and/or higher MD with difficulties in processing speed (Fan et al, 2016), reading (Treit et al, 2013), working memory (Wozniak et al, 2009), mathematics (Lebel et al, 2010), and executive functioning (Treit et al, 2017), as well as eyeblink conditioning (Fan et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

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White Matter Alterations in Young Children with Prenatal Alcohol Exposure

Kar

Reynolds

Grohs

et al. 2021

Preprint

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Prenatal alcohol exposure (PAE) can lead to cognitive, behavioural, and social-emotional challenges. Previous neuroimaging research has identified alterations to brain structure in newborns, older children, adolescents, and adults with PAE; however, little is known about brain structure in young children. Extensive brain development takes place during early childhood; therefore, understanding the neurological profiles of young children with PAE is critical for early identification and effective intervention. We studied 54 children (5.21±1.11 years; 27 males) with confirmed PAE compared to 54 age- and sex-matched children without PAE. Children underwent diffusion tensor imaging between 2 and 7 years of age. Mean fractional anisotropy (FA) and mean diffusivity (MD) were obtained for 10 major white matter tracts, along with tract volume, axial and radial diffusivity (AD, RD). A univariate analysis of covariance was conducted to test for group differences (PAE vs. control) controlling for age, sex and tract volume. Our results reveal white matter microstructural differences between young children with PAE and unexposed controls. The PAE group had higher FA and/or lower MD (as well as lower AD and RD) in the genu and the body of the corpus callosum, as well as the bilateral uncinate fasciculus and pyramidal tracts. Our findings align with studies of newborns with PAE finding lower AD, but contrast those in older populations with PAE, which consistently report lower FA and higher MD. These findings may reflect premature development of white matter that may then plateau too early, leading to the lower FA/higher MD observed at older ages.

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Section: Discussioncontrasting

confidence: 80%

Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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White Matter Alterations in Young Children with Prenatal Alcohol Exposure

Kar

Reynolds

Grohs

et al. 2021

Preprint

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“…Animal models have identified numerous direct and indirect mechanisms through which PAE impacts brain structure and function (Goodlett et al, ; Gupta et al, ; Wang and Kroenke, ). In humans, quantitative magnetic resonance imaging (MRI) research has demonstrated group differences in brain structure (e.g., volumes, diffusion metrics, cortical thickness) and function in participants with FASD relative to healthy controls (for review, see Coles and Li, ; Donald et al, ; Ghazi Sherbaf et al, ; Lebel et al, ). However, these quantitative methods rely on time‐consuming and often complex image processing and the observed group differences usually have considerable overlap between PAE and control participants given marked intersubject variability, limiting clinical utility in an individual (Wozniak et al, ).…”

mentioning

confidence: 99%

Radiological Findings on Structural Magnetic Resonance Imaging in Fetal Alcohol Spectrum Disorders and Healthy Controls

Treit

Beaulieu

Emery

2020

Alcoholism Clin & Exp Res

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Background: Fetal alcohol spectrum disorders (FASD) describe a range of physical, behavioral, and cognitive impairments stemming from prenatal alcohol exposure (PAE). Although case studies have demonstrated striking visible brain abnormalities in humans (enlargement of the lateral ventricles, thinning or absence of the corpus callosum, etc.), few studies have systematically determined how these radiological findings generalize to the wider population of individuals living with FASD.Methods: This study examines rates of structural brain anomalies on magnetic resonance imaging (MRI) as determined by 2 radiologists in a retrospective blinded review of 163 controls and 164 individuals with PAE who were previously scanned as participants of past research studies. Incidental findings were categorized as normal variants, nonclinically significant incidental findings, or clinically significant incidental findings. Rates were compared between diagnostic subgroups using chi-square analysis.Results: There was no significant difference in the overall rate of incidental findings between groups: 75% of controls and 73% of PAE participants had no incidental findings of any kind, and only 1% of controls and 3% of PAE participants had incidental finding of clinical significance (the remaining findings were considered nonsignificant anomalies or normal variants). When the PAE group was split by diagnosis, low-lying cerebellar tonsils, polymicrogyria, and ventricular asymmetry/enlargement were all most prevalent in subjects with fetal alcohol syndrome/partial fetal alcohol syndrome. In addition, the overall rate of incidental findings was higher (41%) in participants with FAS/pFAS, compared to 25% in controls. No participants in this relatively large sample had corpus callosum agenesis.Conclusions: Although advanced quantitative MRI research has uncovered a range of differences in brain structure associated with FASD, this qualitative radiological study suggests that routine clinical MRI does not reveal a consistent pattern of brain abnormalities that can be used diagnostically in this population.

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White matter alterations in young children with prenatal alcohol exposure

Kar

Reynolds

Grohs

et al. 2021

Developmental Neurobiology

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Prenatal alcohol exposure (PAE) can lead to cognitive, behavioural, and socialemotional challenges. Previous neuroimaging research has identified structural brain alterations in newborns, older children, adolescents, and adults with PAE; however, little is known about brain structure in young children. Extensive brain development occurs during early childhood; therefore, understanding the neurological profiles of young children with PAE is critical for early identification and effective intervention.We studied 54 children (5.21 ± 1.11 years; 27 males) with confirmed PAE (94% also had other prenatal exposures, 74% had adverse postnatal experiences) compared with 54 age-and sex-matched children without PAE. Children underwent diffusion tensor imaging between 2 and 7 years of age. Mean fractional anisotropy (FA) and mean diffusivity (MD) were obtained for 10 major white matter tracts. Univariate analyses of covariance were used to test group differences (PAE vs. control) controlling for age and sex. The PAE group had higher FA in the genu of the corpus callosum and lower MD in the bilateral uncinate fasciculus. The PAE group also had lower tract volume in the corpus callosum, the bilateral inferior fronto-occipital fasciculi, and the right superior longitudinal fasciculus. Our findings align with studies of newborns with PAE reporting lower diffusivity, but contrast those in older populations with PAE, which consistently report lower FA and higher MD. Further research is needed to understand trajectories of white matter development and how our results of higher FA/lower MD in young children connect with lower FA/higher MD observed at older ages. K E Y W O R D Sdiffusion tensor imaging, fetal alcohol spectrum disorder, prenatal alcohol exposure, preschool children, white matter | 401

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White matter microstructure in fetal alcohol spectrum disorders: A systematic review of diffusion tensor imaging studies

Cited by 50 publications

References 110 publications

White Matter Alterations in Young Children with Prenatal Alcohol Exposure

White Matter Alterations in Young Children with Prenatal Alcohol Exposure

Radiological Findings on Structural Magnetic Resonance Imaging in Fetal Alcohol Spectrum Disorders and Healthy Controls

White matter alterations in young children with prenatal alcohol exposure

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