Caudate Volume Predicts Neurocognitive Performance in Youth with Heavy Prenatal Alcohol Exposure

Abstract

Background Fetal alcohol spectrum disorders (FASD) result from heavy prenatal alcohol exposure, and are characterized, in some cases, by CNS anomalies and cognitive impairment. Regional patterns of neuroanatomical abnormalities suggest that alcohol exerts selective damage on the developing fetal brain. This study assessed brain-behavior relationships in a sample of youth with histories of heavy prenatal alcohol exposure. The aim was to characterize how structural brain alterations observed in our previous studies relate to cognitive deficits commonly reported in individuals with histories of heavy prenatal alcohol exposure. Methods Twenty-one youth (mean age 13 years) with histories of heavy prenatal alcohol exposure and seven non-exposed healthy comparison subjects underwent structural magnetic resonance imaging (MRI) and neurobehavioral testing. Regional brain volumes within the alcohol-exposed group were correlated with neuropsychological measures of cognitive control and verbal learning/recall, as these aspects of cognition have previously been shown to be vulnerable to alcohol teratogenesis. Results Between-group effect sizes revealed moderate to large cognitive performance and brain volume decrements in alcohol-exposed subjects, compared to typically developing peers. Within the alcohol-exposed group, volume of the caudate nuclei was the most consistent predictor of neuropsychological performance, after controlling for potentially confounding variables including total brain volume, IQ, and age. Conclusions These data are consistent with previous research associating gestational alcohol exposure with structural and functional changes of the caudate nucleus. Our findings extend this previous work by demonstrating that volume reductions of the caudate have behavioral relevance for this population, in relation to cognitive control and verbal learning and recall abilities.

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

“…For example, a smaller caudate nucleus, a structure that is essential in learning and memory processing and storing [65], was found to strongly correlate with poor cognitive performance and verbal learning ability [66]. Poor verbal learning ability was also correlated with the amount of displacement of the corpus callosum [59] and the cerebellar vermis [49].…”

Review of Current Neuroimaging Studies of the Effects of Prenatal Drug Exposure: Brain Structure and Function

“…Several studies indicate that reductions in brain volume linked to prenatal alcohol exposure were associated with deficits in cognitive function and facial dsymorphology. For example, prenatal alcohol exposed is linked to reductions in caudate volume which are also associated with deficits in cognitive control and verbal learning and memory [44] as well as palpebral fissure length [45]. Moreover, reductions in brain volume increase as a function of the amount of alcohol consumed during pregnancy and the severity of diagnosis [38,46] and were reported from early childhood through young adulthood, suggesting long-term and persistent alterations in brain structure.…”

“…Among pregnant women, the rate of any illicit drug use is 5.4% and has not changed significantly since 2010-2011 [12]. Use remains higher in younger women (14.6%, ages 18-25) compared to older women (3.2%, ages [26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44]. A high proportion of women are using marijuana illegally and fail to disclose their use to their providers.…”

Cerebral Magnetic Resonance Imaging in Children With Prenatal Drug Exposure

“…The caudate, thalamus, and cerebellum are all crucial parts of the neurobiological circuits involved in regulating attention [51]. In youth with prenatal alcohol exposure, reduced volumes of the caudate nuclei have been shown to predict decreased cognitive control and verbal learning performance, and smaller basal ganglia volumes have been associated with lower IQ scores in patients with FASD [35,52]. Subtle attentional deficits mediated by reduced caudate volumes have been suggested in children with prenatal exposure to methamphetamine [43].…”

“…15 There has been no consistent pattern of general cognitive impairment, but even after adjustment for numerous confounding variables prenatal cocaine exposure has been associated with deficits related to attention, executive functioning, language and behavior. [51][52][53] In "The Infant Development, Environment, and Lifestyle" (IDEAL) study possible longterm effects of prenatal amphetamines were explored for the first time in a large, prospective cohort. 19 Subtle cognitive and behavioral deficits were found in the amphetamine-exposed group.…”