Background
Magnetic resonance imaging (MRI) studies of prenatal alcohol exposure (PAE) commonly report reduced hippocampal volumes, which animal models suggest may result from microstructural changes that include cell loss and altered myelination. Diffusion tensor imaging (DTI) is sensitive to microstructural changes but has not yet been used to study the hippocampus in PAE.
Methods
Thirtyâsix healthy controls (19 females; 8 to 24âyears) and 19 participants with PAE (8 females; 8 to 23âyears) underwent highâresolution (1 mm isotropic) DTI, anatomical T1âweighted imaging, and cognitive testing. Wholeâhippocampus, head, body, and tail subregions were manually segmented to yield DTI metrics (mean, axial, and radial diffusivitiesâMD, AD, and RD; fractional anisotropyâFA), volumes, and qualitative assessments of hippocampal morphology and digitations. Automated segmentation of T1âweighted images was used to corroborate manual wholeâhippocampus volumes.
Results
Gross morphology and digitation counts were similar in both groups. Wholeâhippocampus volumes were 18% smaller in the PAE than the control group on manually traced diffusion images, but automated T1âweighted image segmentations were not significantly different. Subregion segmentation on DTI revealed reduced volumes of the body and tail, but not the head. There were no significant differences in diffusion metrics between groups for any hippocampal region. Correlations between age and volume were not significant in either group, whereas negative correlations between age and wholeâhippocampus MD/AD/RD, and head/body (but not tail) MD/AD/RD were significant in both groups. There were no significant effects of sex, group by age, or group by sex for any hippocampal metric. In controls, seven positive linear correlations were found between hippocampal volume and cognition; five of these were left lateralized and included episodic and working memory, and two were right lateralized and included working memory and processing speed. In PAE, left tail MD positively correlated with executive functioning, and right head MD negatively correlated with episodic memory.
Conclusions
Reductions of hippocampal volumes and altered relationships with memory suggest disrupted hippocampal development in PAE.