Neurodevelopmental Trajectories Following Prenatal Alcohol Exposure

Abstract

Prenatal alcohol exposure (PAE) interferes with neurodevelopment. The brain is particularly susceptible to the adverse consequences of prenatal alcohol exposure, and numerous studies have documented changes to brain anatomy and function, as well as consequences for cognition, behavior, and mental health. Studies in typically developing individuals have shown that the brain undergoes dynamic developmental processes over an individual’s lifespan. Furthermore, magnetic resonance imaging (MRI) studies in other neurodevelopmental and psychiatric disorders have shown that their developmental trajectories differ from the typical pattern. Therefore, to understand long-term clinical outcomes of fetal alcohol spectrum disorders (FASD), it is necessary to investigate changes in neurodevelopmental trajectories in this population. Here we review studies that have used MRI to evaluate changes in brain structure and function over time via cross-sectional or longitudinal methods in individuals with PAE. Research demonstrates that individuals with PAE have atypical cortical and white matter microstructural developmental trajectories through childhood and adolescence. More research is needed to understand how factors such as sex and postnatal experiences may further mediate these trajectories. Furthermore, nothing is known about the trajectories beyond young adulthood.

The impact of prenatal alcohol and/or tobacco exposure on brain structure in a large sample of children from a South African birth cohort

“…Contrary to the literature examining brain structure in children with FASDs (e.g., Moore & Xia, 2021), we did not see large effects of PAE in this community sample (i.e., large effect sizes and wide spatial distribution of brain differences). There could be numerous explanations for the discrepancies, but we highlight three possibilities.…”

“…Despite similarities between the exposed and control participants on extreme environmental adversity (described below), these results suggest that the MTL may be more vulnerable to PAE than other brain structures are, in comparison to previous studies of PAE in the same geographical region of South Africa. Abnormalities of MTL structures have been previously reported in PAE (Moore & Xia, 2021), and neuroimaging analyses of 51 6‐year‐olds from the PASS cohort also revealed structural differences in the fusiform gyrus given PAE (i.e., another structure that spans the MTL; Uban et al, 2022). Other cortical regions affected by PAE included precentral sulcus and medial occipital cortices as well as the caudate nucleus subcortically, but these effects did not survive correction for multiple comparisons.…”

“…reported in PAE (Moore & Xia, 2021), and neuroimaging analyses of 51 6-year-olds from the PASS cohort also revealed structural differences in the fusiform gyrus given PAE (i.e., another structure that spans the MTL; Uban et al, 2022). Other cortical regions affected by PAE included precentral sulcus and medial occipital cortices as well as the caudate nucleus subcortically, but these effects did not survive correction for multiple comparisons.…”

Brain structural connectome in neonates with prenatal opioid exposure

“…These early brain microstructural alterations noted on diffusion imaging in prenatal cocaine, marijuana and methadone or heroin exposure may also serve as predictors of 12 month behavioral and language outcomes (Peterson et al, 2020). Similarly, infants with prenatal alcohol exposure also showed altered FA values and reduced white matter microstructural integrity (Donald et al, 2015), and these early brain microstructural disruptions may persist until later life (Wozniak et al, 2009;Moore and Xia, 2021;Roos et al, 2021;Stephen et al, 2021).…”

Current considerations for fetal alcohol spectrum disorders: identification to intervention

“…Over the past few decades, there has been a growing base of research literature describing the structural and functional changes associated with prenatal alcohol exposure to help differentiate those with alcohol exposure from typically developing youth [33] and identify potential clinical correlates that may be provide cause of deficits or targets for intervention [34]. Smaller overall brain size is among the most reported findings, underscoring alcohol's global teratogenic effect on the brain; however, this is not specific to prenatal alcohol exposure, as it also occurs in other disorders.…”