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Brain Volume in Fetal Alcohol Spectrum Disorders Over a 20-Year Span
IMPORTANCE: Anomalous brain development and mental health problems are prevalent in fetal alcohol spectrum disorders (FASD), but there is a paucity of longitudinal brain imaging research into adulthood. This study presents long-term follow-up of brain volumetrics in a cohort of participants with FAS...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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American Medical Association
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10656646/ https://www.ncbi.nlm.nih.gov/pubmed/37976065 http://dx.doi.org/10.1001/jamanetworkopen.2023.43618 |
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author | Pfefferbaum, Adolf Sullivan, Edith V. Pohl, Kilian M. Bischoff-Grethe, Amanda Stoner, Susan A. Moore, Eileen M. Riley, Edward P. |
author_facet | Pfefferbaum, Adolf Sullivan, Edith V. Pohl, Kilian M. Bischoff-Grethe, Amanda Stoner, Susan A. Moore, Eileen M. Riley, Edward P. |
author_sort | Pfefferbaum, Adolf |
collection | PubMed |
description | IMPORTANCE: Anomalous brain development and mental health problems are prevalent in fetal alcohol spectrum disorders (FASD), but there is a paucity of longitudinal brain imaging research into adulthood. This study presents long-term follow-up of brain volumetrics in a cohort of participants with FASD. OBJECTIVE: To test whether brain tissue declines faster with aging in individuals with FASD compared with control participants. DESIGN, SETTING, AND PARTICIPANTS: This cohort study used magnetic resonance imaging (MRI) data collected from individuals with FASD and control individuals (age 13-37 years at first magnetic resonance imaging [MRI1] acquired 1997-2000) compared with data collected 20 years later (MRI2; 2018-2021). Participants were recruited for MRI1 through the University of Washington Fetal Alcohol Syndrome (FAS) Follow-Up Study. For MRI2, former participants were recruited by the University of Washington Fetal Alcohol and Drug Unit. Data were analyzed from October 2022 to August 2023. MAIN OUTCOMES AND MEASURES: Intracranial volume (ICV) and regional cortical and cerebellar gray matter, white matter, and cerebrospinal fluid volumes were quantified automatically and analyzed, with group and sex as between-participant factors and age as a within-participant variable. RESULTS: Of 174 individuals with MRI1 data, 48 refused participation, 36 were unavailable, and 24 could not be located. The remaining 66 individuals (37.9%) were rescanned for MRI2, including 26 controls, 18 individuals with nondysmorphic heavily exposed fetal alcohol effects (FAE; diagnosed prior to MRI1), and 22 individuals with FAS. Mean (SD) age was 22.9 (5.6) years at MRI1 and 44.7 (6.5) years at MRI2, and 35 participants (53%) were male. The FAE and FAS groups exhibited enduring stepped volume deficits at MRI1 and MRI2; volumes among control participants were greater than among participants with FAE, which were greater than volumes among participants with FAS (eg, mean [SD] ICV: control, 1462.3 [119.3] cc at MRI1 and 1465.4 [129.4] cc at MRI2; FAE, 1375.6 [134.1] cc at MRI1 and 1371.7 [120.3] cc at MRI2; FAS, 1297.3 [163.0] cc at MRI1 and 1292.7 [172.1] cc at MRI2), without diagnosis-by-age interactions. Despite these persistent volume deficits, the FAE participants and FAS participants showed patterns of neurodevelopment within reference ranges: increase in white matter and decrease in gray matter of the cortex and decrease in white matter and increase in gray matter of the cerebellum. CONCLUSIONS AND RELEVANCE: The findings of this cohort study support a nonaccelerating enduring, brain structural dysmorphic spectrum following prenatal alcohol exposure and a diagnostic distinction based on the degree of dysmorphia. FASD was not a progressive brain structural disorder by middle age, but whether accelerated decline occurs in later years remains to be determined. |
format | Online Article Text |
id | pubmed-10656646 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | American Medical Association |
record_format | MEDLINE/PubMed |
spelling | pubmed-106566462023-11-17 Brain Volume in Fetal Alcohol Spectrum Disorders Over a 20-Year Span Pfefferbaum, Adolf Sullivan, Edith V. Pohl, Kilian M. Bischoff-Grethe, Amanda Stoner, Susan A. Moore, Eileen M. Riley, Edward P. JAMA Netw Open Original Investigation IMPORTANCE: Anomalous brain development and mental health problems are prevalent in fetal alcohol spectrum disorders (FASD), but there is a paucity of longitudinal brain imaging research into adulthood. This study presents long-term follow-up of brain volumetrics in a cohort of participants with FASD. OBJECTIVE: To test whether brain tissue declines faster with aging in individuals with FASD compared with control participants. DESIGN, SETTING, AND PARTICIPANTS: This cohort study used magnetic resonance imaging (MRI) data collected from individuals with FASD and control individuals (age 13-37 years at first magnetic resonance imaging [MRI1] acquired 1997-2000) compared with data collected 20 years later (MRI2; 2018-2021). Participants were recruited for MRI1 through the University of Washington Fetal Alcohol Syndrome (FAS) Follow-Up Study. For MRI2, former participants were recruited by the University of Washington Fetal Alcohol and Drug Unit. Data were analyzed from October 2022 to August 2023. MAIN OUTCOMES AND MEASURES: Intracranial volume (ICV) and regional cortical and cerebellar gray matter, white matter, and cerebrospinal fluid volumes were quantified automatically and analyzed, with group and sex as between-participant factors and age as a within-participant variable. RESULTS: Of 174 individuals with MRI1 data, 48 refused participation, 36 were unavailable, and 24 could not be located. The remaining 66 individuals (37.9%) were rescanned for MRI2, including 26 controls, 18 individuals with nondysmorphic heavily exposed fetal alcohol effects (FAE; diagnosed prior to MRI1), and 22 individuals with FAS. Mean (SD) age was 22.9 (5.6) years at MRI1 and 44.7 (6.5) years at MRI2, and 35 participants (53%) were male. The FAE and FAS groups exhibited enduring stepped volume deficits at MRI1 and MRI2; volumes among control participants were greater than among participants with FAE, which were greater than volumes among participants with FAS (eg, mean [SD] ICV: control, 1462.3 [119.3] cc at MRI1 and 1465.4 [129.4] cc at MRI2; FAE, 1375.6 [134.1] cc at MRI1 and 1371.7 [120.3] cc at MRI2; FAS, 1297.3 [163.0] cc at MRI1 and 1292.7 [172.1] cc at MRI2), without diagnosis-by-age interactions. Despite these persistent volume deficits, the FAE participants and FAS participants showed patterns of neurodevelopment within reference ranges: increase in white matter and decrease in gray matter of the cortex and decrease in white matter and increase in gray matter of the cerebellum. CONCLUSIONS AND RELEVANCE: The findings of this cohort study support a nonaccelerating enduring, brain structural dysmorphic spectrum following prenatal alcohol exposure and a diagnostic distinction based on the degree of dysmorphia. FASD was not a progressive brain structural disorder by middle age, but whether accelerated decline occurs in later years remains to be determined. American Medical Association 2023-11-17 /pmc/articles/PMC10656646/ /pubmed/37976065 http://dx.doi.org/10.1001/jamanetworkopen.2023.43618 Text en Copyright 2023 Pfefferbaum A et al. JAMA Network Open. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the CC-BY License. |
spellingShingle | Original Investigation Pfefferbaum, Adolf Sullivan, Edith V. Pohl, Kilian M. Bischoff-Grethe, Amanda Stoner, Susan A. Moore, Eileen M. Riley, Edward P. Brain Volume in Fetal Alcohol Spectrum Disorders Over a 20-Year Span |
title | Brain Volume in Fetal Alcohol Spectrum Disorders Over a 20-Year Span |
title_full | Brain Volume in Fetal Alcohol Spectrum Disorders Over a 20-Year Span |
title_fullStr | Brain Volume in Fetal Alcohol Spectrum Disorders Over a 20-Year Span |
title_full_unstemmed | Brain Volume in Fetal Alcohol Spectrum Disorders Over a 20-Year Span |
title_short | Brain Volume in Fetal Alcohol Spectrum Disorders Over a 20-Year Span |
title_sort | brain volume in fetal alcohol spectrum disorders over a 20-year span |
topic | Original Investigation |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10656646/ https://www.ncbi.nlm.nih.gov/pubmed/37976065 http://dx.doi.org/10.1001/jamanetworkopen.2023.43618 |
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