Microstructural corpus callosum anomalies in children with prenatal alcohol exposure: an extension of previous diffusion tensor imaging findings.
BACKGROUND
Several studies have now shown corpus callosum abnormalities using diffusion tensor imaging (DTI) in children with fetal alcohol spectrum disorders (FASD) in comparison with nonexposed controls. The data suggest that posterior regions of the callosum may be disproportionately affected. The current study builds on previous efforts, including our own work, and moves beyond midline corpus callosum to probe major inter-hemispheric white matter pathways with an improved DTI tractographic method. This study also expands on our prior work by evaluating a larger sample and by incorporating children with a broader range of clinical effects including full-criteria fetal alcohol syndrome (FAS).


METHODS
Participants included 33 children with FASD (8 FAS, 23 partial FAS, 2 static encephalopathy) and 19 nonexposed controls between the ages of 10 and 17 years. Participants underwent DTI scans and intelligence testing. Groups (FASD vs. controls) were compared on fractional anisotropy (FA) and mean diffusivity (MD) in 6 white matter tracts projected through the corpus callosum. Exploratory analyses were also conducted examining the relationships between DTI measures in the corpus callosum and measures of intellectual functioning and facial dysmorphology.


RESULTS
In comparison with the control group, the FASD group had significantly lower FA in 3 posterior tracts of the corpus callosum: the posterior mid-body, the isthmus, and the splenium. A trend-level finding also suggested lower FA in the genu. Measures of white matter integrity and cognition were correlated and suggest some regional specificity, in that only posterior regions of the corpus callosum were associated with visual-perceptual skills. Correlations between measures of facial dysmorphology and posterior regions of the corpus callosum were nonsignificant.


CONCLUSIONS
Consistent with previous DTI studies, these results suggest that microstructural posterior corpus callosum abnormalities are present in children with prenatal alcohol exposure and cognitive impairment. These abnormalities are clinically relevant because they are associated with cognitive deficits and appear to provide evidence of abnormalities associated with prenatal alcohol exposure independent of dysmorphic features. As such, they may yield important diagnostic and prognostic information not provided by the traditional facial characteristics.
Wozniak
Jeffrey R
JR
University of Minnesota, Twin Cities, Minnesota 55454, USA. jwozniak@umn.edu
Muetzel
Ryan L
RL
Mueller
Bryon A
BA
McGee
Christie L
CL
Freerks
Melesa A
MA
Ward
Erin E
EE
Nelson
Miranda L
ML
Chang
Pi-Nian
PN
Lim
Kelvin O
KO
D000293:Adolescent; D016880:Anisotropy; D002540:Cerebral Cortex / Q000473:pathology; D002648:Child; D003071:Cognition / Q000502:physiology; D003337:Corpus Callosum / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging; D005145:Face / Q000002:abnormalities; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000473:pathology* / Q000523:psychology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007361:Intelligence Tests; D008297:Male; D009434:Neural Pathways / Q000473:pathology; D009483:Neuropsychological Tests; D011247:Pregnancy; D014796:Visual Perception / Q000502:physiology