title: Neuroimaging effects of prenatal alcohol exposure on the developing human brain: a magnetic resonance imaging review.
abstract: OBJECTIVE
  This paper reviews the magnetic resonance imaging (MRI) literature on the effects of prenatal alcohol exposure on the developing human brain.
  
  
  METHODS
  A literature search was conducted through the following databases: PubMed, PsycINFO and Google Scholar. Combinations of the following search terms and keywords were used to identify relevant studies: 'alcohol', 'fetal alcohol spectrum disorders', 'fetal alcohol syndrome', 'FAS', 'FASD', 'MRI', 'DTI', 'MRS', 'neuroimaging', 'children' and 'infants'.
  
  
  RESULTS
  A total of 64 relevant articles were identified across all modalities. Overall, studies reported smaller total brain volume as well as smaller volume of both the white and grey matter in specific cortical regions. The most consistently reported structural MRI findings were alterations in the shape and volume of the corpus callosum, as well as smaller volume in the basal ganglia and hippocampi. The most consistent finding from diffusion tensor imaging studies was lower fractional anisotropy in the corpus callosum. Proton magnetic resonance spectroscopy studies are few to date, but showed altered neurometabolic profiles in the frontal and parietal cortex, thalamus and dentate nuclei. Resting-state functional MRI studies reported reduced functional connectivity between cortical and deep grey matter structures. Discussion There is a critical gap in the literature of MRI studies in alcohol-exposed children under 5 years of age across all MRI modalities. The dynamic nature of brain maturation and appreciation of the effects of alcohol exposure on the developing trajectory of the structural and functional network argue for the prioritisation of studies that include a longitudinal approach to understanding this spectrum of effects and potential therapeutic time points.
authors.affiliation: 1Division of Developmental Paediatrics,Department of Paediatrics and Child Health,Red Cross War Memorial Children's Hospital,University of Cape Town,Cape Town,South Africa.
authors.forename: Kirsten Ann
authors.initials: KA
authors.lastname: Donald
authors.affiliation: 1Division of Developmental Paediatrics,Department of Paediatrics and Child Health,Red Cross War Memorial Children's Hospital,University of Cape Town,Cape Town,South Africa.
authors.forename: Emma
authors.initials: E
authors.lastname: Eastman
authors.affiliation: 2Department of Psychiatry and Mental Health,University of Cape Town,Cape Town,South Africa.
authors.forename: Fleur Margaret
authors.initials: FM
authors.lastname: Howells
authors.affiliation: 2Department of Psychiatry and Mental Health,University of Cape Town,Cape Town,South Africa.
authors.forename: Colleen
authors.initials: C
authors.lastname: Adnams
authors.affiliation: 3Department of Psychology,San Diego State University,San Diego,CA,USA.
authors.forename: Edward Patrick
authors.initials: EP
authors.lastname: Riley
authors.affiliation: 4Department of Neurology,David Geffen School of Medicine,University of California,Los Angeles,CA,USA.
authors.forename: Roger Paul
authors.initials: RP
authors.lastname: Woods
authors.affiliation: 4Department of Neurology,David Geffen School of Medicine,University of California,Los Angeles,CA,USA.
authors.forename: Katherine Louise
authors.initials: KL
authors.lastname: Narr
authors.affiliation: 2Department of Psychiatry and Mental Health,University of Cape Town,Cape Town,South Africa.
authors.forename: Dan Joseph
authors.initials: DJ
authors.lastname: Stein
mesh_terms: D000293:Adolescent; D000428:Alcohol Drinking / Q000009:adverse effects*; D001921:Brain / Q000187:drug effects* / Q000196:embryology / Q000254:growth & development* / Q000473:pathology; D002648:Child; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D056324:Diffusion Tensor Imaging; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000473:pathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods; D059906:Neuroimaging / Q000379:methods*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000209:etiology / Q000473:pathology*; D019966:Substance-Related Disorders / Q000473:pathology / Q000523:psychology
keywords: foetal alcohol spectrum disorders (FASD); foetal alcohol syndrome (FAS); magnetic resonance imaging (MRI); neuroimaging