title: A study of the effects of prenatal alcohol exposure on white matter microstructural integrity at birth.
abstract: BACKGROUND
  Neuroimaging studies have indicated that prenatal alcohol exposure is associated with alterations in the structure of specific brain regions in children. However, the temporal and regional specificity of such changes and their behavioural consequences are less known. Here we explore the integrity of regional white matter microstructure in infants with in utero exposure to alcohol, shortly after birth.
  
  
  METHODS
  Twenty-eight alcohol-exposed and 28 healthy unexposed infants were imaged using diffusion tensor imaging sequences to evaluate white matter integrity using validated tract-based spatial statistics analysis methods. Second, diffusion values were extracted for group comparisons by regions of interest. Differences in fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity were compared between groups and associations with measures from the Dubowitz neonatal neurobehavioural assessment were examined.
  
  
  RESULTS
  Lower AD values (p<0.05) were observed in alcohol-exposed infants in the right superior longitudinal fasciculus compared with non-exposed infants. Altered FA and MD values in alcohol-exposed neonates in the right inferior cerebellar were associated with abnormal neonatal neurobehaviour.
  
  
  CONCLUSIONS
  These exploratory data suggest that prenatal alcohol exposure is associated with reduced white matter microstructural integrity even early in the neonatal period. The association with clinical measures reinforces the likely clinical significance of this finding. The location of the findings is remarkably consistent with previously reported studies of white matter structural deficits in older children with a diagnosis of foetal alcohol spectrum disorders.
authors.affiliation: 1Division of Developmental Paediatrics,Department of Paediatrics and Child Health,Red Cross War Memorial Children's Hospital and University of Cape Town,Cape Town,South Africa.
authors.forename: Kirsten Ann
authors.initials: KA
authors.lastname: Donald
authors.affiliation: 2MRC Unit on Anxiety & Stress Disorders,Stellenbosch University,Cape Town,South Africa.
authors.forename: Annerine
authors.initials: A
authors.lastname: Roos
authors.affiliation: 3Department of Human Biology,University of Cape Town and Department of Psychiatry,Stellenbosch University,Cape Town,South Africa.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Fouche
authors.affiliation: 4Department of Psychiatry and Mental Health,University of Cape Town,Cape Town,South Africa.
authors.forename: Nastassja
authors.initials: N
authors.lastname: Koen
authors.affiliation: 4Department of Psychiatry and Mental Health,University of Cape Town,Cape Town,South Africa.
authors.forename: Fleur M
authors.initials: FM
authors.lastname: Howells
authors.affiliation: 5Department of Neurology,University of California,LA,USA.
authors.forename: Roger P
authors.initials: RP
authors.lastname: Woods
authors.affiliation: 6Department of Paediatrics and Child Health,Red Cross War Memorial Children's Hospital and University of Cape Town,Cape Town,South Africa.
authors.forename: Heather J
authors.initials: HJ
authors.lastname: Zar
authors.affiliation: 5Department of Neurology,University of California,LA,USA.
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Narr
authors.affiliation: 2MRC Unit on Anxiety & Stress Disorders,Stellenbosch University,Cape Town,South Africa.
authors.forename: Dan J
authors.initials: DJ
authors.lastname: Stein
mesh_terms: D000428:Alcohol Drinking / Q000009:adverse effects*; D002531:Cerebellum / Q000473:pathology; D002675:Child, Preschool; D015331:Cohort Studies; D056324:Diffusion Tensor Imaging / Q000379:methods; D000431:Ethanol / Q000506:poisoning*; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000473:pathology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008431:Maternal-Fetal Exchange; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D066127:White Matter / Q000187:drug effects* / Q000473:pathology*
chemical_list: D000431:Ethanol
keywords: DTI; MRI; dubowitz; foetal alcohol spectrum disorders; infant