title: Heavy Prenatal Alcohol Exposure is Related to Smaller Corpus Callosum in Newborn MRI Scans.
abstract: BACKGROUND
  Magnetic resonance imaging (MRI) studies have consistently demonstrated disproportionately smaller corpus callosa in individuals with a history of prenatal alcohol exposure (PAE) but have not previously examined the feasibility of detecting this effect in infants. Tissue segmentation of the newborn brain is challenging because analysis techniques developed for the adult brain are not directly transferable, and segmentation for cerebral morphometry is difficult in neonates, due to the latter's incomplete myelination. This study is the first to use volumetric structural MRI to investigate PAE effects in newborns using manual tracing and to examine the cross-sectional area of the corpus callosum (CC).
  
  
  METHODS
  Forty-three nonsedated infants born to 32 Cape Coloured heavy drinkers and 11 controls recruited prospectively during pregnancy were scanned using a custom-designed birdcage coil for infants, which increases signal-to-noise ratio almost 2-fold compared to the standard head coil. Alcohol use was ascertained prospectively during pregnancy, and fetal alcohol spectrum disorders diagnosis was conducted by expert dysmorphologists. Data were acquired using a multi-echo FLASH protocol adapted for newborns, and a knowledge-based procedure was used to hand-segment the neonatal brains.
  
  
  RESULTS
  CC was disproportionately smaller in alcohol-exposed neonates than controls after controlling for intracranial volume. By contrast, CC area was unrelated to infant sex, gestational age, age at scan, or maternal smoking, marijuana, or methamphetamine use during pregnancy.
  
  
  CONCLUSIONS
  Given that midline craniofacial anomalies have been recognized as a hallmark of fetal alcohol syndrome in humans and animal models since this syndrome was first identified, the CC deficit identified here in newborns may support early identification of a range of midline structural impairments. Smaller CC during the newborn period may provide an early indicator of fetal alcohol-related cognitive deficits that have been linked to this critically important brain structure in childhood and adolescence.
authors.affiliation: Department of Psychiatry and Behavioral Neurosciences , Wayne State University School of Medicine, Detroit, Michigan.|Department of Human Biology , Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.|Department of Psychiatry and Mental Health , Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
authors.forename: Sandra W
authors.identifier: http://orcid.org/0000-0002-9768-2671
authors.initials: SW
authors.lastname: Jacobson
authors.affiliation: Department of Psychiatry and Behavioral Neurosciences , Wayne State University School of Medicine, Detroit, Michigan.|Department of Human Biology , Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.|Department of Psychiatry and Mental Health , Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Jacobson
authors.affiliation: Department of Psychiatry and Mental Health , Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Molteno
authors.affiliation: Department of Human Biology , Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
authors.forename: Christopher M R
authors.initials: CMR
authors.lastname: Warton
authors.affiliation: Montreal Children's Hospital , Montreal, Quebec, Canada.
authors.forename: Pia
authors.initials: P
authors.lastname: Wintermark
authors.affiliation: Department of Pediatrics , Sanford School of Medicine, University of South Dakota, Sioux Falls, South Dakota.|College of Medicine , University of Arizona, Tucson, Arizona.
authors.forename: H Eugene
authors.initials: HE
authors.lastname: Hoyme
authors.affiliation: Division of Molecular Biology and Human Genetics , Stellenbosch University, Faculty of Medicine and Health Sciences, Cape Town, South Africa.
authors.forename: Greetje
authors.initials: G
authors.lastname: De Jong
authors.affiliation: Department of Human Biology , Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.|Scientific and Statistical Computing Core , National Institutes of Health, Bethesda, Maryland.
authors.forename: Paul
authors.initials: P
authors.lastname: Taylor
authors.affiliation: Department of Human Biology , Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
authors.forename: Fleur
authors.initials: F
authors.lastname: Warton
authors.affiliation: Department of Psychology , University of Cape Town, Cape Town, South Africa.
authors.forename: Nadine M
authors.initials: NM
authors.lastname: Lindinger
authors.affiliation: Division of Pediatric Emergency Medicine , Morgan Stanley Children's Hospital of New York, Columbia University Medical Center, New York, New York.
authors.forename: R Colin
authors.identifier: http://orcid.org/0000-0003-1554-6914
authors.initials: RC
authors.lastname: Carter
authors.affiliation: Department of Psychiatry and Behavioral Neurosciences , Wayne State University School of Medicine, Detroit, Michigan.
authors.forename: Neil C
authors.initials: NC
authors.lastname: Dodge
authors.affiliation: Division of Pediatric Emergency Medicine , Morgan Stanley Children's Hospital of New York, Columbia University Medical Center, New York, New York.
authors.forename: Ellen
authors.initials: E
authors.lastname: Grant
authors.affiliation: Department of Pediatrics , Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts.
authors.forename: Simon K
authors.initials: SK
authors.lastname: Warfield
authors.affiliation: Department of Radiology , Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Lilla
authors.initials: L
authors.lastname: Zöllei
authors.affiliation: Department of Radiology , Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: André J W
authors.initials: AJW
authors.lastname: van der Kouwe
authors.affiliation: Department of Human Biology , Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.|MRC/UCT Medical Imaging Research Unit , Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
authors.forename: Ernesta M
authors.initials: EM
authors.lastname: Meintjes
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects* / Q000453:epidemiology; D003337:Corpus Callosum / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000000981:diagnostic imaging* / Q000453:epidemiology; D013019:South Africa / Q000453:epidemiology; D055815:Young Adult
keywords: Corpus Callosum; Fetal Alcohol Spectrum Disorders; Fetal Alcohol Syndrome; Manual Tracing; Neonatal Brain MRI; Prenatal Alcohol Exposure