Recent:
"Regional cerebellum volume anomalies and associated cognitive function in children with fetal alcohol spectrum disorders"
The cerebellum is an often underappreciated, but highly complex and important part of the brain that contains about 80% of the brain’s neurons. It controls balance and movement, but also plays a critical role in thinking and problem-solving. PAE can negatively affect cerebellum development which may interfere with these important functions. Brain MRI scans of children with FASD were compared to scans of typically developing children and the results showed that children with FASD had lower volumes of white and grey matter. White matter is the brain’s “wiring”, responsible for communicating to other areas of the brain, and grey matter is responsible for integrating and processing information. The FASD group also had a smaller vermis, the middle of the cerebellum which controls posture and balance but may also be involved in social behavior. Participants also completed cognitive testing which evaluated intelligence, executive function, visual memory, and visual-motor processing speed. In the FASD group larger white matter volume was found to be associated with better performance on verbal working memory and processing speed tasks. These findings suggest that PAE is associated with developmental abnormalities in cerebellum structure which may be partially responsible for the lower cognitive performance of the FASD group.
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"Choline enhances elicited imitation memory performance in preschool children with prenatal alcohol exposure: a cumulative report of 3 randomized controlled trials"
PAE can negatively impact an individual's brain, including worsened memory. Choline is a nutrient (sometimes included as part of the B vitamin family) commonly found in fish and eggs, and is critical for brain development, specifically memory. In this study, a choline supplement was found to improve the memory of individuals with PAE between the ages of 2.5 and 5.9 years old. Participants were randomly placed into one of two groups: either a “Choline group” where they received a choline supplement or a “Placebo group” where they received a similar product containing no choline. The choline group received 260-500mg of supplement each day for 9 months. A memory test was used to see if the choline helped. The test involved the participant repeating actions shown to them by the researcher. After the researcher demonstrated the actions, the child had to wait 15 minutes before repeating them. This delay helps us measure how well the child transfers the actions from short-term memory (i.e.,typically lasting a few seconds during active concentration) to long-term memory (more permanent memory, lasting hours to days). The choline group performed 25% better at remembering and repeating the actions in order compared to the placebo group. Choline appeared to be most helpful to participants who started at a younger age. These results support the use of choline to optimize / improve memory in young children who were exposed to alcohol prenatally and suggests that supplementing choline in their diet early-on may be more beneficial than waiting until later ages.
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"Regional hippocampal thinning and gyrification abnormalities and associated cognition in children with prenatal alcohol exposure"
The hippocampus is a brain structure that is very important for many different brain functions, but especially memory. The development of the hippocampus is very complex, and it includes a process of “folding” to conserve space in the brain - where more folds typically means better development. PAE is known to impact the development of the hippocampus, leading to impaired memory and decision making. In this study, MRI brain scans were used to compare the structure of the hippocampus in children with PAE to unexposed children. Children ages 8-16 completed a physical examination, neuropsychological assessment and an MRI. These tests were used to determine diagnosis, intellectual and memory function, and measurements of brain thickness and folding. The PAE group had significantly thinner tissue (fewer cells) with less-complex folding than the unexposed group. Furthermore, in the participants with PAE, thinner tissue was associated with lower IQ and worse memory. These results suggest that PAE inhibits the growth of the hippocampus by limiting the thickness and the complex folding that are important for efficient processing. These results also reveal how this inhibited growth results in functional deficits for these children.
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"Normative modeling of brain MRI data identifies small subcortical volumes and associations with cognitive function in youth with fetal alcohol spectrum disorder (FASD)"
As children age, growth-charts are commonly used by pediatricians to track height and weight to ensure proper developmental milestones are being met. This study applies the same concept for brain development, with newly developed brain growth-charts. Using MRI scans, the researchers took brain measurements of children with FASD and compared them to the brain growth-charts of unaffected children. Physical measurements were used to determine the impact alcohol had on overall growth (e.g., head size, height, and weight), which has been part of the standard for diagnosing FASD for decades. Finally, neuropsychological tests were used to measure brain function and behavior such as intelligence, memory, and self-regulation. A total of 89% of the children with FASD had at least one brain area that was abnormally small, compared to only 72% of unaffected children. The hippocampus and caudate nucleus—areas used in memory, planning, and learning—were the most different between the FASD group and the unaffected individuals. Furthermore, the children with small brain regions were more likely to perform lower on the intelligence tests. Importantly, it was found that head size (measured with a tape measure) did not always reflect brain growth in this group. Some children with normal size heads still had brain areas that were smaller than average according to the growth charts. Overall, these results suggest that children with FASD are at risk for having smaller brain volumes and, therefore, altered brain function that results in problems with memory, attention, and problem-solving.
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"Normative magnetic resonance imaging data increase the sensitivity to brain volume abnormalities in the classification of fetal alcohol spectrum disorder"
In this study, individuals with PAE between the ages of 8-17 years, showed lower average brain volumes compared to individuals without prenatal alcohol exposure (controls). Additionally, the individuals with PAE who had brain volumes that were less than or equal to the 10th percentile also had lower performance on tests of intellectual and executive functioning compared to controls who had brain volumes greater than the 10th percentile. Hence, brain volumes may be helpful in identifying more individuals who have FASD.
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"Delayed cortical thinning in children and adolescents with prenatal alcohol exposure"
In this study, brain MRI scans found differences in the timeline of brain development when comparing children, aged 8–17, with PAE to children without exposure. This aspect of brain development is thought to be important in increasing efficiency as children get older because it is associated with increased performance on cognitive tasks - like attention and memory. In this study, children with PAE showed an atypical pattern in this measure of brain development and cognitive performance. This study suggests that PAE may continue to have an impact on brain health into childhood and adolescence, delaying important steps in brain development compared to typically developing children of the same age. The findings illustrate the importance of repeated assessments of cognitive functioning over childhood / adolescence and highlight the need for continuous interventions such as special education programming and therapies.
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"Atypical developmental trajectories of white matter microstructure in prenatal alcohol exposure: Preliminary evidence from neurite orientation dispersion and density imaging"
Advanced experimental brain scanning techniques revealed small differences in the timing of brain development in children with PAE when compared to typically developing children of the same age. These subtle differences were associated with performance on memory and attention tasks for children with PAE. Typically-developing children showed a specific pattern of brain change over time with age that was not seen in those with PAE. This suggests that PAE may cause an alteration in the timing of important aspects of brain growth. Advanced scanning techniques such as this one will continue to push our understanding of how PAE affects brain development over the child’s life-span.
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"Long-term follow-up of a randomized controlled trial of choline for neurodevelopment in fetal alcohol spectrum disorder: corpus callosum white matter microstructure and neurocognitive outcomes"
Our research group has been testing a nutrient, choline, as a neurodevelopmental treatment for preschool age children (2-5 years old) with FASD for more than a decade. Many children have been followed for long periods after their participation in the treatment study. In comparing cognitive testing of skills such as attention, working memory, and reaction time seven years after initial supplementation, children who received choline showed better performance than children who did not receive choline. Brain scans also found better organization of white matter (the nerve fibers that handle long-distance communication in the brain) in the children who had received choline years earlier. This difference in treatment groups was even more pronounced than that observed initially in our previous four-year follow-up. These data suggest that choline may have long-lasting benefits for brain development in FASD and, perhaps, early intervention may have permanent beneficial effects on the brain.
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"Prenatal and Postnatal Choline Supplementation in Fetal Alcohol Spectrum Disorder"
PAE can cause a broad range of thinking, memory, attention, and learning difficulties in affected individuals. One intervention that has been investigated to aid with these difficulties is supplementation with a nutrient called choline, which is best administered during early stages of brain development (ages 2-5 in our studies). This paper provides information about alcohol’s effects on the brain, the role of choline in typical brain development, and a summary of several studies that have investigated choline supplementation in animals and humans exposed to alcohol both before and after birth. Importantly, the paper includes very practical information and advice for those interested in supplementing choline in children.
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Previous:
"A randomized controlled trial of transcranial direct-current stimulation and cognitive training in children with fetal alcohol spectrum disorder"
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"Four-year follow-up of a randomized controlled trial of choline for neurodevelopment in fetal alcohol spectrum disorder"
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"Choline supplementation in children with fetal alcohol spectrum disorders: a randomized, double-blind, placebo-controlled trial"
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"Choline supplementation in children with fetal alcohol spectrum disorders has high feasibility and tolerability"
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"Inadequate intake of nutrients essential for neurodevelopment in children with fetal alcohol spectrum disorders (FASD)"
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If you have any questions about our publications or are unable to access them via the links provided, please email us at [email protected].