Longitudinal development trajectories of the periventricular zone (blue) and the corpus callosum (red) in fetuses with (PAE+) and without (PAE-) prenatal alcohol direct exposure.
Color coding: blue– external CSF-spaces, red– cortex, orange– subcortical parenchyma, brown– periventricular zone, dark green– ganglionic eminence, white– ventricular system, dark blue– corpus callosum, yellow– deep gray nuclei (basal ganglia and thalamus), light green– brainstem, light blue– cerebellum, turquoise– left hippocampus, gray– right hippocampus. Credit: RSNA and Marlene Stuempflen, M.D
. In the first MRI-based study to examine prenatal alcohol exposure, scientists discovered considerable changes in the brain structure of fetuses exposed to alcohol compared to healthy controls.
” Fetal alcohol syndrome is a worldwide issue in countries where alcohol is easily offered,” said Gregor Kasprian, M.D., associate teacher of radiology at the Medical University of Vienna in Austria. “Its approximated that 9.8% of all pregnant ladies are consuming alcohol during pregnancy, which number is likely undervalued.”
Fetal alcohol syndrome is the most severe form of a group of conditions called fetal alcohol spectrum conditions that arise from alcohol exposure throughout pregnancy. Children born with fetal alcohol spectrum disorders may have particular physical features, discovering specials needs, behavioral problems or speech and language delays. According to Dr. Kasprian, one in 70 pregnancies with alcohol exposure results in fetal alcohol syndrome.
” There are many postnatal studies on infants exposed to alcohol,” Dr. Kasprian said. “We wished to see how early its possible to discover changes in the fetal brain as a result of alcohol direct exposure.”
Visual abstract: results of prenatal alcohol direct exposure (PAE). PAE results in a volume decrease in the periventricular zone and a volume increase in the corpus callosum. Credit: RSNA and Marlene Stuempflen, M.D.
For the study, scientists recruited 500 pregnant women who were referred for a fetal MRI for medical reasons. On a confidential survey, 51of the women admitted to consuming alcohol throughout their pregnancy. The surveys used were the Pregnancy Risk Assessment Monitoring System (PRAMS), a monitoring job of the Centers for Disease Control and Prevention and health departments, and the T-ACE Screening Tool, a measurement tool of 4 questions that recognize danger drinking.
” We provided a safe environment where ladies could feel comfy honestly addressing the concerns,” Dr. Kasprian said.
After removing a few of the fetal MRIs for reasons such as structural brain anomalies and/or poor image quality, the final study hall included 26 fetal MRI examinations from 24 alcohol-positive fetuses and a control group of 52 gender- and age-matched healthy fetuses. At the time of imaging, fetuses varied in age in between 20 and 37 weeks.
The scientists utilized super-resolution imaging, which allowed them to create one dataset to re-construct each fetal brain. Next, they completed an analysis of 12 various brain structures, computing total brain volume and segment volumes of specific brain compartments.
Longitudinal growth trajectories of the periventricular zone (blue) and the corpus callosum (red) in fetuses with (PAE+) and without (PAE-) prenatal alcohol direct exposure. The volumetric relations of included images are not representative: The scaling has been altered to enable an easy comparison of shape and structure of the particular compartments. Credit: RSNA and Marlene Stuempflen, M.D.
” One of the primary hallmarks of our research study is that we examined many smaller sized sub-compartments of the brain,” said co-author Marlene Stuempflen, M.D., scientific researcher at the Medical University of Vienna.
The statistical analysis exposed two major differences in the alcohol-exposed fetuses compared to healthy controls: an increased volume in the corpus collosum and a decreased volume in the periventricular zone.
” This is the very first time that a prenatal imaging study has actually been able to quantify these early alcohol-associated modifications,” Dr. Stuempflen stated.
The corpus collosum is the main connection between the brains two hemispheres. Dr. Stuempflen kept in mind that it is fitting that this extremely central structure is impacted, due to the fact that the clinical signs of fetal alcohol spectrum disorders are extremely heterogenous, or diverse, and can not be identified to one specific base of the brain.
” The changes discovered in the periventricular zone, where all neurons are born, likewise show a global result on brain advancement and function,” she stated.
The researchers said discovering a thicker corpus collosum in the alcohol-positive fetuses was surprising due to the fact that the corpus collosum is thinner in infants with fetal alcohol spectrum conditions.
” It appears that alcohol direct exposure during pregnancy puts the brain on a course of development that diverges from a regular trajectory,” Dr. Kasprian said. “Fetal MRI is a very powerful tool to define brain development not just in genetic conditions, but also acquired conditions that arise from direct exposure to poisonous agents.”
Additional co-authors are Ernst Schwartz, M.Sc., Mariana Diogo, M.D., Ph.D., Sarah Glatter, M.D., M.M.Sc., Birgit Pfeiler, Victor Schmidbauer, M.D., Lisa Bartha-Doering, Ph.D., Rainer Seidl, M.D., Elisabeth Krampl-Bettelheim, M.D., and Daniela Prayer, M.D.
Meeting: 107th Scientific Assembly and Annual Meeting of the Radiological Society of North America
In the very first MRI-based research study to investigate prenatal alcohol direct exposure, researchers discovered substantial changes in the brain structure of fetuses exposed to alcohol compared to healthy controls. Fetal alcohol syndrome is the most severe kind of a group of conditions called fetal alcohol spectrum conditions that result from alcohol direct exposure during pregnancy. Babies born with fetal alcohol spectrum conditions might have specific physical features, finding out disabilities, behavioral problems or speech and language hold-ups. According to Dr. Kasprian, one in 70 pregnancies with alcohol exposure results in fetal alcohol syndrome.
