Astley Susan J, Richards Todd, Aylward Elizabeth H, Olson Heather Carmichael, Kerns Kimberly, Brooks Allison, Coggins Truman E, Davies Julian, Dorn Susan, Gendler Beth, Jirikowic Tracy, Kraegel Paul, Maravilla Kenneth
Department of Epidemiology, University of Washington, Seattle, WA 98195, USA.
Magn Reson Imaging. 2009 Jul;27(6):760-78. doi: 10.1016/j.mri.2009.01.003. Epub 2009 Apr 2.
Magnetic resonance (MR) technology offers noninvasive methods for in vivo assessment of neuroabnormalities. A comprehensive neuropsychological/behavioral, MR imaging (MRI), MR spectroscopy (MRS) and functional MRI (fMRI) assessment was administered to children with fetal alcohol spectrum disorders (FASD) to determine whether global and/or focal abnormalities could be identified and to distinguish diagnostic subclassifications across the spectrum. The four study groups included (1) FAS/partial FAS; (2) static encephalopathy/alcohol exposed (SE/AE); (3) neurobehavioral disorder/alcohol exposed (ND/AE) as diagnosed with the FASD 4-Digit Code; and (4) healthy peers with no prenatal alcohol exposure. Results are presented in four separate reports: MRS (reported here) and neuropsychological/behavioral, MRI and fMRI outcomes (reported separately). MRS was used to compare neurometabolite concentrations [choline (Cho), n-acetyl-aspartate (NAA) and creatine (Cre)] in a white matter region and a hippocampal region between the four study groups. Choline concentration in the frontal/parietal white matter region, lateral to the midsection of the corpus callosum, was significantly lower in FAS/PFAS relative to all other study groups. Choline decreased significantly with decreasing frontal white matter volume and corpus callosum length. These outcomes suggest low choline concentrations may reflect white matter deficits among FAS/PFAS. Choline also decreased significantly with increasing severity of the 4-Digit FAS facial phenotype, increasing impairment in psychological performance and increasing alcohol exposure. NAA and Cre concentrations did not vary significantly. This study provides further evidence of the vulnerability of the cholinergic system in FASD.
磁共振（MR）技术为体内神经异常评估提供了非侵入性方法。对患有胎儿酒精谱系障碍（FASD）的儿童进行了全面的神经心理学/行为学、磁共振成像（MRI）、磁共振波谱（MRS）和功能磁共振成像（fMRI）评估，以确定是否能识别出整体和/或局部异常，并区分整个谱系中的诊断亚分类。四个研究组包括：（1）胎儿酒精综合征/部分胎儿酒精综合征；（2）静态脑病/酒精暴露（SE/AE）；（3）神经行为障碍/酒精暴露（ND/AE），根据FASD 4位数字编码进行诊断；（4）无产前酒精暴露的健康同龄人。结果在四份单独的报告中呈现：MRS（本文报告）以及神经心理学/行为学、MRI和fMRI结果（单独报告）。MRS用于比较四个研究组之间白质区域和海马区域的神经代谢物浓度[胆碱（Cho）、N-乙酰天门冬氨酸（NAA）和肌酸（Cre）]。相对于所有其他研究组，FAS/部分胎儿酒精综合征（PFAS）患者胼胝体中部外侧额叶/顶叶白质区域的胆碱浓度显著降低。胆碱随着额叶白质体积和胼胝体长度的减少而显著降低。这些结果表明，低胆碱浓度可能反映了FAS/PFAS患者白质缺陷。胆碱也随着4位数字FAS面部表型严重程度的增加、心理表现损害的增加以及酒精暴露的增加而显著降低。NAA和Cre浓度没有显著变化。本研究为FASD中胆碱能系统的脆弱性提供了进一步证据。
