Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA.
Department of Psychology, San Diego State University, San Diego, CA 92182, USA.
Cereb Cortex. 2020 Jul 30;30(9):4729-4746. doi: 10.1093/cercor/bhaa020.
The extensive prenatal developmental growth period of the cerebellum renders it vulnerable to unhealthy environmental agents, especially alcohol. Fetal alcohol spectrum disorders (FASD) is marked by neurodysmorphology including cerebral and cerebellar volume deficits, but the cerebellar lobular deficit profile has not been delineated. Legacy MRI data of 115 affected and 59 unaffected adolescents and young adults were analyzed for lobular gray matter volume and revealed graded deficits supporting a spectrum of severity. Graded deficits were salient in intracranial volume (ICV), where the fetal alcohol syndrome (FAS) group was smaller than the fetal alcohol effects (FAE) group, which was smaller than the controls. Adjusting for ICV, volume deficits were present in VIIB and VIIIA of the FAE group and were more widespread in FAS and included lobules I, II, IV, V, VI, Crus II, VIIB, and VIIIA. Graded deficits (FAS < FAE) were consistently present in lobules VI; neither group showed volume deficits in Crus I or IX. Neuroradiological readings blind to diagnosis identified 20 anomalies, 8 involving the cerebellum, 5 of which were in the FAS group. We speculate that the regional cerebellar FASD-related volume deficits may contribute to diagnostically characteristic functional impairment involving emotional control, visuomotor coordination, and postural stability.
小脑具有广泛的产前发育生长时期，使其易受不健康环境因素的影响，尤其是酒精。胎儿酒精谱系障碍（FASD）的特征是神经形态畸形，包括大脑和小脑体积缺陷，但小脑小叶缺陷的特征尚未确定。对 115 名受影响和 59 名未受影响的青少年和年轻人的遗留 MRI 数据进行了分析，以评估小叶灰质体积，结果显示存在分级缺陷，支持严重程度的谱系。在颅内体积（ICV）中存在分级缺陷，其中胎儿酒精综合征（FAS）组小于胎儿酒精效应（FAE）组，而 FAE 组又小于对照组。在调整 ICV 后，FAE 组的 VIIB 和 VIIIA 存在体积缺陷，而 FAS 组的体积缺陷更为广泛，包括 I、II、IV、V、VI、Crus II、VIIB 和 VIIIA 小叶。在 FAS 组和 FAE 组中，VI 小叶都存在分级缺陷（FAS<FAE）；两组在 Crus I 或 IX 小叶都没有体积缺陷。对诊断盲目的神经影像学读数确定了 20 种异常，其中 8 种涉及小脑，其中 5 种在 FAS 组中。我们推测，与小脑 FASD 相关的区域性体积缺陷可能导致涉及情绪控制、视动协调和姿势稳定性的诊断特征性功能障碍。
