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Jacobson SW, Jacobson JL, Molteno CD, Warton CMR, Wintermark P, Hoyme HE, De Jong G, Taylor P, Warton F, Lindinger NM, Carter RC, Dodge NC, Grant E, Warfield SK, Zöllei L, van der Kouwe AJW, Meintjes EM. Heavy Prenatal Alcohol Exposure is Related to Smaller Corpus Callosum in Newborn MRI Scans. Alcohol Clin Exp Res 2017; 41:965-975. [PMID: 28247416 DOI: 10.1111/acer.13363] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 02/23/2017] [Indexed: 01/17/2023]
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.
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Affiliation(s)
- Sandra W Jacobson
- 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
| | - Joseph L Jacobson
- 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
| | - Christopher D Molteno
- Department of Psychiatry and Mental Health , Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Christopher M R Warton
- Department of Human Biology , Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | | | - H Eugene Hoyme
- Department of Pediatrics , Sanford School of Medicine, University of South Dakota, Sioux Falls, South Dakota.,College of Medicine , University of Arizona, Tucson, Arizona
| | - Greetje De Jong
- Division of Molecular Biology and Human Genetics , Stellenbosch University, Faculty of Medicine and Health Sciences, Cape Town, South Africa
| | - Paul Taylor
- 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
| | - Fleur Warton
- Department of Human Biology , Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Nadine M Lindinger
- Department of Psychology , University of Cape Town, Cape Town, South Africa
| | - R Colin Carter
- Division of Pediatric Emergency Medicine , Morgan Stanley Children's Hospital of New York, Columbia University Medical Center, New York, New York
| | - Neil C Dodge
- Department of Psychiatry and Behavioral Neurosciences , Wayne State University School of Medicine, Detroit, Michigan
| | - Ellen Grant
- Division of Pediatric Emergency Medicine , Morgan Stanley Children's Hospital of New York, Columbia University Medical Center, New York, New York
| | - Simon K Warfield
- Department of Pediatrics , Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts
| | - Lilla Zöllei
- Department of Radiology , Massachusetts General Hospital, Boston, Massachusetts
| | | | - Ernesta M Meintjes
- 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
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Abstract
BACKGROUND Demonstrating an association between physical malformation and schizophrenia could be considered supportive of a neurodevelopmental origin of schizophrenia and may offer insights into a critical period for the development of this illness. The aim of our study was to investigate whether differences in the presence of minor physical anomalies could be demonstrated between schizophrenia sufferers and normal controls in a Xhosa population with a view to identifying a means of subtyping schizophrenia for use in future genetic studies. METHODS Sixty-three subjects with schizophrenia (21 sibling pairs, 1 sibship of four and a group of probands with an affected non-participating sibling (n = 17)), 81 normal controls (37 singletons and 22 sibling pairs) of Xhosa ethnicity were recruited. Each participant was then examined for minor physical anomalies using the Modified Waldrop scale. The relationship between each of the morphological features and the presence of an affected sib was examined using the Chi-squared test, followed by an intra-pair concordance analysis in the sibling pairs. RESULTS Gap between first and second toes was significantly more common in the affected sib pair group when compared to the non-affected sib pair group (p = 0.019) and non-affected singleton control group (p = 0.013). Concordance analysis also revealed increased concordance for this item in the affected sib pair group. CONCLUSION These findings offer an intriguing possibility that in the Xhosa population, affected sib pair status may be linked to a neurodevelopmental insult during a specific period of the fetal developmental.
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Affiliation(s)
- Liezl Koen
- Ngaphakathi Group, Department of Psychiatry, University of Stellenbosch, South Africa
| | - Dana JH Niehaus
- Ngaphakathi Group, Department of Psychiatry, University of Stellenbosch, South Africa
| | - Greetje De Jong
- Department of Obstetrics and Gynaecology, University of Stellenbosch, South Africa
| | - Jacqueline E Muller
- Ngaphakathi Group, Department of Psychiatry, University of Stellenbosch, South Africa
| | - Esme Jordaan
- Biostatistics Unit, Medical Research Council of South Africa, Bellville, South Africa
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Van Balkom IDC, Alders M, Allanson J, Bellini C, Frank U, De Jong G, Kolbe I, Lacombe D, Rockson S, Rowe P, Wijburg F, Hennekam RCM. Lymphedema-lymphangiectasia-mental retardation (Hennekam) syndrome: a review. Am J Med Genet 2002; 112:412-21. [PMID: 12376947 DOI: 10.1002/ajmg.10707] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The Hennekam syndrome is an infrequently reported heritable entity characterized by lymphedema, lymphangiectasia, and developmental delay. Here we add an additional 8 patients, and compare their findings to the 16 cases from the literature. The lymphedema is usually congenital, can be markedly asymmetrical, and, often, gradually progressive. Complications such as erysipelas are common. The lymphangiectasias are present in the intestines, but have also been found in the pleura, pericardium, thyroid gland, and kidney. Several patients have demonstrated congenital cardiac and blood vessel anomalies, pointing to a disturbance of angiogenesis in at least some of the patients. Facial features are variable, and are chiefly characterized, in a typical patient, by a flat face, flat and broad nasal bridge, and hypertelorism. Facial features are thought to mirror the extent of intrauterine facial lymphedema, or may be caused by lymphatic obstruction that affects the early migration of neural crest tissue. Other anomalies have included glaucoma, dental anomalies, hearing loss, and renal anomalies. The psychomotor development varies widely, even within a single family, from almost normal development to severe mental retardation. Convulsions are common. The existence of 10 familial cases, equal sex ratio, increased parental consanguinity rate (4/20 families), and absence of vertical transmission are consistent with an autosomal recessive pattern of inheritance. It seems likely that most (but not all) manifestations of the entity can be explained as sequences of impaired prenatal and postnatal lymphatic flow, suggesting that the causative gene(s) should have a major function in lymphangiogenesis.
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Affiliation(s)
- Inge D C Van Balkom
- Child- and Adolescent Psychiatry Clinic, Oranjestad, Aruba, Dutch West Indies
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