Frontoparietal and temporal white matter diffusion MRI in children and youth with prenatal alcohol exposure

Background Prenatal alcohol exposure (PAE) is associated with brain alterations and neurocognitive deficits, but relationships between brain alterations and neurocognitive deficits remain unclear. Methods Diffusion tensor imaging (DTI) data were obtained from 31 participants with PAE and 31 unexposed controls aged 7–15 years. Mean diffusivity (MD) and fractional anisotropy (FA) were derived from the genu, body, and splenium of the corpus callosum (CC), bilateral cingulum, and inferior and superior longitudinal fasciculus (ILF, SLF). Participants completed language subtests from the NEPSY‐II. Executive functioning was measured using the Behavior Rating Inventory of Executive Functioning (BRIEF‐PR) and verbal learning was assessed using the California Verbal Learning Test‐Children's Version (CVLT‐C) only in children with PAE. Group differences in diffusion metrics and cognitive scores were tested. Principal component analysis was used to reduce redundancy in cognitive and behavior variables; associations between components and brain measures were then assessed. Results Children with PAE had lower MD in the right SLF compared with unexposed controls. FA was positively related to age in 6 of 9 tracts and MD negatively related to age in all tracts; there were no significant age‐by‐group interactions. Participants with PAE scored lower than unexposed peers on the NEPSY‐II Comprehension of Instructions and Phonological Processing and above population norms (indicating worse performance) on the BRIEF‐PR. Children with PAE had a negative association between a principal component closely associated with Speeded Naming and FA in the left SLF (PAE: p = 0.002) and left ILF (PAE: p = 0.002); unexposed controls showed no significant associations. Conclusion We found widespread cognitive difficulties in children with PAE, but relatively limited differences in brain metrics and associations with age. Different brain–cognitive relationships were found in children with PAE compared with controls. Overall, the results provide additional evidence that PAE may lead to cognitive difficulties and disrupt typical brain–function relationships. We used diffusion tensor imaging to investigate neurocognitive abilities and frontoparietal and temporal white matter in children with prenatal alcohol exposure (PAE). The PAE group had widespread cognitive difficulties, as well as lower mean diffusivity (MD) in the right superior longitudinal fasciculus than unexposed controls. Typical age‐r