Maternal choline supplementation mitigates alcohol exposure effects on neonatal brain volumes. (18th August 2021)

• Record Type: Journal Article
• Authors: Warton, Fleur L.; Molteno, Christopher D.; Warton, Christopher M. R.; Wintermark, Pia; Lindinger, Nadine M.; Dodge, Neil C.; Zöllei, Lilla; van der Kouwe, Andre J.W.; Carter, R. Colin; Jacobson, Joseph L.; Jacobson, Sandra W.; Meintjes, Ernesta M.
• Is Part Of: Alcoholism. Volume 45:Number 9(2021)
• Page Start: 1762
• Page End: 1774
• Publication Date: 2021-08-18
• Subjects: brain volumes -- Fagan Test of Infant Intelligence -- magnetic resonance imaging -- maternal choline supplementation -- neonates -- prenatal alcohol exposure; Alcoholism -- Periodicals; Alcoholism -- Periodicals; Alcoolisme; Electronic journals; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.861005
• DOI: 10.1111/acer.14672
• Languages: English
• ISSNs: 0145-6008

Abstract

Abstract: Background: Prenatal alcohol exposure (PAE) is associated with smaller regional and global brain volumes. In rats, gestational choline supplementation mitigates adverse developmental effects of ethanol exposure. Our recent randomized, double‐blind, placebo‐controlled maternal choline supplementation trial showed improved somatic and functional outcomes in infants at 6.5 and 12 months postpartum. Here, we examined whether maternal choline supplementation protected the newborn brain from PAE‐related volume reductions and, if so, whether these volume changes were associated with improved infant recognition memory. Methods: Fifty‐two infants born to heavy‐drinking women who had participated in a choline supplementation trial during pregnancy underwent structural magnetic resonance imaging with a multi‐echo FLASH protocol on a 3T Siemens Allegra MRI (median age = 2.8 weeks postpartum). Subcortical regions were manually segmented. Recognition memory was assessed at 12 months on the Fagan Test of Infant Intelligence (FTII). We examined the effects of choline on regional brain volumes, whether choline‐related volume increases were associated with higher FTII scores, and the degree to which the regional volume increases mediated the effects of choline on the FTII. Results: Usable MRI data were acquired in 50 infants (choline: n = 27; placebo: n = 23). Normalized volumes were larger in six of 12 regions in the choline than placebo arm ( t ≥ 2.05, p ≤ 0.05) and were correlated with the degree of maternal choline adherence (β ≥ 0.28, p ≤ 0.04). Larger right putamen and corpus callosum were related to higher FTII scores ( r = 0.36, p = 0.02) with a trend toward partial mediation of the choline effect on recognition memory. Conclusions: High‐dose choline supplementation during pregnancy mitigated PAE‐related regional volume reductions, with larger volumes associated with improved 12‐month recognition memory. These results provide the first evidence that choline may be neuroprotective against PAE‐related brain structural deficits in humans. Abstract : Drinking during pregnancy, which continues to be highly prevalent despite psychosocial interventions, is associated with smaller newborn regional brain volumes. High‐dose maternal choline supplementation during pregnancy mitigated prenatal alcohol exposure (PAE)‐related reductions in neonatal caudate, thalamus and right putamen volumes and corpus callosum area. Moreover, larger right putamen and corpus callosum partially mediated the choline‐associated improvement in infant recognition memory at 12 months. This is the first evidence that choline is neuroprotective against PAE‐related brain structural deficits in humans.