Published online November 1, 2006
PEDIATRICS Vol. 118 No. 5 November 2006, pp. 2014-2024 (doi:10.1542/peds.2006-0003)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via ISI Web of Science (8)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Warner, T. D.
Right arrow Articles by Blackband, S. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Warner, T. D.
Right arrow Articles by Blackband, S. J.
Related Collections
Right arrow Neurology & Psychiatry

ARTICLE

Diffusion Tensor Imaging of Frontal White Matter and Executive Functioning in Cocaine-Exposed Children

Tamara Duckworth Warner, PhDa, Marylou Behnke, MDa, Fonda Davis Eyler, PhDa, Kyle Padgett, PhDb, Christiana Leonard, PhDc, Wei Hou, PhDd, Cynthia Wilson Garvan, PhDd, Ilona M. Schmalfuss, MDe,f and Stephen J. Blackband, PhDc,g

Departments of a Pediatrics
c Neuroscience
d Epidemiology and Health Policy Research
e Radiology, College of Medicine, University of Florida, Gainesville, Florida
b Department of Radiology, School of Medicine, University of Miami, Miami, Florida
f Malcolm Randall VA Medical Center, Gainesville, Florida
g National High Magnetic Field Laboratory, Tallahassee, Florida

BACKGROUND. Although animal studies have demonstrated frontal white matter and behavioral changes resulting from prenatal cocaine exposure, no human studies have associated neuropsychological deficits in attention and inhibition with brain structure. We used diffusion tensor imaging to investigate frontal white matter integrity and executive functioning in cocaine-exposed children.

METHODS. Six direction diffusion tensor images were acquired using a Siemens 3T scanner with a spin-echo echo-planar imaging pulse sequence on right-handed cocaine-exposed (n = 28) and sociodemographically similar non-exposed children (n = 25; mean age: 10.6 years) drawn from a prospective, longitudinal study. Average diffusion and fractional anisotropy were measured in the left and right frontal callosal and frontal projection fibers. Executive functioning was assessed using two well-validated neuropsychological tests (Stroop color-word test and Trail Making Test).

RESULTS. Cocaine-exposed children showed significantly higher average diffusion in the left frontal callosal and right frontal projection fibers. Cocaine-exposed children were also significantly slower on a visual-motor set-shifting task with a trend toward lower scores on a verbal inhibition task. Controlling for gender and intelligence, average diffusion in the left frontal callosal fibers was related to prenatal exposure to alcohol and marijuana and an interaction between cocaine and marijuana exposure. Performance on the visual-motor set-shifting task was related to prenatal cocaine exposure and an interaction between cocaine and tobacco exposure. Significant correlations were found between test performance and fractional anisotropy in areas of the frontal white matter.

CONCLUSIONS. Prenatal cocaine exposure, alone and in combination with exposure to other drugs, is associated with slightly poorer executive functioning and subtle microstructural changes suggesting less mature development of frontal white matter pathways. The relative contribution of postnatal environmental factors, including characteristics of the caregiving environment and stressors associated with poverty and out-of-home placement, on brain development and behavioral functioning in polydrug-exposed children awaits further research.

Key Words: prenatal exposure • cocaine infants • neuroimaging • cognitive function • neuropsychology

Abbreviations: PCE—prenatal cocaine exposure • IQ—intelligence quotient • ROI—regions of interest • DTI—diffusion tensor neuroimaging • Dav—average diffusion • FA—fractional anisotropy • SES—socioeconomic status • TMT—Trail Making Test • df—degrees of freedom

Accepted Jul 5, 2006.




This article has been cited by other articles:


Home page
 Am. J. Neuroradiol.Home page
R. Arnold, C. Johnson, B. McNulty, and G. Gaisie
Substantia Nigra MR Imaging Signal Changes and Cardiomyopathy Following Prenatal Exposure to Cocaine and Heroin
AJNR Am. J. Neuroradiol., April 1, 2008; 29(4): 828 - 829.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
M. J. Rivkin, P. E. Davis, J. L. Lemaster, H. J. Cabral, S. K. Warfield, R. V. Mulkern, C. D. Robson, R. Rose-Jacobs, and D. A. Frank
Volumetric MRI Study of Brain in Children With Intrauterine Exposure to Cocaine, Alcohol, Tobacco, and Marijuana
Pediatrics, April 1, 2008; 121(4): 741 - 750.
[Abstract] [Full Text] [PDF]