Sex-specific alterations of white matter developmental trajectories in infants with prenatal exposure to methamphetamine and tobacco

Linda Chang, Kenichi Oishi, Jon Skranes, Steven Buchthal, Eric Cunningham, Robyn Yamakawa, Sara Hayama, Caroline S. Jiang, Daniel Alicata, Antonette Hernandez, Christine Cloak, Tricia Wright, Thomas Ernst

Research output: Contribution to journalArticle

Abstract

IMPORTANCE Methamphetamine is a common illicit drug used worldwide.Methamphetamine and/or tobacco use by pregnant women remains prevalent. However, little is known about the effect of comorbid methamphetamine and tobacco use on human fetal brain development. OBJECTIVE To investigate whether microstructural brain abnormalities reported in children with prenatal methamphetamine and/or tobacco exposure are present at birth before childhood environmental influences. DESIGN, SETTING, AND PARTICIPANTS A prospective, longitudinal studywas conducted between September 17, 2008, and February 28, 2015, at an ambulatory academic medical center. A total of 752 infant-mother dyads were screened and 139 of 195 qualified neonates were evaluated (36 methamphetamine/tobacco exposed, 32 tobacco exposed, and 71 unexposed controls). They were recruited consecutively from the community. EXPOSURES Prenatal methamphetamine and/or tobacco exposure. MAIN OUTCOMES AND MEASURES Quantitative neurologic examination and diffusion tensor imaging performed 1 to 3 times through age 4 months; diffusivities and fractional anisotropy (FA) assessed in 7 white matter tracts and 4 subcortical brain regions using an automated atlas-based method. RESULTS Of the 139 infants evaluated, 72were female (51.8%); the mean (SE) postmenstrual age at baselinewas 41.5 (0.27)weeks.Methamphetamine/tobacco-exposed infants showed delayed developmental trajectories on active muscle tone (group × age, P < .001) and total neurologic scores (group × age, P = .01) that normalized by ages 3 to 4 months. Onlymethamphetamine/ tobacco-exposed boys had lower FA(group × age, P = .02) and higher diffusivities in superior (SCR) and posterior corona radiatae (PCR) (group × age × sex, P = .002; group × age × sex, P = .01) at baseline that normalized by age 3 months. Onlymethamphetamine/tobacco- and tobacco-exposed girls showed persistently lower FAin anterior corona radiata (ACR) (group, P = .04; group × age × sex, P = .01). Tobacco-exposed infants showed persistently lower axial diffusion in the thalamus and internal capsule across groups (P = .02). CONCLUSIONS AND RELEVANCE Prenatal methamphetamine/tobacco exposure may lead to delays in motor development, with less coherent fibers and lessmyelination in SCR and PCR only in male infants, but these abnormalitiesmay normalize by ages 3 to 4 months after cessation of stimulant exposure. In contrast, persistently less coherent ACR fibers were observed inmethamphetamine/tobacco- and tobacco-exposed girls, possibly from increased dendritic branching or spine density due to epigenetic influences. Persistently lower diffusivity in the thalamus and internal capsule of all tobacco-exposed infants suggests aberrant axonal development. Collectively, prenatal methamphetamine and/or tobacco exposure may lead to delayed motor development and white matter maturation in sex- and regional-specific manners.

Original languageEnglish (US)
Pages (from-to)1217-1227
Number of pages11
JournalJAMA Psychiatry
Volume73
Issue number12
DOIs
StatePublished - Dec 1 2016

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Methamphetamine
Tobacco
Age Groups
Internal Capsule
Anisotropy
Tobacco Use
White Matter
Thalamus
Brain
Sexual Maturation
Diffusion Tensor Imaging
Atlases
Neurologic Examination
Street Drugs
Fetal Development
Epigenomics
Nervous System
Pregnant Women

ASJC Scopus subject areas

  • Psychiatry and Mental health

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Sex-specific alterations of white matter developmental trajectories in infants with prenatal exposure to methamphetamine and tobacco. / Chang, Linda; Oishi, Kenichi; Skranes, Jon; Buchthal, Steven; Cunningham, Eric; Yamakawa, Robyn; Hayama, Sara; Jiang, Caroline S.; Alicata, Daniel; Hernandez, Antonette; Cloak, Christine; Wright, Tricia; Ernst, Thomas.

In: JAMA Psychiatry, Vol. 73, No. 12, 01.12.2016, p. 1217-1227.

Research output: Contribution to journalArticle

Chang, L, Oishi, K, Skranes, J, Buchthal, S, Cunningham, E, Yamakawa, R, Hayama, S, Jiang, CS, Alicata, D, Hernandez, A, Cloak, C, Wright, T & Ernst, T 2016, 'Sex-specific alterations of white matter developmental trajectories in infants with prenatal exposure to methamphetamine and tobacco', JAMA Psychiatry, vol. 73, no. 12, pp. 1217-1227. https://doi.org/10.1001/jamapsychiatry.2016.2794
Chang, Linda ; Oishi, Kenichi ; Skranes, Jon ; Buchthal, Steven ; Cunningham, Eric ; Yamakawa, Robyn ; Hayama, Sara ; Jiang, Caroline S. ; Alicata, Daniel ; Hernandez, Antonette ; Cloak, Christine ; Wright, Tricia ; Ernst, Thomas. / Sex-specific alterations of white matter developmental trajectories in infants with prenatal exposure to methamphetamine and tobacco. In: JAMA Psychiatry. 2016 ; Vol. 73, No. 12. pp. 1217-1227.
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T1 - Sex-specific alterations of white matter developmental trajectories in infants with prenatal exposure to methamphetamine and tobacco

AU - Chang, Linda

AU - Oishi, Kenichi

AU - Skranes, Jon

AU - Buchthal, Steven

AU - Cunningham, Eric

AU - Yamakawa, Robyn

AU - Hayama, Sara

AU - Jiang, Caroline S.

AU - Alicata, Daniel

AU - Hernandez, Antonette

AU - Cloak, Christine

AU - Wright, Tricia

AU - Ernst, Thomas

PY - 2016/12/1

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N2 - IMPORTANCE Methamphetamine is a common illicit drug used worldwide.Methamphetamine and/or tobacco use by pregnant women remains prevalent. However, little is known about the effect of comorbid methamphetamine and tobacco use on human fetal brain development. OBJECTIVE To investigate whether microstructural brain abnormalities reported in children with prenatal methamphetamine and/or tobacco exposure are present at birth before childhood environmental influences. DESIGN, SETTING, AND PARTICIPANTS A prospective, longitudinal studywas conducted between September 17, 2008, and February 28, 2015, at an ambulatory academic medical center. A total of 752 infant-mother dyads were screened and 139 of 195 qualified neonates were evaluated (36 methamphetamine/tobacco exposed, 32 tobacco exposed, and 71 unexposed controls). They were recruited consecutively from the community. EXPOSURES Prenatal methamphetamine and/or tobacco exposure. MAIN OUTCOMES AND MEASURES Quantitative neurologic examination and diffusion tensor imaging performed 1 to 3 times through age 4 months; diffusivities and fractional anisotropy (FA) assessed in 7 white matter tracts and 4 subcortical brain regions using an automated atlas-based method. RESULTS Of the 139 infants evaluated, 72were female (51.8%); the mean (SE) postmenstrual age at baselinewas 41.5 (0.27)weeks.Methamphetamine/tobacco-exposed infants showed delayed developmental trajectories on active muscle tone (group × age, P < .001) and total neurologic scores (group × age, P = .01) that normalized by ages 3 to 4 months. Onlymethamphetamine/ tobacco-exposed boys had lower FA(group × age, P = .02) and higher diffusivities in superior (SCR) and posterior corona radiatae (PCR) (group × age × sex, P = .002; group × age × sex, P = .01) at baseline that normalized by age 3 months. Onlymethamphetamine/tobacco- and tobacco-exposed girls showed persistently lower FAin anterior corona radiata (ACR) (group, P = .04; group × age × sex, P = .01). Tobacco-exposed infants showed persistently lower axial diffusion in the thalamus and internal capsule across groups (P = .02). CONCLUSIONS AND RELEVANCE Prenatal methamphetamine/tobacco exposure may lead to delays in motor development, with less coherent fibers and lessmyelination in SCR and PCR only in male infants, but these abnormalitiesmay normalize by ages 3 to 4 months after cessation of stimulant exposure. In contrast, persistently less coherent ACR fibers were observed inmethamphetamine/tobacco- and tobacco-exposed girls, possibly from increased dendritic branching or spine density due to epigenetic influences. Persistently lower diffusivity in the thalamus and internal capsule of all tobacco-exposed infants suggests aberrant axonal development. Collectively, prenatal methamphetamine and/or tobacco exposure may lead to delayed motor development and white matter maturation in sex- and regional-specific manners.

AB - IMPORTANCE Methamphetamine is a common illicit drug used worldwide.Methamphetamine and/or tobacco use by pregnant women remains prevalent. However, little is known about the effect of comorbid methamphetamine and tobacco use on human fetal brain development. OBJECTIVE To investigate whether microstructural brain abnormalities reported in children with prenatal methamphetamine and/or tobacco exposure are present at birth before childhood environmental influences. DESIGN, SETTING, AND PARTICIPANTS A prospective, longitudinal studywas conducted between September 17, 2008, and February 28, 2015, at an ambulatory academic medical center. A total of 752 infant-mother dyads were screened and 139 of 195 qualified neonates were evaluated (36 methamphetamine/tobacco exposed, 32 tobacco exposed, and 71 unexposed controls). They were recruited consecutively from the community. EXPOSURES Prenatal methamphetamine and/or tobacco exposure. MAIN OUTCOMES AND MEASURES Quantitative neurologic examination and diffusion tensor imaging performed 1 to 3 times through age 4 months; diffusivities and fractional anisotropy (FA) assessed in 7 white matter tracts and 4 subcortical brain regions using an automated atlas-based method. RESULTS Of the 139 infants evaluated, 72were female (51.8%); the mean (SE) postmenstrual age at baselinewas 41.5 (0.27)weeks.Methamphetamine/tobacco-exposed infants showed delayed developmental trajectories on active muscle tone (group × age, P < .001) and total neurologic scores (group × age, P = .01) that normalized by ages 3 to 4 months. Onlymethamphetamine/ tobacco-exposed boys had lower FA(group × age, P = .02) and higher diffusivities in superior (SCR) and posterior corona radiatae (PCR) (group × age × sex, P = .002; group × age × sex, P = .01) at baseline that normalized by age 3 months. Onlymethamphetamine/tobacco- and tobacco-exposed girls showed persistently lower FAin anterior corona radiata (ACR) (group, P = .04; group × age × sex, P = .01). Tobacco-exposed infants showed persistently lower axial diffusion in the thalamus and internal capsule across groups (P = .02). CONCLUSIONS AND RELEVANCE Prenatal methamphetamine/tobacco exposure may lead to delays in motor development, with less coherent fibers and lessmyelination in SCR and PCR only in male infants, but these abnormalitiesmay normalize by ages 3 to 4 months after cessation of stimulant exposure. In contrast, persistently less coherent ACR fibers were observed inmethamphetamine/tobacco- and tobacco-exposed girls, possibly from increased dendritic branching or spine density due to epigenetic influences. Persistently lower diffusivity in the thalamus and internal capsule of all tobacco-exposed infants suggests aberrant axonal development. Collectively, prenatal methamphetamine and/or tobacco exposure may lead to delayed motor development and white matter maturation in sex- and regional-specific manners.

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