Brain Structure and Mental Health Symptoms in Children and Adolescents with Prenatal Alcohol Exposure

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Prenatal alcohol exposure (PAE) can impact brain development, leading to an increased risk of cognitive difficulties and mental health challenges. Mental health challenges affect many people with PAE, however, associations with brain structure remain unknown. In unexposed populations, mental health symptoms are closely linked to brain volume of subcortical structures and limbic subregions. Whether there is a similar association in individuals with PAE is unknown. Beyond brain volume, iron is a key component of healthy brain development; PAE lowers fetal brain iron and may be associated with the development of mental health symptoms. Whether increased mental health symptoms in youth with PAE are associated with alterations in brain volume or brain iron of subcortical brain structures is yet to be determined. This dissertation used quantitative susceptibility mapping (QSM) and T1-weighted magnetic resonance imaging (MRI) to assess differences in brain iron and brain volume of limbic and subcortical brain regions in youth with and without PAE. Additionally, associations between brain structure and mental health symptoms were assessed within and between groups. Multiple subcortical brain structures and limbic subregions were smaller in the PAE group, but only limbic subregion volume showed associations with mental health symptoms. I found minimal group differences in magnetic susceptibility, a marker of brain iron, but many associations between brain iron and mental health symptoms within and between groups. Furthermore, PAE moderated the association between internalizing symptoms for both brain iron and subnuclei volumes in the thalamus, suggesting that the thalamus may be a unique correlate of mental health symptoms in youth with PAE. This research provides greater insight into limbic subregions that may be affected by PAE that are not observed when looking at the whole volume of a brain region. As the first study to examine magnetic susceptibility in humans with PAE, it provides important information to help understand mental health symptoms in exposed and unexposed populations. This study highlights brain structures and regions that are uniquely associated with mental health symptoms in youth with PAE. Implications of this work include increasing awareness around mental health and promoting appropriate interventions to support youth with PAE.
Prenatal alcohol exposure, FASD, Neuroimaging, MRI, QSM, Mental Health, Anxiety, Depression, Limbic subregions
Nakhid, D. K. M. (2023). Brain structure and mental health symptoms in children and adolescents with prenatal alcohol exposure (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from