MRI Brain Study of Adolescents with Prenatal Exposure to Cocaine or Other Drugs

The epidemic of intrauterine cocaine exposure (IUCE) during the 1980’s and 1990’s raised the currently unresolved questions of lasting neurologic, cognitive and behavioral consequences in exposed children who are now reaching adolescence. Cocaine use by pregnant women is usually accompanied by cigarette, alcohol or marijuana use.  While information has been gathered about the neurologic, cognitive and behavioral characteristics of children for individual exposures, the extent to which intrauterine cocaine exposure may interact with concomitant cigarette, alcohol and marijuana exposures to affect brain function and structure during childhood is poorly understood.  Quantitative magnetic resonance imaging (MRI) techniques offer an unparalleled opportunity to determine if specific features of brain structure and function differ in adolescents with IUCE and concurrent intrauterine exposures to cigarette, alcohol or marijuana relative to demographically comparable controls.  Despite scant use of recently developed quantitative neuroimaging techniques to study brain structure and function in children with IUCE, our own preliminary neuroimaging studies in a subset of children from the longstanding and well characterized “Cocaine Exposure In Utero” cohort of children with intrauterine exposure to cocaine, cigarettes, alcohol or marijuana provide strong evidence that, indeed, there exist structural differences associated with IUCE that are detectable in early adolescence. The proposed neuroimaging study will be the first to employ multimodal MRI neuroimaging to evaluate potential structural and functional neural sequelae in this well characterized group of adolescent children.  Further, the proposed project offers a unique and novel opportunity to characterize brain structure and function in adolescents with IUCE or intrauterine exposure to cigarettes, cocaine, and alcohol before they emerge from the teenage years into adulthood.  Quantitative volumetric neuroimaging will be employed for brain segmentation and parcellation.  Diffusion tensor imaging will be utilized to study white matter microstructure. Finally, functional magnetic resonance imaging (fMRI) will be harnessed to study patterns of brain activation, generally, and of frontal lobes, in particular, while subjects perform the classic Stroop task.  We hypothesize that each method employed will reveal distinctive features of brain structure and function that characterize intrauterine exposures to cocaine, cigarettes, alcohol and marijuana as well as their interactions.  Further, by utilizing available data on substance abuse by this adolescent sample, we will assess whether structural features of brain correlate with early initiation of substance use.