Cocaína

Neuropsychol Rev (2010) 20:376–397 DOI 10.1007/s11065-010-9150-x

REVIEW

Structural, Metabolic, and Functional Brain Abnormalities as a Result of Prenatal Exposure to Drugs of Abuse: Evidence from Neuroimaging
Florence Roussotte & Lindsay Soderberg & Elizabeth Sowell

Received: 9 August 2010 / Accepted: 6 October 2010 / Published online: 28 October 2010 # The Author(s) 2010. This articleis published with open access at Springerlink.com

Abstract Prenatal exposure to alcohol and stimulants negatively affects the developing trajectory of the central nervous system in many ways. Recent advances in neuroimaging methods have allowed researchers to study the structural, metabolic, and functional abnormalities resulting from prenatal exposure to drugs of abuse in living humansubjects. Here we review the neuroimaging literature of prenatal exposure to alcohol, cocaine, and methamphetamine. Neuroimaging studies of prenatal alcohol exposure have reported differences in the structure and metabolism of many brain systems, including in frontal, parietal, and temporal regions, in the cerebellum and basal ganglia, as well as in the white matter tracts that connect these brainregions. Functional imaging studies have identified significant differences in brain activation related to various cognitive domains as a result of prenatal alcohol exposure. The published literature of prenatal exposure to cocaine and methamphetamine is much smaller, but evidence is beginning to emerge suggesting that exposure to stimulant drugs in utero may be particularly toxic to dopamine-rich basalF. Roussotte : L. Soderberg : E. Sowell Developmental Cognitive Neuroimaging Group, Department of Neurology, University of California, Los Angeles, CA, USA F. Roussotte : E. Sowell Interdepartmental Ph.D. Program for Neuroscience, University of California, Los Angeles, CA, USA E. Sowell (*) Developmental Cognitive Neuroimaging Group, Laboratory of Neuro Imaging, University of California, LosAngeles, 710 Westwood Plaza, Room 1-138, Los Angeles, CA 90095-7332, USA e-mail: esowell@ucla.edu

ganglia regions. Although the interpretation of such findings is somewhat limited by the problem of polysubstance abuse and by the difficulty of obtaining precise exposure histories in retrospective studies, such investigations provide important insights into the effects of drugs of abuse on thestructure, function, and metabolism of the developing human brain. These insights may ultimately help clinicians develop better diagnostic tools and devise appropriate therapeutic interventions to improve the condition of children with prenatal exposure to drugs of abuse. Keywords Neuroimaging . Prenatal exposure . Drugs of abuse . Alcohol . Fetal alcohol spectrum disorders . Cocaine . Methamphetamine .Teratogens . Brain development

Introduction Prenatal exposure to drugs of abuse, such as alcohol and stimulants, leads to complex alterations in developing trajectory of the central nervous system. Until recently, researchers relied on animal models to study the effects of drugs of abuse on brain development. In recent years, however, important advances in neuroimaging, particularly innon-invasive Magnetic Resonance (MR)-based imaging techniques, have led to a much better understanding of the way in which prenatal exposure to drugs of abuse impact the structure, function, and metabolism of the developing human brain. Magnetic Resonance Imaging (MRI) is the most commonly used brain imaging modality in human scientific research. We will describe recent MR neuroimaging studies examiningalterations in the structure, function, or metabolism of the brains of children, adoles-

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cents, and young adults who were prenatally exposed to drugs of abuse; including alcohol, cocaine, methamphetamine, or a combination of these drugs. For each of these drugs, we will briefly describe the pharmacological mechanisms of action, the current...