Deep serotonergic and dopaminergic structures in fetal alcoholic syndrome:: A study with nor-β-CIT-single-photon emission computed tomography and magnetic resonance imaging volumetry

Background: In prenatally alcohol exposed children, the relationship between brain structure and function is highlighted to be important to study. Methods. We studied 12 children with fetal alcoholic syndrome (FAS) and fetal alcoholic effects (FAE) by magnetic resonance imaging volumetry and by single-photon emission computed tomography with iodine-123 labeled 2 beta-carbomethoxy-3 beta-(4-iodophenyl) ([(123)]nor-beta-CIT) and related these findings to those from neuropsychological and psychiatric tests. Results. The absolute volumes of studied nuclei. including the brain volume, were significantly smaller in FAS/FAE children than in control patients. After normalization of volumes, significant differences were not found. Left hippocampus was smaller than the tight (p < .003) but did not significantly differ from the control subjects. The children with FAS/FAE showed reduced serotonin (p = .02) in the medial frontal cortex and slightly increased striatal dopamine transporter binding. All FAS/FAE children had attention-deficit/hyperkinetic disorder (ADHD). None bad depression. The internalization scores correlated witb dopamine transporter binding (r = -.65; p = .03). Conclusions. The results indicate that the serotonin (5-HT) system may be vulnerable to the effects of ethanol in utero. The high dopamine transporter levels may correlate witb the ADHD findings. Reduced serotonin and increased binding of dopamine transporter are also seen in type 2 alcoholism. Some behavioral problems of FAS/FAE might be preventable by early intervention and treatment.