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Katherine L Narr

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3 papers
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3

YNICL Journal 2025 Journal Article

The impact of prenatal alcohol and tobacco exposure on white matter integrity in 8–12-year-old children

  • Annerine Roos
  • Deborah Jonker
  • Eric Kan
  • Andrew T Marshall
  • Kirsten A Donald
  • Freda Scheffler
  • Lucy T Brink
  • Weslin Charles

The combined impact of prenatal alcohol exposure (PAE) and prenatal tobacco exposure (PTE) on white-matter integrity in pre-adolescence is poorly understood. We aimed to explore white-matter integrity in children aged 8- to 12-years with PAE and/or PTE versus those without (controls, CON). Here, 410 children (CON: n = 84; PAE: n = 94; PTE: n = 67; PAE + PTE: n = 165) underwent diffusion tensor MRI as part of the Safe Passage Study, a cohort based in Cape Town, South Africa. Linear regression modeling was used to investigate the main and interaction effects of PAE and PTE. There were disordinal PAE × PTE interactions on right-cerebral-peduncle mean, axial, and radial diffusivity: Individuals with PAE and PTE had higher mean and axial diffusivity than those with either exposure on its own, but similar to those with neither. In children with PAE, there were associations with altered axial diffusivity among those exposed during the first trimester and mean, axial, and radial diffusivity in those exposed during the second trimester in commissural, association, and projection tracts. Further, there were PTE associations with fractional anisotropy and radial diffusivity in projection tracts among those exposed mainly during the second trimester. These results support previous research in children with PAE and add to the PTE literature, highlighting potentially lasting impact on axonal and myelin microstructural development, which are important for motor, sensory, cognitive, and behavioral functions. Our results suggest sensitivity to the timing of exposure of PAE and PTE, particularly during the first and second trimesters of pregnancy.

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YNICL Journal 2017 Journal Article

The Global ECT-MRI Research Collaboration (GEMRIC): Establishing a multi-site investigation of the neural mechanisms underlying response to electroconvulsive therapy

  • Leif Oltedal
  • Hauke Bartsch
  • Ole Johan Evjenth Sørhaug
  • Ute Kessler
  • Christopher Abbott
  • Annemieke Dols
  • Max L Stek
  • Lars Ersland

Major depression, currently the world's primary cause of disability, leads to profound personal suffering and increased risk of suicide. Unfortunately, the success of antidepressant treatment varies amongst individuals and can take weeks to months in those who respond. Electroconvulsive therapy (ECT), generally prescribed for the most severely depressed and when standard treatments fail, produces a more rapid response and remains the most effective intervention for severe depression. Exploring the neurobiological effects of ECT is thus an ideal approach to better understand the mechanisms of successful therapeutic response. Though several recent neuroimaging studies show structural and functional changes associated with ECT, not all brain changes associate with clinical outcome. Larger studies that can address individual differences in clinical and treatment parameters may better target biological factors relating to or predictive of ECT-related therapeutic response. We have thus formed the Global ECT-MRI Research Collaboration (GEMRIC) that aims to combine longitudinal neuroimaging as well as clinical, behavioral and other physiological data across multiple independent sites. Here, we summarize the ECT sample characteristics from currently participating sites, and the common data-repository and standardized image analysis pipeline developed for this initiative. This includes data harmonization across sites and MRI platforms, and a method for obtaining unbiased estimates of structural change based on longitudinal measurements with serial MRI scans. The optimized analysis pipeline, together with the large and heterogeneous combined GEMRIC dataset, will provide new opportunities to elucidate the mechanisms of ECT response and the factors mediating and predictive of clinical outcomes, which may ultimately lead to more effective personalized treatment approaches.

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