The impact of prenatal cocaine exposure on the developing CNS has also been studied using DTI and MRS. Warner et al. found increased ADC in the left frontal callosal and the right frontal projection fibers among exposed children in comparison to a socio-economically matched comparison group, however, no significant differences in FA were identified37. These six-directional DTI images were acquired on a 3T Siemens scanner and the ADC outcomes were controlled for age and gender. A study utilizing MRS showed increased creatine (Cr) in the frontal white matter with normal N-acetylaspartate (NAA) and the absence of any observable brain abnormalities on structural MRI38. The investigators hypothesized that the increased Cr may reflect altered energy metabolism or glial proliferation. The frontal white matter findings in both of these studies are consistent with an underlying mechanism of intrauterine hypoxia, which is one of the most commonly identified mechanisms explaining the consequences of prenatal cocaine exposure38-40.
