Prenatal and Postnatal Choline Supplementation in Fetal Alcohol Spectrum Disorder

• Published in: Nutrients 2022-02, Vol.14 (3), p.688
• Main Authors: Ernst, Abigail M, Gimbel, Blake A, de Water, Erik, Eckerle, Judith K, Radke, Joshua P, Georgieff, Michael K, Wozniak, Jeffrey R
• Format: Article
• Language: English
• Subjects: Attention deficit hyperactivity disorder; Behavior; Brain; Brain injury; Child; Choline; Cognition & reasoning; Comorbidity; COVID-19; Dietary Supplements; DNA methylation; Ethanol - adverse effects; Executive function; Female; fetal alcohol spectrum disorders; Fetal Alcohol Spectrum Disorders - prevention & control; Fetal Alcohol Spectrum Disorders - psychology; Fetal alcohol syndrome; Gene expression; Humans; Intervention; Iron; Literature reviews; Longitudinal studies; Medical imaging; Memory; Motor ability; Motor skill; Nutrients; Optimization; Pregnancy; Prenatal experience; Public health; randomized controlled trials; Review; Reviews; Sensorimotor integration; Social interactions; Visual perception; Vitamins
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu14030688

Fetal alcohol spectrum disorder (FASD) is common and represents a significant public health burden, yet very few interventions have been tested in FASD. Cognitive deficits are core features of FASD, ranging from broad intellectual impairment to selective problems in attention, executive functioning, memory, visual-perceptual/motor skills, social cognition, and academics. One potential intervention for the cognitive impairments associated with FASD is the essential nutrient choline, which is known to have numerous direct effects on brain and cognition in both typical and atypical development. We provide a summary of the literature supporting the use of choline as a neurodevelopmental intervention in those affected by prenatal alcohol. We first discuss how alcohol interferes with normal brain development. We then provide a comprehensive overview of the nutrient choline and discuss its role in typical brain development and its application in the optimization of brain development following early insult. Next, we review the preclinical literature that provides evidence of choline's potential as an intervention following alcohol exposure. Then, we review a handful of existing human studies of choline supplementation in FASD. Lastly, we conclude with a review of practical considerations in choline supplementation, including dose, formulation, and feasibility in children.