In This Article
- Increased in utero folic acid exposure is associated with changes in later brain development that predict a reduced risk for symptoms of psychosis
- Young people born after full implementation of folic acid fortification in the U.S. had different patterns of cortical maturation compared with those born before the program
- Brain imaging provides biological evidence that helps support a cause-and-effect relationship between prenatal folic acid exposure and the prevention of severe psychiatric disorders
Fortification of grain-based food with folic acid was implemented in the U.S. between 1996 and 1998 to protect children against neural tube defects such as spina bifida. This created a unique opportunity to study the development of young brains before and after folic acid fortification.
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Research led by Joshua Roffman, MD, MMSc, co-director of Mass General Neuroscience, compared brain images of school-aged children born just prior to the fortification mandate to those of young people born afterwards. This analysis, published in JAMA Psychiatry, found that increased in utero folic acid exposure was associated with changes in later brain development. These brain changes, in turn, predicted a reduced risk for symptoms of psychosis.
The study compared two sets of brain MRIs taken of youths ages 8 to 18 who were born between 1993 to 2001: 292 Mass General patients, with images taken as a part of normal clinical care, and 861 participants in the Philadelphia Neurodevelopmental Cohort, a study that included assessment of psychiatric symptoms.
Both of sets of images were divided into three groups according to probable prenatal exposure to folic acid:
- Those born before July 1, 1996, when fortification began
- Those born after July 1, 1998, when implementation was complete
- Those born in the intervening two years, for whom group exposure would have been intermediate
Analysis of the images revealed that young people born after full implementation of folic acid fortification had different patterns of cortical maturation compared with children born before the program began. These brains showed thicker brain tissue and delayed thinning of the cerebral cortex, which itself was associated with a significantly reduced risk of symptoms of psychosis.
There is currently no known prevention or cure for severe mental illnesses like autism and schizophrenia, but the research team believes these folic acid findings are a step in the right direction.
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