Neglect affects brain composition, function


Children institutionalized early in life show significant reductions in gray and white matter in the cerebral cortex, researchers report. Can the effects be reversed?

Children exposed to the physical and social deprivation associated with institutionalization early in life show reductions in gray and white matter in the cerebral cortex, researchers report in a new study. They also found that quality foster care increased the volume of white matter but not gray matter in these children.

Using data from the Bucharest Early Intervention Project, the first randomized, controlled trial to compare institutional care of children with foster care, researchers evaluated brain structure and function measured by magnetic resonance imaging (MRI) and electroencephalography (EEG) in a subset of 74 children: 20 who were never institutionalized, 29 exposed to institutional care in Romanian orphanages, and 25 who were institutionalized then randomized to receive high-quality foster care.

Children in both the institutionalized and foster care groups had significantly lower volumes of cortical gray matter than children who had never been institutionalized. Gray matter volume did not differ between institutionalized children and children in the group that received foster care.

White matter volume also was significantly lower in institutionalized children who did not receive foster care compared with children who were never institutionalized. However, children randomized to foster care had white matter volume comparable to that of children who were never institutionalized, indicating a catch-up effect from placement in loving foster homes, even after severe environmental deprivation.

In addition, institutionalization was associated with lower EEG α-wave power, which has been linked to the structural integrity of white matter. Both institutionalized and foster care children showed lower α-power after controlling for age and sex than children who were never institutionalized. This finding in conjunction with reduced white matter volume in children exposed to institutionalization supports the connection between white matter volume and EEG α-power, the researchers say.

Researchers say that the implications of the study extend beyond institutionalized children to children suffering from other forms of neglect and abuse, including violence, chronic poverty, and physical and sexual abuse.

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