Executive function and cortical thickness in youths prenatally exposed to cocaine, alcohol and tobacco

• 14–16 yo youth with prenatal cocaine exposure (27) and socio-demographically matched controls (15) were given MRI.
• Executive function was similar between groups but cortical thickness differences observed in those with PCE.
• Children with PCE could have subtle but persistent brain cortical differences until mid-to-late adolescence.

Small and detrimental, albeit inconsistent, effects of prenatal cocaine exposure (PCE) during early childhood have been reported. The teratogenic effects of prenatal alcohol (PAE) and tobacco exposure (PTE) on neurobehavior are more firmly established than PCE. We tested if co-exposure to all three drugs could be related to greater differences in brain structure than exposure to cocaine alone. Participants (n = 42, PCE = 27; age range = 14–16 years) received an executive function battery prior to a T1-weighted 3 T structural MRI scan. Cortical thickness was measured using FreeSurfer (v5.1). Fetal drug exposure was quantified through maternal self-reports usage during pregnancy. Using general linear modeling, we found no main effects of PCE on cortical thickness, but significant main effects of PAE and PTE in superior and medial frontal regions, after co-varying for the effects of age, sex, and each drug of exposure. Significant alcohol-by-tobacco interactions, and significant cocaine-by-alcohol interactions on cortical thickness in medial parietal and temporal regions were also observed. Poly-drug exposure and cognitive function also showed significant interactions with cortical thickness: lower cortical thickness was associated with better performance in PCE-exposed adolescents. Results suggest that although children with PCE have subtle but persistent brain cortical differences until mid-to-late adolescence.