From the Journals

Fetal exposure to folic acid may reduce youth psychosis risk

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Findings complement previous studies

The results of this study complement previous studies in the Netherlands “addressing similar questions using plasma levels of folate in maternal blood during pregnancy,” Tomáš Paus, MD, PhD, wrote in an editorial (JAMA Psychiatry. 2018 Jul 3. doi: 10.1001/jamapsychiatry.2018.1255) published with the study. However, he added, “it is unfortunate that the authors did not report values of cortical surface area in the different groups of individuals studied.”

Previous studies have shown that the children of mothers with high folic acid levels during pregnancy showed greater head growth and larger brain volumes at 6-8 years of age, Dr. Paus wrote, adding that future research should explore the possibility that exposure to folic acid induces effects such as DNA methylation, that may persist over time.

“This folate-methylation hypothesis needs to be tested empirically in large data sets, ideally in conjunction with relevant brain phenotypes, to replicate and expand the initial findings reported” in this study, he concluded.

Dr. Paus is affiliated with the department of psychology at the Rotman Research Institute, Toronto. He reported no conflicts of interest.


 

FROM JAMA PSYCHIATRY

In the PNC group, 248 of the 861 patients included in the MRI analysis were typically developing, 199 had a psychosis diagnosis, 105 had attenuated psychotic symptoms, and 309 had various other psychiatric conditions. Best-fit local thinning slopes were calculated for each participant for each region with postfortification thinning, and in three of four regions, less-negative local slopes were associated with significantly reduced adjusted odds of psychosis spectrum diagnosis (odds ratio, 0.37-0.59; P less than .001 to P = .02), the authors reported.

The findings confirm that “fetal exposure to population-wide folic acid fortification was associated with subsequent alterations in cortical development among school-aged youths,” Dr. Eryilmaz and his coauthors wrote. “These cortical changes were associated with reduced risk of psychosis.”

The results also suggest that the protective effects of folic acid in gestation “may extend beyond prevention of neural tube defects and span neurodevelopment during childhood and adolescence,” they concluded.

The study was funded by MQ: Transforming Mental Health, with support from grants from several additional sources, including the National Institutes of Health.

SOURCE: Eryilmaz H et al. JAMA Psychiatry. 2018 Jul 3. doi: 10.1001/jamapsychiatry.2018.1381.

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