Opioid exposure in womb alters infants’ brain function, MRI scans reveal

Exposing infants to opioids while in utero may disturb connectivity to the part of the brain that regulates emotions such as anger, fear and sadness.

Indiana University School of Medicine recently made that discovery using resting state functional MRI to scan the brains of 16 sleeping newborns. Their early findings—set to be shared at RSNA’s annual meeting that kicks off Dec. 1—may help scientists better understand opioids’ impact on maturing minds later in life.

"Little is known about brain changes and their relationship to long-term neurological outcomes in infants who are exposed to opioids in utero," Rupa Radhakrishnan, MD, an assistant professor of radiology and imaging sciences at Indiana University, said in a statement. “By studying infants' brain activity soon after birth, we are in a better position to understand the effect of opioids on the developing brain, and explain how this exposure could influence long-term outcomes in the context of other social and environmental factors," she added later.

Neonatal abstinence syndrome (NAS), as the condition is called, is a growing concern in the U.S. The syndrome affected less than 3,000 babies in the year 2000, but that number skyrocketed to nearly 22,000 in 2012 as the opioid epidemic worsened. These babies are costly and difficult to care for, and exposure to opioids can lead to developmental delays or impaired communication in early childhood, one study noted. Others are also attempting to better understand this phenomenon, with the National Institutes of Health granting millions in funding to study pregnant mothers who have exposed their fetus to painkillers.

Radhakrishnan hopes that understanding how opioids affect the young mind may help lead to earlier detection and better management of NAS. Her team of obstetricians, neonatologists, psychologists and imaging experts all worked together to study fMRI brain scans of 16 babies, half of which were exposed to opioids in the womb.

They created brain maps of each subject aiming to better understand connectivity to the amygdala, a limbic region of the brain that’s pivotal for emotional functioning. Early results showed “significant” difference between NAS babies and those who are “opioid naïve” and not exposed to such drugs. Radhakrishnan and colleagues will now pursue testing with a greater number of subjects to tease out better methods for managing the disease.

"Although our early results showed differences between the two groups in a small study sample, it is very important that we further investigate and validate these findings in larger studies," she said in the statement.