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Children affected by prenatal alcohol exposure (PAE) experience long-lasting cognitive gains after treatment with supplemental choline, an essential nutrient, a new study suggests. The findings point to a potentially scalable intervention for neurodevelopmental differences that currently have few treatment options. Fetal alcohol spectrum disorder (FASD) is an umbrella term for several diagnoses that affect 1%–5% of the global population and can involve physical, cognitive and behavioral deficits and challenges.

Choline supplementation has been shown to benefit brain development in animal models of PAE. Prenatal choline supplementation during human pregnancies involving alcohol exposure has also shown benefits. While randomized controlled trials (RCTs) of FASD treatments have been scarce, researchers at the University of Minnesota previously conducted three such studies involving choline supplementation in young children. For the new study in Alcohol: Clinical & Experimental Research, investigators reassessed those children five years later.

The three RCTs collectively involved 104 children ages 2 to 5 at enrollment—each diagnosed with a form of FASD—and compared nine months of choline treatment with placebo in the 84 children who completed a trial. The children demonstrated improvements in sequential memory and delayed recall, with higher doses linked to greater benefits. For the follow-up, 58 of the children—average age 9—were reassessed.

Children treated with choline again performed better on tests of certain cognitive functions than those who received placebo. Nonverbal IQ was on average 7% higher, and working memory scores were 9% higher, in children treated with choline (medium to large effect sizes).

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