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Folic Acid Exposure Linked with Psychosis Reduction

JAMA Psychiatry; ePub 2018 Jul 3; Eryilmaz, et al

There is an association between gestational exposure to fortification of grain products with folic acid and altered cortical development and, in turn, a reduction in the risk of psychosis in youths. This according to a recent retrospective, observational clinical cohort study conducted at Massachusetts General Hospital (MGH) among 292 youths aged 8-18, born between January 1993-December 2001 (inclusive of folic acid fortification rollout ±3.5 years). In addition, researchers studied 2 independent, observational, community-based cohorts, comprising 1,078 youths aged 8-18 born throughout (Philadelphia Neurodevelopmental Cohort [PNC], 1992-2003) or before (National Institutes of Health [NIH], 1983-1995) the rollout of folic acid fortification. They found:

  • The MGH cohort demonstrated exposure-associated cortical thickness increases in bilateral frontal and temporal regions and emergence of quadratic (delayed) age-associated thinning in temporal and parietal regions.
  • The contemporaneous PNC cohort also exhibited exposure-associated delays of cortical thinning, located in similar regions and with similar durations of delay as in the MGH cohort.
  • Flatter thinning profiles in frontal, temporal, and parietal regions were associated with lower odds of psychosis spectrum symptoms in the PNC cohort.

Eryilmaz H, Dowling KF, Huntington FC, et al. Association of prenatal exposure to population-wide folic acid fortification with altered cerebral cortex maturation in youths. [Published online ahead of print July 3, 2018]. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2018.1381.