A new study of Romanian orphans confined to institutions reveals that early social and emotional neglect leads to compromises in development of the brain’s white matter, some of which may be reversible with early intervention.  White matter is made up mostly of glia, so-called “helper cells” that promote neuronal growth, and the axonal “wires” that connect cells in different parts of the brain. The white color reflects the presence of myelin, the substance that coats axons (like the rubber that sheathes electrical wires) to protect them and speed signal transmission.

The findings, published January 6th in JAMA Pediatrics, were part of the Bucharest Early Intervention Project, the first-ever randomized clinical trial to study whether children removed from institutions early and placed in foster care have better developmental outcomes. The project, which began in 2000, examined the brains and behavior in children randomly assigned at around two years old to remain institutionalized or be removed from the institution and placed in high-quality foster care. Both groups of children were compared with children from the Bucharest community who were raised by their biological families. All of the children––those who had been institutionalized, those in foster care, and those raised by their biological families––received brain scans years around their eighth birthday.

The research team, including 2007 NARSAD Distinguished Investigator grantee Nathan A. Fox, Ph.D., of the University of Maryland, College Park, found structural differences in white matter circuitry in children who had remained institutionalized compared to those who had never been in an institution. These altered connections were found throughout the brain and included white matter tracts that support cognitive and emotional regulation.

In contrast, the white matter of children who moved from the institution to foster care, after the passage of some years, looked similar to that of children who had never been institutionalized. This suggests that removing children from institutions where they suffered social, emotional, linguistic, and cognitive impoverishment and moving them into a more supportive environment may have led to more normal brain development.

“These findings suggest a potential for remediation of specific white matter pathways for children removed from institutional care and placed in responsive families early in life,” reported the researchers. “Our findings have implications for public health and policy efforts designed to promote normative brain development among vulnerable children.”

Read the abstract.