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While such effects on cortical gray matter and cognition are widely researched, there is less research on the effects of PAE and PTE on white\u2010matter development and cognition, particularly in non\u2010clinical, community samples.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We analyzed white\u2010matter microstructure and its cognitive correlates in four hundred and sixty five 8\u201312\u2010year\u2010olds in the urban Cape Town region of South Africa: 192 were prenatally exposed to alcohol\n                      <jats:italic>and<\/jats:italic>\n                      tobacco (PAE\u2009+\u2009PTE), 73 to tobacco only (PTE), 102 to alcohol only (PAE), and 98 to neither tobacco nor alcohol (CON). White\u2010matter microstructure was quantified via neurite orientation and dendrite dispersion imaging (NODDI). The outcome variables were fractional anisotropy (FA), the neurite density index (NDI), and neurite orientation dispersion index (ODI) for 52 white\u2010matter tracts. Cognition was measured using the Wechsler Intelligence Scale for Children\u2014Fifth Edition (WISC\u2010V).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>PAE (but not PTE) was associated with NDI in 35 of 52 white\u2010matter tracts analyzed. There were no false\u2010discovery\u2010rate (FDR) corrected main effects of PAE or PTE on FA or ODI. For 17 of the 35 tracts affected by PAE, the corresponding NDIs were positively associated with scores on the WISC\u2010V Processing Speed Index.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our previous research of neuroanatomical structure in this cohort suggested that there are stronger effects of PTE on cortical gray matter. In contrast, the present data suggest that PAE may have stronger associations with white\u2010matter microstructure, with such effects potentially manifesting as downstream deficits in processing speed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acer.70387","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T04:34:33Z","timestamp":1785904473000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prenatal Alcohol and\/or Tobacco Exposure, White\u2010Matter Microstructure, and Cognition: Analyzing a South African Birth Cohort With Neurite Orientation and Dendrite Dispersion Imaging"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6593-0845","authenticated-orcid":false,"given":"Eric","family":"Kan","sequence":"first","affiliation":[{"name":"Department of Pediatrics Keck School of Medicine, Children's Hospital Los Angeles, University of 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