TY - JOUR
T1 - Regional alterations in cerebral growth exist preoperatively in infants with congenital heart disease
AU - Ortinau, Cynthia
AU - Beca, John
AU - Lambeth, Jennifer
AU - Ferdman, Barbara
AU - Alexopoulos, Dimitrios
AU - Shimony, Joshua S.
AU - Wallendorf, Michael
AU - Neil, Jeffrey
AU - Inder, Terrie
N1 - Funding Information:
This research was supported by grants from the National Heart Foundation of New Zealand, Green Lane Research and Education Fund, Auckland Medical Research Fund, Doris Duke Charitable Foundation, National Institutes of Health under Ruth L. Kirschstein National Research Service Award T32 HD043010 , National Institutes of Health grant K23 HD053212 , and award P30HD062171 from the Eunice Kennedy Shriver National Institute of Child Health & Human Development .
PY - 2012/6
Y1 - 2012/6
N2 - Objectives: Magnetic resonance imaging has been used to define the neurologic abnormalities in infants with congenital heart disease (CHD), including preoperative injury and delayed brain maturation. The present study used qualitative scoring, cerebral biometry, and diffusion imaging to characterize the preoperative brain abnormalities in infants with CHD, including the identification of regions of greater vulnerability. Methods: A total of 67 infants with CHD had preoperative magnetic resonance imaging scans available for analysis of brain injury using qualitative scoring and brain development using qualitative scoring, metrics, and diffusion imaging. Results: Qualitative abnormalities were common, with 42% of infants having preoperative focal white matter lesions. Infants with CHD had smaller brain measures in the frontal lobe, parietal lobe, cerebellum, and brainstem (P < .001), with the frontal lobe and brainstem displaying the greatest alterations (P < .001). A smaller brain size in the frontal and parietal lobes correlated with delayed white matter microstructure reflected by diffusion imaging. Conclusions: Infants with CHD commonly display brain injury and delayed brain development. Regional alterations in brain size are present, with the frontal lobe and brainstem demonstrating the greatest alterations. This might reflect a combination of developmental vulnerability and regional differences in cerebral circulation.
AB - Objectives: Magnetic resonance imaging has been used to define the neurologic abnormalities in infants with congenital heart disease (CHD), including preoperative injury and delayed brain maturation. The present study used qualitative scoring, cerebral biometry, and diffusion imaging to characterize the preoperative brain abnormalities in infants with CHD, including the identification of regions of greater vulnerability. Methods: A total of 67 infants with CHD had preoperative magnetic resonance imaging scans available for analysis of brain injury using qualitative scoring and brain development using qualitative scoring, metrics, and diffusion imaging. Results: Qualitative abnormalities were common, with 42% of infants having preoperative focal white matter lesions. Infants with CHD had smaller brain measures in the frontal lobe, parietal lobe, cerebellum, and brainstem (P < .001), with the frontal lobe and brainstem displaying the greatest alterations (P < .001). A smaller brain size in the frontal and parietal lobes correlated with delayed white matter microstructure reflected by diffusion imaging. Conclusions: Infants with CHD commonly display brain injury and delayed brain development. Regional alterations in brain size are present, with the frontal lobe and brainstem demonstrating the greatest alterations. This might reflect a combination of developmental vulnerability and regional differences in cerebral circulation.
UR - http://www.scopus.com/inward/record.url?scp=84861202806&partnerID=8YFLogxK
U2 - 10.1016/j.jtcvs.2011.10.039
DO - 10.1016/j.jtcvs.2011.10.039
M3 - Article
C2 - 22143100
AN - SCOPUS:84861202806
SN - 0022-5223
VL - 143
SP - 1264-1270.e2
JO - Journal of Thoracic and Cardiovascular Surgery
JF - Journal of Thoracic and Cardiovascular Surgery
IS - 6
ER -