Related Experiment Videos
Multimodality evoked potential findings in infants with congenital heart defects
C Limperopoulos1, A Majnemer, B Rosenblatt
1School of Physical and Occupational Therapy, McGill University-Montreal Children's Hospital, QC.
Insights
Evoked potential abnormalities are common in newborns with congenital heart defects, predicting developmental delays. These findings highlight the prognostic value of evoked potentials in at-risk infants.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Pediatric Cardiology
Background:
- Evoked potentials serve as sensitive prognostic indicators for developmental disabilities in infants.
- Congenital heart defects (CHDs) can impact neurodevelopmental outcomes.
- The perioperative period for cardiac surgery presents a critical window for assessing neurological function.
Purpose of the Study:
- To investigate evoked potential abnormalities in infants with CHDs before and after open-heart surgery.
- To determine the association between evoked potential abnormalities and developmental status one year post-surgery.
- To assess the predictive value of evoked potentials for long-term neurodevelopmental outcomes in this population.
Main Methods:
- Prospective study involving newborns and infants (<2 years) with CHDs undergoing open-heart surgery.
- Perioperative recordings of somatosensory evoked potentials (SSEPs) and brainstem auditory evoked potentials (BAEPs).
- Neurologic examination and standardized developmental assessments (motor performance, functional independence) at 1-year follow-up.
Main Results:
- Perioperative SSEP abnormalities were frequent in newborns (41%) but not in older infants (13%) with CHDs.
- BAEPs showed normal conduction times, but 32% had mild hearing threshold elevations.
- All newborns with abnormal SSEPs exhibited abnormal neurologic exams and developmental deficits at 1 year.
Conclusions:
- Perioperative SSEP abnormalities are prevalent in newborns with CHDs.
- Abnormal SSEPs in the perioperative period strongly predict persistent developmental delay in infants post-cardiac surgery.
- Evoked potentials are valuable prognostic tools for identifying neurodevelopmental risks in infants with CHDs.
Abstract:
Evoked potentials are sensitive prognostic tools in young infants at risk for developmental disability. The objective of this prospective study was to determine whether infants with congenital heart defects demonstrate evoked potential abnormalities prior to or following open heart surgery, and to examine the association between these abnormalities and developmental status 1 year following surgery. A consecutive series of newborns (less than 1 month old) and infants (1 month to 2 years old) were recruited. Somatosensory and brain stem auditory evoked potentials were carried out before or after cardiac surgery, or both. One year later, neurologic examination and standardized measures of motor performance and functional independence were carried out. Twenty-seven newborns and 31 infants underwent perioperative somatosensory evoked potential recordings. Results indicate that perioperative somatosensory evoked potential abnormalities were common in newborns (41%) but not in infants (13%) with congenital heart defects. Brainstem conduction times were within normal limits in all subjects; however, 32% presented with mild elevations in hearing thresholds. All newborns with abnormal somatosensory evoked potentials had abnormal neurologic examinations both perioperatively and again 1 year after open heart surgery. Moreover, standardized developmental assessments 1 year following surgery indicate that all newborns with somatosensory evoked potential abnormalities had developmental deficits in one or more domains. Somatosensory evoked potential abnormalities in the perioperative period are common in newborns with congenital heart defects, and are strongly predictive of persistent developmental delay later.