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Investigating altered brain development in infants with congenital heart disease using tensor-based morphometry
Isabel H X Ng1, Alexandra F Bonthrone1, Christopher J Kelly1
1Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, SE1 7EH, UK.
Insights
Infants with congenital heart disease (CHD) show reduced brain volumes in key areas like the basal ganglia and lobes. This study used tensor-based morphometry to pinpoint these developmental differences in newborns with CHD.
Area of Science:
- Neuroimaging
- Developmental Biology
- Pediatric Cardiology
Background:
- Congenital heart disease (CHD) is linked to altered brain development in infants.
- Previous magnetic resonance (MR) imaging studies indicate reduced brain volumes in infants with CHD.
- A detailed structural brain analysis in newborns with CHD is needed.
Purpose of the Study:
- To evaluate altered structural brain development in newborn infants with CHD compared to healthy controls.
- To utilize tensor-based morphometry (TBM) for detailed voxel-wise brain analysis.
- To investigate the relationship between cerebral oxygen delivery (CDO2) and brain structure in infants with CHD.
Main Methods:
- Compared T2-weighted MR images of 64 infants with CHD to 192 healthy controls.
- Employed tensor-based morphometry (TBM) for voxel-wise structural comparisons.
- Measured cerebral oxygen delivery (CDO2) in 49 infants with CHD using phase contrast MR imaging.
Main Results:
- Significant bilateral volume reductions were observed in the basal ganglia, thalami, corpus callosum, occipital, temporal, parietal, and frontal lobes, and right hippocampus in infants with CHD.
- Enlarged cerebrospinal fluid spaces were identified in infants with CHD.
- No significant association was found between voxel-wise brain structure and CDO2 after correcting for global brain size.
Conclusions:
- Tensor-based morphometry effectively localizes abnormal brain development in infants with CHD.
- Specific brain regions, including the basal ganglia and cerebral lobes, are particularly vulnerable to structural alterations in infants with CHD.
- Altered brain development in infants with CHD is complex and not solely explained by reduced cerebral oxygen delivery.
Abstract:
Magnetic resonance (MR) imaging studies have demonstrated reduced global and regional brain volumes in infants with congenital heart disease (CHD). This study aimed to provide a more detailed evaluation of altered structural brain development in newborn infants with CHD compared to healthy controls using tensor-based morphometry (TBM). We compared brain development in 64 infants with CHD to 192 age- and sex-matched healthy controls. T2-weighted MR images obtained prior to surgery were analysed to compare voxel-wise differences in structure across the whole brain between groups. Cerebral oxygen delivery (CDO2) was measured in infants with CHD (n = 49) using phase contrast MR imaging and the relationship between CDO2 and voxel-wise brain structure was assessed using TBM. After correcting for global scaling differences, clusters of significant volume reduction in infants with CHD were demonstrated bilaterally within the basal ganglia, thalami, corpus callosum, occipital, temporal, parietal and frontal lobes, and right hippocampus (p < 0.025 after family-wise error correction). Clusters of significant volume expansion in infants with CHD were identified in cerebrospinal fluid spaces (p < 0.025). After correcting for global brain size, there was no significant association between voxel-wise brain structure and CDO2. This study localizes abnormal brain development in infants with CHD, identifying areas of particular vulnerability.
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