Investigating altered brain development in infants with congenital heart disease using tensor-based morphometry

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.