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Infant study of hemispheric asymmetry after long-gap esophageal atresia repair

Mackenzie S Kagan1, Chandler R L Mongerson1, David Zurakowski1,2

  • 1Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, 300 Longwood Ave., Boston, Massachusetts, 02115, USA.

Annals of Clinical and Translational Neurology
|October 18, 2021
PubMed

Insights

Infants treated for long-gap esophageal atresia (LGEA) show altered forebrain asymmetry, with premature infants exhibiting a right-dominant pattern. This deviation from typical development warrants further investigation into potential neurobehavioral impacts.

Area of Science:

  • Neuroimaging
  • Developmental Pediatrics
  • Surgical Innovation

Background:

  • Infants typically develop left-greater-than-right forebrain asymmetry in the first year.
  • Long-gap esophageal atresia (LGEA) is a congenital condition requiring surgical intervention.
  • Altered brain development may occur in infants with critical illnesses and surgical histories.

Purpose of the Study:

  • To investigate forebrain asymmetry in infants treated for LGEA.
  • To compare brain asymmetry between term-born and premature LGEA patients and controls.
  • To identify potential deviations from typical hemispheric development post-LGEA repair.

Main Methods:

  • Quantitative MRI (T1 and T2 weighted) was used to assess forebrain volumes.
  • Forebrain tissue segmentation and volume acquisition were performed using ITK-SNAP.
  • General linear models compared hemispheric volumes between LGEA patients and controls, controlling for age.

Main Results:

  • Term-born and premature LGEA patients had smaller absolute forebrain volumes than controls.
  • Premature LGEA patients showed a subtle right-greater-than-left forebrain volume asymmetry.
  • This finding represents a deviation from the expected left-dominant asymmetry in infants.

Conclusions:

  • Infants with LGEA, particularly premature infants, may experience altered forebrain asymmetry post-surgical repair.
  • These anatomical findings suggest a potential risk for neurodevelopmental differences.
  • Further neurobehavioral studies are necessary to understand the functional implications of these MRI observations.
Abstract

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