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Altered brain structure in preschool-aged children with tetralogy of Fallot
Mingwen Yang1, Yuting Liu1, Siyu Ma2
1Department of Radiology, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China.
Insights
Children with tetralogy of Fallot (ToF) show altered brain cortical structure, impacting neurodevelopment. This study reveals specific brain regions affected and suggests cortical morphology as an early biomarker for ToF-related neurodevelopmental issues.
Area of Science:
- Neuroscience
- Pediatric Cardiology
- Developmental Pediatrics
Background:
- Neurodevelopmental abnormalities are common in children with tetralogy of Fallot (ToF).
- Investigating structural brain alterations in preschool-aged children with ToF is crucial for understanding neurodevelopmental outcomes.
Purpose of the Study:
- To investigate structural brain alterations in preschool-aged children with ToF.
- To correlate these brain changes with neurodevelopmental outcomes.
Main Methods:
- T1-weighted structural MRI was used for 25 children with ToF and 24 controls.
- Cortical morphology indices (volume, thickness, gyrification) were compared.
- Neurodevelopmental assessments used the Wechsler Preschool and Primary Scale of Intelligence.
Main Results:
- Significant cortical morphological differences were found in specific brain regions, including the right caudal middle frontal gyrus and left inferior parietal lobule.
- Altered cortical structures correlated with visual-spatial and working memory indices in children with ToF.
- These brain changes also correlated with perioperative variables.
Conclusions:
- Abnormal cortical structure in children with ToF may result from delayed fetal brain development.
- Cortical morphology shows potential as an early biomarker for identifying regional brain abnormalities linked to neurodevelopmental outcomes in ToF.
- Cortical morphology analysis can aid in evaluating neuroanatomical changes and underlying neural mechanisms in ToF patients.
Background:
Neurodevelopmental abnormalities are prevalent in children with tetralogy of Fallot. Our aim was to investigate the structural brain alterations of preschool-aged children with tetralogy of Fallot and its correlation with neurodevelopmental outcome.
Methods:
T1-weighted structural images were obtained from 25 children with tetralogy of Fallot who had undergone cardiopulmonary bypass surgery and from 24 normal controls. Cortical morphological indices including gray matter volume, cortical thickness, sulcal depth, gyrification, and cortical surface complexity were compared between the two groups. Neurodevelopmental assessments of the children with tetralogy of Fallot were performed with the Wechsler Preschool and Primary Scale of Intelligence.
Results:
Cortical morphological differences between groups were distributed throughout the right caudal middle frontal gyrus, right fusiform gyrus, right lateral occipital gyrus, right precuneus, and left inferior parietal lobule. Among children with tetralogy of Fallot, altered cortical structures were correlated with the visual spatial index, working memory index, and perioperative variables.
Conclusion:
Our results suggested that abnormal cortical structure in preschool-aged children with tetralogy of Fallot may be the persistent consequence of delayed cortical development in fetuses and cortical morphology can be used as an early potential biomarker to capture regional brain abnormalities that are relevant to neurodevelopmental outcomes.
Impact:
Altered cortical structures in preschool-aged children with ToF were correlated with both neurodevelopmental outcomes and clinical risk factors. Cortical morphology can be used as an effective tool to evaluate neuroanatomical changes and detect underlying neural mechanisms in ToF patients. Abnormal cortical structure may be the continuous consequence of delayed fetal brain development in children with ToF.
