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Altered myelination in youth born with congenital heart disease
Kaitlyn Easson1,2, Guillaume Gilbert3, Charles V Rohlicek4
1Advances in Brain & Child Development (ABCD) Research Laboratory, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.
Insights
Youth with congenital heart disease (CHD) show widespread, lasting myelination deficits in their white matter. These brain differences may explain neurodevelopmental issues in CHD survivors.
Area of Science:
- Neuroscience
- Radiology
- Developmental Biology
Background:
- Congenital heart disease (CHD) is linked to brain injury and dysmaturation in fetuses and neonates.
- These early brain alterations are hypothesized to cause persistent myelination deficits.
- Understanding these deficits is crucial for addressing neurodevelopmental outcomes in CHD survivors.
Purpose of the Study:
- To quantify and compare in vivo myelin content in the brains of youth with CHD and healthy controls.
- To investigate whether myelination deficits are a long-lasting consequence of early-life brain dysmaturation in CHD.
- To explore the potential of myelination status as a biomarker for neuropsychological function.
Main Methods:
- Brain magnetic resonance imaging (MRI) was used in youth aged 16-24 years.
- Multicomponent driven equilibrium single pulse observation of T1 and T2 (mcDESPOT) was employed for myelin quantification.
- Myelin water fraction (MWF) was calculated for 33 white matter tracts and summarized using the White Matter Myelination Index.
Main Results:
- Youth with CHD exhibited lower tract-average MWF compared to controls.
- Deficits were observed throughout the corpus callosum, association tracts, and projection tracts in the CHD group.
- The White Matter Myelination Index was significantly lower in youth with CHD, indicating widespread myelination deficits.
Conclusions:
- This study provides specific evidence of widespread, persistent myelination deficits in youth with CHD.
- These findings suggest that deficient myelination is a long-lasting consequence of early-life brain dysmaturation in this population.
- Deficient myelination may underlie neurodevelopmental impairments and could serve as a biomarker of neuropsychological function in CHD survivors.
Abstract:
Brain injury and dysmaturation is common in fetuses and neonates with congenital heart disease (CHD) and is hypothesized to result in persistent myelination deficits. This study aimed to quantify and compare myelin content in vivo between youth born with CHD and healthy controls. Youth aged 16 to 24 years born with CHD and healthy age- and sex-matched controls underwent brain magnetic resonance imaging including multicomponent driven equilibrium single pulse observation of T1 and T2 (mcDESPOT). Average myelin water fraction (MWF) values for 33 white matter tracts, as well as a summary measure of average white matter MWF, the White Matter Myelination Index, were calculated and compared between groups. Tract-average MWF was lower throughout the corpus callosum and in many bilateral association tracts and left hemispheric projection tracts in youth with CHD (N = 44) as compared to controls (N = 45). The White Matter Myelination Index was also lower in the CHD group. As such, this study provides specific evidence of widespread myelination deficits in youth with CHD, likely representing a long-lasting consequence of early-life brain dysmaturation in this population. This deficient myelination may underlie the frequent neurodevelopmental impairments experienced by CHD survivors and could eventually serve as a biomarker of neuropsychological function.
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