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Altered white matter connectivity in children with congenital heart disease with single ventricle physiology
Brady J Williamson1, Maria E Barnes-Davis2,3, Jennifer Vannest4
1Department of Radiology, University of Cincinnati, Cincinnati, OH, USA.
Insights
Children with congenital heart disease (CHD) show reduced white matter connectivity, impacting cognitive function. This study compared these children to healthy peers, revealing widespread differences in brain networks and their relation to neurodevelopmental outcomes.
Area of Science:
- Neuroscience
- Pediatric Cardiology
- Developmental Psychology
Background:
- Congenital heart disease (CHD) survival has improved, but neurodevelopmental issues persist.
- Psychological deficits and brain abnormalities are common in adults with CHD.
- White matter connectivity is crucial for neurodevelopment.
Purpose of the Study:
- To investigate white matter connectivity in children with complex cyanotic CHD post-Fontan palliation.
- To compare white matter connectivity in CHD patients with typically developing controls (TPC).
- To examine the relationship between white matter connectivity and cognitive performance in both groups.
Main Methods:
- Used diffusion tensor imaging (DTI) to assess white matter tracts.
- Compared children aged 6-11 with single ventricle physiology (CHD) to TPC.
- Administered a comprehensive neuropsychological battery to assess cognitive domains.
Main Results:
- CHD patients exhibited widespread reductions in white matter connectivity.
- The degree of white matter decrease correlated with cognitive performance.
- Network topology analysis revealed less extensive and more unilateral hub distribution in CHD patients compared to TPC.
Conclusions:
- Children with complex cyanotic CHD have significantly altered white matter connectivity.
- These alterations are associated with cognitive deficits.
- Findings support theories linking perinatal factors to white matter abnormalities in CHD.
Abstract:
Children born with congenital heart disease (CHD) have seen a dramatic decrease in mortality thanks to surgical innovations. However, there are numerous risk factors associated with CHD that can disrupt neurodevelopment. Recent studies have found that psychological deficits and structural brain abnormalities persist into adulthood. The goal of the current study was to investigate white matter connectivity in early school-age children (6-11 years), born with complex cyanotic CHD (single ventricle physiology), who have undergone Fontan palliation, compared to a group of heart-healthy, typically developing controls (TPC). Additionally, we investigated associations between white matter tract connectivity and measures on a comprehensive neuropsychological battery within each group. Our results suggest CHD patients exhibit widespread decreases in white matter connectivity, and the extent of these decreases is related to performance in several cognitive domains. Analysis of network topology showed that hub distribution was more extensive and bilateral in the TPC group. Our results are consistent with previous studies suggesting perinatal ischemia leads to white matter lesions and delayed maturation.
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