Meta-regression of sulcal patterns, clinical and environmental factors on neurodevelopmental outcomes in participants
Lara Maleyeff1, Hannah J Park2, Zahra S H Khazal2
1Department of Biostatistics, Epidemiology, and Occupational Health, McGill University, Montreal, QC, Canada.
Insights
Brain sulcal patterns in infants with congenital heart disease may predict neurodevelopmental outcomes. Greater right hemisphere similarity correlates with better executive function, memory, and processing speed, offering a potential early biomarker for cognitive challenges.
Area of Science:
- Neuroscience
- Developmental Biology
- Cardiology
Background:
- Congenital heart disease (CHD) affects 1% of infants and is linked to neurodevelopmental impairments.
- Previous research indicates a correlation between sulcal features and executive function in specific CHD types (Tetralogy of Fallot, single ventricle).
- The relationship between sulcal patterns and neurocognition across diverse CHD types, including d-transposition of the great arteries, requires further investigation.
Purpose of the Study:
- To investigate the association between brain sulcal patterns and neurocognitive functions (executive function, general memory, processing speed) in individuals with various types of congenital heart disease.
- To explore regional differences in sulcal patterns and their impact on neurodevelopment.
- To identify potential early biomarkers for predicting neurocognitive challenges in CHD patients.
Main Methods:
- A meta-regression analysis was conducted involving 247 participants with three types of CHD (single ventricle, d-transposition of the great arteries, Tetralogy of Fallot) and 94 controls.
- Statistical analyses included Pearson correlation, false discovery rate adjustment, multivariable linear regression, and regression tree analysis.
- The study assessed the relationship between right hemisphere sulcal pattern similarity and cognitive scores.
Main Results:
- Higher right hemisphere sulcal pattern similarity was significantly associated with improved scores in executive function, general memory, and processing speed across the CHD cohort.
- These positive associations were particularly significant for individuals with d-transposition of the great arteries and Tetralogy of Fallot in multivariable analyses.
- Duration of deep hypothermic circulatory arrest also emerged as a significant factor associated with neurocognitive outcomes.
Conclusions:
- Brain sulcal pattern similarity, particularly in the right hemisphere, may serve as an early predictive biomarker for neurocognitive outcomes in individuals with congenital heart disease.
- Understanding regional sulcal differences can help elucidate the mechanisms underlying neurodevelopmental challenges in CHD.
- These findings highlight the potential for non-invasive imaging markers to guide early interventions for cognitive deficits in CHD patients.
Abstract:
Congenital heart disease affects 1% of infants and is associated with impaired neurodevelopment. Right- or left-sided sulcal features correlate with executive function among people with Tetralogy of Fallot or single ventricle congenital heart disease. Studies of multiple congenital heart disease types are needed to understand regional differences. Further, sulcal pattern has not been studied in people with d-transposition of the great arteries. Therefore, we assessed the relationship between sulcal pattern and executive function, general memory, and processing speed in a meta-regression of 247 participants with three congenital heart disease types (114 single ventricle, 92 d-transposition of the great arteries, and 41 Tetralogy of Fallot) and 94 participants without congenital heart disease. Higher right hemisphere sulcal pattern similarity was associated with improved executive function (Pearson r = 0.19, false discovery rate-adjusted P = 0.005), general memory (r = 0.15, false discovery rate P = 0.02), and processing speed (r = 0.17, false discovery rate P = 0.01) scores. These positive associations remained significant in for the d-transposition of the great arteries and Tetralogy of Fallot cohorts only in multivariable linear regression (estimated change β = 0.7, false discovery rate P = 0.004; β = 4.1, false discovery rate P = 0.03; and β = 5.4, false discovery rate P = 0.003, respectively). Duration of deep hypothermic circulatory arrest was also associated with outcomes in the multivariate model and regression tree analysis. This suggests that sulcal pattern may provide an early biomarker for prediction of later neurocognitive challenges among people with congenital heart disease.
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