Associations between preoperative cerebral white matter microstructural changes and neurodevelopmental deficits in...

Area of Science:

• Neuroscience
• Pediatric Cardiology
• Medical Imaging

Background:

• Cyanotic congenital heart disease (CCHD) is associated with hemodynamic abnormalities leading to neurodevelopmental deficits (NDs).
• Understanding white matter (WM) microstructural changes in infants with congenital heart disease (CHD) is crucial for assessing NDs.

Purpose of the Study:

• To evaluate white matter (WM) microstructural changes in infants with CHD using diffusion tensor imaging (DTI).
• To analyze the relationship between WM microstructural changes and neurodevelopmental outcomes in infants with CHD.

Main Methods:

• Prospective enrollment of 40 infants (20 CCHD, 20 ACHD) undergoing preoperative DTI.
• Assessment of neurodevelopmental outcomes using Gesell Developmental Schedules-Third Edition (GDS-III).
• Multiple linear regression analysis to investigate associations between brain microstructural changes, clinical variables, and neurodevelopmental outcomes.

Main Results:

• Infants with CCHD showed significantly lower fractional anisotropy (FA) in key WM tracts (CGH, ATR, fminor) and poorer performance in adaptive, motor, language, and personal-social behaviors.
• Positive correlations were found between FA values in fminor, ATR, and CGH and specific neurodevelopmental behaviors (adaptive, motor, language).
• Hypoxia indicators and cardiac/vascular dimensions were associated with both neurodevelopmental and WM microstructural changes.

Conclusions:

• Cerebral white matter microstructural changes identified via DTI may serve as imaging biomarkers for neurodevelopmental deficits in infants with CHD.
• Oxygen supply is a critical factor influencing white matter microstructural development in infants with congenital heart disease.