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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Neonatal Brain Network Integration Trajectories Predict Neurodevelopment in Congenital Heart Disease
Lauren Harasymiw1, Amy Kuang2, Duan Xu2
1Department of Pediatrics, University of California San Francisco.
Insights
Longitudinal brain network development in infants with critical congenital heart disease predicts cognitive, language, and motor outcomes. Early network growth is a potential biomarker for neurodevelopmental risk and resilience.
Area of Science:
- Neuroscience
- Developmental Biology
- Pediatric Cardiology
Background:
- Infants with critical congenital heart disease (CHD) face heightened risks for developmental impairments.
- Abnormal brain development is a significant concern in this vulnerable population.
Purpose of the Study:
- To investigate the association between perioperative whole-brain network development trajectories and neurodevelopmental outcomes in early childhood.
- To determine if longitudinal brain network development predicts cognitive, language, and motor skills.
Main Methods:
- Prospective longitudinal cohort study of 97 neonates with critical CHD.
- Brain MRI with diffusion imaging to derive whole-brain network measures from structural connectomes.
- Neurodevelopmental assessment using Bayley Scales of Infant and Toddler Development between 1 and 4 years.
Main Results:
- Slower perioperative growth in global efficiency (network integration) was linked to white matter injury, not cardiac physiology subtype.
- Increased perioperative global efficiency growth correlated with higher cognitive, language, and motor scores.
- Each 1-SD increase in global efficiency trajectory predicted an 8.2-point increase in cognitive scores, independent of other factors.
Conclusions:
- Longitudinal whole-brain network development in infants with critical CHD is associated with neurodevelopment across multiple domains.
- Early network development serves as a potential biomarker for identifying neurodevelopmental risk and resilience.
- Findings support future risk stratification and targeted interventions for infants with critical CHD.
Background:
Infants with critical congenital heart disease (CHD) are at high risk for abnormal brain development and later neurodevelopmental impairment. We hypothesized that the trajectory of perioperative whole-brain network development would predict neurodevelopmental outcomes in early childhood.
Methods:
This prospective longitudinal cohort of neonates with critical CHD (n = 97) underwent preoperative and/or postoperative brain MRI with diffusion imaging. Whole-brain network measures were derived from structural connectomes. Neurodevelopment was assessed between 1 and 4 years using the Bayley Scales of Infant and Toddler Development.
Results:
White matter injury was associated with slower perioperative growth in global efficiency (p = 0.013), a measure of network integration, whereas cardiac physiology was not associated with network development. Infants with greater perioperative increases in global efficiency had higher cognitive (p = 0.001), language (p < 0.001), and motor (p = 0.008) scores. For each 1-standard deviation increase in the trajectory of global efficiency, cognitive scores increased by 8.2 points (95% CI, 3.64-12.78), independent of brain injury and socioeconomic factors.
Conclusion:
In infants with critical CHD, longitudinal whole-brain network development was associated with neurodevelopment across multiple domains. Early network development may represent a candidate biomarker of neurodevelopmental risk and resilience in this population.
