Document Detail


Regional alterations in cerebral growth exist preoperatively in infants with congenital heart disease.
MedLine Citation:
PMID:  22143100     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Magnetic resonance imaging has been used to define the neurologic abnormalities in infants with congenital heart disease (CHD), including preoperative injury and delayed brain maturation. The present study used qualitative scoring, cerebral biometry, and diffusion imaging to characterize the preoperative brain abnormalities in infants with CHD, including the identification of regions of greater vulnerability.
METHODS: A total of 67 infants with CHD had preoperative magnetic resonance imaging scans available for analysis of brain injury using qualitative scoring and brain development using qualitative scoring, metrics, and diffusion imaging.
RESULTS: Qualitative abnormalities were common, with 42% of infants having preoperative focal white matter lesions. Infants with CHD had smaller brain measures in the frontal lobe, parietal lobe, cerebellum, and brainstem (P < .001), with the frontal lobe and brainstem displaying the greatest alterations (P < .001). A smaller brain size in the frontal and parietal lobes correlated with delayed white matter microstructure reflected by diffusion imaging.
CONCLUSIONS: Infants with CHD commonly display brain injury and delayed brain development. Regional alterations in brain size are present, with the frontal lobe and brainstem demonstrating the greatest alterations. This might reflect a combination of developmental vulnerability and regional differences in cerebral circulation.
Authors:
Cynthia Ortinau; John Beca; Jennifer Lambeth; Barbara Ferdman; Dimitrios Alexopoulos; Joshua S Shimony; Michael Wallendorf; Jeffrey Neil; Terrie Inder
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-12-03
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  143     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-05-18     Completed Date:  2012-07-11     Revised Date:  2013-06-27    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1264-70     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.
Affiliation:
Department of Pediatrics, St. Louis Children's Hospital and Washington University, St. Louis, MO 63110, USA. Ortinau_c@kids.wustl.edu
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MeSH Terms
Descriptor/Qualifier:
Brain / growth & development,  pathology*
Brain Injuries / complications*,  pathology,  physiopathology
Cardiac Surgical Procedures
Chi-Square Distribution
Child, Preschool
Diffusion Magnetic Resonance Imaging*
Female
Heart Defects, Congenital / complications*,  pathology,  physiopathology,  surgery
Humans
Infant
Infant, Newborn
Leukoencephalopathies / complications*,  pathology,  physiopathology
Longitudinal Studies
Male
New Zealand
Organ Size
Predictive Value of Tests
Preoperative Period
Prospective Studies
Regression Analysis
Time Factors
Treatment Outcome
Grant Support
ID/Acronym/Agency:
K23 HD053212/HD/NICHD NIH HHS; K23 HD053212-05/HD/NICHD NIH HHS; KL2 RR024994/RR/NCRR NIH HHS; P30 HD062171-03/HD/NICHD NIH HHS; P30HD062171/HD/NICHD NIH HHS; T32 HD043010/HD/NICHD NIH HHS; T32 HD043010-09/HD/NICHD NIH HHS; UL1 RR024992-05/RR/NCRR NIH HHS
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