Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jul 26;9(1):10885.
doi: 10.1038/s41598-019-47328-9.

Postoperative brain volumes are associated with one-year neurodevelopmental outcome in children with severe congenital heart disease

Eliane Meuwly  1   2 , Maria Feldmann  1   2 , Walter Knirsch  2   3 , Michael von Rhein  1   2 , Kelly Payette  2   4 , Hitendu Dave  5 , Ruth O' Gorman Tuura  2   4 , Raimund Kottke  6 , Cornelia Hagmann  2   7 , Beatrice Latal  8   9 , András Jakab  10   11 ; Research Group Heart and Brain*
Collaborators, Affiliations

Postoperative brain volumes are associated with one-year neurodevelopmental outcome in children with severe congenital heart disease

Eliane Meuwly et al. Sci Rep. .

Abstract

Children with congenital heart disease (CHD) remain at risk for neurodevelopmental impairment despite improved perioperative care. Our prospective cohort study aimed to determine the relationship between perioperative brain volumes and neurodevelopmental outcome in neonates with severe CHD. Pre- and postoperative cerebral MRI was acquired in term born neonates with CHD undergoing neonatal cardiopulmonary bypass surgery. Brain volumes were measured using an atlas prior-based automated method. One-year neurodevelopmental outcome was assessed with the Bayley-III. CHD infants (n = 77) had lower pre- and postoperative total and regional brain volumes compared to controls (n = 44, all p < 0.01). CHD infants had poorer cognitive and motor outcome (p ≤ 0.0001) and a trend towards lower language composite score compared to controls (p = 0.06). Larger total and selected regional postoperative brain volumes were found to be associated with better cognitive and language outcomes (all p < 0.04) at one year. This association was independent of length of intensive care unit stay for total, cortical, temporal, frontal and cerebellar volumes. Therefore, reduced cerebral volume in CHD neonates undergoing bypass surgery may serve as a biomarker for impaired outcome.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
3D reconstruction and brain segmentation. (a) Reconstruction of 3D T2-weighted images (bottom row) from three orthogonally acquired images, (b) example segmentations: cortex, white matter and cerebellum (top row), and four-lobe segmentation (bottom row).
Figure 2
Figure 2
Association between postoperative total and regional brain volumes and one-year neurodevelopmental outcome in CHD infants. Dot-whisker plot of multiple linear regression models for each respective postoperative brain volume and neurodevelopmental outcome domain in CHD infants. Dots indicate the ß coefficients while whiskers display the 95% confidence interval. Models adjusted for sex, postmenstrual age at MRI, MRI cohort and socioeconomic status. Further model details and p-values adjusted for multiple comparison can be found in Supplementary Table S5.
See this image and copyright information in PMC

References

    1. Latal B. Neurodevelopmental outcomes of the child with congenital heart disease. Clinics in perinatology. 2016;43:173–185. doi: 10.1016/j.clp.2015.11.012. - DOI - PubMed
    1. Dimitropoulos A, et al. Brain injury and development in newborns with critical congenital heart disease. Neurology. 2013;81:241–248. doi: 10.1212/WNL.0b013e31829bfdcf. - DOI - PMC - PubMed
    1. von Rhein M, et al. Severe congenital heart defects are associated with global reduction of neonatal brain volumes. J. Pediatr. 2015;167:1259–1263 e1251. doi: 10.1016/j.jpeds.2015.07.006. - DOI - PubMed
    1. Owen M, et al. Brain volume and neurobehavior in newborns with complex congenital heart defects. J. Pediatr. 2014;164:1121–1127 e1121. doi: 10.1016/j.jpeds.2013.11.033. - DOI - PMC - PubMed
    1. Snookes SH, et al. A systematic review of motor and cognitive outcomes after early surgery for congenital heart disease. Pediatrics. 2010;125:e818–827. doi: 10.1542/peds.2009-1959. - DOI - PubMed

Publication types