Brain Volume and Neurobehavior in Newborns with Complex Congenital Heart Defects.
Owen, Mallory MSc 1, 2; Shevell, Michael MDCM 3; Donofrio, Mary MD 4; Majnemer, Annette PhD 3, 5; McCarter, Robert ScD 6; Vezina, Gilbert MD 7; Bouyssi-Kobar, Marine MSc 2; Evangelou, Iordanis DPhil 2; Freeman, Dena MPH 2; Weisenfeld, Neil PhD 8; Limperopoulos, Catherine PhD 2, 3, *
[Article]
Journal of Pediatrics.
164(5):1121-1127e1, May 2014.
(Format: HTML, PDF)
Objective: To investigate the relationship between tissue-specific alterations in brain volume and neurobehavioral status in newborns with complex congenital heart defects preoperatively.
Study design: Three-dimensional volumetric magnetic resonance imaging was used to calculate tissue-specific brain volumes and a standardized neurobehavioral assessment was performed to assess neurobehavioral status in 35 full-term newborns admitted to the hospital before cardiopulmonary bypass surgery. Multiple linear regression models were performed to evaluate relationships between neurobehavioral status and brain volumes.
Results: Reduced subcortical gray matter (SCGM) volume and increased cerebrospinal fluid (CSF) volume were associated with poor behavioral state regulation (SCGM, P = .04; CSF, P = .007) and poor visual orienting (CSF, P = .003). In cyanotic newborns, reduced SCGM was associated with higher overall abnormal scores on the assessment (P = .001) and poor behavioral state regulation (P = .04), and increased CSF volume was associated with poor behavioral state regulation (P = .02), and poor visual orienting (P = .02). Conversely, acyanotic newborns showed associations between reduced cerebellar volume and poor behavioral state regulation (P = .03).
Conclusion: Abnormal neurobehavior is associated with impaired volumetric brain growth before open heart surgery in infants with complex congenital heart defects. This study highlights a need for routine preoperative screening and early intervention to improve neurodevelopmental outcomes.
(C) 2014Elsevier, Inc.
