Reduced structural connectivity in cortico-striatal-thalamic network in neonates with congenital heart disease

Bhroin, Megan Ní; Seada, Samy Abo; Bonthrone, Alexandra F; Kelly, Christopher; Christiaens, Daan; Schuh, Andreas; Pietsch, Maximilian; Hutter, Jana; Tournier, J-Donald; Cordero‐Grande, Lucilio; Rueckert, Daniel; Hajnal, Joseph V.; Pushparajah, Kuberan; Simpson, John; Edwards, A. David; Rutherford, Mary; Counsell, Serena J.; Batalle, Dafnis

doi:10.1016/j.nicl.2020.102423

Cited by 23 publications

(33 citation statements)

References 95 publications

(126 reference statements)

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“…White matter injury is thought to be one of the most common brain abnormalities in newborns with severe forms of CHD, 52 , 54 , 61 but increasingly, attention is being placed on cortical gray matter and functional connectivity. 60 , 62 , 67 In the cohort imaged by Miller and colleagues, white matter injury was found in 30% to as much as 69% of preoperative infants with CHD in the first week of life. 53 , 54 White matter injury in preoperative neonates with CHD has been shown to have predilection for anterior and posterior locations, rather than the central white matter injury seen in preterm infants.…”

Section: Structural and Functional Brain Abnormalitiesmentioning

confidence: 98%

Neuroplacentology in congenital heart disease: placental connections to neurodevelopmental outcomes

et al. 2021

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Children with congenital heart disease (CHD) are living longer due to effective medical and surgical management. However, the majority have neurodevelopmental delays or disorders. The role of the placenta in fetal brain development is unclear and is the focus of an emerging field known as neuroplacentology. In this review, we summarize neurodevelopmental outcomes in CHD and their brain imaging correlates both in utero and postnatally. We review differences in the structure and function of the placenta in pregnancies complicated by fetal CHD and introduce the concept of a placental inefficiency phenotype that occurs in severe forms of fetal CHD, characterized by a myriad of pathologies. We propose that in CHD placental dysfunction contributes to decreased fetal cerebral oxygen delivery resulting in poor brain growth, brain abnormalities, and impaired neurodevelopment. We conclude the review with key areas for future research in neuroplacentology in the fetal CHD population, including (1) differences in structure and function of the CHD placenta, (2) modifiable and nonmodifiable factors that impact the hemodynamic balance between placental and cerebral circulations, (3) interventions to improve placental function and protect brain development in utero, and (4) the role of genetic and epigenetic influences on the placenta–heart–brain connection. Impact Neuroplacentology seeks to understand placental connections to fetal brain development. In fetuses with CHD, brain growth abnormalities begin in utero. Placental microstructure as well as perfusion and function are abnormal in fetal CHD.

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Section: Structural and Functional Brain Abnormalitiesmentioning

confidence: 98%

Neuroplacentology in congenital heart disease: placental connections to neurodevelopmental outcomes

et al. 2021

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“…The cerebellum which is also important for language functioning (42) ( is increasingly being identified as a brain region vulnerable to hypoxia in infants with NE (43), and in preterm infants, cerebellar abnormalities have been associated with neurodevelopmental outcomes (44). Reduced structural connectivity involving both the hippocampus and cerebellum has also been previously identified in populations at-risk of neurodevelopmental impairments (45).…”

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

Relationship Between MRI Scoring Systems and Neurodevelopmental Outcome at Two Years in Infants With Neonatal Encephalopathy

Bhroin

Kelly

Sweetman

et al. 2022

Pediatric Neurology

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…This type of analysis has also been used to evaluate adolescents with d-transposition of the great arteries (d-TGA), in which network topology differences were found to mediate multiple domains of adverse neurocognitive outcomes. 16 We have recently described a quantitative data-driven network topology (connectome) graph analysis to compare neonates with CHD to normal controls, and demonstrated the early presence of brain reorganization in CHD neonates [17][18][19][20][21] . Other recent studies have described aberrant diffusion tensor -based connectome in CHD neonates and infants in both preoperative and postoperative periods, finding distinct patterns of structural network topology alterations [17][18][19][20][21] .…”

Section: Introductionmentioning

confidence: 99%

“…16 We have recently described a quantitative data-driven network topology (connectome) graph analysis to compare neonates with CHD to normal controls, and demonstrated the early presence of brain reorganization in CHD neonates [17][18][19][20][21] . Other recent studies have described aberrant diffusion tensor -based connectome in CHD neonates and infants in both preoperative and postoperative periods, finding distinct patterns of structural network topology alterations [17][18][19][20][21] . There is also recent literature to suggest that genetic factors might impact the structural connectome in CHD 19 .…”

Section: Introductionmentioning

confidence: 99%

“…A recent published study comparing critical/serious CHD prior to surgery and 116 matched healthy controls as part of the developing Human Connectome Project imaged with high angular resolution diffusion MRI (HARDI) and processed with multi-tissue constrained spherical deconvolution, anatomically constrained probabilistic tractography (ACT) and spherical-deconvolution informed filtering of tractograms (SIFT2) was used to construct weighted structural networks, and identified one subnetwork with reduced structural connectivity in CHD infants involving basal ganglia, amygdala, hippocampus, and the cerebellar vermis 17,18 . We have recently described a similar pattern of structural subcortical dysmaturation both in human infants with CHD and genetically relevant ciliary motion dysfunction, and also in relation to preclinical models of CHD including hypoplastic left heart syndrome (HLHS).…”

Section: Introductionmentioning

confidence: 99%

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Clinical Factors Associated with Microstructural Connectome Related Brain Dysmaturation in Term Neonates with Congenital Heart Disease

Votava‐Smith

Gaesser

Harbison³

et al. 2022

Preprint

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Objective: Term congenital heart disease (CHD) neonates display abnormalities of brain structure and maturation, which are possibly related to underlying patient factors and perioperative insults. Our primary goal was to delineate associations between clinical factors and postnatal brain microstructure in term CHD neonates using diffusion tensor imaging (DTI) magnetic resonance (MR) acquisition combined with complementary data-driven connectome and seed-based tractography quantitative analysis. Our secondary goal was to delineate associations between mild dysplastic structural abnormalities and connectome and seed-base tractography as our primary goal. Methods: Neonates undergoing cardiac surgery for CHD were prospectively recruited from two large centers. Both pre- and postoperative magnetic resonance (MR) brain scans were obtained. DTI in 42 directions was segmented to 90 regions using neonatal brain template and three weighted methods. Seed- based tractography was performed in parallel. Clinical data :18 patient85 specific and 9 preoperative variables associated with preoperative scan and 6 intraoperative and 12 postoperative variables associated with postoperative scan. A composite Brain Dysplasia Score (BDS) was created including cerebellar, olfactory bulbs, and hippocampus abnormalities. The outcomes included (1) connectome metrics: cost and global/nodal efficiency (2) seed-based tractography: fractional anisotropy. Statistics: multiple regression with false discovery rate correction (FDR). Results: A total of 133 term neonates with complex CHD were prospectively enrolled and 110 had analyzable DTI. Multiple patient-specific factors including d-transposition of the great arteries physiology and severity of impairment of fetal cerebral substrate delivery were predictive of preoperative reduced cost (p<0.0073), reduced global/nodal efficiency (p <0.03). Multiple postoperative factors (extracorporeal membrane oxygenation [ECMO], seizures, cardiopulmonary resuscitation) were predictive of postoperative reduced cost, reduced global/nodal efficiency (p < 0.05). All three subcortical structures of the BDS (including olfactory bulb/sulcus, cerebellum, and hippocampus) predicted distinct patterns of altered nodal efficiency (p<0.05). Conclusion: Patient-specific and postoperative clinical factors were most predictive of diffuse postnatal microstructural dysmaturation in term CHD neonates. In contrast, subcortical components of a structurally based- brain dysplasia score, predicted more regional based postnatal microstructural differences. Collectively, these findings suggest that brain DTI connectome may facilitate deciphering the mechanistic relative contribution of clinical and genetic risk factors related to poor neurodevelopmental outcomes in CHD.

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Reduced structural connectivity in cortico-striatal-thalamic network in neonates with congenital heart disease

Cited by 23 publications

References 95 publications

Neuroplacentology in congenital heart disease: placental connections to neurodevelopmental outcomes

Neuroplacentology in congenital heart disease: placental connections to neurodevelopmental outcomes

Relationship Between MRI Scoring Systems and Neurodevelopmental Outcome at Two Years in Infants With Neonatal Encephalopathy

Clinical Factors Associated with Microstructural Connectome Related Brain Dysmaturation in Term Neonates with Congenital Heart Disease

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