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Clinical Neuroradiology

14-05-2024 | Aortic Coarctation | Original Article

Children with Congenital Heart Diseases Exhibit Altered Deep Gray Matter Structures

Authors: Nils D. Forkert, Sarah J. MacEachern, Allison K. Duh, Peter Moon, Sarah Lee, Kristen W. Yeom

Published in: Clinical Neuroradiology

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Abstract

Background and Objectives

Children with congenital heart diseases (CHDs) have an increased risk of developing neurologic deficits, even in the absence of apparent brain pathology. The aim of this work was to compare quantitative macro- and microstructural properties of subcortical gray matter structures of pediatric CHD patients with normal appearing brain magnetic resonance imaging to healthy controls.

Methods

We retrospectively reviewed children with coarctation of the aorta (COA) and hypoplastic left heart syndrome (HLHS) admitted to our hospital. We identified 24 pediatric CHD patients (17 COA, 7 HLHS) with normal-appearing brain MRI. Using an atlas-based approach, the volume and apparent diffusion coefficient (ADC) were determined for the thalamus, caudate, putamen, pallidum, hippocampus, amygdala, nucleus accumbens, cerebral white matter, cerebral cortex, and brainstem. Multivariate statistics were used to compare the extracted values to reference values from 100 typically developing children without any known cardiac or neurological diseases.

Results

Multivariate analysis of covariance using the regional ADC and volume values as dependent variables and age and sex as co-variates revealed a significant difference between pediatric CHD patients and healthy controls (p < 0.001). Post-hoc comparisons demonstrated significantly reduced brain volumes in most subcortical brain regions investigated and elevated ADC values in the thalamus for children with CHD. No significant differences were found comparing children with COA and HLHS.

Conclusions

Despite normal appearing brain MRI, children with CHD exhibit wide-spread macro-structural and regional micro-structural differences of subcortical brain structures compared to healthy controls, which could negatively impact neurodevelopment, leading to neurological deficits in childhood and beyond.
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Metadata
Title
Children with Congenital Heart Diseases Exhibit Altered Deep Gray Matter Structures
Authors
Nils D. Forkert
Sarah J. MacEachern
Allison K. Duh
Peter Moon
Sarah Lee
Kristen W. Yeom
Publication date
14-05-2024
Publisher
Springer Berlin Heidelberg
Published in
Clinical Neuroradiology
Print ISSN: 1869-1439
Electronic ISSN: 1869-1447
DOI
https://doi.org/10.1007/s00062-024-01417-z