Abnormal Microstructural Development of the Cerebral Cortex in Neonates With Congenital Heart Disease Is Associated With Impaired Cerebral Oxygen Delivery
Year: 2019
Type: article
Study design: Observational Study
Abstract: Background Abnormal macrostructural development of the cerebral cortex has been associated with hypoxia in infants with congenital heart disease (CHD). Animal studies have suggested that hypoxia results in cortical dysmaturation at the cellular level. New magnetic resonance imaging (MRI) techniques offer the potential to investigate the relationship between cerebral oxygen delivery and microstructural development of the cortex in newborn infants with CHD. Methods We measured macrostructural and microstructural properties of the cortex in 48 newborn infants with complex CHD and 48 age-matched healthy controls. Cortical volume and gyrification index were calculated from high resolution structural MRI. Neurite density and orientation dispersion indices were modelled using high angular resolution diffusion MRI. Cerebral oxygen delivery was estimated in infants with CHD using phase contrast MRI and pre-ductal pulse oximetry. We used tract-based spatial statistics to examine voxel-wise group differences in cortical microstructure. Results Microstructural development of the cortex was abnormal in 48 infants with CHD, with regions of increased fractional anisotropy (FA) and reduced orientation dispersion index (ODI) compared to 48 healthy controls, correcting for gestational age at birth and scan (FWE-corrected for multiple comparisons at P<0.05). Regions of reduced cortical ODI in infants with CHD were related to impaired cerebral oxygen delivery (R 2 =0.637, n=39). Cortical ODI was associated with gyrification index (R 2 =0.589, P<0.0001, n=48). Conclusions This study suggests that the primary component of cerebral cortex dysmaturation in CHD is impaired dendritic arborisation, which may underlie abnormal macrostructural findings reported in this population. The degree of impairment was related to cerebral oxygen delivery, supporting the hypothesis that maternal oxygen therapy may be beneficial in this population.
Authors: Christopher J. Kelly, Daan Christiaens, Dafnis Batalle, Antonios Makropoulos, Lucilio Cordero-Grande, Johannes K. Steinweg, Jonathan O’Muircheartaigh, Hammad Khan, Geraint Lee, Suresh Victor, Daniel C. Alexander, Hui Zhang, John Simpson, Joseph V. Hajnal, A. David Edwards, Mary A. Rutherford, Serena J. Counsell
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,178
Funders: Wellcome Trust, NIHR Biomedical Research Centre, Royal Marsden NHS Foundation Trust/Institute of Cancer Research, National Institute for Health and Care Research, British Heart Foundation, Imperial College London, King's College London, University College London, European Commission, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, Medical Research Council, Engineering and Physical Sciences Research Council, Biotechnology and Biological Sciences Research Council, Menzies Centre for Australian Studies, King's College London, University of London, Centre For Medical Engineering, King’s College London
OpenAlex ID: W2953041327