Structural Covariance Networks in the Fetal Brain Reveal Altered Neurodevelopment for Specific Subtypes of Congenital Heart Disease
Year: 2024
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Altered structural brain development has been identified in fetuses with congenital heart disease (CHD), suggesting that the neurodevelopmental impairment observed later in life might originate in utero. There are many interacting factors that may perturb neurodevelopment during the fetal period and manifest as structural brain alterations, such as altered cerebral substrate delivery and aberrant fetal hemodynamics. METHODS AND RESULTS: We extracted structural covariance networks from the log Jacobian determinants of 435 in utero T2 weighted image magnetic resonance imaging scans, (n=67 controls, 368 with CHD) acquired during the third trimester. We fit general linear models to test whether age, sex, expected cerebral substrate delivery, and CHD diagnosis were significant predictors of structural covariance. We identified significant effects of age, sex, cerebral substrate delivery, and specific CHD diagnosis across a variety of structural covariance networks, including primary motor and sensory cortices, cerebellar regions, frontal cortex, extra-axial cerebrospinal fluid, thalamus, brainstem, and insula, consistent with widespread coordinated aberrant maturation of specific brain regions over the third trimester. CONCLUSIONS: Structural covariance networks offer a sensitive, data-driven approach to explore whole-brain structural changes without anatomical priors. We used them to stratify a heterogenous patient cohort with CHD, highlighting similarities and differences between diagnoses during fetal neurodevelopment. Although there was a clear effect of abnormal fetal hemodynamics on structural brain maturation, our results suggest that this alone does not explain all the variation in brain development between individuals with CHD.
Authors: Siân Wilson, Daniel Cromb, Alexandra F. Bonthrone, Alena Uus, Anthony Price, Alexia Egloff, Milou P.M Van Poppe, Johannes K Steinweg, Kuberan Pushparajah, John Simpson, David FA Lloyd, Reza Razavi, Jonathan O’Muircheartaigh, A. David Edwards, Joseph V. Hajnal, Mary Rutherford, Serena J. Counsell
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,700
Funders: Wellcome Trust, NIHR Biomedical Research Centre, Royal Marsden NHS Foundation Trust/Institute of Cancer Research, National Institute for Health and Care Research, King's College London, Medical Research Council, Engineering and Physical Sciences Research Council, Centre For Medical Engineering, King’s College London
Awards: G1247657515, Neurodevelopment from the fetus to childhood in individuals with congenital heart disease, G1814604835, A computer-guided imaging system for prenatal screening and comprehensive diagnosis of fetal abnormalities., G2417159676, In vivo microstructural neuroimaging in infants at risk of developing neurocognitive delay or neurobehavioural disorders, G6591802155, G7082644654, G961285871
OpenAlex ID: W4403769579