Early motor outcomes in infants with critical congenital heart disease are related to neonatal brain development and brain injury
| Autor: | Janjaap van der Net, Manon J.N.L. Benders, Nicolaas J. G. Jansen, Johannes M.P.J. Breur, Raymond Stegeman, Nathalie H.P. Claessens, Maaike C. A. Sprong, Felix Haas, Linda S. de Vries, Floris Groenendaal |
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| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
Heart Defects
Congenital Male medicine.medical_specialty Developmental Disabilities Gross motor skill Pyramidal Tracts Cerebral palsy White matter Child Development Developmental Neuroscience Interquartile range Cerebellum Internal medicine PRETERM INFANTS Humans Medicine Prospective Studies Gray Matter Critical congenital heart disease Ischemic Stroke Cerebral Cortex medicine.diagnostic_test business.industry Cerebral Palsy Infant Newborn Infant Magnetic resonance imaging medicine.disease Magnetic Resonance Imaging White Matter Cardiac surgery medicine.anatomical_structure Motor Skills Brain Injuries Pediatrics Perinatology and Child Health Corticospinal tract Cardiology Female Neurology (clinical) business |
| Zdroj: | Developmental Medicine and Child Neurology, 64(2), 192-199. Blackwell Publishing Ltd |
| ISSN: | 1469-8749 0012-1622 |
| Popis: | Aim To assess the relationship between neonatal brain development and injury with early motor outcomes in infants with critical congenital heart disease (CCHD). Method Neonatal brain magnetic resonance imaging was performed after open-heart surgery with cardiopulmonary bypass. Cortical grey matter (CGM), unmyelinated white matter, and cerebellar volumes, as well as white matter motor tract fractional anisotropy and mean diffusivity were assessed. White matter injury (WMI) and arterial ischaemic stroke (AIS) with corticospinal tract (CST) involvement were scored. Associations with motor outcomes at 3, 9, and 18 months were corrected for repeated cardiac surgery. Results Fifty-one infants (31 males, 20 females) were included prospectively. Median age at neonatal surgery and postoperative brain magnetic resonance imaging was 7 days (interquartile range [IQR] 5-11d) and 15 days (IQR 12-21d) respectively. Smaller CGM and cerebellar volumes were associated with lower fine motor scores at 9 months (CGM regression coefficient=0.51, 95% confidence interval [CI]=0.15-0.86; cerebellum regression coefficient=3.08, 95% CI=1.07-5.09) and 18 months (cerebellum regression coefficient=2.08, 95% CI=0.47-5.12). The fractional anisotropy and mean diffusivity of white matter motor tracts were not related with motor scores. WMI was related to lower gross motor scores at 9 months (mean difference -0.8SD, 95% CI=-1.5 to -0.2). AIS with CST involvement increased the risk of gross motor problems and muscle tone abnormalities. Cerebral palsy (n=3) was preceded by severe ischaemic brain injury. Interpretation Neonatal brain development and injury are associated with fewer favourable early motor outcomes in infants with CCHD. |
| Databáze: | OpenAIRE |
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