Newborns with congenital heart disease at increased risk for neurodevelopmental disabilities

Infants born with congenital heart disease (CHD) could be at increased risk for neurodevelopmental disabilities even before undergoing initial open-heart surgery, a new study published in NeuroImage: Clinical states.

While newborns with CHD are experiencing higher rates of survival than ever before, more than half still struggle with neurodevelopmental disabilities, corresponding author Catherine Limperopolous, PhD, and colleagues at the Children’s National Health System wrote in the study. While recent quantitative MRI studies have shown disrupted growth, microstructure and metabolism in fetuses and infants born with complex CHD, scientists still don’t know much about how brain connectivity in these populations is altered between birth and initial heart surgery.

Using graph theory and network-based statistics, Limperopolous and co-authors evaluated functional brain connectivity in 82 healthy, full-term babies and 30 newborns with CHD before corrective heart surgery. According to the study, the researchers used an MRI to examine the infants’ brain topography, finding intact global organization but reduced functional connectivity between critical  brain regions.

“Resting state networks in CHD, like controls, showed an efficient and economic small world architecture,” the authors wrote. “While global network organization was preserved, region network functional connectivity was perturbed in newborns with CHD.”

According to the study, an extensive neural network is an important quality for any functioning body, but infants with CHD tend to have reduced, weaker connections between brain hubs.

Newborns with CHD often ultimately struggle with neurodevelopmental disabilities that affect motor function, learning, social behavior and executive function, the authors wrote. They also generally have lower birth weights and AP-GAR scores than healthy infants.

The greatest functional disturbances in the CHD-affected infants’ brains were found in subcortical regions, Limperopolous and colleagues wrote, and there also appeared to be weaker functional connectivity between the right and left thalamus and the right thalamus and left supplementary motor area.

The researchers’ preliminary findings suggest early brain dysfunction in newborns with CHD, they wrote, which could be associated with additional neurodevelopmental issues that evolve in the years following open heart surgery.