Synchronous Aberrant Cerebellar and Opercular Development in Fetuses and Neonates with Congenital Heart Disease: Correlation with Early Communicative Neurodevelopmental Outcomes, Initial Experience

• Published in: American journal of perinatology reports Vol. 7; no. 1; pp. e17 - e27
• Main Authors: Wong, A., Chavez, T., O'Neil, S., Votava-Smith, J., Miller, D., delCastillo, S., Panigrahy, A., Paquette, L.
• Format: Journal Article
• Language: English
• Published: 333 Seventh Avenue, New York, NY 10001, USA Thieme Medical Publishers 01.01.2017; Thieme Medical Publishers, Inc
• Subjects: brain growth; Case Report; communication; congenital heart disease; fetus; neonate; neurodevelopment; congenital heart disease; neonate; neurodevelopment; communication; brain growth; fetus
• ISSN: 2157-6998; 2157-7005
• DOI: 10.1055/s-0036-1597934

Abstract Patients with congenital heart disease (CHD) demonstrate multidomain cognitive delays. Cingulo-opercular and cerebellar brain networks are critical to language functions. This is a description of our initial experience aiming to identify an anatomic correlate for CHD patients with expressive language delays. Fetal CHD patients, prospectively enrolled, underwent serial fetal (1.5T), postnatal pre- and postoperative (3T) MRI. Non-CHD patients were enrolled retrospectively from the same epoch. Comparable fetal and neonatal T2 contrast was used for manual linear cross-sectional measurement. Multivariable analysis was used for adjustments and curve fitting. Neurodevelopment was assessed with Battelle Developmental Inventory, 2nd ed. between 9 and 36 months of age. This interim analysis included patients from our longitudinal CHD study who had fetal, postnatal imaging and neurodevelopmental data—yielding a total of 62 mothers (11 CHD fetuses and 51 non-CHD fetuses). Altered brain trajectories were seen in selected cerebellar and opercular measurements in CHD patients compared with the non-CHD group. Smaller inferior cerebellar vermis measurements were associated with multiple communication-related abnormalities. Altered early structural development of the cerebellum and operculum is present in patients with CHD, which correlates with specific neurodevelopmental abnormalities.