Daniel Cromb, Siân Wilson, Alexandra F Bonthrone, Andrew Chew, Christopher Kelly, Manu Kumar, Paul Cawley, Ralica Dimitrova, Tomoki Arichi, J Donald Tournier, Kuberan Pushparajah, John Simpson, Mary Rutherford, Joseph V Hajnal, A David Edwards, Chiara Nosarti, Jonathan O'Muircheartaigh, Serena J Counsell
{"title":"Individualized cortical gyrification in neonates with congenital heart disease.","authors":"Daniel Cromb, Siân Wilson, Alexandra F Bonthrone, Andrew Chew, Christopher Kelly, Manu Kumar, Paul Cawley, Ralica Dimitrova, Tomoki Arichi, J Donald Tournier, Kuberan Pushparajah, John Simpson, Mary Rutherford, Joseph V Hajnal, A David Edwards, Chiara Nosarti, Jonathan O'Muircheartaigh, Serena J Counsell","doi":"10.1093/braincomms/fcae356","DOIUrl":null,"url":null,"abstract":"<p><p>Congenital heart disease is associated with impaired early brain development and adverse neurodevelopmental outcomes. This study investigated how individualized measures of preoperative cortical gyrification index differ in 142 infants with congenital heart disease, using a normative modelling approach with reference data from 320 typically developing infants. Gyrification index <i>Z</i>-scores for the whole brain and six major cortical areas were generated using two different normative models: one accounting for post-menstrual age at scan, post-natal age at scan and sex, and another additionally accounting for supratentorial brain volume. These <i>Z</i>-scores were compared between congenital heart disease and control groups to test the hypothesis that cortical folding in infants with congenital heart disease deviates from the normal developmental trajectory. The relationships between whole-brain gyrification index <i>Z</i>-scores from the two normative models and both cerebral oxygen delivery and neurodevelopmental outcomes were also investigated. Global and regional brain gyrification was significantly reduced in neonates with congenital heart disease, but not when supratentorial brain volume was accounted for. This finding suggests that whilst cortical folding is reduced in congenital heart disease, it is primarily driven by a reduction in brain size. There was a significant positive correlation between cerebral oxygen delivery and whole-brain gyrification index <i>Z</i>-scores in congenital heart disease, but not when supratentorial brain volume was accounted for. Cerebral oxygen delivery is therefore likely to play a more important role in the biological processes underlying volumetric brain growth than cortical folding. No significant associations between whole-brain gyrification index <i>Z</i>-scores and motor/cognitive outcomes or autism traits were identified in the 70 infants with congenital heart disease who underwent neurodevelopmental assessment at 22-months. Our results suggest that chronic <i>in utero</i> and early post-natal hypoxia in congenital heart disease is associated with reductions in cortical folding that are proportional to reductions in supratentorial brain volume.</p>","PeriodicalId":93915,"journal":{"name":"Brain communications","volume":null,"pages":null},"PeriodicalIF":4.1000,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11487749/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Brain communications","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/braincomms/fcae356","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Congenital heart disease is associated with impaired early brain development and adverse neurodevelopmental outcomes. This study investigated how individualized measures of preoperative cortical gyrification index differ in 142 infants with congenital heart disease, using a normative modelling approach with reference data from 320 typically developing infants. Gyrification index Z-scores for the whole brain and six major cortical areas were generated using two different normative models: one accounting for post-menstrual age at scan, post-natal age at scan and sex, and another additionally accounting for supratentorial brain volume. These Z-scores were compared between congenital heart disease and control groups to test the hypothesis that cortical folding in infants with congenital heart disease deviates from the normal developmental trajectory. The relationships between whole-brain gyrification index Z-scores from the two normative models and both cerebral oxygen delivery and neurodevelopmental outcomes were also investigated. Global and regional brain gyrification was significantly reduced in neonates with congenital heart disease, but not when supratentorial brain volume was accounted for. This finding suggests that whilst cortical folding is reduced in congenital heart disease, it is primarily driven by a reduction in brain size. There was a significant positive correlation between cerebral oxygen delivery and whole-brain gyrification index Z-scores in congenital heart disease, but not when supratentorial brain volume was accounted for. Cerebral oxygen delivery is therefore likely to play a more important role in the biological processes underlying volumetric brain growth than cortical folding. No significant associations between whole-brain gyrification index Z-scores and motor/cognitive outcomes or autism traits were identified in the 70 infants with congenital heart disease who underwent neurodevelopmental assessment at 22-months. Our results suggest that chronic in utero and early post-natal hypoxia in congenital heart disease is associated with reductions in cortical folding that are proportional to reductions in supratentorial brain volume.
先天性心脏病与早期大脑发育受损和不良的神经发育结果有关。本研究采用常模方法,参考320名发育正常婴儿的数据,研究了142名先天性心脏病婴儿术前皮质回旋指数的个体化测量结果有何不同。我们使用两种不同的标准模型生成了全脑和六个主要皮质区域的回旋指数 Z 值:一种模型考虑了扫描时的月经后年龄、扫描时的产后年龄和性别,另一种模型则额外考虑了脐上脑容量。将这些 Z 值在先天性心脏病组和对照组之间进行比较,以验证患有先天性心脏病的婴儿大脑皮层折叠偏离正常发育轨迹的假设。此外,还研究了两种标准模型得出的全脑回旋指数 Z 值与脑氧输送和神经发育结果之间的关系。患有先天性心脏病的新生儿的全脑和区域脑回显著减少,但如果考虑到上脑室体积,则不会出现这种情况。这一发现表明,虽然先天性心脏病会导致大脑皮层折叠减少,但这主要是由于大脑体积缩小所致。在先天性心脏病患者中,脑氧输送与全脑回旋指数 Z 值之间存在明显的正相关,但如果考虑到颅上脑容量,则两者之间不存在正相关。因此,在大脑体积增长的生物学过程中,脑氧输送可能比皮质折叠起更重要的作用。70名患有先天性心脏病的婴儿在22个月大时接受了神经发育评估,他们的全脑回旋指数Z分数与运动/认知结果或自闭症特征之间没有发现明显的关联。我们的研究结果表明,先天性心脏病患儿在子宫内和出生后早期的长期缺氧与皮质折叠的减少有关,而皮质折叠的减少与上胚层脑容量的减少成正比。