Impact of non-cyanotic congenital heart disease on Children's brain studied by voxel-based morphometry: A case-control study.

Background: Considerable research has shown brain injury during surgery for patients with cyanotic congenital heart disease (CHD), but the preoperative neurodevelopment and brain injury in children with non-cyanotic CHD are not well understood. The aim of this study is to investigate changes in global and local grey matter (GM) volumes of pediatric patients with non-cyanotic CHD before catheter-based procedure using voxel-based morphometry (VBM).

Methods: One-to three-year-old toddlers with acyanotic CHD (n = 54) hospitalized for treatment were prospectively enrolled. Each toddler underwent a 3D T1-weighted brain Magnetic Resonance Imaging (MRI) scan before catheter-based procedure. Meanwhile, 3D T1-weighted brain MR images of age- and sex-matched healthy controls (n = 35) were retrospectively analyzed. The volume of GM and total intracranial volume (TIV) were assessed by VBM within the SPM 12 (Statistical Parametric Mapping software), and regional differences in GM volume were analyzed by two-sample t-test and familywise error (FWE) rate correction.

Results: There was no difference in gross GM volume and TIV between the two groups (p > 0.05), but VBM analysis showed reduced structures of GM in middle frontal gyrus (both sides), inferior frontal gyrus, orbital gyrus, subcallosal gyrus, thalamus (both sides), medial globus pallidus (both sides) and culmen (both sides) of the non-cyanotic CHD group compared with the controls (p < 0.05, FWE correction).

Conclusion: Toddlers aged 1-3 years with acyanotic CHD suffer a decrease in local GM volume before catheter-based procedure, which tends to be distributed across the bilateral frontal lobe, thalamus, globus pallidus, and cerebellum.