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Canadian Journal of Cardiology

Structural brain alterations and their associations with function in children, adolescents, and young adults with congenital heart disease

  • Marie Brossard-Racine
    Correspondence
    Corresponding author' addresses: Marie Brossard-Racine O.T., Ph.D., Research Institute of the McGill University Health Centre, 5252 boul. de Maisonneuve – 3F.46, Montréal, QC H4A 3S5, (514)934-1934, 76295
    Affiliations
    Director, Advances in Brain and Child Development Research Laboratory, Research Institute of McGill University Health Center - Child Heald and Human Development, Montreal PQ Canada, Associate Professor, School of Physical and Occupational Therapy, Associate member, Department of Pediatrics - Division of Neonatology and Department of Neurology and Neurosurgery McGill University, Montreal PQ Canada
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  • Ashok Panigrahy
    Correspondence
    Corresponding author: Ashok Panigrahy M.D., Department of Pediatric Radiology, Children’s Hospital of Pittsburgh of UPMC, 4401 Penn Avenue, Pittsburgh, PA 15224, Tel: 412-692-5510, Fax: 412-864-8622
    Affiliations
    Professor, Radiologist-in-Chief, John F. Caffey Endowed Chair in Pediatric Radiology, Children's Hospital of Pittsburgh of UPMC, Vice Chair, Clinical and Translational Imaging Research, Dept. of Radiology, University of Pittsburgh Medical Center
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Published:November 03, 2022DOI:https://doi.org/10.1016/j.cjca.2022.10.028

      Abstract

      Most neonates operated for complex congenital heart disease (CHD) will survive well into adulthood, however, many of them will face functional challenges at one point during their life as a consequence of their atypical neurodevelopment. Recent advances in neuroscience and the increasing accessibility of magnetic resonance imaging (MRI) have allowed numerous studies to describe the nature and extent of the brain alterations that are particular to survivors with CHD. Nevertheless, and considering that the range of outcomes is broad in this population, the functional impact of these brain differences is not always evident. This review summarizes the present state of knowledge regarding the structure-function relationships evaluated in children, adolescents, and young adults with CHD using structural MRI. Overall smaller total and regional brain volume, as well as lower fractional anisotropy in numerous brain regions, were frequently associated with lower cognitive outcomes including executive functioning and memory in adolescents and young adults with CHD. However, we identify several gaps in knowledge including the limited number of prospective investigations involving both neonatal imaging and follow-up during childhood or adolescence, as well as the need for studies that evaluate a broader range of functional outcomes and not only cognitive abilities. Future interdisciplinary investigations using multimodal imaging techniques could help address these gaps.
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