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CC-BY-NC-ND 4.0 · AJP Rep 2017; 07(01): e17-e27
DOI: 10.1055/s-0036-1597934
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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

A. Wong
1   New York Medical College, Valhalla, New York
,
T. Chavez
2   Division of Neonatology, University Southern California, Children's Hospital Los Angeles Center for Fetal and Neonatal Medicine, Los Angeles, California
,
S. O'Neil
3   Division of Neurology, University Southern California, Children's Hospital Los Angeles, Los Angeles, California
,
J. Votava-Smith
4   Division of Cardiology, University Southern California, Children's Hospital Los Angeles, Los Angeles, California
,
D. Miller
7   Division of Obstetrics/Gynecology, University Southern California, Children's Hospital Los Angeles Center for Fetal and Neonatal Medicine, Los Angeles, California
,
S. delCastillo
5   Division of Anesthesiology Critical Care Medicine, University Southern California, Children's Hospital Los Angeles, Los Angeles, California
,
A. Panigrahy
6   Department of Radiology, University of Pittsburgh, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania
,
L. Paquette
2   Division of Neonatology, University Southern California, Children's Hospital Los Angeles Center for Fetal and Neonatal Medicine, Los Angeles, California
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Publikationsverlauf

22. September 2016

03. November 2016

Publikationsdatum:
13. Februar 2017 (online)

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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.

Keywords

congenital heart disease - fetus - neonate - brain growth - neurodevelopment - communication