Early motor outcomes in infants with critical congenital heart disease are related to neonatal brain development and brain injury.
Dev Med Child Neurol
; 64(2): 192-199, 2022 02.
Article
in En
| MEDLINE
| ID: mdl-34416027
ABSTRACT
AIM:
To assess the relationship between neonatal brain development and injury with early motor outcomes in infants with critical congenital heart disease (CCHD).METHOD:
Neonatal brain magnetic resonance imaging was performed after open-heart surgery with cardiopulmonary bypass. Cortical grey matter (CGM), unmyelinated white matter, and cerebellar volumes, as well as white matter motor tract fractional anisotropy and mean diffusivity were assessed. White matter injury (WMI) and arterial ischaemic stroke (AIS) with corticospinal tract (CST) involvement were scored. Associations with motor outcomes at 3, 9, and 18 months were corrected for repeated cardiac surgery.RESULTS:
Fifty-one infants (31 males, 20 females) were included prospectively. Median age at neonatal surgery and postoperative brain magnetic resonance imaging was 7 days (interquartile range [IQR] 5-11d) and 15 days (IQR 12-21d) respectively. Smaller CGM and cerebellar volumes were associated with lower fine motor scores at 9 months (CGM regression coefficient=0.51, 95% confidence interval [CI]=0.15-0.86; cerebellum regression coefficient=3.08, 95% CI=1.07-5.09) and 18 months (cerebellum regression coefficient=2.08, 95% CI=0.47-5.12). The fractional anisotropy and mean diffusivity of white matter motor tracts were not related with motor scores. WMI was related to lower gross motor scores at 9 months (mean difference -0.8SD, 95% CI=-1.5 to -0.2). AIS with CST involvement increased the risk of gross motor problems and muscle tone abnormalities. Cerebral palsy (n=3) was preceded by severe ischaemic brain injury.INTERPRETATION:
Neonatal brain development and injury are associated with fewer favourable early motor outcomes in infants with CCHD.
Full text:
1
Database:
MEDLINE
Main subject:
Pyramidal Tracts
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Brain Injuries
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Cerebral Palsy
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Child Development
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Developmental Disabilities
/
Ischemic Stroke
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Heart Defects, Congenital
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Motor Skills
Type of study:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Language:
En
Year:
2022
Type:
Article