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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

Authors

  • 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
Further Information

Publication History

22 September 2016

03 November 2016

Publication Date:
13 February 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