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先天性心脏病婴儿中与睫状肌功能障碍相关的脑发育异常

Brain Dysplasia Associated with Ciliary Dysfunction in Infants with Congenital Heart Disease.

作者信息

Panigrahy Ashok, Lee Vincent, Ceschin Rafael, Zuccoli Giulio, Beluk Nancy, Khalifa Omar, Votava-Smith Jodie K, DeBrunner Mark, Munoz Ricardo, Domnina Yuliya, Morell Victor, Wearden Peter, Sanchez De Toledo Joan, Devine William, Zahid Maliha, Lo Cecilia W

机构信息

Department of Pediatric Radiology, Childrens Hospital of Pittsburgh of University of Pittsburgh Medical Center and University of Pittsburgh School of Medicine, Pittsburgh, PA; Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA.

Department of Pediatric Radiology, Childrens Hospital of Pittsburgh of University of Pittsburgh Medical Center and University of Pittsburgh School of Medicine, Pittsburgh, PA.

出版信息

J Pediatr. 2016 Nov;178:141-148.e1. doi: 10.1016/j.jpeds.2016.07.041. Epub 2016 Aug 26.

Abstract

OBJECTIVE

To test for associations between abnormal respiratory ciliary motion (CM) and brain abnormalities in infants with congenital heart disease (CHD) STUDY DESIGN: We recruited 35 infants with CHD preoperatively and performed nasal tissue biopsy to assess respiratory CM by videomicroscopy. Cranial ultrasound scan and brain magnetic resonance imaging were obtained pre- and/or postoperatively and systematically reviewed for brain abnormalities. Segmentation was used to quantitate cerebrospinal fluid and regional brain volumes. Perinatal and perioperative clinical variables were collected.

RESULTS

A total of 10 (28.5%) patients with CHD had abnormal CM. Abnormal CM was not associated with brain injury but was correlated with increased extraaxial cerebrospinal fluid volume (P < .001), delayed brain maturation (P < .05), and a spectrum of subtle dysplasia including the hippocampus (P < .0078) and olfactory bulb (P < .034). Abnormal CM was associated with higher composite dysplasia score (P < .001), and both were correlated with elevated preoperative serum lactate (P < .001).

CONCLUSIONS

Abnormal respiratory CM in infants with CHD is associated with a spectrum of brain dysplasia. These findings suggest that ciliary defects may play a role in brain dysplasia in patients with CHD and have the potential to prognosticate neurodevelopmental risks.

摘要

目的

检测先天性心脏病(CHD)婴儿的呼吸纤毛运动(CM)异常与脑异常之间的关联。

研究设计

我们术前招募了35例CHD婴儿,并进行鼻组织活检,通过视频显微镜评估呼吸CM。术前和/或术后进行头颅超声扫描和脑磁共振成像,并系统检查脑异常情况。采用分割法对脑脊液和局部脑容量进行定量分析。收集围产期和围手术期的临床变量。

结果

共有10例(28.5%)CHD患者存在CM异常。CM异常与脑损伤无关,但与脑外脑脊液量增加(P < 0.001)、脑成熟延迟(P < 0.05)以及包括海马体(P < 0.0078)和嗅球(P < 0.034)在内的一系列细微发育异常相关。CM异常与较高的综合发育异常评分相关(P < 0.001),且两者均与术前血清乳酸升高相关(P < 0.001)。

结论

CHD婴儿的呼吸CM异常与一系列脑发育异常有关。这些发现表明,纤毛缺陷可能在CHD患者的脑发育异常中起作用,并有可能预测神经发育风险。

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