UCLA School of Nursing, University of California Los Angeles, Los Angeles, CA, USA.
Department of Anesthesiology, University of California Los Angeles, Los Angeles, CA, USA.
Pediatr Res. 2020 Jan;87(1):169-175. doi: 10.1038/s41390-019-0569-3. Epub 2019 Sep 9.
Adolescents with single ventricle heart disease (SVHD) who have undergone the Fontan procedure show cognitive/memory deficits. Mammillary bodies are key brain sites that regulate memory; however, their integrity in SVHD is unclear. We evaluated mammillary body (MB) volumes and their associations with cognitive/memory scores in SVHD and controls.
Brain MRI data were collected from 63 adolescents (25 SVHD; 38 controls) using a 3.0-Tesla MRI scanner. Cognition and memory were assessed using Montreal Cognitive Assessment (MoCA) and Wide Range Assessment of Memory and Learning 2. MB volumes were calculated and compared between groups (ANCOVA, covariates: age, sex, and total brain volume [TBV]). Partial correlations and linear regression were performed to examine associations between volumes and cognitive scores (covariates: age, sex, and TBV).
SVHD group showed significantly lower MoCA and WRAML2 scores over controls. MB volumes were significantly reduced in SVHD over controls. After controlling for age, sex, and TBV, MB volumes correlated with MoCA and delayed memory recall scores in SVHD and controls.
Adolescents with SVHD show reduced MB volumes associated with cognitive/memory deficits. Potential mechanisms of volume losses may include developmental and/or hypoxic/ischemic-induced processes. Providers should screen for cognitive deficits and explore possible interventions to improve memory.
接受 Fontan 手术的单心室心脏病（SVHD）青少年表现出认知/记忆缺陷。乳头体是调节记忆的关键脑区；然而，其在 SVHD 中的完整性尚不清楚。我们评估了 SVHD 和对照组中乳头体（MB）体积及其与认知/记忆评分的关系。
使用 3.0-Tesla MRI 扫描仪从 63 名青少年（25 名 SVHD；38 名对照组）中收集脑 MRI 数据。使用蒙特利尔认知评估（MoCA）和广泛范围评估记忆和学习 2 号（WRAML2）评估认知和记忆。在组间进行 MB 体积计算和比较（ANCOVA，协变量：年龄、性别和总脑体积[TBV]）。进行偏相关和线性回归以检查体积与认知评分之间的关联（协变量：年龄、性别和 TBV）。
SVHD 组的 MoCA 和 WRAML2 评分明显低于对照组。SVHD 中的 MB 体积明显低于对照组。在控制年龄、性别和 TBV 后，SVHD 和对照组的 MB 体积与 MoCA 和延迟记忆回忆评分相关。
SVHD 青少年的 MB 体积减少与认知/记忆缺陷相关。体积损失的潜在机制可能包括发育和/或缺氧/缺血诱导的过程。提供者应筛查认知缺陷并探索可能的干预措施以改善记忆。
