From the Advances in Brain and Child Health Development Research Laboratory (K.F., F.C., K.E., M.B.-R.), Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.
Department of Pediatrics, Division of Cardiology (C.V.R.).
AJNR Am J Neuroradiol. 2020 Aug;41(8):1503-1508. doi: 10.3174/ajnr.A6667. Epub 2020 Jul 23.
Congenital heart disease is a leading cause of neurocognitive impairment. Many subcortical structures are known to play a crucial role in higher-order cognitive processing. However, comprehensive anatomic characterization of these structures is currently lacking in the congenital heart disease population. Therefore, this study aimed to compare the morphometry and volume of the globus pallidus, striatum, and thalamus between youth born with congenital heart disease and healthy peers.
We recruited youth between 16 and 24 years of age born with congenital heart disease who underwent cardiopulmonary bypass surgery before 2 years of age ( = 48) and healthy controls of the same age ( = 48). All participants underwent a brain MR imaging to acquire high-resolution 3D T1-weighted images.
Smaller surface area and inward bilateral displacement across the lateral surfaces of the globus pallidus were concentrated anteriorly in the congenital heart disease group compared with controls ( < 0.15). On the lateral surfaces of bilateral thalami, we found regions of both larger and smaller surface areas, as well as inward and outward displacement in the congenital heart disease group compared with controls ( < 0.15). We did not find any morphometric differences between groups for the striatum. For the volumetric analyses, only the right globus pallidus showed a significant volume reduction ( < 0.05) in the congenital heart disease group compared with controls.
This study reports morphometric alterations in youth with congenital heart disease in the absence of volume reductions, suggesting that volume alone is not sufficient to detect and explain subtle neuroanatomic differences in this clinical population.
先天性心脏病是导致神经认知障碍的主要原因。许多皮质下结构被认为在高级认知处理中起着至关重要的作用。然而,目前在先天性心脏病人群中,这些结构的全面解剖特征尚不清楚。因此,本研究旨在比较先天性心脏病患者和健康同龄人的苍白球、纹状体和丘脑的形态和体积。
我们招募了年龄在 16 至 24 岁之间、在 2 岁之前接受过心肺旁路手术的先天性心脏病患者(n=48)和同龄的健康对照组(n=48)。所有参与者均接受了脑部磁共振成像,以获取高分辨率的 3D T1 加权图像。
与对照组相比,先天性心脏病组的苍白球外侧表面的表面积较小,且双侧向内侧移位,主要集中在前部(<0.15)。在双侧丘脑的外侧表面,我们发现先天性心脏病组的表面积更大和更小,以及向内侧和外侧的移位区域,与对照组相比(<0.15)。我们没有发现两组间纹状体的形态差异。对于体积分析,只有右侧苍白球在先天性心脏病组中与对照组相比体积显著减小(<0.05)。
本研究报告了先天性心脏病患者在无体积减少的情况下出现形态改变,这表明仅体积不足以检测和解释该临床人群中细微的神经解剖差异。