Ma Siyu, Hu Yuanli, Liu Yuting, Pu Yiwei, Zuo Pengcheng, Hu Qinghui, Yang Zhaocong, Chen Feng, Xie Zongyun, Cun Yueshuang, Liu Xiaoxu, Yang Ming, Mo Xuming
Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China.
Department of Radiology, Children's Hospital of Nanjing Medical University, Nanjing, China.
Front Neurosci. 2022 Feb 7;15:685372. doi: 10.3389/fnins.2021.685372. eCollection 2021.
Despite intracardiac malformation correction, children with Tetralogy of Fallot (TOF) may still suffer from brain injury. This cross-sectional study was primarily designed to determine the relationship between blood oxygenation level-dependent (BOLD) signal changes after surgery and cognition in school-aged children with TOF. To evaluate the differences between TOF children ( = 9) and healthy children ( = 9), resting-state functional magnetic resonance imaging (rs-fMRI) and the Wechsler Intelligence Scale for Children-Chinese revised edition (WISC-CR) were conducted in this study. The results showed that TOF children had a lower full-scale intelligence quotient (FSIQ, 95.444 ± 5.354, = 0.022) and verbal intelligence quotient (VIQ, 92.444 ± 4.708, = 0.003) than healthy children (FSIQ = 118.500 ± 4.330;VIQ = 124.250 ± 4.404), and that significant differences in regional homogeneity (ReHo) and amplitude of low-frequency fluctuation (ALFF) existed between the two groups. Besides, VIQ had significantly positive correlations with the decreased ALFF value of the middle inferior occipital gyrus (MIOG, beta = 0.908, = 0.012) after fully adjusting for all covariates. In addition, elevated ReHo values of the left and right precuneus were positively related to ALFF in the MIOG. This study revealed that brain injury substantially influences neural activity and cognition in postoperative TOF children, providing direct evidence of an association between BOLD signal changes and the VIQ and prompting further attention to language development in TOF children.
尽管法洛四联症（TOF）患儿的心脏内畸形已得到矫正，但仍可能遭受脑损伤。这项横断面研究的主要目的是确定TOF学龄儿童术后血氧水平依赖（BOLD）信号变化与认知之间的关系。为了评估TOF患儿（n = 9）与健康儿童（n = 9）之间的差异，本研究进行了静息态功能磁共振成像（rs-fMRI）和韦氏儿童智力量表中国修订版（WISC-CR）测试。结果显示，TOF患儿的全量表智商（FSIQ，95.444±5.354，P = 0.022）和言语智商（VIQ，92.444±4.708，P = 0.003）低于健康儿童（FSIQ = 118.500±4.330；VIQ = 124.250±4.404），且两组之间在局部一致性（ReHo）和低频振幅（ALFF）方面存在显著差异。此外，在对所有协变量进行充分调整后，VIQ与枕中下回（MIOG）的ALFF值降低呈显著正相关（β = 0.908，P = 0.012）。此外，左右楔前叶的ReHo值升高与MIOG的ALFF呈正相关。本研究表明，脑损伤对TOF术后患儿的神经活动和认知有显著影响，为BOLD信号变化与VIQ之间的关联提供了直接证据，并促使人们进一步关注TOF患儿的语言发育。
