Effects of Congenital Heart Disease on Brain Development

Overview

Journal Prog Pediatr Cardiol

Specialty Cardiology & Vascular Diseases

Date 2010 Aug 31

PMID 20802830

Citations 47

Authors

Patrick S McQuillen

Donna A Goff

Daniel J Licht

Affiliations

Soon will be listed here.

Abstract

Brain and heart development occurs simultaneously in the fetus with congenital heart disease. Early morphogenetic programs in each organ share common genetic pathways. Brain development occurs across a more protracted time-course with striking brain growth and activity-dependent formation and refinement of connections in the third trimester. This development is associated with increased metabolic activity and the brain is dependent upon the heart for oxygen and nutrient delivery. Congenital heart disease leads to derangements of fetal blood flow that result in impaired brain growth and development that can be measured with advanced magnetic resonance imaging. Delayed development results in a unique vulnerability to cerebral white matter injury in newborns with congenital heart disease. Delayed brain development and acquired white matter injury may underlay mild but pervasive neurodevelopmental impairment commonly observed in children following neonatal congenital heart surgery.

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References

Donofrio M, Bremer Y, Schieken R, Gennings C, Morton L, Eidem B . Autoregulation of cerebral blood flow in fetuses with congenital heart disease: the brain sparing effect. Pediatr Cardiol. 2003; 24(5):436-43. DOI: 10.1007/s00246-002-0404-0. View

Bayatti N, Moss J, Sun L, Ambrose P, Ward J, Lindsay S . A molecular neuroanatomical study of the developing human neocortex from 8 to 17 postconceptional weeks revealing the early differentiation of the subplate and subventricular zone. Cereb Cortex. 2007; 18(7):1536-48. PMC: 2430151. DOI: 10.1093/cercor/bhm184. View

Limperopoulos C, Gauvreau K, OLeary H, Moore M, Bassan H, Eichenwald E . Cerebral hemodynamic changes during intensive care of preterm infants. Pediatrics. 2008; 122(5):e1006-13. PMC: 2665182. DOI: 10.1542/peds.2008-0768. View

Howard B, Mo Z, Filipovic R, Moore A, Antic S, Zecevic N . Radial glia cells in the developing human brain. Neuroscientist. 2008; 14(5):459-73. PMC: 2702478. DOI: 10.1177/1073858407313512. View

Glenn O, Quiroz E, Berman J, Studholme C, Xu D . Diffusion-weighted imaging in fetuses with unilateral cortical malformations and callosal agenesis. AJNR Am J Neuroradiol. 2009; 31(6):1100-2. PMC: 6034013. DOI: 10.3174/ajnr.A1863. View

Novotny E, Ashwal S, Shevell M . Proton magnetic resonance spectroscopy: an emerging technology in pediatric neurology research. Pediatr Res. 1998; 44(1):1-10. DOI: 10.1203/00006450-199807000-00001. View

Hoffman G, Mussatto K, Brosig C, Ghanayem N, Musa N, Fedderly R . Systemic venous oxygen saturation after the Norwood procedure and childhood neurodevelopmental outcome. J Thorac Cardiovasc Surg. 2005; 130(4):1094-100. DOI: 10.1016/j.jtcvs.2005.06.029. View

Hinton R, Andelfinger G, Sekar P, Hinton A, Gendron R, Michelfelder E . Prenatal head growth and white matter injury in hypoplastic left heart syndrome. Pediatr Res. 2008; 64(4):364-9. PMC: 2681225. DOI: 10.1203/PDR.0b013e3181827bf4. View

Back S, Riddle A, McClure M . Maturation-dependent vulnerability of perinatal white matter in premature birth. Stroke. 2007; 38(2 Suppl):724-30. DOI: 10.1161/01.STR.0000254729.27386.05. View

10.

Back S, Craig A, Luo N, Ren J, Akundi R, Ribeiro I . Protective effects of caffeine on chronic hypoxia-induced perinatal white matter injury. Ann Neurol. 2006; 60(6):696-705. DOI: 10.1002/ana.21008. View

11.

Kehrer M, Krageloh-Mann I, Goelz R, Schoning M . The development of cerebral perfusion in healthy preterm and term neonates. Neuropediatrics. 2003; 34(6):281-6. DOI: 10.1055/s-2003-44663. View

12.

McQuillen P, Ferriero D . Perinatal subplate neuron injury: implications for cortical development and plasticity. Brain Pathol. 2005; 15(3):250-60. PMC: 8096042. DOI: 10.1111/j.1750-3639.2005.tb00528.x. View

13.

Rosenthal G . Patterns of prenatal growth among infants with cardiovascular malformations: possible fetal hemodynamic effects. Am J Epidemiol. 1996; 143(5):505-13. DOI: 10.1093/oxfordjournals.aje.a008771. View

14.

Hevner R . Development of connections in the human visual system during fetal mid-gestation: a DiI-tracing study. J Neuropathol Exp Neurol. 2000; 59(5):385-92. DOI: 10.1093/jnen/59.5.385. View

15.

Miller S, Cozzio C, Goldstein R, Ferriero D, Partridge J, Vigneron D . Comparing the diagnosis of white matter injury in premature newborns with serial MR imaging and transfontanel ultrasonography findings. AJNR Am J Neuroradiol. 2003; 24(8):1661-9. PMC: 7973994. View

16.

McQuillen P, Barkovich A, Hamrick S, Perez M, Ward P, Glidden D . Temporal and anatomic risk profile of brain injury with neonatal repair of congenital heart defects. Stroke. 2007; 38(2 Suppl):736-41. DOI: 10.1161/01.STR.0000247941.41234.90. View

17.

Yoxall C, Weindling A . Measurement of cerebral oxygen consumption in the human neonate using near infrared spectroscopy: cerebral oxygen consumption increases with advancing gestational age. Pediatr Res. 1998; 44(3):283-90. DOI: 10.1203/00006450-199809000-00004. View

18.

Mrzljak L, Uylings H, Kostovic I, Van Eden C . Prenatal development of neurons in the human prefrontal cortex: I. A qualitative Golgi study. J Comp Neurol. 1988; 271(3):355-86. DOI: 10.1002/cne.902710306. View

19.

Sur M, Rubenstein J . Patterning and plasticity of the cerebral cortex. Science. 2005; 310(5749):805-10. DOI: 10.1126/science.1112070. View

20.

Kostovic I, Rakic P . Development of prestriate visual projections in the monkey and human fetal cerebrum revealed by transient cholinesterase staining. J Neurosci. 1984; 4(1):25-42. PMC: 6564757. View