1Department of Neurology, Boston Children's Hospital, Boston, MA2Department of Neurology, Harvard Medical School, Boston, MA3Department of Cardiology, Boston Children's Hospital, Boston, MA4Department of Radiology, Harvard Medical School, Boston, MA5Department of Anesthesia, Harvard Medical School, Boston, MA6Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA7Department of Radiology, Boston Children's Hospital, Boston, MA8Department of Psychiatry, Boston Children's Hospital, Boston, MA9Department of Pediatrics, Harvard Medical School, Boston, MA10Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA
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ObjectiveTo determine whether brain volume is reduced at 1 year of age and whether these volumes are associated with neurodevelopment in biventricular congenital heart disease (CHD) repaired in infancy.Study designInfants with biventricular CHD (n = 48) underwent brain magnetic resonance imaging (MRI) and neurodevelopmental testing with the Bayley Scales of Infant Development-II and the MacArthur-Bates Communicative Development Inventories at 1 year of age. A multitemplate based probabilistic segmentation algorithm was applied to volumetric MRI data. We compared volumes with those of 13 healthy control infants of comparable ages. In the group with CHD, we measured Spearman correlations between neurodevelopmental outcomes and the residuals from linear regression of the volumes on corrected chronological age at MRI and sex.ResultsCompared with controls, infants with CHD had reductions of 54 mL in total brain (P = .009), 40 mL in cerebral white matter (P < .001), and 1.2 mL in brainstem (P = .003) volumes. Within the group with CHD, brain volumes were not correlated with Bayley Scales of Infant Development-II scores but did correlate positively with MacArthur-Bates Communicative Development Inventory language development.ConclusionsInfants with biventricular CHD show total brain volume reductions at 1 year of age, driven by differences in cerebral white matter. White matter volume correlates with language development, but not broader developmental indices. These findings suggest that abnormalities in white matter development detected months after corrective heart surgery may contribute to language impairment.Trial registrationClinicalTrials.gov: NCT00006183.