Children's National Health System Posters

Impaired Amygdala and Hippocampal Growth in Neonates with Congenital Heart Disease

Document Type

Poster

Status

Faculty

Abstract Category

Neuroscience

Keywords

Congenital Heart Disease, Amygdala, Hippocampus

Publication Date

Spring 2019

Abstract

Congenital heart disease (CHD) is one of the most common forms of birth defects, and has been linked with impaired brain development. The disruption in hemodynamics caused by CHD is thought to prevent the brain from developing normally due to the failure of compensatory mechanisms to meet the high oxygen demands of the brain. A vital region of the brain that may be adversely affected is the amygdala and hippocampus which are structures important to learning, memory, and emotions. By using Magnetic Resonance Imaging (MRI), these structures can be observed and measured in neonates at different stages. The main goal of the study was to observe the amygdala and hippocampal growth in neonates with CHD compared with healthy controls. Neonates with CHD diagnosed by fetal echocardiography were recruited and had no other abnormalities detected by antenatal ultrasound and amniocentesis. Healthy controls were recruited from low risk obstetrics clinics with normal ultrasounds and fetal biometrics. Controls were scanned shortly after birth, while CHD neonates were scanned for pre-operative MRI prior to the cardiac surgery. The MRI scans were performed in GE Discovery 750 3.0T MRI with 8-channel head coil. For volumetric measurements, coronal 3D T2 CUBE sequence was acquired with the following parameters: TR of 2500ms, TE of 64.7 ms, flip angle of 90°, and 1 mm slice thickness. This 3D brain image was then segmented into sub-region to obtain a volumetric measurement. Manual corrections were performed using ITK-SNAP to avoid motion-induced errors. The mean and standard deviation volumes for the left hippocampus, right hippocampus, left amygdala, and the left amygdala were calculated. The p-values were obtained by using linear regression lines and controlling for gestational age. The following means and standard deviations were calculated and are in the order of pre-operative CHD (N=22) and controls (N=34). The left hippocampal volumes were: 651.27±127.94 mm3 and 755.41±140.10 mm3(p=0.0175); the right hippocampal volumes were: 784±133.28 mm3 and 885.76±152.02 mm3(p=0.0234); the left amygdala results were: 405.47±50.45 mm3 and 468.45±62.53 mm3(p=0.1855); and the right amygdala results were: 418.28±75.35 mm3 and 475.47±70.54 mm3(p=0.0458). The results suggest CHD neonates tend to have lower volumes in the amygdala and hippocampal regions compared to controls, which can be explained by the disruption in hemodynamics in CHD. Further covariates such as gender need to be adjusted and scans at post-operative MRI need to be analyzed to track abnormal development.

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Presented at Research Days 2019.

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Impaired Amygdala and Hippocampal Growth in Neonates with Congenital Heart Disease

Congenital heart disease (CHD) is one of the most common forms of birth defects, and has been linked with impaired brain development. The disruption in hemodynamics caused by CHD is thought to prevent the brain from developing normally due to the failure of compensatory mechanisms to meet the high oxygen demands of the brain. A vital region of the brain that may be adversely affected is the amygdala and hippocampus which are structures important to learning, memory, and emotions. By using Magnetic Resonance Imaging (MRI), these structures can be observed and measured in neonates at different stages. The main goal of the study was to observe the amygdala and hippocampal growth in neonates with CHD compared with healthy controls. Neonates with CHD diagnosed by fetal echocardiography were recruited and had no other abnormalities detected by antenatal ultrasound and amniocentesis. Healthy controls were recruited from low risk obstetrics clinics with normal ultrasounds and fetal biometrics. Controls were scanned shortly after birth, while CHD neonates were scanned for pre-operative MRI prior to the cardiac surgery. The MRI scans were performed in GE Discovery 750 3.0T MRI with 8-channel head coil. For volumetric measurements, coronal 3D T2 CUBE sequence was acquired with the following parameters: TR of 2500ms, TE of 64.7 ms, flip angle of 90°, and 1 mm slice thickness. This 3D brain image was then segmented into sub-region to obtain a volumetric measurement. Manual corrections were performed using ITK-SNAP to avoid motion-induced errors. The mean and standard deviation volumes for the left hippocampus, right hippocampus, left amygdala, and the left amygdala were calculated. The p-values were obtained by using linear regression lines and controlling for gestational age. The following means and standard deviations were calculated and are in the order of pre-operative CHD (N=22) and controls (N=34). The left hippocampal volumes were: 651.27±127.94 mm3 and 755.41±140.10 mm3(p=0.0175); the right hippocampal volumes were: 784±133.28 mm3 and 885.76±152.02 mm3(p=0.0234); the left amygdala results were: 405.47±50.45 mm3 and 468.45±62.53 mm3(p=0.1855); and the right amygdala results were: 418.28±75.35 mm3 and 475.47±70.54 mm3(p=0.0458). The results suggest CHD neonates tend to have lower volumes in the amygdala and hippocampal regions compared to controls, which can be explained by the disruption in hemodynamics in CHD. Further covariates such as gender need to be adjusted and scans at post-operative MRI need to be analyzed to track abnormal development.