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J Pediatr. 2014 Nov;165(5):936-44.e1-2. doi: 10.1016/j.jpeds.2014.07.028. Epub 2014 Sep 10.

White matter microstructure and cognition in adolescents with congenital heart disease.

Author information

1
Department of Neurology, Boston Children's Hospital, Boston, MA; Department of Neurology, Harvard Medical School, Boston, MA.
2
Department of Neurology, Boston Children's Hospital, Boston, MA; Graduate Program for Neuroscience, Boston University, Boston, MA.
3
Department of Cardiology, Boston Children's Hospital, Boston, MA.
4
Department of Cardiology, Boston Children's Hospital, Boston, MA; Department of Pediatrics, Harvard Medical School, Boston, MA; Department of Biostatistics, Harvard School of Public Health, Boston, MA.
5
Department of Radiology, Boston Children's Hospital, Boston, MA.
6
Department of Cardiology, Boston Children's Hospital, Boston, MA; Department of Pediatrics, Harvard Medical School, Boston, MA; Department of Psychiatry, Harvard Medical School, Boston, MA; Department of Psychiatry, Boston Children's Hospital, Boston, MA.
7
Department of Radiology, Boston Children's Hospital, Boston, MA; Department of Radiology, Harvard Medical School, Boston, MA.
8
Department of Cardiology, Boston Children's Hospital, Boston, MA; Department of Pediatrics, Harvard Medical School, Boston, MA.
9
Department of Neurology, Boston Children's Hospital, Boston, MA; Department of Neurology, Harvard Medical School, Boston, MA; Department of Radiology, Boston Children's Hospital, Boston, MA; Department of Psychiatry, Boston Children's Hospital, Boston, MA. Electronic address: michael.rivkin@childrens.harvard.edu.

Abstract

OBJECTIVE:

To describe the relationship between altered white matter microstructure and neurodevelopment in children with dextro-transposition of the great arteries (d-TGA).

STUDY DESIGN:

We report correlations between regional white matter microstructure as measured by fractional anisotropy (FA) and cognitive outcome in a homogeneous group of adolescents with d-TGA. Subjects with d-TGA (n = 49) and controls (n = 29) underwent diffusion tensor imaging and neurocognitive testing. In the group with d-TGA, we correlated neurocognitive scores with FA in 14 composite regions of interest in which subjects with d-TGA had lower FA than controls.

RESULTS:

Among the patients with d-TGA, mathematics achievement correlated with left parietal FA (r = 0.39; P = .006), inattention/hyperactivity symptoms correlated with right precentral FA (r = -0.39; P = .006) and left parietal FA (r = -0.30; P = .04), executive function correlated with right precentral FA (r = -0.30; P = .04), and visual-spatial skills correlated with right frontal FA (r = 0.30; P = .04). We also found an unanticipated correlation between memory and right posterior limb of the internal capsule FA (r = 0.29; P = .047).

CONCLUSION:

Within the group with d-TGA, regions of reduced white matter microstructure are associated with cognitive performance in a pattern similar to that seen in healthy adolescents and adults. Diminished white matter microstructure may contribute to cognitive compromise in adolescents who underwent open-heart surgery in infancy.

PMID:
25217200
PMCID:
PMC4258111
DOI:
10.1016/j.jpeds.2014.07.028
[Indexed for MEDLINE]
Free PMC Article

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