title: Impaired neuroanatomic development in infants with congenital heart disease.
abstract: OBJECTIVE
  We performed a regional volumetric study of the brain using 3-dimensional magnetic resonance imaging in infants with congenital heart disease to search for variables in anatomic development of the brain that may be associated with functional impairment.
  
  
  METHODS
  Forty infants with congenital heart disease-17 infants with single ventricle physiology, 5 with transposition of great arteries, and 18 with ventricular septal defect-were studied prospectively by 3-dimensional magnetic resonance imaging of the brain several months after heart surgery.
  
  
  RESULTS
  The global volume of gray matter was significantly reduced in the patients with congenital heart disease compared with normal controls (P < .001), whereas no significant difference in the volume of white matter was observed. Further, the decrease in gray matter volume was more apparent in the frontal lobe than in the temporal lobe, especially in infants with single ventricle physiology or transposition of the great arteries. Multivariate analysis revealed that preoperative hypoxia is strongly associated with decreased frontal gray matter volume (P < .01), as well as a diagnosis of hypoplastic left heart syndrome (P < .05). Of note, frontal gray matter volume, which includes the motor area, correlated weakly with psychomotor developmental index scores (P < .01).
  
  
  CONCLUSIONS
  Brain developmental impairment occurs in many infants with congenital heart disease, especially in those who have preoperative hypoxia and critical congenital heart disease. This quantitative volumetric study encourages larger scale and longitudinal follow-up to elucidate the significance of impaired neuroanatomic development on functional outcome.
authors.affiliation: Department of Pediatrics, University of Toyama, Toyama, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Watanabe
authors.forename: Mie
authors.initials: M
authors.lastname: Matsui
authors.forename: Junko
authors.initials: J
authors.lastname: Matsuzawa
authors.forename: Chiaki
authors.initials: C
authors.lastname: Tanaka
authors.forename: Kyo
authors.initials: K
authors.lastname: Noguchi
authors.forename: Naoki
authors.initials: N
authors.lastname: Yoshimura
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Hongo
authors.forename: Mayumi
authors.initials: M
authors.lastname: Ishiguro
authors.forename: Sayaka
authors.initials: S
authors.lastname: Wanatabe
authors.forename: Keiich
authors.initials: K
authors.lastname: Hirono
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Uese
authors.forename: Fukiko
authors.initials: F
authors.lastname: Ichida
authors.forename: Hideki
authors.initials: H
authors.lastname: Origasa
authors.forename: Jun
authors.initials: J
authors.lastname: Nakazawa
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Oshima
authors.forename: Toshio
authors.initials: T
authors.lastname: Miyawaki
authors.forename: Tachiyo
authors.initials: T
authors.lastname: Matsuzaki
authors.forename: Toshikatsu
authors.initials: T
authors.lastname: Yagihara
authors.forename: Warren
authors.initials: W
authors.lastname: Bilker
authors.forename: Ruben C
authors.initials: RC
authors.lastname: Gur
mesh_terms: D001921:Brain / Q000254:growth & development*; D002658:Developmental Disabilities / Q000209:etiology*; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications* / Q000503:physiopathology*; D006801:Humans; D021621:Imaging, Three-Dimensional; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D009929:Organ Size; D011446:Prospective Studies