title: Abnormal cerebral microstructure in premature neonates with congenital heart disease.
abstract: OBJECTIVE
  Abnormal cerebral microstructure has been documented in term neonates with congenital heart disease, portending risk for injury and poor neurodevelopmental outcome. Our hypothesis was that preterm neonates with congenital heart disease would demonstrate diffuse cerebral microstructural abnormalities when compared with critically ill neonates without congenital heart disease. A secondary aim was to identify any association between microstructural abnormalities, white matter injury (eg, punctate white matter lesions), and other clinical variables, including heart lesions.
  
  
  METHODS
  With the use of tract-based spatial statistics, an unbiased, voxelwise method for analyzing diffusion tensor imaging data, we compared 21 preterm neonates with congenital heart disease with 2 cohorts of neonates without congenital heart disease: 28 term and 27 preterm neonates, identified from the same neonatal intensive care unit.
  
  
  RESULTS
  Compared with term neonates without congenital heart disease, preterm neonates with congenital heart disease had microstructural abnormalities in widespread regions of the central white matter. However, 42% of the preterm neonates with congenital heart disease had punctate white matter lesions. When neonates with punctate white matter lesions were excluded, microstructural abnormalities remained only in the splenium. Preterm neonates with congenital heart disease had similar microstructure to preterm neonates without congenital heart disease.
  
  
  CONCLUSIONS
  Diffuse microstructural abnormalities were observed in preterm neonates with congenital heart disease, strongly associated with punctate white matter lesions. Independently, regional vulnerability of the splenium, a structure associated with visual spatial function, was observed in all preterm neonates with congenital heart disease.
authors.affiliation: Division of Neonatology.
authors.forename: L B
authors.initials: LB
authors.lastname: Paquette
authors.forename: J L
authors.initials: JL
authors.lastname: Wisnowski
authors.forename: R
authors.initials: R
authors.lastname: Ceschin
authors.forename: J D
authors.initials: JD
authors.lastname: Pruetz
authors.forename: J A
authors.initials: JA
authors.lastname: Detterich
authors.forename: S
authors.initials: S
authors.lastname: Del Castillo
authors.forename: A C
authors.initials: AC
authors.lastname: Nagasunder
authors.forename: R
authors.initials: R
authors.lastname: Kim
authors.forename: M J
authors.initials: MJ
authors.lastname: Painter
authors.forename: F H
authors.initials: FH
authors.lastname: Gilles
authors.forename: M D
authors.initials: MD
authors.lastname: Nelson
authors.forename: R G
authors.initials: RG
authors.lastname: Williams
authors.forename: S
authors.initials: S
authors.lastname: Blüml
authors.forename: A
authors.initials: A
authors.lastname: Panigrahy
mesh_terms: D001921:Brain / Q000002:abnormalities*; D001927:Brain Diseases / Q000401:mortality* / Q000473:pathology*; D015331:Cohort Studies; D003337:Corpus Callosum / Q000473:pathology; D016638:Critical Illness / Q000401:mortality; D056324:Diffusion Tensor Imaging; D006330:Heart Defects, Congenital / Q000401:mortality*; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000401:mortality / Q000473:pathology; D015931:Intensive Care, Neonatal; D056784:Leukoencephalopathies / Q000401:mortality / Q000473:pathology; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D009413:Nerve Fibers, Myelinated / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate