title: Adolescents with tetralogy of Fallot: neuropsychological assessment and structural brain imaging.
abstract: BACKGROUND
  Few data are available on the neuropsychological, behavioural, or structural brain imaging outcomes in adolescents who underwent corrective surgery in infancy for tetralogy of Fallot.
  
  
  METHODS
  In this single-centre cross-sectional study, we enrolled 91 adolescents (13-16 years old) with tetralogy of Fallot and 87 referent subjects. Assessments included tests of academic achievement, memory, executive functions, visual-spatial skills, attention, and social cognition, as well as brain magnetic resonance imaging.
  
  
  RESULTS
  Genetic abnormalities or syndromes were present in 25% of tetralogy of Fallot patients, who had markedly greater neuropsychological morbidities than did patients without a syndrome. However, even patients without a syndrome performed significantly worse than the referent group or population norms in all of the neuropsychological domains assessed. In multivariable regression in those without a genetic/phenotypic syndrome, the strongest predictors of adverse late neurodevelopmental outcomes included a greater number of complications at the first operation, more total surgical complications across all operations, and occurrence of post-operative seizures. The presence of at least one abnormality on structural magnetic resonance imaging was more frequent in tetralogy of Fallot patients than the referent group (42% versus 8%).
  
  
  CONCLUSIONS
  Adolescents with tetralogy of Fallot are at increased neurodevelopmental risk and would benefit from ongoing surveillance and educational supports even after childhood.
authors: 1Department of Neurology,Boston Children's Hospital,Harvard Medical School,Boston,MA,United States of America.
authors: David C
authors: DC
authors: Bellinger
authors: 1Department of Neurology,Boston Children's Hospital,Harvard Medical School,Boston,MA,United States of America.
authors: Michael J
authors: MJ
authors: Rivkin
authors: 2Department of Psychiatry,Boston Children's Hospital,Harvard Medical School,Boston,MA,USA.
authors: David
authors: D
authors: DeMaso
authors: 3Department of Radiology,Boston Children's Hospital,Boston,MA,USA.
authors: Richard L
authors: RL
authors: Robertson
authors: 4Department of Cardiology,Boston Children's Hospital,Boston,MA,USA.
authors: Christian
authors: C
authors: Stopp
authors: 4Department of Cardiology,Boston Children's Hospital,Boston,MA,USA.
authors: Carolyn
authors: C
authors: Dunbar-Masterson
authors: 4Department of Cardiology,Boston Children's Hospital,Boston,MA,USA.
authors: David
authors: D
authors: Wypij
authors: 4Department of Cardiology,Boston Children's Hospital,Boston,MA,USA.
authors: Jane W
authors: JW
authors: Newburger
mesh_terms: D000124:Achievement; D000293:Adolescent; D001288:Attention; D001921:Brain / Q000473:pathology*; D003072:Cognition Disorders / Q000150:complications / Q000523:psychology*; D056344:Executive Function; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008568:Memory; D009483:Neuropsychological Tests; D012044:Regression Analysis; D012938:Social Perception; D066107:Social Skills; D013028:Space Perception; D017741:Survivors / Q000523:psychology*; D013771:Tetralogy of Fallot / Q000150:complications / Q000523:psychology* / Q000601:surgery
keywords: magnetic resonance imaging