title: Altered Gray Matter in Adolescents with d-Transposition of the Great Arteries.
abstract: OBJECTIVE
  To investigate the structural brain characteristics of adolescent patients with d-transposition of the great arteries (d-TGA), repaired with the arterial switch operation in early infancy, using quantitative volumetric magnetic resonance imaging.
  
  
  METHODS
  Ninety-two patients with d-TGA from the Boston Circulatory Arrest Study (76% male; median age at scan 16.1 years) and 49 control subjects (41% male; median age at scan 15.7 years) were scanned using a 1.5-Tesla magnetic resonance imaging system. Subcortical and cortical gyral volumes and cortical gyral thicknesses were measured using surface-based morphometry. Group differences were assessed with linear regression.
  
  
  RESULTS
  Compared with controls, patients with d-TGA demonstrated significantly reduced subcortical volumes bilaterally in the striatum and pallidum. Cortical regions that showed significant volume and thickness differences between groups were distributed throughout parietal, medial frontoparietal, cingulate, and temporal gyri. Among adolescents with d-TGA, volumes and thicknesses correlated with several perioperative variables, including age at surgery, cooling duration, total support time, and days in the cardiac intensive care unit.
  
  
  CONCLUSIONS
  Adolescents with d-TGA repaired early in life exhibit widespread differences from control adolescents in gray matter volumes and thicknesses, particularly in parietal, midline, and subcortical brain regions, corresponding to white matter regions already known to demonstrate altered microstructure. These findings complement observations made in white matter in this group and suggest that the adolescent d-TGA cognitive profile derives from altered brain development involving both white and gray matter.
authors.affiliation: Graduate Program for Neuroscience, Boston University, Boston, MA; Department of Neurology, Boston Children's Hospital, Boston, MA.
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Watson
authors.affiliation: Department of Cardiology, Boston Children's Hospital, Boston, MA.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Asaro
authors.affiliation: Department of Cardiology, Boston Children's Hospital, Boston, MA; Department of Pediatrics, Harvard Medical School, Boston, MA; Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA.
authors.forename: David
authors.initials: D
authors.lastname: Wypij
authors.affiliation: Department of Radiology, Boston Children's Hospital, Boston, MA; Department of Radiology, Harvard Medical School, Boston, MA.
authors.forename: Richard L
authors.initials: RL
authors.lastname: Robertson
authors.affiliation: Department of Cardiology, Boston Children's Hospital, Boston, MA; Department of Pediatrics, Harvard Medical School, Boston, MA.
authors.forename: Jane W
authors.initials: JW
authors.lastname: Newburger
authors.affiliation: Department of Neurology, Boston Children's Hospital, Boston, MA; Department of Radiology, Boston Children's Hospital, Boston, MA; Department of Psychiatry, Boston Children's Hospital, Boston, MA; Department of Neurology, Harvard Medical School, Boston, MA. Electronic address: michael.rivkin@childrens.harvard.edu.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Rivkin
mesh_terms: D000293:Adolescent; D005260:Female; D066128:Gray Matter / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D014188:Transposition of Great Vessels / Q000150:complications*; D055815:Young Adult