Altered brain diffusion tensor imaging indices in adolescents with the Fontan palliation.

Purpose: Single ventricle heart disease (SVHD) patients show injury in brain sites that regulate autonomic, mood, and cognitive functions. However, the nature (acute or chronic changes) and extent of brain injury in SVHD are unclear. Our aim was to examine regional brain tissue damage in SVHD over c...

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Publicado en:Neuroradiology Vol. 61; no. 7; pp. 811 - 825
Autores principales: Singh, Sadhana, Roy, Bhaswati, Pike, Nancy, Daniel, Ebenezer, Ehlert, Luke, Lewis, Alan B., Halnon, Nancy, Woo, Mary A., Kumar, Rajesh
Formato: diagnostic images research tables/charts Journal Article
Publicado: Springer Nature Jul2019
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jul2019
      vid: 61
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00234-019-02208-x
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        atl: Altered brain diffusion tensor imaging indices in adolescents with the Fontan palliation.
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        au:
          Singh, Sadhana
          Roy, Bhaswati
          Pike, Nancy
          Daniel, Ebenezer
          Ehlert, Luke
          Lewis, Alan B.
          Halnon, Nancy
          Woo, Mary A.
          Kumar, Rajesh
        affil: Department of Anesthesiology, David Geffen School of Medicine at UCLA, University of California at Los Angeles, 56-141 CHS, 10833 Le Conte Aves, 90095-1763, Los Angeles, CA, USA
      sug:
        subj:
          Heart Ventricle Surgery
          Heart Defects, Congenital Surgery
          Magnetic Resonance Imaging Methods
          Brain Injuries In Adolescence
          Human
          Neuroradiography
          Adolescence
          Affect
          Cognition
          Analysis of Covariance
          Telencephalon
          Neural Pathways
          Temporal Lobe
          Frontal Lobe
          Hypothalamus
          Thalamus
          Cerebellum
          Amygdala
          Adolescent: 13-18 years
      ab: Purpose: Single ventricle heart disease (SVHD) patients show injury in brain sites that regulate autonomic, mood, and cognitive functions. However, the nature (acute or chronic changes) and extent of brain injury in SVHD are unclear. Our aim was to examine regional brain tissue damage in SVHD over controls using DTI-based mean diffusivity (MD), axial diffusivity (AD), radial diffusivity (RD), and fractional anisotropy (FA) procedures. Methods: We collected two DTI series (3.0-T MRI), mood and cognitive data, from 27 SVHD and 35 control adolescents. Whole-brain MD, AD, RD, and FA maps were calculated from each series, realigned and averaged, normalized to a common space, smoothed, and compared between groups using ANCOVA (covariates, age and sex; false discovery rate, p < 0.05). Region-of-interest analyses were performed to calculate MD, AD, RD, and FA values for magnitude assessment between groups. Results: SVHD patients showed impaired mood and cognitive functions over healthy adolescents. Multiple brain sites in SVHD showed increased MD values, including the insula, caudate, cingulate, hypothalamus, thalamus, medial prefrontal and frontal cortices, parahippocampal gyrus, hippocampus, precentral gyrus, amygdala, cerebellum, corpus callosum, basal forebrain, mammillary bodies, internal capsule, midbrain, fornix, and occipital, parietal, and temporal cortices, indicating chronic tissue changes. Similar areas showed either increased AD or RD values, with RD changes more enhanced over AD in SVHD compared to controls. Few brain regions emerged with increased or decreased FA values in SVHD patients over controls. Conclusion: SVHD adolescents, more than a decade from their last surgical procedure, show widespread brain abnormalities in autonomic, mood, and cognitive regulatory areas. These findings indicate that brain injury is in a chronic stage in SVHD with predominantly myelin changes that may result from previous hypoxia/ischemia- or developmental-induced processes.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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