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Relationship of white matter network topology and cognitive outcome in adolescents with d-transposition of the great arteries.

Abstract：

:Patients with congenital heart disease (CHD) are at risk for neurocognitive impairments. Little is known about the impact of CHD on the organization of large-scale brain networks. We applied graph analysis techniques to diffusion tensor imaging (DTI) data obtained from 49 adolescents with dextro-transposition of the great arteries (d-TGA) repaired with the arterial switch operation in early infancy and 29 healthy referent adolescents. We examined whether differences in neurocognitive functioning were related to white matter network topology. We developed mediation models revealing the respective contributions of peri-operative variables and network topology on cognitive outcome. Adolescents with d-TGA had reduced global efficiency at a trend level (p = 0.061), increased modularity (p = 0.012), and increased small-worldness (p = 0.026) as compared to controls. Moreover, these network properties mediated neurocognitive differences between the d-TGA and referent adolescents across every domain assessed. Finally, structural network topology mediated the neuroprotective effect of longer duration of core cooling during reparative neonatal cardiac surgery, as well as the detrimental effects of prolonged hospitalization. Taken together, worse neurocognitive function in adolescents with d-TGA is mediated by global differences in white matter network topology, suggesting that disruption of this configuration of large-scale networks drives neurocognitive dysfunction. These data provide new insights into the interplay between perioperative factors, brain organization, and cognition in patients with complex CHD.

journal_name

Neuroimage Clin

journal_title

NeuroImage. Clinical

authors

Panigrahy A,Schmithorst VJ,Wisnowski JL,Watson CG,Bellinger DC,Newburger JW,Rivkin MJ

doi

10.1016/j.nicl.2015.01.013

subject

Has Abstract

pub_date

2015-01-27 00:00:00

pages

438-48

issn

2213-1582

pii

S2213-1582(15)00014-5

journal_volume

7

pub_type

杂志文章,随机对照试验

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