Fetal Brain MRI as a Predictor of Late Neurodevelopmental Outcome in Congenital Heart Disease

胎儿脑 MRI 作为先天性心脏病晚期神经发育结果的预测因子

• 批准号: 10364835
• 负责人: Caitlin Rollins
• 金额: $ 46.45万
• 依托单位: BOSTON CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-01-01 至 2026-12-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10364835
• 关键词: 2 year old; 7 year old; Adolescence; Adult; Advanced Development; Affect; Anatomy; Area; Attention; Birth; Brain; Brain Hypoxia-Ischemia; Cardiac; Cell Compartmentation; Cells; Cerebrum; Child; Childhood; Congenital Abnormality; Data; Data Set; Development; Employment; Executive Dysfunction; Fetus; Foundations; Genetic; Genetic Status; Health; High Prevalence; Impairment; Intervention; Knowledge; Live Birth; Location; Magnetic Resonance Imaging; Measures; Medical; Mental Health; Modeling; Morbidity - disease rate; Nature; Neurobiology; Neurodevelopmental Disability; Neurodevelopmental Impairment; Neurons; Oligodendroglia; Operative Surgical Procedures; Outcome; Outcome Measure; Pathology; Pathway interactions; Patients; Perinatal; Population; Predictive Value; Process; Property; Quality of life; Recording of previous events; School-Age Population; Services; Severities; Socioeconomic Status; Special Education; Structural Congenital Anomalies; Structural defect; Structure; Surface; Survivors; System; Techniques; Therapeutic; Thick; Variant; brain abnormalities; brain magnetic resonance imaging; brain volume; clinical care; clinical development; clinical risk; cognitive function; cohort; congenital heart disorder; disability; executive function; experience; fetal; in utero; indexing; individual patient; innovation; myelination; neonate; nerve stem cell; neurodevelopment; neuroimaging; personalized medicine; postnatal; prenatal; primary outcome; processing speed; risk stratification; secondary outcome; skills; social cognition; therapy design; tool; white matter

PROJECT SUMMARY/ABSTRACT Congenital heart disease is the most common birth defect, affecting 0.5-2% of all live births. As medical and surgical advances have dramatically increased survival, the burgeoning population of children and adults with congenital heart disease has exposed a high prevalence of neurodevelopmental disabilities in survivors. By adolescence, more than 2 out of every 3 children with critical congenital heart disease experience deficits requiring developmental/special education services. As these children reach adulthood, their disabilities may limit educational opportunities, employment, and quality of life. Abnormal fetal brain development may contribute to neurodevelopmental disability in patients with congenital heart disease. Neonates with congenital heart disease have abnormal brain structure before surgery. Neurobiological processes that lay the foundation for long-term structural brain organization begin in utero. Components of fetal brain critical for this process, in particular neural progenitor cells, premyelinating oligodendrocytes, and subplate neurons, are sensitive to hypoxia-ischemia, rendering this system vulnerable to prenatal circulatory disturbances. The impact of abnormal fetal brain development on long-term brain structure and function in congenital heart disease is unknown. To date, there are no congenital heart disease cohorts that have been studied in both the fetal period and later in childhood when these deficits are typically detected. This proposal will leverage an existing fetal MRI cohort, including children both with and without congenital heart disease, to acquire long-term neuroimaging and neurodevelopmental data at 7 years of age, thereby determining the fetal contribution to long-term outcome. Specifically, the proposed study will investigate 1) the association between fetal brain structure and school-age structural brain connectivity; 2) the relationship between fetal brain structure and school-age neurodevelopmental functioning; and 3) the potential for a clinical risk stratification tool harnessing measures available in utero to predict school-age neurodevelopmental outcome. The overarching hypothesis is that abnormal fetal brain structure is associated with long-term differences in structural brain connectivity and neurodevelopmental functioning in congenital heart disease. This project will support the development of clinical risk stratification and advance the development of interventions designed to protect the brain in children with congenital heart disease.

项目摘要/摘要 先天性心脏病是最常见的先天缺陷，影响了所有活产的0.5-2％。作为医疗和 手术进展大大提高了生存，儿童和成人的迅速迅速 先天性心脏病已暴露于幸存者中神经发育障碍的高流行率。经过 青春期，每3个患有关键先天性心脏病的儿童中有2多个经历赤字 需要发展/特殊教育服务。当这些孩子成年时，他们的残疾可能 限制教育机会，就业和生活质量。 胎儿脑发育异常可能导致先天患者的神经发育障碍 心脏病。先天性心脏病的新生儿在手术前患有异常的大脑结构。 为长期结构脑组织奠定基础的神经生物学过程在子宫内始于子宫。 胎儿大脑的组成部分对此过程至关重要，特别是神经祖细胞，延髓 少突胶质细胞和子板神经元对缺氧 - 偶然敏感，使该系统容易受到伤害 产前循环障碍。异常胎儿脑发育对长期大脑结构的影响 和先天性心脏病的功能尚不清楚。迄今为止，没有先天性心脏病队列 通常在胎儿时期和童年后期研究了这些缺陷。 该建议将利用现有的胎儿MRI队列，包括有或没有先天性的儿童 心脏病，在7岁时获得长期神经影像学和神经发育数据 确定胎儿对长期结局的贡献。具体而言，拟议的研究将研究1） 胎儿大脑结构与学龄的结构大脑连通性之间的关联； 2）关系 胎儿大脑结构和学龄儿童神经发育功能之间； 3）临床的潜力 风险分层工具利用子宫内可用的措施来预测学龄的神经发育 结果。总体假设是胎儿脑结构异常与长期有关 先天性心脏病中结构性大脑连通性和神经发育功能的差异。 该项目将支持临床风险分层的发展，并推动 旨在保护先天性心脏病儿童的大脑的干预措施。