Neuroimaging and Neurodevelopmental Outcomes Among Individuals With Complex Congenital Heart Disease: JACC State-of-the-Art Review

Katelyn Phillips; Bridget Callaghan; Vidya Rajagopalan; Farah Akram; Jane W Newburger; Nadine A Kasparian

doi:10.1016/j.jacc.2023.09.824

Neuroimaging and Neurodevelopmental Outcomes Among Individuals With Complex Congenital Heart Disease: JACC State-of-the-Art Review

J Am Coll Cardiol. 2023 Dec 5;82(23):2225-2245. doi: 10.1016/j.jacc.2023.09.824.

Authors

Katelyn Phillips¹, Bridget Callaghan², Vidya Rajagopalan³, Farah Akram¹, Jane W Newburger⁴, Nadine A Kasparian⁵

Affiliations

¹ Discipline of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia.
² Department of Psychology, University of California Los Angeles, Los Angeles, California, USA.
³ Department of Radiology, Children's Hospital Los Angeles and Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
⁴ Department of Cardiology, Boston Children's Hospital and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.
⁵ Heart and Mind Wellbeing Center, Heart Institute and the Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA. Electronic address: nadine.kasparian@cchmc.org.

Abstract

Although neuroimaging advances have deepened our understanding of brain health in individuals with congenital heart disease (CHD), it is less clear how neuroimaging findings relate to neurodevelopmental and mental health outcomes across the lifespan. We systematically synthesized and critically evaluated evidence on associations between neuroimaging and neurodevelopmental, neurocognitive, psychiatric, or behavioral outcomes among individuals with transposition of great arteries or single-ventricle CHD (Protocol CRD42021229617). Six databases were searched and 45 papers from 25 unique studies were identified. Structural brain injury was generally linked to poorer neurodevelopment in infancy. Brain volumes and microstructural and functional brain changes appear linked to neurocognitive outcomes, including deficits in attention, learning, memory, and executive function in children and adolescents. Fetal neuroimaging studies were limited. Four papers investigated psychiatric outcomes; none found associations with neuroimaging. Multicenter, longitudinal studies incorporating functional neuroimaging and mental health outcomes are much-needed to inform early neuroprotective and therapeutic strategies in CHD.

Keywords: behavior; brain development; brain health; magnetic resonance imaging; mental health.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Brain / diagnostic imaging
Brain Injuries*
Child
Executive Function
Heart Defects, Congenital* / complications
Heart Defects, Congenital* / diagnostic imaging
Humans
Multicenter Studies as Topic
Neuroimaging

Grants and funding

K01 HL153942/HL/NHLBI NIH HHS/United States