Relationships Between Regional Cerebral Blood Flow and Neurocognitive Outcomes in Children and Adolescents With Congenital Heart Disease.
Relationships Between Regional Cerebral Blood Flow and Neurocognitive Outcomes in Children and Adolescents With Congenital Heart Disease.
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DOI：
10.1053/j.semtcvs.2021.10.014
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发表时间：
2022
影响因子：
2.5
通讯作者：
中科院分区：
文献类型：
--
作者：
使用无偏倚的数据驱动方法，确定先天性心脏病(CHD)儿童和青少年的局部脑血流量(RCBF)变化与神经认知结果的关系。这是一项使用伪连续动脉自旋标记(PCASL)MRI对无脑损伤的CHD儿童和青少年和健康对照进行的前瞻性、观察性研究。使用体素数据驱动的方法比较了冠心病参与者和健康对照组之间的定量rCBF。然后在体素基础上进行中介分析，以分组变量为自变量，以神经认知结果(来自NIH工具箱认知成套测验)为因变量，以rCBF为中介变量。运动矫正后，共有80项研究可分析(27项为冠心病患者，53项为对照)。我们发现，与正常对照组相比，CHD患者脑岛/腹内侧额前区(突起网络)、背侧前扣带回和楔前/后扣带回(默认模式网络)以及顶后/背外侧前额叶(中央执行网络)rCBF的下降幅度更大(经校正p<；0.05)。默认模式/显著网络中rCBF的减少被发现与对照组相比，在NIH工具箱认知电池的结晶认知指数上，冠心病患者的表现较差。相反，与对照组相比，中央执行网络/显著网络中rCBF的减少介导了CHD患者流体认知缺陷的减少。局部脑血流改变调节CHD儿童和青少年与健康对照组相比认知表现的领域特异性差异，独立于损伤，并可能与脑和认知储备机制有关。需要进一步的研究来评估冠心病干预措施的潜力，这些干预针对的是整个生命周期的局部脑血流。中心图片图例数据驱动的体素CBF比较CHD与对照组与NIH工具箱评分的中介中心消息区域脑血流改变与对照组相比调节CHD儿童和青少年的认知表现，并可能与大脑和认知储备机制有关。
To identify regional cerebral blood flow (rCBF) alterations in children and adolescents with congenital heart disease (CHD) in relation to neurocognitive outcomes using a non-biased data-driven approach. This is a prospective, observational study of children and adolescents with CHD without brain injury and healthy controls using pseudo-continuous arterial spin labeling (pCASL) MRI. Quantitative rCBF was compared between participants with CHD and healthy controls using a voxel-wise data-driven method. Mediation analysis was then performed on a voxelwise basis, with the grouping variable as the independent variable, neurocognitive outcomes (from the NIH Toolbox Cognitive Battery) as the dependent variables, and rCBF as the mediator. After motion correction, a total of 80 studies were analyzable (27 for patients with CHD, 53 for controls). We found steeper age-related decline in rCBF among those with CHD compared to normal controls in the insula/ventromedial prefrontal regions (salience network) and the dorsal anterior cingulate and precuneus/posterior cingulate (default mode network), and posterior parietal/dorsolateral prefrontal (central executive network) (FWE-corrected p < 0.05). The reduced rCBF in the default mode/salience network was found to mediate poorer performance on an index of crystallized cognition from the NIH Toolbox Cognitive Battery in those with CHD compared to controls. In contrast, reduced rCBF in the central executive network/salience network mediated reduced deficits in fluid cognition among patients with CHD compared to controls. Regional cerebral blood flow alterations mediate domain-specific differences in cognitive performance in children and adolescents with CHD compared to healthy controls, independent of injury, and are likely related to brain and cognitive reserve mechanisms. Further research is needed to evaluate the potential of interventions in CHD targeting regional cerebral blood flow across lifespan. CENTRAL PICTURE LEGEND Data-driven voxelwise CBF comparison of CHD vs controls vs mediation of NIH Toolbox scores CENTRAL MESSAGE Regional cerebral blood flow alterations mediate cognitive performance in children and adolescents with CHD compared to controls and are likely related to brain and cognitive reserve mechanisms.
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DOI：
10.1017/s1355617714001027
发表时间：
2015-01
期刊：
Journal of the International Neuropsychological Society : JINS
影响因子：
--
作者：
Cassidy AR;White MT;DeMaso DR;Newburger JW;Bellinger DC
通讯作者：
Bellinger DC
影响因子：
3.2
作者：
Kuebler, Andrea;Dixon, Veronica;Garavan, Hugh
通讯作者：
Garavan, Hugh
影响因子：
3.1
作者：
Menon, Vinod;Uddin, Lucina Q.
通讯作者：
Uddin, Lucina Q.
影响因子：
37.8
作者：
Limperopoulos C;Tworetzky W;McElhinney DB;Newburger JW;Brown DW;Robertson RL Jr;Guizard N;McGrath E;Geva J;Annese D;Dunbar-Masterson C;Trainor B;Laussen PC;du Plessis AJ
通讯作者：
du Plessis AJ
影响因子：
5.7
作者：
Juttukonda MR;Donahue MJ
通讯作者：
Donahue MJ