Repair in High Risk Newborns with Congential Heart Disease

项目II-先天性心脏病高危新生儿的修复先天性心脏病(CHD)是最常见的出生缺陷，新生儿手术往往是生存所必需的。尽管这些手术很复杂，但大多数患有CHD的婴儿都存活了下来。尽管严重的神经残疾很少见，但学龄儿童CHD经常表现出行为、情感、认知和运动障碍。这些残疾的普遍性质表明大脑发育存在根本问题。利用先进的磁共振成像技术，我们发现，与正常婴儿相比，患有CHD的新生儿大脑发育延迟，手术前后获得新的脑损伤的风险很高。这项建议的总体目标是在结构脑网络结构水平上了解新生儿CHD手术后的神经发育障碍，并确定新生儿脑损伤后的修复能力。为了实现这一目标，这项研究将使用新技术来分析一整套大脑连接--即所谓的“连接体”。患有两种类型CHD的新生儿将在手术前后以及6个月大时再次进行研究。这两组人在将心脏功能和血氧水平恢复到接近正常水平所需的手术次数上存在差异。通过在三个时间点进行磁共振成像，我们将了解CHD的大脑网络发育是如何受到影响的，以及新生儿手术后脑损伤的修复和恢复是如何进行的。这些信息将有助于开发新的治疗方法，以优化脑发育和在任何情况下因低脑氧和/或低血流量而发生新生儿脑损伤的脑损伤恢复。

Project II - Repair in High Risk Newborns with Congenital Heart Disease Congenital heart disease (CHD) is the most common birth defect, and neonatal surgery is often necessary for survival. Despite the complexity of these surgeries, most infants with CHD survive. Although severe neurologic disability is rare, school age children with CHD frequently exhibit behavioral, emotional, cognitive and motor impairments. The pervasive nature of these disabilities suggests fundamental problems with brain development. Using advanced magnetic resonance imaging techniques, we have discovered that newborns with CHD have delayed brain development compared with normal babies and are at high risk of acquiring new brain injuries before and after surgery. The overall goal of this proposal is to understand neurodevelopmental impairment following neonatal CHD surgery at a structural brain network level and to determine the capacity for repair following neonatal brain injury. To achieve this goal, this study will use new techniques for analyzing the complete set of brain connections - the so-called 'connectome'. Newborns with two types of CHD will be studied before and after surgery and again at six months of age. The groups differ in the number of surgeries needed to restore heart function and blood oxygen levels to near normal levels. By performing MRIs at three time points, we will learn how development of brain networks are affected in CHD and how repair and recovery from brain injury proceeds following neonatal surgery. This information will be useful for developing new treatments to optimize brain development and recovery from brain injury in any condition where newborn brain injury occurs because of low brain oxygen and/or blood flow.