Repair in High Risk Newborns with Congential Heart Disease

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，但大多数患有冠心病的婴儿都能活下来。虽然严重的神经功能障碍是罕见的，学龄儿童冠心病经常表现出行为，情感，认知和运动障碍。这些残疾的普遍性表明了大脑发育的根本问题。利用先进的磁共振成像技术，我们发现与正常婴儿相比，患有冠心病的新生儿大脑发育迟缓，并且在手术前后获得新的脑损伤的风险很高。本研究的总体目标是在脑结构网络水平上了解新生儿冠心病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大脑连接的完整集合，即所谓的“连接组”。患有两种类型冠心病的新生儿将在手术前后进行研究，并在六个月大时再次进行研究。两组患者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有所不同。通过在三个时间点进行核磁共振成像，我们将了解冠心病脑网络的发育如何受到影响，以及新生儿手术后脑损伤的修复和恢复如何进行。这一信息将有助于开发新的治疗方法，以优化大脑发育和脑损伤后的恢复，在任何情况下，新生儿脑损伤是由于低脑氧和/或血流量造成的。

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.