Peer-reviewed article
Neonatal Brain Network Integration Trajectories Predict Neurodevelopment in Congenital Heart Disease
Harasymiw L, Kuang A, Xu D, Scheffler A, George E et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This is a medical research study examining brain network development in infants with congenital heart disease and its association with later neurodevelopmental outcomes. The study uses longitudinal brain imaging and developmental assessments to identify patterns that predict cognitive, language, and motor development. While the research involves children, it is a clinical biomarker study focused on understanding disease mechanisms rather than evaluating an intervention to improve child well-being.
Key points
- Greater perioperative increases in whole-brain network integration were associated with higher cognitive, language, and motor scores in early childhood
- White matter injury was associated with slower growth in network integration
- Cardiac physiology subtype was not associated with network development trajectory
- Each 1-standard deviation increase in global efficiency trajectory was associated with 8.2-point increase in cognitive scores
- Longitudinal measures of brain network development may serve as a biomarker of neurodevelopmental risk
Limitations
This is a descriptive study of disease associations in a specific patient population with congenital heart disease; it does not evaluate any intervention or provide information about effectiveness of treatments to improve child well-being more broadly. The findings are specific to infants with critical CHD and may not generalize to other populations.
Abstract
Impact statement In infants with critical congenital heart disease, perioperative growth in whole-brain network integration was associated with cognitive, language, and motor outcomes in early childhood. White matter injury was associated with slower growth in network integration, whereas cardiac physiology subtype was not associated with network development. This study extends prior work by showing that a longitudinal measure of neonatal whole-brain network development, rather than a single imaging timepoint, predicts neurodevelopment across multiple domains. These findings identify early network development as a potential biomarker of neurodevelopmental risk and resilience, and support future risk-stratification and intervention studies in this population. Background Infants with critical congenital heart disease (CHD) are at high risk for abnormal brain development and later neurodevelopmental impairment. We hypothesized that the trajectory of perioperative whole-brain network development would predict neurodevelopmental outcomes in early childhood. Methods This prospective longitudinal cohort of neonates with critical CHD (n = 97) underwent preoperative and/or postoperative brain MRI with diffusion imaging. Whole-brain network measures were derived from structural connectomes. Neurodevelopment was assessed between 1 and 4 years using the Bayley Scales of Infant and Toddler Development. Results White matter injury was associated with slower perioperative growth in global efficiency ( p = 0.013), a measure of network integration, whereas cardiac physiology was not associated with network development. Infants with greater perioperative increases in global efficiency had higher cognitive ( p = 0.001), language ( p < 0.001), and motor ( p = 0.008) scores. For each 1–standard deviation increase in the trajectory of global efficiency, cognitive scores increased by 8.2 points (95% CI, 3.64–12.78), independent of brain injury and socioeconomic factors. Conclusion In infants with critical CHD, longitudinal whole-brain network development was associated with neurodevelopment across multiple domains. Early network development may represent a candidate biomarker of neurodevelopmental risk and resilience in this population.