Structural brain abnormalities in adolescents and young adults with congenital heart defect: a systematic review. (20th July 2018)

• Record Type: Journal Article
• Authors: Bolduc, Marie‐Eve; Lambert, Heather; Ganeshamoorthy, Sylviya; Brossard‐Racine, Marie
• Is Part Of: Developmental medicine & child neurology. Volume 60:Number 12(2018)
• Page Start: 1209
• Page End: 1224
• Publication Date: 2018-07-20
• Subjects: Child development -- Periodicals; Pediatric neurology -- Periodicals; 616.8
• DOI: 10.1111/dmcn.13975
• Languages: English
• ISSNs: 0012-1622

Abstract

Abstract : Aim: The primary objective of this systematic review is to define and quantify brain structural abnormalities present in adolescents and young adults with complex congenital heart defect (CHD). We also aim to evaluate the extent to which these structural abnormalities are associated with functional outcomes. Method: A search of studies examining brain structure by magnetic resonance imaging in adolescents and young adults with complex CHD was performed in Embase, MEDLINE, and Web of Science. A meta‐analysis was conducted to determine the odds of brain abnormalities in young people with CHD. Results not included in the meta‐analysis were collated using descriptive statistics. Results: Two hundred and fifty‐four studies were identified through the literature search. Among these, 14 original studies were included in the review. The odds of brain abnormalities in young people with CHD were 7.9 times higher ( p <0.001) than in typically developing comparison individuals. Focal and multifocal lesions were the most common types of abnormality (odds ratio 41.7 [ p <0.001]). Preliminary evidence from volumetric, cortical, and microstructural integrity measurements suggests that brain abnormalities are associated with poorer neurocognitive outcomes. Interpretation: This review provides strong evidence that adolescents and young adults with CHD are at increased risk of presenting with structural brain abnormalities and highlights the contribution of advanced quantitative magnetic resonance imaging techniques to identify the subtle but frequent brain alterations in this population. However, more studies are needed to clarify how these abnormalities relate to function. What this paper adds: There is a high prevalence of brain abnormalities in young people with congenital heart defect (CHD). Brain volumes, cortical measurements, and white matter microstructure are altered in young people with CHD. Brain abnormalities are associated with poorer function in young people with CHD. What this paper adds: There is a high prevalence of brain abnormalities in young people with congenital heart defect (CHD). Brain volumes, cortical measurements, and white matter microstructure are altered in young people with CHD. Brain abnormalities are associated with poorer function in young people with CHD. This article's abstract has been translated into Spanish and Portuguese. Follow the links from theabstract to view the translations.