Grant: Operating Grant

Heart birth defects are of the most common birth defects diagnosed in Canada, affecting 1 in 100 newborns each year. Impairments in motor and cognitive development are common in children born with heart birth defects and pose significant burdens on the child, family and society. These impairments are frequently attributed to brain injury secondary to the heart birth defect and may be acquired either before birth or in the weeks after birth. As yet, however, the reasons for brain injury in this population of newborns are poorly understood, limiting the development of effective therapies to prevent brain injury and to counsel parents regarding long term prognosis. Consequently, it is a high priority to improve our understanding of brain injury in newborns with heart birth defects. Our preliminary data suggest that brain development is impaired in newborns with heart birth defects. The overall hypothesis of this study is that delayed brain development results in abnormal motor and cognitive outcomes. We will quantify brain development and brain injury in term newborns with heart birth defects using advanced magnetic resonance (MR) techniques before birth (in utero), shortly after birth before heart surgery and again after heart surgery: MR imaging for brain injury, diffusion tensor imaging for brain connectivity and MR spectroscopic imaging for brain metabolism. We will then follow this group of newborns with heart birth defects through childhood to observe their motor and cognitive outcomes. A better understanding of brain injury that occurs in newborns with heart disease, and the ability to identify and quantify brain injury at a time when intervention is possible, is sorely needed to design and test new strategies for preventing or treating brain injury. The development of accurate measures of brain injury in newborns will also help parents and physicians better care for newborns with heart disease by providing important prognostic information.