Grant: Travel Awards - Institute Community Support

Brain injury is a major neonatal complication of congenital heart disease (CHD), occurring in up to 59% of infants prior to corrective heart surgery and associated with abnormalities in prenatal and neonatal brain growth and maturation. Despite receiving corrective cardiac surgery during infancy, approximately 30% of adolescents born with CHD present with brain abnormalities on conventional magnetic resonance imaging (MRI), accompanied by persistent neuropsychological difficulties. In addition to acquired brain injury, infants born with CHD present with patterns of cerebral dysmaturation, wherein myelin development is primarily affected, that has been previously described in preterm infants. This suggests that myelination impairments may underlie some of the neurodevelopmental difficulties observed across the lifespan in patients with CHD. However, these myelination impairments may be too subtle to detect with conventional MRI. Therefore, this study will use advanced quantitative MRI techniques to investigate the potential role of myelination deficiencies in the impaired long-term neurodevelopment of adolescents and young adults born with CHD. To accomplish this, we will identify and extract white matter bundles using high angular resolution diffusion imaging (HARDI) and quantify average myelination in each of these tracts using multicomponent driven equilibrium single pulse observation of T1 and T2 (mcDESPOT). It is expected that lower myelination will be observed in various white matter tracts in youth born with CHD as compared to healthy age- and sex-matched controls. This study will provide valuable insight into the potential role of altered myelination as an underlying cellular process in the brain damage and subsequent neuropsychological deficits observed in youth born with CHD, thereby elucidating potential therapeutic approaches to ameliorate the progression of these deficits.