Infant Heart Surgery Mends Brain Networks Too

Infants born with congenital heart disease (CHD) often have neurodevelopmental impairments that affect them later in life, including their ability to regulate their emotions and movements. As CHD is the most prevalent congenital disorder in the United States, researchers are eager to find new ways to treat it.¹

To better understand how CHD affects an infant’s developing nervous system, researchers at Children’s National Hospital used resting-state functional magnetic resonance imaging (rs-fMRI) to evaluate how healthy infants and those with CHD differed. They recently reported in the Journal of Neuroscience that babies with CHD had altered brain activity in their sensorimotor and limbic networks, but after neonatal heart surgery, these brain networks looked more like those of healthy children.²

“Using fMRI, we can identify brain networks that are vulnerable to altered oxygen and blood flow from congenital heart disease, which could help guide interventions to improve care for children,” said Jung-Hoon Kim, a brain researcher at Children’s National Hospital and a coauthor of the study, in a press release.

In their study, the researchers analyzed rs-fMRI data from 448 neonates. They first analyzed publicly available data from the Developing Human Connectome Project, which contains a large amount infant brain development MRI data.³ They identified 15 different resting state networks, which represented different regions of brain activity, in the healthy neonate brains.

Kim and his team then compared this baseline with rs-fMRI data from a separate cohort of both healthy neonates and those with CHD at Children’s National Hospital. In CHD patients, the researchers observed significant differences in two of the 15 resting state networks: the sensorimotor region, which is important for movement and sensory perception, and the limbic region, which is involved in emotional processing. In these two regions, CHD infants’ brain activity split into subnetworks in the left and right hemispheres; healthy infants did not show this split.

However, when the researchers analyzed rs-fMRI data of CHD infants before and after heart surgery, they discovered that the brain activity in these two networks changed to look more like those of healthy infants, suggesting that restoring blood flow and oxygen delivery to the brain helped these networks reorganize.

“Can we identify subsets of infants who show lack of restoration after surgery? This could help with developing targeted and tailored interventions early on,” said study coauthor and maternal-infant health researcher at Children’s National Hospital, Catherine Limperopoulos, in the statement. “From a medical perspective, these data also suggest that cardiac surgery improves brain health! Leveraging brain-based biomarkers to identify the optimal timing for performing surgery could improve outcomes.”