Oxygen-carrying Capacity Impacts Gross Motor in Congenital Heart Disease by Altering Brain Structure
Poster No:
418
Submission Type:
Abstract Submission
Authors:
Pengcheng Xue1, Meijiao Zhu2, Siyu Ma2, Yuting Liu2, Peng Liu2, Bin Jing3, Daoqiang Zhang1, Ming Yang4, Xuming Mo2, Xuyun Wen1
Institutions:
1Nanjing University of Aeronautics and Astronautics, Nanjing, Jiangsu, 2Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, 3Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Beijing, Beijing, 4Children's Hospital of Nanjing Medical University, Nanjing, China
First Author:
Co-Author(s):
Bin Jing
Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application
Beijing, Beijing
Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application
Beijing, Beijing
Introduction:
Congenital Heart Disease (CHD), as the most prevalent congenital anomaly, profoundly affects numerous newborns [1]. While advanced medical interventions have substantially enhanced the survival rates of infants with CHD, a significant proportion of these patients, especially those with complex conditions, experience persistent neurodevelopmental disorders [2]. These disorders detrimentally affect both their physical and mental health. Recent research efforts have thus been focused on elucidating the neurological underpinnings of these disorders, aiming to improve early intervention and treatment strategies. Prior studies in the realm of CHD neurodevelopment have identified a correlation between cortical structural anomalies and adverse neurodevelopmental outcomes [3]. Additionally, many studies has underscored the critical role of abnormal oxygen supply in contributing to brain injuries in CHD patients [4][5]. Nevertheless, the association between oxygen supply capacity and neurodevelopmental levels remains inadequately investigated. This study, therefore, seeks to integrate multimodal data, including clinical biology, neuroimaging, and neurodevelopmental evaluations, to investigate the relationship between blood oxygen-carrying capacity and gross motor skills in CHD infants.
Methods:
In this study, 83 infants with complex CHD and 86 age-matched healthy controls (HCs), aged 1 to 2 years, were enrolled from the Children's Hospital of Nanjing Medical University. We assessed the HB and HCT scores as surrogate markers of blood oxygen-carrying capacity for each participant. Additionally, T1-weighted imaging data were acquired to evaluate cortical developmental levels, and the Gesell Scale was utilized for gross motor performance assessment. Initially, a linear regression model was applied to ascertain the direct correlation between blood oxygen-carrying capacity and gross motor performance. Thereafter, a mediation analysis was conducted to examine the potential indirect relationship between these two variables with the cortical surface area of abnormal brain regions in CHDs serving as the mediator. Specifically, T1-weighted data underwent preprocessing using a specialized infant pipeline [6]. The cerebral cortex was then parcellated into 68 regions using the Desikan-Killiany atlas [7], and cortical surface area of each region was calculated. Abnormal brain regions were identified through group-level two-sample t-tests and Gaussian Process Regression (GPR), as depicted in Fig. 1. The GPR model employed a multi-kernel, multi-output strategy to enhance its effectiveness, trained on 60% of the HCs and tested on the remaining 40% to identify abnormal developmental brain regions in CHDs.
Results:
The linear regression analysis revealed no significant correlation between gross motor skills and either HB or HCT scores (HB: normalized β = 0.068, p = 0.568; HCT: normalized β = 0.042, p = 0.725). This suggests the absence of a direct relationship between blood oxygen-carrying capacity and gross motor performance. The results of the mediation analysis were depicted in Fig. 2, underwent bootstrapping validation for each pathway. We discovered multiple significant indirect relationships between gross motor performance and both HB and HCT, mediated by cortical surface area. The patterns of mediation effects for HB and HCT were similar, predominantly observed in the temporal, inferior parietal, orbitofrontal, and primary motor regions. Notably, the left middle temporal area, left inferior temporal area, and left precentral area demonstrated the strongest mediation effects among these regions.
Conclusions:
This study reveals an indirect association, mediated by cortical surface area, between blood oxygen-carrying capacity and gross motor abilities in infants with complex CHD. This discovery is crucial in deciphering the complex neurodevelopmental disorders associated with CHD.
Disorders of the Nervous System:
Neurodevelopmental/ Early Life (eg. ADHD, autism) 1
Motor Behavior:
Motor Behavior Other
Neuroanatomy, Physiology, Metabolism and Neurotransmission:
Cortical Anatomy and Brain Mapping 2
Keywords:
Blood
Congenital
Cortex
Data analysis
DISORDERS
Motor
Other - Complex Congenital heart disease
1|2Indicates the priority used for review
Provide references using author date format
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