Gender Effects on Cortical Alterations in infants with Complex Congenital Heart Disease
Poster No:
2146
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) is one of the most common birth defects in neonates, affecting millions of infants worldwide [1]. CHD not only impacts cardiac function but also has a significant negative effect on the development of the cerebral cortex, leading to long-term neurodevelopmental disorders[2]. Research has revealed that the brain structural abnormalities and incidence rates of various neurodevelopmental disorders (such as Attention-Deficit/Hyperactivity Disorder[3] and Autism Spectrum Disorder [4]) display notable gender differences. A deeper understanding of these differences can aid in the development of precise and effective treatment and intervention strategies. However, current knowledge about how gender affects brain structures in CHD patients, particularly during infancy, remains quite limited. This study aims to explore this under-researched area by utilizing magnetic resonance imaging (MRI) to reveal potential gender effects on brain development in infants with complex CHD, providing deeper insights for clinical diagnosis and treatment.
Methods:
In this study, we recruited 89 infants with complex CHD (43 females and 46 males) and 87 age-matched healthy controls (HCs, 40 females and 47 males) from the Children's Hospital of Nanjing Medical University, aged between 1 and 2 years. For each subject, T1-weighted imaging data were collected and preprocessed using a pipeline [5] specifically designed for infants. We then parcellated the brain into 17 functional systems [6] and calculated the regional cortical surface area (SA), cortical thickness (CT), and gray matter volume (GMV). Finally, we employed a Linear Mixed Effects Model (LMER) to compare the developmental differences in functional system between male CHD and male HC infants, as well as between female CHD and female HC infants, to capture the potential gender difference. The LMER model used age as an independent variable and morphological characteristics as dependent variables, with "diagnosis" as the grouping factor. The variable "diagnosis" was used to examine the main effect difference (i.e., intercept difference), while "diagnosis*age" was employed to evaluate the interaction effect difference (i.e., slope difference). We applied false discovery rate (FDR)[7] for multiple correction, setting the significance level at p<0.05.
Results:
Fig. 1 presents the comparative results of cortical development in functional systems for SA, CT, and GMV in male and female infants with complex CHD. As shown in Fig. 1(A), we found significant developmental abnormalities in several systems for male and female CHDs compared to HCs. The regions exhibiting abnormalities demonstrate considerable overlap across genders, particularly in the aspect of GMV. Subsequent in-depth analysis, however, uncovers significant gender effect in the developmental pattern in CHD infants, as depicted in Figs. 1(B) and 1(C). Developmental alterations in female CHDs predominantly manifested as interaction effects, contributing to 75%, 66.7%, and 71.4% of the anomalies in SA, CT, and GMV, respectively. Conversely, male CHD patients predominantly displayed main effects, with proportions of 66.7%, 100%, and 100% in SA, CT, and GMV, respectively. These findings indicate cortical development delays in both male and female CHD infants. Yet, the rate of development in female CHDs is considerably accelerated compared to that in healthy infants, whereas in males, it aligns closely with that of HCs. This suggests the potential for an earlier normalization of cortical structures in female CHD infants compared to their male counterparts.
Conclusions:
This study for the first time reveals the impact of gender on brain developmental abnormalities in infants with complex CHD. The results suggest the potential for an earlier normalization of cortical structures in female CHD infants compared to their male counterparts.
Neuroanatomy, Physiology, Metabolism and Neurotransmission:
Cortical Anatomy and Brain Mapping 2
Normal Development 1
Keywords:
Congenital
Cortex
Data analysis
Development
STRUCTURAL MRI
Other - Complex Congenital heart disease
1|2Indicates the priority used for review
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