Abstract 12003: Brain Injury in Cognition and Mood Regulatory Regions in Adolescents With Single Ventricle Heart Disease

Abstract

Introduction: Adolescents with palliated single ventricle congenital heart disease (SVCHD) show a distinct pattern of cognitive and mood impairment, indicating the probability of brain injury in regions that control these functions. However, brain tissue integrity in cognitive and mood regulatory sites in SVCHD remains unclear. Our aim was to evaluate regional brain tissue changes in SVCHD compared to controls using T2-relaxometry procedures, which measure free water in tissues (higher T2-relaxation values indicate tissue damage). Methods: Proton-density and T2-weighted images were collected from 9 SVCHD (age: 15.8±1.1 years, male: 6, BMI: 19.8±3.6 kg/m 2 ) and 8 healthy controls (age: 16.3±0.9 years, male: 4, BMI: 25.4±8.1 kg/m 2 ), using a 3.0-Tesla magnetic resonance imaging scanner. Whole-brain T2-relaxation maps were calculated, normalized to a common space, smoothed, and compared between groups using ANCOVA (covariates: age and gender). Results: Several brain regions in SVCHD showed increased T2-relaxation values, indicating tissue injury, including the prefrontal cortices (a, b; executive thinking), anterior and posterior cingulate cortices (f; conflict resolution; emotion and memory), bilateral insular cortices (c; autonomic and emotion control), and bilateral parahippocampal gyrus (g; facial and topographical recognition; see Figure). In addition to gray matter injury, white matter changes were also detected in regions that link important gray matter regions associated with cognition and mood, including bilateral frontal white matter, anterior corpus callosum, and middle cerebellar peduncles (d, e), compared to controls [all regions p<0.05]. Conclusion: Adolescents with palliated SVCHD showed significantly increased T2-relaxation values, indicating tissue injury, in brain regions that control cognition and mood. These findings indicate that functional deficits in SVCHD may result from tissue injury in those regulatory areas.