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Brain Dysplasia Associated with Ciliary Dysfunction in Infants with Congenital Heart Disease - 25/10/16

Doi : 10.1016/j.jpeds.2016.07.041 
Ashok Panigrahy, MD 1, 2, * , Vincent Lee, BS 1, Rafael Ceschin, MS 1, 2, Giulio Zuccoli, MD 1, Nancy Beluk, BS 1, Omar Khalifa, BS 3, Jodie K. Votava-Smith, MD 4, Mark DeBrunner, MD 5, Ricardo Munoz, MD 6, Yuliya Domnina, MD 6, Victor Morell, MD 7, Peter Wearden, MD 7, Joan Sanchez De Toledo, MD 6, William Devine, BS 3, Maliha Zahid, MD 3, Cecilia W. Lo, PhD 3
1 Department of Pediatric Radiology, Childrens Hospital of Pittsburgh of University of Pittsburgh Medical Center and University of Pittsburgh School of Medicine, Pittsburgh, PA 
2 Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA 
3 Department of Developmental Biology, University of Pittsburgh School of Medicine, Pittsburgh, PA 
4 Department of Pediatrics, Division of Cardiology, Childrens Hospital of Los Angeles, Los Angeles, CA 
5 Division of Pediatric Cardiology, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA 
6 Cardiac Intensive Care Division, University of Pittsburgh School of Medicine, Pittsburgh, PA 
7 Division of Pediatric Cardiothoracic Surgery, Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA 

*Reprint requests: Department of Pediatric Radiology, Children's Hospital of Pittsburgh of UPMC, 45th St and Penn Ave, Pittsburgh, PA 15201.Department of Pediatric RadiologyChildren's Hospital of Pittsburgh of UPMC45th St and Penn AvePittsburghPA15201

Abstract

Objective

To test for associations between abnormal respiratory ciliary motion (CM) and brain abnormalities in infants with congenital heart disease (CHD)

Study design

We recruited 35 infants with CHD preoperatively and performed nasal tissue biopsy to assess respiratory CM by videomicroscopy. Cranial ultrasound scan and brain magnetic resonance imaging were obtained pre- and/or postoperatively and systematically reviewed for brain abnormalities. Segmentation was used to quantitate cerebrospinal fluid and regional brain volumes. Perinatal and perioperative clinical variables were collected.

Results

A total of 10 (28.5%) patients with CHD had abnormal CM. Abnormal CM was not associated with brain injury but was correlated with increased extraaxial cerebrospinal fluid volume (P < .001), delayed brain maturation (P < .05), and a spectrum of subtle dysplasia including the hippocampus (P < .0078) and olfactory bulb (P < .034). Abnormal CM was associated with higher composite dysplasia score (P < .001), and both were correlated with elevated preoperative serum lactate (P < .001).

Conclusions

Abnormal respiratory CM in infants with CHD is associated with a spectrum of brain dysplasia. These findings suggest that ciliary defects may play a role in brain dysplasia in patients with CHD and have the potential to prognosticate neurodevelopmental risks.

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Keywords : extraaxial CSF, olfactory, choroid plexus, hippocampus, motile cilia

Abbreviations : BBS, CHD, CM, CP, CSF, CUS, MRI, RACHS, TE, TR


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 Supported by the Pennsylvania Department of Health, National Institute of Neurological Disorders and Stroke (K23-063371), the Twenty Five Club Fund of Magee Women's Hospital, the Mario Lemieux Foundation, and National Library of Medicine (5T15LM007059-27). The authors declare no conflicts of interest.


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P. 141 - novembre 2016 Ritorno al numero
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