Alexandra F Bonthrone¹, Raymond Stegeman^2,3,4,5,6, Maria Feldmann⁷, Nathalie HP Claessens^2,3,4,6, Maaike Nijman^2,3,4,6, Nicolaas JG Jansen^3,8, Joppe Nijman³, Floris Groenendaal^2,6, Linda S de Vries², Manon JNL Benders², Felix Haas⁵, Mireille N Bekker⁹, Thushiha Logeswaran¹⁰, Bettina Reich¹¹, Raimund Kottke¹², Cornelia Hagmann¹³, Bea Latal⁷, Hitendu Dave¹⁴, John Simpson¹⁵, Kuberan Pushparajah^15,16, Conal Austin¹⁵, Christopher J Kelly¹, Sophie Arulkumaran¹, Mary A Rutherford¹, Serena J Counsell¹, Walter Knirsch¹⁷, and Johannes MPJ Breur^4
1Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom, ²Department of Neonatology, Wilhelmina Children’s Hospital, University Medical Center Utrecht and Utrecht University, Utrecht, Netherlands, ³Department of Pediatric Intensive Care, Wilhelmina Children’s Hospital, University Medical Center Utrecht and Utrecht University, Utrecht, Netherlands, ⁴Department of Pediatric Cardiology, Wilhelmina Children’s Hospital, University Medical Center Utrecht and Utrecht University, Utrecht, Netherlands, ⁵Congenital Cardiothoracic Surgery, Wilhelmina Children’s Hospital, University Medical Center Utrecht and Utrecht University, Utrecht, Netherlands, ⁶Utrecht Brain Center, University Medical Center Utrecht and Utrecht University, Utrecht, Netherlands, ⁷Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland, ⁸Department of Pediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, Groningen, Netherlands, ⁹Department of Obstetrics, Wilhelmina Children’s Hospital, University Medical Center Utrecht and Utrecht University, Utrecht, Netherlands, ¹⁰Pediatric Heart Center, University Hospital Giessen, Justus-Liebig-University Giessen, Giessen, Germany, ¹¹Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University of Munich, Munich, Germany, ¹²Department of Diagnostic Imaging, University Children’s Hospital Zurich, Zurich, Switzerland, ¹³Department of Neonatology and Pediatric Intensive Care, University Children’s Hospital Zurich, Zurich, Switzerland, ¹⁴Division of Congenital Cardiovascular Surgery, Pediatric Heart Centre, University Children’s Hospital Zurich, Zurich, Switzerland, ¹⁵Paediatric Cardiology Department, Evelina London Children's Healthcare, London, United Kingdom, ¹⁶Biomedical Engineering Department, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom, ¹⁷Pediatric Cardiology, Pediatric Heart Center, Department of Surgery, Children’s Research Center, University Children’s Hospital, and University of Zurich, Zurich, Switzerland

Infants with Congenital Heart Disease (CHD) are at risk of neurodevelopmental impairments. MRI studies have identified brain injury in infants with CHD both before and after cardiac surgery. We characterized risk factors for preoperative and new postoperative arterial ischaemic stroke (AIS), white matter injury (WMI) and cerebral sinovenous thrombosis (CSVT) in a cohort of infants with severe CHD. Balloon atrial septostomy was associated with increased risk of preoperative brain injury. Induced vaginal delivery was associated with preoperative WMI.  Cardiac physiology and perioperative factors were associated with increased risk of new postoperative brain injury.

Vincent Kyu Lee^1,2, Rafael Ceschin^3,4, William Thomas Reynolds^2,3, Benjamin Meyers⁴, Julia Wallace⁴, Douglas Landsittel⁵, Daryaneh Badaly⁶, J William Gaynor⁷, Daniel Licht⁸, Nathaniel H Greene⁹, Ken M Brady¹⁰, Jill V Hunter¹¹, Zili D Chu¹², Elisabeth A Wilde¹³, R Blaine Easley¹⁴, Dean Andropoulos¹⁴, and Ashok Panigrahy^1,2,3,4
1Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States, ²Radiology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, United States, ³Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA, United States, ⁴Radiology, University of Pittsburgh, Pittsburgh, PA, United States, ⁵Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, IN, United States, ⁶Learning and Development Center, Child Mind Institute, New York, NY, United States, ⁷Division of Cardiothoracic Surgery, Children’s Hospital of Philadelphia, Philadelphia, PA, United States, ⁸Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA, United States, ⁹Anesthesiology, Oregon Health and Sciences University, Portland, OR, United States, ¹⁰Anesthesiology, Lurie Children’s Hospital, Northwestern University, Chicago, IL, United States, ¹¹Radiology, Texas Children's Hospital, Houston, TX, United States, ¹²Radiology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, United States, ¹³Neurology, University of Utah School of Medicine, Salt Lake City, UT, United States, ¹⁴Anesthesiology, Perioperative and Pain Medicine, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, United States

This study examined trajectories of early postnatal brain structure (macrostructural brain volumes and microstructural white matter tractography) relationship with early childhood neurodevelopmental deficits (NDD) in complex congenital heart disease patients. This analysis included development of predictive multi-variable models incorporating other known risk factors of poor NDD in CHD. A multi-modal dysmaturation phenotype of reduced subcortical volume and cerebral white matter volume/connectivity predicted poor early childhood language outcomes, despite high relative contribution of genetic and socio-demographic factors (maternal IQ). Favorable socio-demographic factors, despite the high incidence of focal WMI and presence of genetic abnormalities, predicted better neurodevelopmental outcomes.

Ruth O'Gorman Tuura¹, Raimund Kottke², Barbara Brotschi³, Carola Sabandal⁴, Cornelia Hagmann³, and Beatrice Latal^5
1Center for MR Research, University Children's Hospital, Zurich, Switzerland, ²Radiology, University Children's Hospital, Zurich, Switzerland, ³Neonatology and Pediatric Intensive Care, University Children's Hospital, Zurich, Switzerland, ⁴Anaesthesia, University Children's Hospital, Zurich, Switzerland, ⁵Child Development Center, University Children's Hospital, Zurich, Switzerland

Neonatal hypoxic ischemic encephalopathy (HIE) is a serious neurological condition, representing a primary cause of neonatal death and developmental impairment. In newborns with HIE, hyperperfusion is related to severe adverse outcomes, but less is known about the link between perfusion and mild to moderate developmental impairments. Using a voxelwise correlation analysis, we investigated the link between ASL perfusion in newborns with HIE and developmental outcome at 2 years. A more adverse outcome was associated with hyperperfusion across the whole brain. A better cognitive outcome was associated with lower perfusion in the bilateral basal ganglia, thalamus, hippocampus and cerebellum.

Jia Fan^1,2, Fleur Warton^1,2, Samantha Fry³, Mark Cotton³, Sandra Jacobson^1,4, Joseph Jacobson^1,4, Christopher Molteno⁵, Francesca Little⁶, Andre van der Kouwe^1,7,8, Barbara Laughton³, and Ernesta Meintjes^1,2,9
1Biomedical Engineering Research Centre, Division of Biomedical Engineering, Department of Human Biology, University of Cape Town, Cape Town, South Africa, ²Neuroscience Institute, University of Cape Town, Cape Town, South Africa, ³Family Centre for Research with Ubuntu, Department of Paediatrics and Child Health and Tygerberg Children’s Hospital, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa, ⁴Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States, ⁵Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa, ⁶Department of Statistical Sciences, University of Cape Town, Cape Town, South Africa, ⁷A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States, ⁸Department of Radiology, Harvard Medical School, Boston, MA, United States, ⁹Cape Universities Body Imaging Centre, University of Cape Town, Cape Town, South Africa

Aggressive combination antiretroviral treatment in pregnancy has significantly reduced new perinatal HIV infections giving rise to a growing population of HIV exposed uninfected (HEU) children. Children who are HEU demonstrate neurodevelopmental delay compared to their HIV-unexposed uninfected (HUU) peers. We examined resting-state functional connectivity (RSFC) in neonates exposed to HIV and ART in utero and perinatally using resting-state fMRI. Ten standard resting-state networks were identified from independent component analysis. Voxelwise group comparison between neonates who are HEU and HUU revealed localized RSFC reductions in the cingulate gyrus within 3 networks: medial somatosensory, and anterior and posterior default mode networks.

Aliza Jaffer¹, Kathryn Y Manning², Gerald F Giesbrecht ³, Lianne Tomfohr-Madsen³, and Catherine Lebel^2
1University of Calgary, Calgary, AB, Canada, ²Department of Radiology, University of Calgary, Calgary, AB, Canada, ³Department of Pediatrics, University of Calgary, Calgary, AB, Canada

Prenatal psychological distress has been substantially higher during the COVID-19 pandemic, but its impacts on infant brain development remain unclear. We investigated the relationship between prenatal pandemic-related distress and functional connectivity within the default mode (DMN), auditory, and left frontoparietal brain networks in 3-month old infants. Resting-state functional MRI scans were analysed using FSL. Higher prenatal anxiety was associated with increased infant functional connectivity within the DMN. These connectivity changes may predispose these infants to later mental health challenges, and highlight the need to screen for prenatal anxiety and provide support for pregnant individuals and infants born during the pandemic.