A comparison of altered white matter microstructure in youth born with congenital heart disease or born preterm

Kaitlyn Easson; May Khairy; Charles V Rohlicek; Christine Saint-Martin; Guillaume Gilbert; Kim-Anh Nguyen; Thuy Mai Luu; Élise Couture; Anne-Monique Nuyt; Pia Wintermark; Sean C L Deoni; Maxime Descoteaux; Marie Brossard-Racine

doi:10.3389/fneur.2023.1167026

A comparison of altered white matter microstructure in youth born with congenital heart disease or born preterm

Front Neurol. 2023 May 12:14:1167026. doi: 10.3389/fneur.2023.1167026. eCollection 2023.

Authors

Kaitlyn Easson^{1

2}, May Khairy³, Charles V Rohlicek⁴, Christine Saint-Martin⁵, Guillaume Gilbert⁶, Kim-Anh Nguyen⁷, Thuy Mai Luu⁸, Élise Couture³, Anne-Monique Nuyt⁸, Pia Wintermark³, Sean C L Deoni⁹, Maxime Descoteaux¹⁰, Marie Brossard-Racine^{1

2

3

11}

Affiliations

¹ Advances in Brain and Child Development (ABCD) Research Laboratory, Research Institute of the McGill University Health Centre, Montreal, QC, Canada.
² Department of Neurology and Neurosurgery, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada.
³ Division of Neonatology, Department of Pediatrics, Montreal Children's Hospital, Montreal, QC, Canada.
⁴ Division of Cardiology, Department of Pediatrics, Montreal Children's Hospital, Montreal, QC, Canada.
⁵ Department of Medical Imaging, Division of Pediatric Radiology, Montreal Children's Hospital, Montreal, QC, Canada.
⁶ MR Clinical Science, Philips Healthcare, Mississauga, ON, Canada.
⁷ Division of Neonatology, Department of Pediatrics, Jewish General Hospital, Montreal, QC, Canada.
⁸ Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada.
⁹ Advanced Baby Imaging Lab, Brown University, Providence, RI, United States.
¹⁰ Sherbrooke Connectivity Imaging Laboratory (SCIL), Université de Sherbrooke, Sherbrooke, QC, Canada.
¹¹ School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.

Abstract

Introduction: Alterations to white matter microstructure as detected by diffusion tensor imaging have been documented in both individuals born with congenital heart disease (CHD) and individuals born preterm. However, it remains unclear if these disturbances are the consequence of similar underlying microstructural disruptions. This study used multicomponent driven equilibrium single pulse observation of T₁ and T₂ (mcDESPOT) and neurite orientation dispersion and density imaging (NODDI) to characterize and compare alterations to three specific microstructural elements of white matter - myelination, axon density, and axon orientation - in youth born with CHD or born preterm.

Methods: Participants aged 16 to 26 years with operated CHD or born ≤33 weeks gestational age and a group of healthy peers of the same age underwent a brain MRI including mcDESPOT and high angular resolution diffusion imaging acquisitions. Using tractometry, average values of myelin water fraction (MWF), neurite density index (NDI), and orientation dispersion index (ODI) were first calculated and compared between groups for 30 white matter bundles. Afterwards, bundle profiling was performed to further characterize the topology of the detected microstructural alterations.

Results: The CHD and preterm groups both presented with widespread bundles and bundle segments with lower MWF, accompanied by some occurrences of lower NDI, relative to controls. While there were no differences in ODI between the CHD and control groups, the preterm group presented with both higher and lower ODI compared to the control group and lower ODI compared to the CHD group.

Discussion: While youth born with CHD or born preterm both presented with apparent deficits in white matter myelination and axon density, youth born preterm presented with a unique profile of altered axonal organization. Future longitudinal studies should aim to better understand the emergence of these common and distinct microstructural alterations, which could orient the development of novel therapeutic approaches.

Keywords: congenital heart disease; multicomponent driven equilibrium single pulse observation of T1 and T2; neurite orientation dispersion and density imaging; preterm; white matter microstructure.