Neuropsychiatric disorders in children with congenital heart defects

Authors

DOI:

https://doi.org/10.15574/SP.2023.131.74

Keywords:

children, brain, congenital heart defects, diagnosis, neurodevelopment

Abstract

The article is devoted to the actual problem of children’s neurology, children’s cardiology and children’s cardiac surgery - namely, the features of neuropsychological development (NPD) in children with congenital heart defects (CHD).

Purpose - to review modern research on the diagnosis of NPD in children with CHD, which is a necessary condition for optimizing patient care and developing a rehabilitation plan.

The topicality of the topic is due to the lack of research on the early diagnosis of the violation of the NPD of this category of children. Consider features of development and damage to the brain in children with congenital heart defects. The relationship between the action of various epigenetic factors and pathophysiological factors that influence neuropsychological development in children with CHD is highlighted. Features of diagnosis of NPD in children with CHD using neuromonitoring, scales and tests (near-infrared spectroscopy, electroencephalography, magnetic resonance imaging, ultrasound, Bailey scales, Peabody scale) are shown.

Conclusions. The relationship between the type of heart defect and the features of the child’s NPD has been determined. The adverse effect of cyanotic heart defects on the child’s neurodevelopment has been confirmed. Early diagnosis of CHD, including prenatal, and timely surgical correction at an early age significantly improve the results of surgical treatment and exert a positive influence on further NPD. The emphasis is on continuing the search for early diagnostic markers in order to optimize the treatment of NPD in children with CHD, as well as the development of effective rehabilitation methods for this category of children.

No conflict of interests was declared by the authors.

Author Biographies

N.M. Rudenko, Shupyk National Healthcare University of Ukraine, Kyiv

SI «Scientific and practical medical center of children’s cardiology and cardiac surgery of the Ministry of Health of Ukraine», Kyiv

H.M. Fedushka, Shupyk National Healthcare University of Ukraine, Kyiv

National Specialised Children’s Hospital «Okhmatdyt» of the Ministry of Health of Ukraine, Kyiv

References

Abella R, Varrica A, Satriano A et al. (2015). Biochemical Markers for Brain Injury Monitoring in Children with or without Congenital Heart Diseases. CNS & Neurological Disorders - Drug Targets (Formerly Current Drug Targets - CNS & Neurological Disorders). 14; 1: 12-23. https://doi.org/10.2174/1871527314666150116114648; PMid:25613500

Barkhuizen M, Abella R, Vles JSH, Zimmermann LJI et al. (2021). Antenatal and Perioperative Mechanisms of Global Neurological Injury in Congenital Heart Disease. Pediatric Cardiology. 42: 1-18. https://doi.org/10.1007/s00246-020-02440-w; PMid:33373013 PMCid:PMC7864813

Bellinger DC, Rivkin MJ, DeMaso D, Robertson RL et al. (2015, Feb). Adolescents with tetralogy of Fallot: neuropsychological assessment and structural brain imaging. Cardiol Young. 25 (2): 338-347. https://doi.org/10.1017/S1047951114000031; PMid:24512980 PMCid:PMC4426334

Birca A, Vakorin VA, Porayette P. (2016). Interplay of brain structure and function in neonatal congenital heart disease. Annals of Clinical and Translational Neurology. 3 (9): 708-722. https://doi.org/10.1002/acn3.336; PMid:27648460 PMCid:PMC5018583

Bolduc M-E, Lambert H, Ganeshamoorthy S, Brossard-Racine M. (2019). Structural brain abnormalities in adolescents and young adults with congenital heart defect: a systematic review. Developmental Medicine & Child Neurology. 60: 1209-1224. https://doi.org/10.1111/dmcn.13975; PMid:30028505

Castillo-Pinto C, Carpenter J, Donofrio M, Zhang A, Wernovsky G, Sinha P, Harrar D. (2022). Incidence and predictors of epilepsy in children with congenital heart disease. Cardiology in the Young. 32 (6): 918-924. https://doi.org/10.1017/S1047951121003279; PMid:34365987

Council on Children With Disabilities, Section on Developmental Behavioral Pediatrics, Bright Futures Steering Committee, Medical Home Initiatives for Children With Special Needs Project Advisory Committee. (2006). Identifying Infants and Young Children With Developmental Disorders in the Medical Home: An Algorithm for Developmental Surveillance and Screening. Pediatrics. 118: 405-420. https://doi.org/10.1542/peds.2006-1231; PMid:16818591

Cynthia M, Ortinau CM, Rollins CK, Gholipour A, Yun HJ, Marshall M, Gagoski B. (2019, Aug). Early-Emerging Sulcal Patterns Are Atypical in Fetuses with Congenital Heart Disease. Cerebral Cortex. 29; 8: 3605-3616. https://doi.org/10.1093/cercor/bhy235; PMid:30272144 PMCid:PMC6644862

Darlene Huisenga, La Bastide-Van Gemert S et al. (2020, Mar 9). Developmental outcomes after early surgery for complex congenital heart disease: a systematic review and meta-analysis. Developmental Medicine & Child Neurology. 63; 1: 29-46. https://doi.org/10.1111/dmcn.14512; PMid:32149404 PMCid:PMC7754445

Derridj N, Guedj R, Calderon Jo et al. (2021, Oct 1). Long-Term Neurodevelopmental Outcomes of Children with Congenital Heart Defects. The Journal of Pediatrics. 237: 109-114.e5. https://doi.org/10.1016/j.jpeds.2021.06.032; PMid:34157347

Feldmann Maria, Hagmann Cornelia, de Vries Linda et al. (2022). Neuromonitoring, neuroimaging, and neurodevelopmental follow-up practices in neonatal congenital heart disease: a European survey. Pediatric Research. 93 (1):168-175. https://doi.org/10.1038/s41390-022-02063-2; PMid:35414671 PMCid:PMC9876786

Ganesan SL. (2022). Continuous EEG for Diagnosis of Electrographic Seizures in the Pediatric Cardiac Critical Care Unit: Using a Precious Resource Wisely. Neurocritical Care. 36: 13-15. https://doi.org/10.1007/s12028-021-01314-0; PMid:34331204

Gaynor JW, Stopp C, Wypij D, Andropoulos DB et al. (2016). Impact of operative and postoperative factors on neurodevelopmental outcomes after cardiac operations. Ann Thorac Surg 102: 843-849. https://doi.org/10.1016/j.athoracsur.2016.05.081; PMid:27496628

GBD. (2017). Congenital Heart Disease Collaborators. Global, regional, and national burden of congenital heart disease, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Child Adolesc Heal. 4: 185-200. https://doi.org/10.1016/S2352-4642(19)30402-X; PMid:31978374

Goff DA, Shera DM, Tang S, Lavin NA et al. (2014, Apr). Risk factors for preoperative periventricular leukomalacia in term neonates with hypoplastic left heart syndrome are patient related. J Thorac Cardiovasc Surg. 147 (4): 1312-1318. https://doi.org/10.1016/j.jtcvs.2013.06.021; PMid:23879933 PMCid:PMC3896504

Gui J, He Sh, Zhuang J, Sun Yu. (2020, Feb). Peri- and Post-operative Amplitude-integrated Electroencephalography in Infants with Congenital Heart Disease. Indian Pediatrics. 57 (2): 133-137. https://doi.org/10.1007/s13312-020-1730-0; PMid:32060240

Gui J, Liang S, Sun Yu et al. (2020). Effect of perioperative amplitude integrated electroencephalography on neurodevelopmental outcomes following infant heart surgery. Exp Ther Med. 20 (3): 2879-2887. https://doi.org/10.3892/etm.2020.9004

Hövels-Gürich HH, Seghaye M-C, Schnitker R, Wiesner M et al. (2016, Nov). Long-term neurodevelopmental outcomes in school-aged children after neonatal arterial switch operation. J Thorac Cardiovasc Surg Pediatr Res actions. 80 (5): 668-674. https://doi.org/10.1038/pr.2016.145; PMid:27434120

Hövels-Gürich HH. (2016, Dec 15). Factors Influencing Neurodevelopment after Cardiac Surgery during Infancy. Front. Pediatr. Sec. Pediatric Cardiology. 4: 137. https://doi.org/10.3389/fped.2016.00137; PMid:28018896 PMCid:PMC5156661

Huang SLB, Said AS, Smyser ChD. (2021, Mar). Seizures Are Associated With Brain Injury in Infants Undergoing Extracorporeal Membrane Oxygenation. J Child Neurol. 36 (3): 230-236. https://doi.org/10.1177/0883073820966917; PMid:33112194 PMCid:PMC8086759

Hussein AAF, Amira E, Tantawy EEL, Eel-Fayom NM et al. (2019). Electroencephalography Findings in Children with Congential Heart Disease Pediatric Cardiology Unit and Clinical Neurophysiology Unit, Faculty of Medicine, Cairo University. URL: https://mjcu.journals.ekb.eg/article_52413_53d7bf85040177ac324b7d93ed3c8ebb.pdf.

Khalil A, Bennet S, Thilaganathan B et al. (2016). Prevalence of prenatal brain abnormalities in fetuses with congenital heart disease: a systematic review. Ultrasound Obstet Gynecol. 48: 296-307. https://doi.org/10.1002/uog.15932; PMid:27062519

Lazoryshinets VV, Krikunov OA, Koltunova GB. (2017). The problem of patient safety in cardiosurgery and a strategy to reduce the risk of postoperative complications. Bulletin of Cardiovascular Cardiosurgery. 2: 71-75.

Leonetti C, Back SA, Gallo V, Ishibashi N. (2019, Mar). Cortical dysmaturation in congenital heart disease. Trends Neurosci. Trends Neurosci. 42 (3): 192-204. https://doi.org/10.1016/j.tins.2018.12.003; PMid:30616953 PMCid:PMC6397700

Levy Rebecca J, Mayne Elizabeth W, Amanda G, Sandoval Karamian et al. (2022). Evaluation of Seizure Risk in Infants After Cardiopulmonary Bypass in the Absence of Deep Hypothermic Cardiac Arres. Neurocritical Care. 36 (1): 30-38. URL: https://link.springer.com/article/10.1007/s12028-021-01313-1. https://doi.org/10.1007/s12028-021-01313-1; PMid:34322828 PMCid:PMC8318326

Liang S, Sun Y, Liu Y. (2020, Sep). Effect of perioperative amplitude integrated electroencephalography on neurodevelopmental outcomes following infant heart surgery. Exp Ther Med. 20 (3): 2879-2887. https://doi.org/10.3892/etm.2020.9004

Limperopoulos C, Majnemer A, Rosenblatt B et al. (2001, Jul). Association Between Electroencephalographic Findings and Neurologic Status in Infants With Congenital Heart Defects. J Child Neurol. 16 (7): 471-476. https://doi.org/10.1177/088307380101600702; PMid:11453441

Marelli A, Miller SP, Marino BS et al. (2016, May 17). Brain in Congenital Heart Disease Across the Lifespan. The Cumulative Burden of Injury. Circulation. 133; 20: 1951-1962. https://doi.org/10.1161/CIRCULATIONAHA.115.019881; PMid:27185022 PMCid:PMC5519142

Marino BS, Lipkin PH, Newburger JW et al. (2012). Neurodevelopmental Outcomes in Children With Congenital Heart Disease: Evaluation and Management. Circulation. 126: 1143-1147. https://doi.org/10.1161/CIR.0b013e318265ee8a; PMid:22851541

Matos SM, Sarmento S, Moreira S et al. (2014). Impact of Fatal Development on Neurocognitive Performance of Adolescents with Cyanotic and Acyanotic Congenital Heart Disease. Congenit Heart Dis. 9: 373-381. https://doi.org/10.1111/chd.12152; PMid:24298977

Mebius MJ, Bilardo CM, Kneyber MCJ et al. (2020, Mar 25). Onset of brain injury in infants with prenatally diagnosed congenital heart disease. PLoS One. 15 (3): e0230414. https://doi.org/10.1371/journal.pone.0230414; PMid:32210445 PMCid:PMC7094875

Mendieta-Alcántara GG, Otero G, Motoliniá R, Colmenero M. (2011, Jan). EEG changes in children with severe congenital cardiopathie. Revista Ecuatoriana de Neurologia. 20 (1): 60-67. URL: https://www.researchgate.net/publication/286950403_EEG_changes_in_children_with_severe_congenital_cardiopathies.

Ortinau CM, Shimony JS. (2020). The Congenital Heart Disease Brain: Prenatal Considerations for Perioperative Neurocritical Care. Pediatr Neurol. 108: 23-30. https://doi.org/10.1016/j.pediatrneurol.2020.01.002; PMid:32107137 PMCid:PMC7306416

Padiyar S, Aly H et al. (2022). Role of Conventional EEG in Infants with Congenital Heart Disease and Its Correlation with Long Term Neurodevelopment Outcomes. Pediatrics. 149: 719.

Peyvandi Shabnam, Latal Beatrice, Miller Steven P, McQuillen Patrick S. (2019, Jan 15). The neonatal brain in critical congenital heart disease: Insights and future directions. Neuroimage. 185: 776-782. https://doi.org/10.1016/j.neuroimage.2018.05.045; PMid:29787864

Pfitzer C, Helm PC, Rosenthal L-M et al. (2018). Educational level and employment status in adults with congenital heart disease. Cardiol Young. 28: 32-38. https://doi.org/10.1017/S104795111700138X; PMid:28899436

Porayette P, Lim JM, Saini BS, Madathil S, Zhu MY et al. (2016). Serial prenatal and post-natal brain MRI demonstrates impact of congenital heart disease and cardiac surgery on brain growth and maturity. Journal of Cardiovascular Magnetic Resonance. 18 (1): 156. URL: http://www.jcmr-online.com/content/18/S1/P156. https://doi.org/10.1186/1532-429X-18-S1-P156; PMCid:PMC5032808

Ribera I, Ruiz A, Llurba E. (2019). Multicenter prospective clinical study to evaluate children short-term neurodevelopmental outcome in congenital heart disease (children NEURO-HEART): study protocol. BMC Pediatrics. 19 (1): 326. https://doi.org/10.1186/s12887-019-1689-y; PMid:31506079 PMCid:PMC6737686

Romanyuk OM, Klymyshyn YuI, Rudenko NM. (2018). Twenty-year experience of lung autograft surgery. Journal of Cardiovascular Cardiac Surgery. 1: 60-63.

Rudolph AM. (2016, Aug). Impaired cerebral development in fetuses with congenital cardiovascular malformations: is it the result of inadequate glucose supply? Pediatr Res. 80 (2): 172-177. https://doi.org/10.1038/pr.2016.65; PMid:27055190

Sadhwani A, Wypij D, Rofeberg V et al. (2022, Feb). Fetal Brain Volume Predicts Neurodevelopment in Congenital Heart Disease. Circulation. 145: 1108-1119. https://doi.org/10.1161/CIRCULATIONAHA.121.056305; PMid:35143287 PMCid:PMC9007882

Skotting MB, Eskildsen SF, Ovesen AS et al. (2021). Infants with congenital heart defects have reduced brain volumes. Scientific Reports. 11: 4191. https://doi.org/10.1038/s41598-021-83690-3; PMid:33603031 PMCid:PMC7892565

Stegeman R, Feldmann M, Claessens NHP, Jansen NJG et al. (2021, Nov). A Uniform Description of Perioperative Brain MRI Findings in Infants with Severe Congenital Heart Disease: Results of a European Collaboration. American Journal of Neuroradiology. 42 (11): 2034-2039. https://doi.org/10.3174/ajnr.A7328; PMid:34674999 PMCid:PMC8583253

Stogova OV, Rudenko NM, Khanenova VA et al. (2016). Clinical-instrumental assessment of the effectiveness of pulmonary artery narrowing in the surgical treatment of congenital corrected transposition of the main arteries. Journal of Cardiovascular Cardiac Surgery. 1: 90-93.

Sun L, Macgowan CK, Sled JG, Yoo S-J, Manlhiot C, Porayette P et al. (2015, Apr 14). Reduced fetal cerebral oxygen consumption is associated with smaller brain size in fetuses with congenital heart disease. Circulation. 131 (15): 1313-1323. https://doi.org/10.1161/CIRCULATIONAHA.114.013051; PMid:25762062 PMCid:PMC4398654

Varrica A, Satriano A, Gavilanes ADW et al. (2019, Apr). S100B increases in cyanotic versus noncyanotic infants undergoing heart surgery and cardiopulmonary bypass (CPB). J Matern Fetal Neonatal Med. 32 (7): 1117-1123. Epub 2017 Nov 28. https://doi.org/10.1080/14767058.2017.1401604; PMid:29183208

Verrall CE, Blue GM, Loughran-Fowlds A et al. (2019). 'Big issues' in neurodevelopment for children and adults with congenital heart disease. Open Heart. 6; 2: e000998. https://doi.org/10.1136/openhrt-2018-000998; PMid:31354955 PMCid:PMC6615801

Verrall CE, Walker K, Loughran-Fowlds A et al. (2018). Contemporary incidence of stroke (focal infarct and/or haemorrhage) determined by neuroimaging and neurodevelopmental disability at 12 months of age in neonates undergoing cardiac surgery utilizing cardiopulmonary bypass. Interact Cardiovasc Thorac Surg. 26: 644-650. https://doi.org/10.1093/icvts/ivx375; PMid:29228213

Von Rhein M, Buchmann A, Hagmann C et al. (2014). Brain volumes predict neurodevelopment in adolescents after surgery for congenital heart disease. Brain. 137: 268-276. https://doi.org/10.1093/brain/awt322; PMid:24277720

Yemets IM. (2001). Surgical treatment of transposition of main vessels. Dissertation ... Dr. Med. Sciences: 14.01.04. K.: 265-289.

Zhovnir VA. (2011). Study of pro-inflammatory and anti-inflammatory cytokines in newborns with transposition of main vessels using autologous umbilical cord blood. Pain, Anaesthesia & Intensive Care. 2 (56): 52-56. https://doi.org/10.25284/2519-2078.2(56).2011.109104.

Zhua S, Saiab X, Lina J et al. (2020, Dec). Mechanisms of perioperative brain damage in children with congenital heart disease. Biomedicine & Pharmacotherapy. 132: 110957. https://doi.org/10.1016/j.biopha.2020.110957; PMid:33254442

Znamenska TK, Martynyuk VYu, Shveykina VB. (2019). Morpho-functional features of the development of the brain and circulatory system in ontogenesis. International Neurological Journal. 6 (108): 44-56.

Published

2023-04-28