Relationship of white matter network topology and cognitive outcome in adolescents with d-transposition of the great arteries
Open accessAbstract
Patients with congenital heart disease (CHD) are at risk for neurocognitive impairments. Little is known about the impact of CHD on the organization of large-scale brain networks. We applied graph analysis techniques to diffusion tensor imaging (DTI) data obtained from 49 adolescents with dextro-transposition of the great arteries (d-TGA) repaired with the arterial switch operation in early infancy and 29 healthy referent adolescents. We examined whether differences in neurocognitive functioning were related to white matter network topology. We developed mediation models revealing the respective contributions of peri-operative variables and network topology on cognitive outcome. Adolescents with d-TGA had reduced global efficiency at a trend level (p = 0.061), increased modularity (p = 0.012), and increased small-worldness (p = 0.026) as compared to controls. Moreover, these network properties mediated neurocognitive differences between the d-TGA and referent adolescents across every domain assessed. Finally, structural network topology mediated the neuroprotective effect of longer duration of core cooling during reparative neonatal cardiac surgery, as well as the detrimental effects of prolonged hospitalization. Taken together, worse neurocognitive function in adolescents with d-TGA is mediated by global differences in white matter network topology, suggesting that disruption of this configuration of large-scale networks drives neurocognitive dysfunction. These data provide new insights into the interplay between perioperative factors, brain organization, and cognition in patients with complex CHD.
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In adolescents who had repair of transposition of the great arteries in infancy, disrupted structural network organization is associated with a higher risk of attention deficit disorder and cognitive dysfunction.
“However, in adolescents who had undergone repair of TGA in infancy, disrupted structural network organization was associated with a higher risk of attention deficit disorder 65 and cognitive dysfunction.66”
From Neuroimaging, cardiovascular physiology, and functional outcomes in infants with congenital heart disease (2017) · cites this paper as [66]
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- Authors
- Panigrahy, A., Schmithorst, V. J., Wisnowski, J. L., Watson, C. G., Bellinger, D. C., Newburger, J. W., & Rivkin, M. J.
- Affiliations
- University of Southern California (US)
- Children's Hospital of Pittsburgh (US)
- Boston University (US)
- Boston Children's Hospital (US)
- Corresponding author
- Panigrahy, Ashok
- ORCID
- Venue
- NeuroImage: Clinical
- Publisher
- Elsevier BV
- Published
- 2015
- Volume
- 7
- Pages
- 438-448
- ISSN
- 2213-1582 (ISSN-L)
- PMC
- PMC4318874
- OpenAlex
- W2144872190
- Cited by
- 86
- References
- 95
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 13 · 2023: 12 · 2022: 11 · 2021: 5 · 2020: 8 · 2019: 8 · 2018: 10 · 2017: 6 · 2016: 7 · 2015: 1
- FWCI
- 6.27
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- NeuroImage Clinical (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- U.S. Public Health Service (NINDS K23063371)
- National Heart, Lung, and Blood Institute (R01 HL77681, R01HL077681, RO1 HL77681, HL77681)
- National Institute of Neurological Disorders and Stroke (K23‐063371, K23NS063371)
- National Center for Research Resources (UL1RR025758)
- Topics
- Health Sciences › Medicine › Epidemiology › Congenital Heart Disease Studies
- Life Sciences › Neuroscience › Cognitive Neuroscience › Functional Brain Connectivity Studies
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced Neuroimaging Techniques and Applications
- Keywords
- dextro-transposition of the great arteries, congenital heart disease, large-scale brain networks, neuropsychological outcomes, arterial switch operation, global efficiency, modularity, small-worldness, length of hospital stay, mediation analysis, adolescents
- MeSH terms
- Brain, Cognition Disorders, Female, Humans, Image Processing, Computer-Assisted, Male, Neuropsychological Tests, Transposition of Great Vessels, Diffusion Tensor Imaging, White Matter
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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