Neonatal Brain Network Integration Trajectories Predict Neurodevelopment in...

Paper

Abstract

BACKGROUND: Infants with critical congenital heart disease (CHD) are at high risk for abnormal brain development and later neurodevelopmental impairment. We hypothesized that the trajectory of perioperative whole-brain network development would predict neurodevelopmental outcomes in early childhood. METHODS: This prospective longitudinal cohort of neonates with critical CHD (n = 97) underwent preoperative and/or postoperative brain MRI with diffusion imaging. Whole-brain network measures were derived from structural connectomes. Neurodevelopment was assessed between 1 and 4 years using the Bayley Scales of Infant and Toddler Development. RESULTS: White matter injury was associated with slower perioperative growth in global efficiency ( p = 0.013), a measure of network integration, whereas cardiac physiology was not associated with network development. Infants with greater perioperative increases in global efficiency had higher cognitive ( p = 0.001), language ( p < 0.001), and motor ( p = 0.008) scores. For each 1-standard deviation increase in the trajectory of global efficiency, cognitive scores increased by 8.2 points (95% CI, 3.64-12.78), independent of brain injury and socioeconomic factors. CONCLUSION: In infants with critical CHD, longitudinal whole-brain network development was associated with neurodevelopment across multiple domains. Early network development may represent a candidate biomarker of neurodevelopmental risk and resilience in this population.

Analysis

Paper intelligence

Summary

This study investigates how the development of whole-brain networks in neonates with critical congenital heart disease (CHD) predicts their neurodevelopmental outcomes.

Key findings

White matter injury was linked to slower perioperative growth in global efficiency.
Greater perioperative increases in global efficiency correlated with higher cognitive, language, and motor scores.
Each 1-SD increase in global efficiency trajectory predicted an 8.2-point increase in cognitive scores.
Longitudinal whole-brain network development is associated with neurodevelopment in infants with critical CHD.

Methods

Prospective longitudinal cohort study.
Brain MRI with diffusion imaging (preoperative and/or postoperative).
Structural connectome derivation.
Bayley Scales of Infant and Toddler Development for neurodevelopment assessment.

Limitations

The abstract does not explicitly state limitations.

Applications

Identifying infants at risk for neurodevelopmental impairment.
Developing potential biomarkers for neurodevelopmental outcomes.
Informing therapeutic interventions for infants with CHD.

Confidence100%

Discovery

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Source record

Publication metadata

Authors: Harasymiw L; Kuang A; Xu D; Scheffler A; George E; Peyvandi S; McQuillen P
Published: Jan 1, 2026
Journal or venue: medRxiv : the preprint server for health sciences
DOI: 10.64898/2026.06.06.26355074
Paper type: journal article
Source: Pubmed

DOI PubMed