Hippocampal volume and cognitive performance in children with congenital heart disease

Frontoparietal and temporal brain alterations post-cardiopulmonary bypass

Patients undergoing cardiopulmonary bypass (CPB) often experience neurological complications, but the neurobiological mechanisms remain unclear. This study combined resting-state fMRI, structural MRI, and cognitive testing to examine brain changes in 124 CPB patients and matched controls. Reduced amplitude of low-frequency fluctuation (ALFF) in the bilateral frontoparietal lobes indicated diminished neural activity among patients, and these ALFF values were positively correlated with the degree of executive dysfunction measured by the attention network test. Functional connectivity within the frontoparietal executive control network was weakened. Brain structural analysis revealed cortical thinning in frontoparietal and temporal regions, increased sulcal depth in medial orbitofrontal areas, and reduced gyrification in the insula suggesting long-term morphological impacts. These findings demonstrate CPB-associated functional and structural alterations in brain regions critical for cognition, providing neuroimaging evidence for postoperative dysfunction and potential neuroprotective strategies.

Comparative effectiveness of open and closed skill exercises on cognitive function in young adults: a fNIRS study

While it is widely acknowledged that exercise has positive effects on cognitive function, the specific impacts of different types of exercises, particularly open and closed skill exercises, on cognitive impairment continue to be a debated topic. In this study, we used fNIRS and cognitive psychology tasks to investigate the effects of different types of exercises on cognitive function and brain activity in young adults. We conducted an observational study to assess the cognitive function of participants who had engaged in these exercises for a long period. Additionally, we examined the effects of open skill exercise (badminton) and closed skill exercise (calisthenics) on localized blood flow in the prefrontal lobe of the brain using an experimental research method. Specifically, during the Stroop task, the badminton group exhibited significantly higher △HbO2 in channel 18, corresponding to the dorsolateral prefrontal cortex, compared to the calisthenics group (F = 4.485, P < 0.05, η2 = 0.074). In the 2-back task, the calisthenics group showed significantly higher △HbO2 in channel 17, corresponding to the frontopolar area, dorsolateral prefrontal cortex and inferior prefrontal gyrus, than the badminton group (F = 8.842, P < 0.01, η2 = 0.136). Our findings reveal that open skill exercises are more effective in enhancing cognitive inhibition, thereby increasing attention capacity, self-regulation, and flexibility in response to environmental changes. Conversely, closed skill exercises demonstrate greater efficacy in improving working memory within cognitive functions, showcasing an enhanced capacity for information processing and storage. These data indicate that while both open and closed skill exercises are beneficial for cognitive function, they exhibit significant distinctions in some aspects.

Language brain responses and neurodevelopmental outcome in preschoolers with congenital heart disease: A fNIRS study

Neurodevelopmental disabilities affect up to 50% of survivors of congenital heart disease (CHD). Language difficulties are frequently identified during preschool period and can lead to academic, social, behavioral, and emotional difficulties. Structural brain alterations are associated with poorer neurodevelopmental outcomes in patients with CHD during infancy, childhood, and adolescence. However, evidence is lacking about the functional brain activity in children with CHD and its relationship with neurodevelopment. This study therefore aimed to characterize brain responses during a passive story-listening task in 3-year-old children with CHD, and to investigate the relationship between functional brain patterns of language processing and neurodevelopmental outcomes. To do so, we assessed hemodynamic concentration changes, using functional near-infrared spectroscopy (fNIRS), and neurodevelopmental outcomes, using the Wechsler Preschool and Primary Scale of Intelligence - 4th Edition (WPPSI-IV), in children with CHD (n = 19) and healthy controls (n = 23). Compared to their healthy peers, children with CHD had significantly lower scores on the Verbal comprehension index (VCI), the Vocabulary acquisition index (VAI), the General ability index (GAI), and the Information and the Picture Naming subtests of the WPPSI-IV. During the passive story-listening task, healthy controls showed significant hemodynamic brain responses in the temporal and the temporal posterior regions, with stronger activation in the temporal posterior than in the temporal regions. In contrast, children with CHD showed reduced activation in the temporal posterior regions compared to controls, with no difference of activation between regions. Reduced brain responses in the temporal posterior regions were also correlated with lower neurodevelopmental outcomes in both groups. This is the first study that reveals reduced brain functional responses in preschoolers with CHD during a receptive language task. It also suggests that the temporal posterior activation could be a potential brain marker of cognitive development. These findings provide support for the feasibility of identifying brain correlates of neurodevelopmental vulnerabilities in children with CHD.

Systemic hypertension in adults with congenital heart diseases

Long-term effects of systemic hypertension (HTN) and HTN-mediated damages have been largely studied in non-congenital adult populations. By contrast, robust data about the predisposing factors, prevalence, consequences, and treatment of HTN in adults with congenital heart diseases (ACHD) is still scarce. Different mechanisms including the underlying cardiac disease, cardiac surgery and its consequences, the development of metabolic syndrome and secondary forms seem to play a role in HTN in ACHDs. To mitigate the potential long-term effects of HTN in this complex population, a meticulous follow-up is mandatory to identify patients who should receive treatment, and tailored strategies should be applied to obtain the best as possible result. Thus, this review will investigate risk factors, effects, and treatments of HTN in ACHD patients.

Heart-brain axis: Association of congenital heart abnormality and brain diseases

Brain diseases are a major burden on human health worldwide, and little is known about how most brain diseases develop. It is believed that cardiovascular diseases can affect the function of the brain, and many brain diseases are associated with heart dysfunction, which is called the heart-brain axis. Congenital heart abnormalities with anomalous hemodynamics are common treatable cardiovascular diseases. With the development of cardiovascular surgeries and interventions, the long-term survival of patients with congenital heart abnormalities continues to improve. However, physicians have reported that patients with congenital heart abnormalities have an increased risk of brain diseases in adulthood. To understand the complex association between congenital heart abnormalities and brain diseases, the paper reviews relevant clinical literature. Studies have shown that congenital heart abnormalities are associated with most brain diseases, including stroke, migraine, dementia, infection of the central nervous system, epilepsy, white matter lesions, and affective disorders. However, whether surgeries or other interventions could benefit patients with congenital heart abnormalities and brain diseases remains unclear because of limited evidence.