Our research team studies brain development, brain injury, and neurodevelopmental outcomes of children with congenital heart disease. Congenital heart disease is the most common birth defect and occurs in 1% of all live births. Children with moderate-severe forms of congenital heart disease are at significant risk of neurodevelopmental impairments. These include abnormal motor function, cognitive and language delay, impaired executive functioning, and behavioral and psychosocial challenges. These deficits persist into adulthood and affect educational achievement, quality of life, and employment.
Our ultimate goal is to identify potential neuroprotective strategies for improving neurodevelopment in children with congenital heart disease. To do so, we must understand how this diagnosis affects typical brain development and the mechanisms by which this occurs. Our initial studies focused on characterizing the nature and pattern of brain development in children with moderate-severe congenital heart disease using magnetic resonance imaging. We identified impairments in brain size and growth that correlated with delayed brain microstructural development. We also demonstrated alterations in the gyral and sulcal development of the cerebral cortex. These abnormalities were all present shortly after birth and before cardiac surgery. Based on this work, as well as the work of other experts in the field, we have recognized that the prenatal environment is a critical period in which the brain is already developing differently in fetuses with congenital heart disease. Therefore, our current work focuses on the prenatal environment, using fetal magnetic resonance imaging, to investigate two potential mechanisms of altered brain development in fetuses with congenital heart disease - the impact of altered brain hemodynamics and the role of genomic variation.