Neonatal brain network integration trajectories predict neurodevelopment in congenital heart disease.

Authors

Lauren Harasymiw, Amy Kuang, Duan Xu, Aaron Scheffler, Elizabeth George, Shabnam Peyvandi, Patrick McQuillen

Published in

Pediatric research. Oct 22, 2026. Epub Oct 22, 2026.

Abstract

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.
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 from 80 infants, and 50 had neurodevelopment assessed at 1-4 years using the Bayley Scales of Infant and Toddler Development.
White matter injury was associated with a slower perioperative increase 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.
In infants with critical CHD, longitudinal whole-brain network development was associated with neurodevelopment across multiple domains. Early network development may serve as a biomarker of neurodevelopmental risk and resilience in this population.
In infants with critical congenital heart disease, perioperative increase in whole-brain network integration was associated with cognitive, language, and motor outcomes in early childhood. White matter injury was associated with a slower increase in network integration, whereas cardiac physiology subtype was not associated with network development. This study extends prior work by showing that a longitudinal measure of neonatal whole-brain network development, rather than a single imaging timepoint, predicts neurodevelopment across multiple domains. These findings identify early network development as a potential biomarker of neurodevelopmental risk and resilience, and support future risk-stratification and intervention studies in this population.

PMID:
42918827
Bibliographic data and abstract were imported from PubMed on 24 Oct 2026.

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