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Nancy A Pike - One of the best experts on this subject based on the ideXlab platform.
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optimism despite profound uncertainty school and social relationships in adolescents with single Ventricle Heart disease
Cardiology in The Young, 2021Co-Authors: Jennifer K Peterson, Nancy A Pike, Ellen Olshansky, Yuqing Guo, Lorraine S EvangelistaAbstract:BACKGROUND Survivors of single Ventricle Heart disease must cope with the physical, neurodevelopmental, and psychosocial sequelae of their cardiac disease, which may also affect academic achievement and social relationships. The purpose of this study was to qualitatively examine the experiences of school and social relationships in adolescents with single Ventricle Heart disease. METHODS A descriptive phenomenological methodology was employed, utilising semi-structured interviews. Demographic and clinical characteristics were obtained via chart review. RESULTS Fourteen adolescents (aged 14 to 19 years) with single Ventricle Heart disease participated. Interviews ranged from 25 to 80 minutes in duration. Four themes emerged from the interviews, including "Don't assume": Pervasive ableism; "The elephant in the room": Uncertain future; "Everyone finds something to pick on": Bullying at school; "They know what I have been through": Social support. The overall essence generated from the data was "optimism despite profound uncertainty." CONCLUSIONS Adolescents with single Ventricle Heart disease identified physical limitations and school challenges in the face of an uncertain health-related future. Despite physical and psychosocial limitations, most remained optimistic for the future and found activities that were congruent with their abilities. These experiences reflect "optimism despite profound uncertainty."
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reduced hippocampal volumes and memory deficits in adolescents with single Ventricle Heart disease
Brain and behavior, 2021Co-Authors: Nancy A Pike, Bhaswati Roy, Cristina Cabreramino, Nancy J Halnon, Mary A Woo, Alan B Lewis, Stefanie Moye, Rajneesh KumarAbstract:INTRODUCTION Adolescents with single Ventricle congenital Heart disease (SVHD) show functional deficits, particularly in memory and mood regulation. Hippocampi are key brain structures that regulate mood and memory; however, their tissue integrity in SVHD is unclear. Our study aim is to evaluate hippocampal volumes and their associations with memory, anxiety, and mood scores in adolescents with SVHD compared to healthy controls. METHODS We collected brain magnetic resonance imaging data from 25 SVHD (age 15.9 ± 1.2 years; 15 male) and 38 controls (16.0 ± 1.1 years; 19 male) and assessed memory (Wide Range Assessment of Memory and Learning 2, WRAML2), anxiety (Beck Anxiety Inventory, BAI), and mood (Patient Health Questionnaire 9, PHQ-9) functions. Both left and right hippocampi were outlined and global volumes, as well as three-dimensional surfaces were compared between groups using ANCOVA and associations with cognitive and behavioral scores with partial correlations (covariates: age and total brain volume). RESULTS The SVHD group showed significantly higher BAI (p = .001) and PHQ-9 (p < .001) scores, indicating anxiety and depression symptoms and significantly reduced WRAML2 scores (p < .001), suggesting memory deficits compared with controls. SVHD group had significantly reduced right global hippocampal volumes (p = .036) compared with controls, but not the left (p = .114). Right hippocampal volume reductions were localized in the CA1, CA4, subiculum, and dentate gyrus. Positive correlations emerged between WRAML2 scores and left (r = 0.32, p = .01) and right (r = 0.28, p = .03) hippocampal volumes, but BAI and PHQ-9 did not show significant correlations. CONCLUSION Adolescents with SVHD show reduced hippocampal volumes, localized in several sites (CA1, CA4, subiculum, and dentate gyrus), which are associated with memory deficits. The findings indicate the need to explore ways to improve memory to optimize academic achievement and ability for self-care in the condition.
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caudate nuclei volume alterations and cognition and mood dysfunctions in adolescents with single Ventricle Heart disease
Journal of Neuroscience Research, 2020Co-Authors: Sarah Noorani, Bhaswati Roy, Ashish K Sahib, Cristina Cabreramino, Nancy J Halnon, Mary A Woo, Alan B Lewis, Nancy A Pike, Rajneesh KumarAbstract:Adolescents with single Ventricle Heart disease (SVHD) exhibit mood and cognitive deficits, which may result from injury to the basal ganglia structures, including the caudate nuclei. However, the integrity of the caudate in SVHD adolescents is unclear. Our aim was to examine the global and regional caudate volumes, and evaluate the relationships between caudate volumes and cognitive and mood scores in SVHD and healthy adolescents. We acquired two high-resolution T1-weighted images from 23 SVHD and 37 controls using a 3.0-Tesla MRI scanner, as well as assessed mood (Patient Health Questionnaire-9 [PHQ-9]; Beck Anxiety Inventory [BAI]) and cognition (Montreal Cognitive Assessment [MoCA]; Wide Range Assessment of Memory and Learning-2; General Memory Index [GMI]) functions. Both left and right caudate nuclei were outlined, which were then used to calculate and compare volumes between groups using ANCOVA (covariates: age, gender, and head-size), as well as perform 3D surface morphometry. Partial correlations (covariates: age, gender, and head-size) were used to examine associations between caudate volumes, cognition, and mood scores in SVHD and controls. SVHD subjects showed significantly higher PHQ-9 and BAI scores, indicating more depressive and anxiety symptoms, as well as reduced GMI scores, suggesting impaired cognition, compared to controls. SVHD patients showed significantly reduced caudate volumes (left, 3,198.8 ± 490.1 vs. 3,605.0 ± 480.4 mm3 , p < 0.004; right, 3,162.1 ± 475.4 vs. 3,504.8 ± 465.9 mm3 , p < 0.011) over controls, and changes were localized in the rostral, mid-dorsolateral, and caudal areas. Significant negative correlations emerged between caudate volumes with PHQ-9 and BAI scores and positive correlations with GMI and MoCA scores in SVHD and controls. SVHD adolescents show significantly reduced caudate volumes, especially in sites that have projections to regulate mood and cognition, which may result from developmental and/or hypoxia-/ischemia-induced processes.
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reduced brain mammillary body volumes and memory deficits in adolescents who have undergone the fontan procedure
Pediatric Research, 2020Co-Authors: Cristina Cabreramino, Bhaswati Roy, Nancy J Halnon, Mary A Woo, Alan B Lewis, Sadhana Singh, Rajesh Kumar, Stefanie Moye, Nancy A PikeAbstract:Adolescents with single Ventricle Heart disease (SVHD) who have undergone the Fontan procedure show cognitive/memory deficits. Mammillary bodies are key brain sites that regulate memory; however, their integrity in SVHD is unclear. We evaluated mammillary body (MB) volumes and their associations with cognitive/memory scores in SVHD and controls. Brain MRI data were collected from 63 adolescents (25 SVHD; 38 controls) using a 3.0-Tesla MRI scanner. Cognition and memory were assessed using Montreal Cognitive Assessment (MoCA) and Wide Range Assessment of Memory and Learning 2. MB volumes were calculated and compared between groups (ANCOVA, covariates: age, sex, and total brain volume [TBV]). Partial correlations and linear regression were performed to examine associations between volumes and cognitive scores (covariates: age, sex, and TBV). SVHD group showed significantly lower MoCA and WRAML2 scores over controls. MB volumes were significantly reduced in SVHD over controls. After controlling for age, sex, and TBV, MB volumes correlated with MoCA and delayed memory recall scores in SVHD and controls. Adolescents with SVHD show reduced MB volumes associated with cognitive/memory deficits. Potential mechanisms of volume losses may include developmental and/or hypoxic/ischemic-induced processes. Providers should screen for cognitive deficits and explore possible interventions to improve memory.
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abstract 12655 reduced mammillary body volumes associated with memory deficits in single Ventricle Heart disease
Circulation, 2018Co-Authors: Cristina Cabreramino, Bhaswati Roy, Nancy J Halnon, Mary A Woo, Alan B Lewis, Sadhana Singh, Rajesh Kumar, Nancy A PikeAbstract:Introduction: Adolescents with single Ventricle Heart disease (SVHD) following staged surgical palliation show brain-related functional deficits, particularly in memory. The mammillary bodies are k...
David W Brown - One of the best experts on this subject based on the ideXlab platform.
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development of a validated risk score for interstage death or transplant after stage i palliation for single Ventricle Heart disease
The Journal of Thoracic and Cardiovascular Surgery, 2019Co-Authors: Humera Ahmed, Jeffrey B Anderson, Carole Lannon, Craig E Fleishman, Lynn A Sleeper, Nancy S Ghanayem, Katherine E Bates, Shobha Natarajan, David W BrownAbstract:Abstract Objective To develop a risk score to predict mortality or transplant in the interstage period. Background The “interstage” period between the stage 1 and stage 2 palliation is a time of high morbidity and mortality for infants with single-Ventricle congenital Heart disease. Methods This was an analysis of patients with single-Ventricle congenital Heart disease requiring arch reconstruction who were enrolled in the National Pediatric Cardiology Quality Improvement Collaborative registry from 2008 to 2015. The primary composite endpoint was interstage mortality or transplant. Multivariable logistic regression and classification and regression tree analysis were performed on two-thirds of the patients (“learning cohort”) to build a risk score for the composite endpoint, that was validated in the remaining patients (“validation cohort”). Results In the 2128 patients analyzed in the registry, the overall event rate was 9% (153 [7%] deaths, 42 [2%] transplants). In the learning cohort, factors independently associated with the composite endpoint were (1) type of Norwood; (2) postoperative ECMO; (3) discharge with Opiates; (4) No Digoxin at discharge; (5) postoperative Arch obstruction, (6) moderate-to-severe Tricuspid regurgitation without an oxygen requirement, and (7) Extra Oxygen required at discharge in patients with moderate-to-severe tricuspid regurgitation. This model was used to create a weighted risk score (“NEONATE” score; 0-76 points), with >75% accuracy in the learning and validation cohorts. In the validation cohort, the event rate in patients with a score >17 was nearly three times those with a score ≤17. Conclusions We introduce a risk score that can be used post-stage 1 palliation to predict freedom from interstage mortality or transplant.
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abstract 15515 predicting freedom from interstage death or transplant after stage i palliation for single Ventricle Heart disease
Circulation, 2018Co-Authors: Humera Ahmed, Carole Lannon, Lynn A Sleeper, Nancy S Ghanayem, Jeffrey S Anderson, Katherine E Bates, David W BrownAbstract:Background: The Interstage period between Stage 1 palliation (S1P) and the Stage 2 procedure (S2P; i.e. Glenn or hemi-Fontan) is a time of high morbidity and mortality for infants with single ventr...
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DEVELOPMENT OF A VALIDATED RISK SCORE FOR INTERSTAGE DEATH OR TRANSPLANT AFTER STAGE I PALLIATION FOR SINGLE Ventricle Heart DISEASE
Journal of the American College of Cardiology, 2018Co-Authors: Humera Ahmed, Jeffrey Anderson, Carole Lannon, Craig E Fleishman, Lynn A Sleeper, Nancy S Ghanayem, Katherine E Bates, Shobha Natarajan, David W BrownAbstract:The Interstage period between Stage 1 palliation (S1P) and Glenn operation is a time of high mortality for infants with single Ventricle congenital Heart disease (SVCHD). We sought to develop a risk score that could be employed at discharge post-S1P, to predict Interstage death or transplant. This
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digoxin use is associated with reduced interstage mortality in patients with no history of arrhythmia after stage i palliation for single Ventricle Heart disease
Journal of the American Heart Association, 2016Co-Authors: David W Brown, Jeffrey B Anderson, Steven R Neish, Colleen Mangeot, Laura E Peterson, Stacey Lihn, Christina Phelps, Eileen C King, Craig E Fleishman, Samuel P HankeAbstract:Background Interstage mortality (IM) remains significant after stage 1 palliation (S1P) for single‐Ventricle Heart disease (SVD), with many deaths sudden and unexpected. We sought to determine whether digoxin use post‐S1P is associated with reduced IM, utilizing the multicenter database of the National Pediatric Cardiology Quality Improvement Collaborative (NPCQIC). Methods and Results From June 2008 to July 2013, 816 infants discharged after S1P from 50 surgical sites completed the interstage to stage II palliation, transplant, or IM. Arrhythmia during S1P hospitalization or discharge on antiarrhythmic medications were exclusions (n=270); 2 patients were lost to follow‐up. Two analyses were performed: (1) propensity‐score adjusted logistic regression with IM as outcome and (2) retrospective cohort analysis for patients discharged on digoxin versus not, matched for surgical site and other established IM risk factors. Of 544 study patients, 119 (21.9%) were discharged on digoxin. Logistic regression analysis with propensity score, site‐size group, and digoxin use as predictor variables showed an increased risk of IM in those not discharged on digoxin (odds ratio, 8.6; lower confidence limit, 1.9; upper confidence limit, 38.3; P <0.01). The retrospective cohort analysis for 60 patients on digoxin (matched for site of care, type of S1P, post‐S1P ECMO use, genetic syndrome, discharge feeding route, ventricular function, tricuspid regurgitation, and aortic arch gradient) showed 0% IM in the digoxin at discharge group and an estimated IM difference between the 2 groups of 9% ( P =0.04). Conclusions Among SVD infants in the NPCQIC database discharged post‐S1P with no history of arrhythmia, use of digoxin at discharge was associated with reduced IM.
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digoxin use at discharge is associated with reduced interstage mortality after stage i palliation for single Ventricle Heart disease
Journal of the American College of Cardiology, 2015Co-Authors: David W Brown, Eileen King, Robert H Beekman, Steven R Neish, Colleen Mangeot, Jeffrey Anderson, Laura E Peterson, Stacey Lihn, Carole LannonAbstract:Interstage mortality (IM) remains significant after discharge from Stage I palliation (S1P) for single Ventricle Heart disease (SVD), with many deaths sudden and unexpected. We sought to determine whether digoxin use is associated with reduced IM utilizing the multicenter database of the National
Rajesh Kumar - One of the best experts on this subject based on the ideXlab platform.
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reduced brain mammillary body volumes and memory deficits in adolescents who have undergone the fontan procedure
Pediatric Research, 2020Co-Authors: Cristina Cabreramino, Bhaswati Roy, Nancy J Halnon, Mary A Woo, Alan B Lewis, Sadhana Singh, Rajesh Kumar, Stefanie Moye, Nancy A PikeAbstract:Adolescents with single Ventricle Heart disease (SVHD) who have undergone the Fontan procedure show cognitive/memory deficits. Mammillary bodies are key brain sites that regulate memory; however, their integrity in SVHD is unclear. We evaluated mammillary body (MB) volumes and their associations with cognitive/memory scores in SVHD and controls. Brain MRI data were collected from 63 adolescents (25 SVHD; 38 controls) using a 3.0-Tesla MRI scanner. Cognition and memory were assessed using Montreal Cognitive Assessment (MoCA) and Wide Range Assessment of Memory and Learning 2. MB volumes were calculated and compared between groups (ANCOVA, covariates: age, sex, and total brain volume [TBV]). Partial correlations and linear regression were performed to examine associations between volumes and cognitive scores (covariates: age, sex, and TBV). SVHD group showed significantly lower MoCA and WRAML2 scores over controls. MB volumes were significantly reduced in SVHD over controls. After controlling for age, sex, and TBV, MB volumes correlated with MoCA and delayed memory recall scores in SVHD and controls. Adolescents with SVHD show reduced MB volumes associated with cognitive/memory deficits. Potential mechanisms of volume losses may include developmental and/or hypoxic/ischemic-induced processes. Providers should screen for cognitive deficits and explore possible interventions to improve memory.
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abstract 12655 reduced mammillary body volumes associated with memory deficits in single Ventricle Heart disease
Circulation, 2018Co-Authors: Cristina Cabreramino, Bhaswati Roy, Nancy J Halnon, Mary A Woo, Alan B Lewis, Sadhana Singh, Rajesh Kumar, Nancy A PikeAbstract:Introduction: Adolescents with single Ventricle Heart disease (SVHD) following staged surgical palliation show brain-related functional deficits, particularly in memory. The mammillary bodies are k...
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brain abnormalities in cognition anxiety and depression regulatory regions in adolescents with single Ventricle Heart disease
Journal of Neuroscience Research, 2018Co-Authors: Nancy A Pike, Bhaswati Roy, Nancy J Halnon, Mary A Woo, Alan B Lewis, Sadhana Singh, Ritika Gupta, Rajesh KumarAbstract:BACKGROUND Single Ventricle Heart disease (SVHD) adolescents show cognitive impairments and anxiety and depressive symptoms, indicating the possibility of brain injury in regions that control these functions. However, brain tissue integrity in cognition, anxiety, and depression regulatory sites in SVHD remains unclear. We examined brain tissue changes in SVHD compared to controls using T2-relaxometry procedures, which measure free water content and show tissue injury. METHODS Proton-density and T2-weighted images, using a 3.0-Tesla MRI, as well as anxiety (Beck anxiety inventory [BAI]), depressive symptoms (patient health questionnaire-9 [PHQ-9]), and cognition (wide range assessment of memory and learning 2 [WRAML2] and Montreal cognitive assessment [MoCA]) data were collected from 20 SVHD (age: 15.8 ± 1.1 years, male/female: 11/9) and 36 controls (age: 16.0 ± 1.1 years, male/female: 19/17). Whole-brain T2-relaxation maps were calculated, normalized to a common space, smoothed, and compared between groups and sexes (analysis of covariance; covariates: age, sex; p < 0.001). RESULTS SVHD subjects showed significantly increased BAI and PHQ-9 and reduced MoCA and WRAML2 scores over controls. Several brain regions in SVHD showed increased T2-relaxation values (chronic injury), including the cingulate, and insula, hippocampus/para-hippocampal gyrus, thalamus, hypothalamus, amygdala, frontal white matter, corpus callosum, brainstem, and cerebellar areas. Decreased T2-relaxation values (acute injury) emerged in a few regions, including the prefrontal and cerebellar cortices in SVHD over controls. In addition, male SVHD showed more brain changes over female SVHD. CONCLUSIONS Adolescents with SVHD showed significant brain injury with variable male-female differences in areas that control cognition, anxiety, and depression, which may contribute to functional deficits found in the condition.
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regional brain gray matter changes in adolescents with single Ventricle Heart disease
Neuroscience Letters, 2018Co-Authors: Sadhana Singh, Bhaswati Roy, Nancy J Halnon, Mary A Woo, Alan B Lewis, Rajesh Kumar, Nancy A PikeAbstract:Adolescents with single Ventricle Heart disease (SVHD) show autonomic, mood, and cognitive deficits, indicating aberrations in brain areas that regulate these functions. However, the gray matter integrity in autonomic, mood, and cognitive control sites is unclear. We examined regional brain gray matter changes, using high-resolution T1-weighted images (3.0-T magnetic resonance scanner) with voxel based morphometry procedures, as well as mood and cognitive functions in SVHD (n=18; age, 15.7±1.1years; male, 10) and controls (n=31; age, 16.0±1.1years; male, 17). High-resolution T1-weighted images were realigned, gray matter tissue type partitioned, normalized to a common space, smoothed, and compared between groups (analysis of covariance; covariates, age and gender). The mood and cognitive scores were compared between groups using independent samples t-tests. SVHD subjects showed significantly altered mood and cognitive functions over controls. Significantly reduced gray matter emerged in multiple brain areas, including the thalamus, caudate nuclei, putamen, insula, prefrontal, post-central and precentral gyrus, occipital gyrus, para-hippocampal gyrus, temporal gyrus, and cerebellar sites in SVHD over controls. SVHD subjects show compromised gray matter integrity in autonomic, mood and cognitive control sites. The findings indicate that frequent deficits found in SVHD subjects have a brain structural basis in the condition.
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Abstract 15451: Reduced Hippocampal Volume, Mood, and Memory Deficits in Adolescents With Single Ventricle Heart Disease
Circulation, 2017Co-Authors: Nancy A Pike, Bhaswati Roy, Nancy J Halnon, Mary A Woo, Alan B Lewis, Sadhana Singh, Stefanie Moye, Rajesh KumarAbstract:Introduction: Adolescents with single Ventricle congenital Heart disease (SVHD) show brain related functional deficits, particularly in mood and memory. Hippocampi are key brain structures of mood ...
Alan B Lewis - One of the best experts on this subject based on the ideXlab platform.
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reduced hippocampal volumes and memory deficits in adolescents with single Ventricle Heart disease
Brain and behavior, 2021Co-Authors: Nancy A Pike, Bhaswati Roy, Cristina Cabreramino, Nancy J Halnon, Mary A Woo, Alan B Lewis, Stefanie Moye, Rajneesh KumarAbstract:INTRODUCTION Adolescents with single Ventricle congenital Heart disease (SVHD) show functional deficits, particularly in memory and mood regulation. Hippocampi are key brain structures that regulate mood and memory; however, their tissue integrity in SVHD is unclear. Our study aim is to evaluate hippocampal volumes and their associations with memory, anxiety, and mood scores in adolescents with SVHD compared to healthy controls. METHODS We collected brain magnetic resonance imaging data from 25 SVHD (age 15.9 ± 1.2 years; 15 male) and 38 controls (16.0 ± 1.1 years; 19 male) and assessed memory (Wide Range Assessment of Memory and Learning 2, WRAML2), anxiety (Beck Anxiety Inventory, BAI), and mood (Patient Health Questionnaire 9, PHQ-9) functions. Both left and right hippocampi were outlined and global volumes, as well as three-dimensional surfaces were compared between groups using ANCOVA and associations with cognitive and behavioral scores with partial correlations (covariates: age and total brain volume). RESULTS The SVHD group showed significantly higher BAI (p = .001) and PHQ-9 (p < .001) scores, indicating anxiety and depression symptoms and significantly reduced WRAML2 scores (p < .001), suggesting memory deficits compared with controls. SVHD group had significantly reduced right global hippocampal volumes (p = .036) compared with controls, but not the left (p = .114). Right hippocampal volume reductions were localized in the CA1, CA4, subiculum, and dentate gyrus. Positive correlations emerged between WRAML2 scores and left (r = 0.32, p = .01) and right (r = 0.28, p = .03) hippocampal volumes, but BAI and PHQ-9 did not show significant correlations. CONCLUSION Adolescents with SVHD show reduced hippocampal volumes, localized in several sites (CA1, CA4, subiculum, and dentate gyrus), which are associated with memory deficits. The findings indicate the need to explore ways to improve memory to optimize academic achievement and ability for self-care in the condition.
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caudate nuclei volume alterations and cognition and mood dysfunctions in adolescents with single Ventricle Heart disease
Journal of Neuroscience Research, 2020Co-Authors: Sarah Noorani, Bhaswati Roy, Ashish K Sahib, Cristina Cabreramino, Nancy J Halnon, Mary A Woo, Alan B Lewis, Nancy A Pike, Rajneesh KumarAbstract:Adolescents with single Ventricle Heart disease (SVHD) exhibit mood and cognitive deficits, which may result from injury to the basal ganglia structures, including the caudate nuclei. However, the integrity of the caudate in SVHD adolescents is unclear. Our aim was to examine the global and regional caudate volumes, and evaluate the relationships between caudate volumes and cognitive and mood scores in SVHD and healthy adolescents. We acquired two high-resolution T1-weighted images from 23 SVHD and 37 controls using a 3.0-Tesla MRI scanner, as well as assessed mood (Patient Health Questionnaire-9 [PHQ-9]; Beck Anxiety Inventory [BAI]) and cognition (Montreal Cognitive Assessment [MoCA]; Wide Range Assessment of Memory and Learning-2; General Memory Index [GMI]) functions. Both left and right caudate nuclei were outlined, which were then used to calculate and compare volumes between groups using ANCOVA (covariates: age, gender, and head-size), as well as perform 3D surface morphometry. Partial correlations (covariates: age, gender, and head-size) were used to examine associations between caudate volumes, cognition, and mood scores in SVHD and controls. SVHD subjects showed significantly higher PHQ-9 and BAI scores, indicating more depressive and anxiety symptoms, as well as reduced GMI scores, suggesting impaired cognition, compared to controls. SVHD patients showed significantly reduced caudate volumes (left, 3,198.8 ± 490.1 vs. 3,605.0 ± 480.4 mm3 , p < 0.004; right, 3,162.1 ± 475.4 vs. 3,504.8 ± 465.9 mm3 , p < 0.011) over controls, and changes were localized in the rostral, mid-dorsolateral, and caudal areas. Significant negative correlations emerged between caudate volumes with PHQ-9 and BAI scores and positive correlations with GMI and MoCA scores in SVHD and controls. SVHD adolescents show significantly reduced caudate volumes, especially in sites that have projections to regulate mood and cognition, which may result from developmental and/or hypoxia-/ischemia-induced processes.
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reduced brain mammillary body volumes and memory deficits in adolescents who have undergone the fontan procedure
Pediatric Research, 2020Co-Authors: Cristina Cabreramino, Bhaswati Roy, Nancy J Halnon, Mary A Woo, Alan B Lewis, Sadhana Singh, Rajesh Kumar, Stefanie Moye, Nancy A PikeAbstract:Adolescents with single Ventricle Heart disease (SVHD) who have undergone the Fontan procedure show cognitive/memory deficits. Mammillary bodies are key brain sites that regulate memory; however, their integrity in SVHD is unclear. We evaluated mammillary body (MB) volumes and their associations with cognitive/memory scores in SVHD and controls. Brain MRI data were collected from 63 adolescents (25 SVHD; 38 controls) using a 3.0-Tesla MRI scanner. Cognition and memory were assessed using Montreal Cognitive Assessment (MoCA) and Wide Range Assessment of Memory and Learning 2. MB volumes were calculated and compared between groups (ANCOVA, covariates: age, sex, and total brain volume [TBV]). Partial correlations and linear regression were performed to examine associations between volumes and cognitive scores (covariates: age, sex, and TBV). SVHD group showed significantly lower MoCA and WRAML2 scores over controls. MB volumes were significantly reduced in SVHD over controls. After controlling for age, sex, and TBV, MB volumes correlated with MoCA and delayed memory recall scores in SVHD and controls. Adolescents with SVHD show reduced MB volumes associated with cognitive/memory deficits. Potential mechanisms of volume losses may include developmental and/or hypoxic/ischemic-induced processes. Providers should screen for cognitive deficits and explore possible interventions to improve memory.
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abstract 12655 reduced mammillary body volumes associated with memory deficits in single Ventricle Heart disease
Circulation, 2018Co-Authors: Cristina Cabreramino, Bhaswati Roy, Nancy J Halnon, Mary A Woo, Alan B Lewis, Sadhana Singh, Rajesh Kumar, Nancy A PikeAbstract:Introduction: Adolescents with single Ventricle Heart disease (SVHD) following staged surgical palliation show brain-related functional deficits, particularly in memory. The mammillary bodies are k...
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brain abnormalities in cognition anxiety and depression regulatory regions in adolescents with single Ventricle Heart disease
Journal of Neuroscience Research, 2018Co-Authors: Nancy A Pike, Bhaswati Roy, Nancy J Halnon, Mary A Woo, Alan B Lewis, Sadhana Singh, Ritika Gupta, Rajesh KumarAbstract:BACKGROUND Single Ventricle Heart disease (SVHD) adolescents show cognitive impairments and anxiety and depressive symptoms, indicating the possibility of brain injury in regions that control these functions. However, brain tissue integrity in cognition, anxiety, and depression regulatory sites in SVHD remains unclear. We examined brain tissue changes in SVHD compared to controls using T2-relaxometry procedures, which measure free water content and show tissue injury. METHODS Proton-density and T2-weighted images, using a 3.0-Tesla MRI, as well as anxiety (Beck anxiety inventory [BAI]), depressive symptoms (patient health questionnaire-9 [PHQ-9]), and cognition (wide range assessment of memory and learning 2 [WRAML2] and Montreal cognitive assessment [MoCA]) data were collected from 20 SVHD (age: 15.8 ± 1.1 years, male/female: 11/9) and 36 controls (age: 16.0 ± 1.1 years, male/female: 19/17). Whole-brain T2-relaxation maps were calculated, normalized to a common space, smoothed, and compared between groups and sexes (analysis of covariance; covariates: age, sex; p < 0.001). RESULTS SVHD subjects showed significantly increased BAI and PHQ-9 and reduced MoCA and WRAML2 scores over controls. Several brain regions in SVHD showed increased T2-relaxation values (chronic injury), including the cingulate, and insula, hippocampus/para-hippocampal gyrus, thalamus, hypothalamus, amygdala, frontal white matter, corpus callosum, brainstem, and cerebellar areas. Decreased T2-relaxation values (acute injury) emerged in a few regions, including the prefrontal and cerebellar cortices in SVHD over controls. In addition, male SVHD showed more brain changes over female SVHD. CONCLUSIONS Adolescents with SVHD showed significant brain injury with variable male-female differences in areas that control cognition, anxiety, and depression, which may contribute to functional deficits found in the condition.
Nancy J Halnon - One of the best experts on this subject based on the ideXlab platform.
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reduced hippocampal volumes and memory deficits in adolescents with single Ventricle Heart disease
Brain and behavior, 2021Co-Authors: Nancy A Pike, Bhaswati Roy, Cristina Cabreramino, Nancy J Halnon, Mary A Woo, Alan B Lewis, Stefanie Moye, Rajneesh KumarAbstract:INTRODUCTION Adolescents with single Ventricle congenital Heart disease (SVHD) show functional deficits, particularly in memory and mood regulation. Hippocampi are key brain structures that regulate mood and memory; however, their tissue integrity in SVHD is unclear. Our study aim is to evaluate hippocampal volumes and their associations with memory, anxiety, and mood scores in adolescents with SVHD compared to healthy controls. METHODS We collected brain magnetic resonance imaging data from 25 SVHD (age 15.9 ± 1.2 years; 15 male) and 38 controls (16.0 ± 1.1 years; 19 male) and assessed memory (Wide Range Assessment of Memory and Learning 2, WRAML2), anxiety (Beck Anxiety Inventory, BAI), and mood (Patient Health Questionnaire 9, PHQ-9) functions. Both left and right hippocampi were outlined and global volumes, as well as three-dimensional surfaces were compared between groups using ANCOVA and associations with cognitive and behavioral scores with partial correlations (covariates: age and total brain volume). RESULTS The SVHD group showed significantly higher BAI (p = .001) and PHQ-9 (p < .001) scores, indicating anxiety and depression symptoms and significantly reduced WRAML2 scores (p < .001), suggesting memory deficits compared with controls. SVHD group had significantly reduced right global hippocampal volumes (p = .036) compared with controls, but not the left (p = .114). Right hippocampal volume reductions were localized in the CA1, CA4, subiculum, and dentate gyrus. Positive correlations emerged between WRAML2 scores and left (r = 0.32, p = .01) and right (r = 0.28, p = .03) hippocampal volumes, but BAI and PHQ-9 did not show significant correlations. CONCLUSION Adolescents with SVHD show reduced hippocampal volumes, localized in several sites (CA1, CA4, subiculum, and dentate gyrus), which are associated with memory deficits. The findings indicate the need to explore ways to improve memory to optimize academic achievement and ability for self-care in the condition.
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caudate nuclei volume alterations and cognition and mood dysfunctions in adolescents with single Ventricle Heart disease
Journal of Neuroscience Research, 2020Co-Authors: Sarah Noorani, Bhaswati Roy, Ashish K Sahib, Cristina Cabreramino, Nancy J Halnon, Mary A Woo, Alan B Lewis, Nancy A Pike, Rajneesh KumarAbstract:Adolescents with single Ventricle Heart disease (SVHD) exhibit mood and cognitive deficits, which may result from injury to the basal ganglia structures, including the caudate nuclei. However, the integrity of the caudate in SVHD adolescents is unclear. Our aim was to examine the global and regional caudate volumes, and evaluate the relationships between caudate volumes and cognitive and mood scores in SVHD and healthy adolescents. We acquired two high-resolution T1-weighted images from 23 SVHD and 37 controls using a 3.0-Tesla MRI scanner, as well as assessed mood (Patient Health Questionnaire-9 [PHQ-9]; Beck Anxiety Inventory [BAI]) and cognition (Montreal Cognitive Assessment [MoCA]; Wide Range Assessment of Memory and Learning-2; General Memory Index [GMI]) functions. Both left and right caudate nuclei were outlined, which were then used to calculate and compare volumes between groups using ANCOVA (covariates: age, gender, and head-size), as well as perform 3D surface morphometry. Partial correlations (covariates: age, gender, and head-size) were used to examine associations between caudate volumes, cognition, and mood scores in SVHD and controls. SVHD subjects showed significantly higher PHQ-9 and BAI scores, indicating more depressive and anxiety symptoms, as well as reduced GMI scores, suggesting impaired cognition, compared to controls. SVHD patients showed significantly reduced caudate volumes (left, 3,198.8 ± 490.1 vs. 3,605.0 ± 480.4 mm3 , p < 0.004; right, 3,162.1 ± 475.4 vs. 3,504.8 ± 465.9 mm3 , p < 0.011) over controls, and changes were localized in the rostral, mid-dorsolateral, and caudal areas. Significant negative correlations emerged between caudate volumes with PHQ-9 and BAI scores and positive correlations with GMI and MoCA scores in SVHD and controls. SVHD adolescents show significantly reduced caudate volumes, especially in sites that have projections to regulate mood and cognition, which may result from developmental and/or hypoxia-/ischemia-induced processes.
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reduced brain mammillary body volumes and memory deficits in adolescents who have undergone the fontan procedure
Pediatric Research, 2020Co-Authors: Cristina Cabreramino, Bhaswati Roy, Nancy J Halnon, Mary A Woo, Alan B Lewis, Sadhana Singh, Rajesh Kumar, Stefanie Moye, Nancy A PikeAbstract:Adolescents with single Ventricle Heart disease (SVHD) who have undergone the Fontan procedure show cognitive/memory deficits. Mammillary bodies are key brain sites that regulate memory; however, their integrity in SVHD is unclear. We evaluated mammillary body (MB) volumes and their associations with cognitive/memory scores in SVHD and controls. Brain MRI data were collected from 63 adolescents (25 SVHD; 38 controls) using a 3.0-Tesla MRI scanner. Cognition and memory were assessed using Montreal Cognitive Assessment (MoCA) and Wide Range Assessment of Memory and Learning 2. MB volumes were calculated and compared between groups (ANCOVA, covariates: age, sex, and total brain volume [TBV]). Partial correlations and linear regression were performed to examine associations between volumes and cognitive scores (covariates: age, sex, and TBV). SVHD group showed significantly lower MoCA and WRAML2 scores over controls. MB volumes were significantly reduced in SVHD over controls. After controlling for age, sex, and TBV, MB volumes correlated with MoCA and delayed memory recall scores in SVHD and controls. Adolescents with SVHD show reduced MB volumes associated with cognitive/memory deficits. Potential mechanisms of volume losses may include developmental and/or hypoxic/ischemic-induced processes. Providers should screen for cognitive deficits and explore possible interventions to improve memory.
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abstract 12655 reduced mammillary body volumes associated with memory deficits in single Ventricle Heart disease
Circulation, 2018Co-Authors: Cristina Cabreramino, Bhaswati Roy, Nancy J Halnon, Mary A Woo, Alan B Lewis, Sadhana Singh, Rajesh Kumar, Nancy A PikeAbstract:Introduction: Adolescents with single Ventricle Heart disease (SVHD) following staged surgical palliation show brain-related functional deficits, particularly in memory. The mammillary bodies are k...
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brain abnormalities in cognition anxiety and depression regulatory regions in adolescents with single Ventricle Heart disease
Journal of Neuroscience Research, 2018Co-Authors: Nancy A Pike, Bhaswati Roy, Nancy J Halnon, Mary A Woo, Alan B Lewis, Sadhana Singh, Ritika Gupta, Rajesh KumarAbstract:BACKGROUND Single Ventricle Heart disease (SVHD) adolescents show cognitive impairments and anxiety and depressive symptoms, indicating the possibility of brain injury in regions that control these functions. However, brain tissue integrity in cognition, anxiety, and depression regulatory sites in SVHD remains unclear. We examined brain tissue changes in SVHD compared to controls using T2-relaxometry procedures, which measure free water content and show tissue injury. METHODS Proton-density and T2-weighted images, using a 3.0-Tesla MRI, as well as anxiety (Beck anxiety inventory [BAI]), depressive symptoms (patient health questionnaire-9 [PHQ-9]), and cognition (wide range assessment of memory and learning 2 [WRAML2] and Montreal cognitive assessment [MoCA]) data were collected from 20 SVHD (age: 15.8 ± 1.1 years, male/female: 11/9) and 36 controls (age: 16.0 ± 1.1 years, male/female: 19/17). Whole-brain T2-relaxation maps were calculated, normalized to a common space, smoothed, and compared between groups and sexes (analysis of covariance; covariates: age, sex; p < 0.001). RESULTS SVHD subjects showed significantly increased BAI and PHQ-9 and reduced MoCA and WRAML2 scores over controls. Several brain regions in SVHD showed increased T2-relaxation values (chronic injury), including the cingulate, and insula, hippocampus/para-hippocampal gyrus, thalamus, hypothalamus, amygdala, frontal white matter, corpus callosum, brainstem, and cerebellar areas. Decreased T2-relaxation values (acute injury) emerged in a few regions, including the prefrontal and cerebellar cortices in SVHD over controls. In addition, male SVHD showed more brain changes over female SVHD. CONCLUSIONS Adolescents with SVHD showed significant brain injury with variable male-female differences in areas that control cognition, anxiety, and depression, which may contribute to functional deficits found in the condition.
