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Abstract #3445

Global structural network topology mediates neurocognitive outcome in children with congenital heart defects

Vincent Jerome Schmithorst 1 , Ashok Panigrahy 1 , Jessica Wisnowski 1 , Chris Walsh 2 , David Bellinger 2 , Jane Newburger 2 , and Michael Rivkin 2

1 Radiology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, United States, 2 Boston Children's Hospital, Boston, MA, United States

The precise connection between brain structural/functional differences and neurocognitive deficits in patients with congenital heart defects (CHD) remains poorly understood. We applied graph analysis to DTI data acquired from adolescents born with transposition of the great arteries (d-TGA) corrected surgically in early infancy, and typically developing controls. We used statistical mediation models to more precisely delineate the relation between d-TGA, perioperative factors, global structural network topology, and neurocognitive outcomes. Differences in network topology (increased modularity and small-worldness, decreased global efficiency) mediated worse neurocognitive outcome in d-TGA patients; these effects were ameliorated by longer therapeutic hypothermia during the arterial switch operation.

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