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What did the project achieve?
“We have identified altered brain development in babies with congenital heart disease – and shown that these changes occurring when the baby is still in the womb can impact on their cognitive performance in early childhood,” says Professor Serena Counsell of King’s College London. “Finding ways to boost the amount of oxygen reaching the developing fetal brain and targeted interventions to support parents during the critical early years may help improve outcomes for these vulnerable children.”
Congenital heart disease affects almost one in 100 babies born each year in the UK.1 Thanks to advances in early diagnosis and treatment, around eight out of 10 children with these conditions will now grow up to become adults.2 However, they tend to do worse at school, with up to half experiencing neurodevelopmental problems.2
Professor Counsell is leading a team of researchers who are studying children with congenital heart disease who underwent advanced magnetic resonance imaging (MRI) brain scans shortly after birth, before having surgery to correct their heart defect. They have now carried out tests to assess the children’s movement, learning and language skills at two years.
“We identified several alterations in the brains of babies with congenital heart disease compared with healthy children,” says Professor Counsell. “These include changes in regions that play an important role in various brain functions – including movement, memory and thinking skills.”
The team also demonstrated that smaller brain volumes in newborn babies with congenital heart disease are linked with lower amounts of oxygen reaching the brain during development inside the womb and lower cognitive performance in childhood.
“Importantly, we showed that a mentally stimulating home environment led to a higher cognitive performance in toddlers with congenital heart disease, even when accounting for socioeconomic factors,” says Professor Counsell. “This suggests that strategies aimed at supporting parents may help promote healthy brain development in children at high risk of neurodevelopmental problems.”
This research was completed on
Congenital heart disease includes a range of heart problems that develop in the womb before a baby is born. As one of the most common birth abnormalities, they affect almost one in 100 babies born each year in the UK.1 These heart problems can be serious and sadly, some children lose their lives. But, thanks to advances in early diagnosis and treatment, around eight out of 10 children with congenital heart disease will now grow up to become adults.2 However, they tend to do worse at school, with up to half experiencing neurodevelopmental problems.2 Professor Serena Counsell at King’s College London is investigating the causes of neurodevelopmental delay in children with congenital heart disease, paving the way towards new life-improving treatments.
How are children’s lives affected now?
There are many different types of congenital heart disease, including conditions where a baby’s heart valves don’t form properly or there are holes between the chambers of their heart. For many babies, their problem doesn’t require treatment, or can be corrected with heart surgery. But for others, it can be more serious and sadly, some do not survive.
“Thanks to a combination of outstanding advances in treatment and earlier diagnosis, today most children will survive congenital heart disease and grow up to become adults,” says Professor Counsell.
But unfortunately, this comes at a cost – children with these conditions tend to do worse at school, with up to half experiencing problems with movement, coordination, memory, hyperactivity, attention, speech and language skills.
“We need to understand why so many of these children go on to experience neurodevelopmental difficulties that can have a major impact on their life chances,” says Professor Counsell.
How could this research help?
“Our aim is to reduce the long-term effects of congenital heart disease on brain development, helping children to achieve their full potential” says Professor Counsell. “But first, we need to find out more about what is going wrong.”
To tackle this, she is bringing together a team of leading doctors and scientists who have already collected cutting-edge magnetic resonance imaging (MRI) brain scans of 80 newborn babies with these diseases, before they underwent surgery.
Now that the children are around two years old, the researchers are planning to repeat the scans, as well as carry out tests to assess their movement, learning and language skills. They will look for any specific changes in their brain scans that link with neurodevelopmental delay.
“We hope we can improve our understanding of why many children with congenital heart disease experience neurodevelopmental problems, and achieve a more accurate way of measuring brain development – giving us the tools we will need to test new treatments in the future,” says Professor Counsell.
References
1.NHS Choices website: https://www.nhs.uk/conditions/congenital-heart-disease/ [Website accessed 04/12/2017]
2.Latal B. Neurodevelopmental outcomes of the child with congenital heart disease. Clinical Perinatology 2016; 43(1): 173-85
| Project Leader | Professor Serena J Counsell, PhD |
| Project Team | Dr Dafnis Batalle, PhDDr Chiara Nosarti, PhDProfessor John Simpson, FRCPDr Donald Tournier, PhDDr Suresh Victor, FRCPCHProfessor Mary A Rutherford, FRCR |
| Project Location | Department of Perinatal Imaging and Health, Centre for the Developing Brain, King’s College London |
| Project Location Other | Department of Psychosis Studies, Institute of Psychiatry, King’s College LondonFetal Cardiology, Guy’s and St Thomas’ NHS Foundation Trust, LondonDepartment of Perinatal Imaging and Health, Division of Imaging Sciences and Biomedical Engineering, King’s College London |
| Project duration | 30 months |
| Date awarded | 20 November 2017 |
| Project start date | 9 April 2018 |
| Project end date | 31 March 2021 |
| Grant amount | £174,035 |
| Grant code | GN2630 |
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