Children's National receives grant to identify early signs of prenatal brain injury caused by CHD

Children's National Medical Center has received a five-year grant from the National Institutes of Health to identify reliable early signs of prenatal brain injury caused by congenital heart disease. Catherine Limperopoulos, PhD, Director of the Advanced Pediatric Brain Imaging Research Laboratory at Children's National will lead the study.

Congenital heart disease (CHD) is the most common birth defect. While recent advances have greatly increased survival rates, brain injury associated with CHD remains a challenge and can cause long-term developmental disabilities. A substantial part of the neurologic injury may be prenatal in origin, but exactly how CHD disrupts fetal brain development remains unclear.

"This award reflects the pioneering contributions Dr. Limperopoulos is making in pediatric and prenatal brain imaging, and it is even more significant considering that we are in a period of tight federal research funding," said Mark L. Batshaw, MD, Executive Vice President, Chief Academic Officer, and Physician-in-Chief for Children's National. "This study may help us find earlier ways to detect potential harm to the brain from congenital heart disease and ultimately may help us determine appropriate interventions so that more babies with CHD have an excellent outcome."

Earlier studies by Children's National showed for the first time that impaired brain development in fetuses with CHD occurs largely during the third trimester.

In the study funded by this grant, the Children's National research team will use echocardiography (ultrasound) and quantitative magnetic resonance imaging (MRI) to measure fetal blood circulation and brain maturation, in order to identify the earliest signs, or biomarkers, of impaired brain development in fetuses diagnosed with complex CHD. The study will examine the early and long-term neurodevelopmental significance of these biomarkers.

"In past studies, we have developed and validated new methods to safely and reliably quantify fetal and newborn brain development and metabolism using advanced MRI techniques," said Dr. Limperopoulos. "Our goal now is to develop ways to reliably and non-invasively detect, before birth, those cases with CHD that are at high risk for early brain injury. This will begin to open windows for new treatments to limit or even prevent impaired brain development."

Dr. Limperopoulos is also Director of MRI Research of the Developing Brain at Children's National and an Associate Professor of Neurology, Radiology and Pediatrics at George Washington University School of Medicine and Health Sciences. Her research focuses on the causes and consequences of early life brain injury in high-risk fetal, pre-term, and full-term infant populations. The long-term goal of the Advanced Pediatric Brain Imaging Research Laboratory at Children's National is to guide medical and rehabilitation interventions aimed at preventing brain injury and minimizing long-term developmental disability.