Detecting neurodevelopmental trajectories in congenital heart diseases with a machine-learning approach.

Journal: Scientific reports
Published Date:

Abstract

We aimed to delineate the neuropsychological and psychopathological profiles of children with congenital heart disease (CHD) and look for associations with clinical parameters. We conducted a prospective observational study in children with CHD who underwent cardiac surgery within five years of age. At least 18 months after cardiac surgery, we performed an extensive neuropsychological (intelligence, language, attention, executive function, memory, social skills) and psychopathological assessment, implementing a machine-learning approach for clustering and influencing variable classification. We examined 74 children (37 with CHD and 37 age-matched controls). Group comparisons have shown differences in many domains: intelligence, language, executive skills, and memory. From CHD questionnaires, we identified two clinical subtypes of psychopathological profiles: a small subgroup with high symptoms of psychopathology and a wider subgroup of patients with ADHD-like profiles. No associations with the considered clinical parameters were found. CHD patients are prone to high interindividual variability in neuropsychological and psychological outcomes, depending on many factors that are difficult to control and study. Unfortunately, these dysfunctions are under-recognized by clinicians. Given that brain maturation continues through childhood, providing a significant window for recovery, there is a need for a lifespan approach to optimize the outcome trajectory for patients with CHD.

Authors

  • Elisa Cainelli
    Department of General Psychology, University of Padova, Padua, Italy. elisa.cainelli@unipd.it.
  • Patrizia S Bisiacchi
    Department of General Psychology, University of Padova, Padua, Italy. patrizia.bisiacchi@unipd.it.
  • Paola Cogo
    Department of Medicine, Clinica Pediatrica, University Hospital S Maria Della Misericordia, University of Udine, Udine, Italy.
  • Massimo Padalino
    Pediatric and Congenital Cardiovascular Surgery Unit, Department of Cardiac, Thoracic and Vascular Sciences, Padova University Hospital, Padua, Italy.
  • Manuela Simonato
    PCare Laboratory, Fondazione Istituto Di Ricerca Pediatrica "Citta Della Speranza", Padua, Italy.
  • Michela Vergine
    Department of Medicine, Clinica Pediatrica, University Hospital S Maria Della Misericordia, University of Udine, Udine, Italy.
  • Corrado Lanera
    Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35131 Padova, Italy.
  • Luca Vedovelli
    Unit of Biostatistics, Epidemiology, and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Padua, Italy.