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Are Anesthesia and Surgery during Infancy Associated with Decreased White Matter Integrity and Volume during Childhood?
Journal article   Open access   Peer reviewed

Are Anesthesia and Surgery during Infancy Associated with Decreased White Matter Integrity and Volume during Childhood?

Robert I Block, Vincent A Magnotta, Emine O Bayman, James Y Choi, Joss J Thomas and Karolie K Kimble
Anesthesiology (Philadelphia), Vol.127(5), pp.788-799
11/2017
DOI: 10.1097/ALN.0000000000001808
PMID: 28837436
url
https://doi.org/10.1097/ALN.0000000000001808View
Published (Version of record) Open Access

Abstract

Anesthetics have neurotoxic effects in neonatal animals. Relevant human evidence is limited. We sought such evidence in a structural neuroimaging study. Two groups of children underwent structural magnetic resonance imaging: patients who, during infancy, had one of four operations commonly performed in otherwise healthy children and comparable, nonexposed control subjects. Total and regional brain tissue composition and volume, as well as regional indicators of white matter integrity (fractional anisotropy and mean diffusivity), were analyzed. Analyses included 17 patients, without potential confounding central nervous system problems or risk factors, who had general anesthesia and surgery during infancy and 17 control subjects (age ranges, 12.3 to 15.2 yr and 12.6 to 15.1 yr, respectively). Whole brain white matter volume, as a percentage of total intracranial volume, was lower for the exposed than the nonexposed group, 37.3 ± 0.4% and 38.9 ± 0.4% (least squares mean ± SE), respectively, a difference of 1.5 percentage points (95% CI, 0.3 to 2.8; P = 0.016). Corresponding decreases were statistically significant for parietal and occipital lobes, infratentorium, and brainstem separately. White matter integrity was lower for the exposed than the nonexposed group in superior cerebellar peduncle, cerebral peduncle, external capsule, cingulum (cingulate gyrus), and fornix (cres) and/or stria terminalis. The groups did not differ in total intracranial, gray matter, and cerebrospinal fluid volumes. Children who had anesthesia and surgery during infancy showed broadly distributed, decreased white matter integrity and volume. Although the findings may be related to anesthesia and surgery during infancy, other explanations are possible.
Anesthesia - trends Age Factors Humans Magnetic Resonance Imaging - methods Organ Size White Matter - drug effects Infant Anesthesia - adverse effects Postoperative Complications - epidemiology White Matter - diagnostic imaging Adolescent Diffusion Magnetic Resonance Imaging - methods Child Infant, Newborn Postoperative Complications - diagnostic imaging

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