Figure 1, Key Figure -.

Impact of congenital heart disease on perinatal cortical maturation and subsequent cerebral impairments.

Cartoon illustrating perinatal cortical development in healthy conditions (A) and in congenital heart disease (B). Before corrective surgery, CHD reduces cerebral blood flow and oxygenation. In animal models, hypoxemia is associated with a disruption of subplate neuron maturation and connectivity prenatally, and a decrease of V-SVZ neurogenesis and interneuron populations in the frontal cortex postnatally. These alterations could result in a cortical excitation/inhibition imbalance and potentially explain the cellular basis for the spectrum of cognitive impairments observed in CHD patients. Green lines and arrows represent streams of neuroblasts in the V-SVZ migrating to the olfactory bulb and frontal lobe.