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Association of Retinal Microvascular Characteristics With Short-term Memory Performance in Children Aged 4 to 5 Years
Leen J Luyten1,2, Yinthe Dockx1, Narjes Madhloum1
1Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium.
Insights
Wider retinal venules in children are linked to slower psychomotor speed and poorer short-term visual memory. Retinal microvascular changes may indicate early childhood neurological development.
Area of Science:
- Pediatric Ophthalmology
- Neuroscience
- Developmental Biology
Background:
- Early childhood neurocognitive development relies on cerebral and circulatory system interplay.
- The retinal microvasculature serves as a proxy for cerebrovascular health.
Purpose of the Study:
- To examine the relationship between retinal vessel characteristics and neurological function in 4- to 5-year-old children.
Main Methods:
- A longitudinal cohort study followed 251 children from birth.
- Retinal vascular parameters (CRAE, CRVE, tortuosity, fractal dimensions) were measured.
- Neurological functions, including attention, psychomotor speed, and memory, were assessed using the Cambridge Neuropsychological Test Automated Battery.
Main Results:
- Increased central retinal venular equivalent (CRVE) was associated with slower psychomotor speed and reduced visual memory accuracy.
- Wider central retinal arteriolar equivalent (CRAE) and increased vessel tortuosity showed trends toward poorer performance on memory tasks.
- No significant associations were found between retinal vessel characteristics and visuospatial working memory or executive function tasks.
Conclusions:
- Children's microvascular phenotypes correlate with short-term memory capabilities.
- Retinal microvascular alterations may reflect ongoing neurological development in early childhood.
Importance:
Neurocognitive functions develop rapidly in early childhood and depend on the intrinsic cooperation between cerebral structures and the circulatory system. The retinal microvasculature can be regarded as a mirror image of the cerebrovascular circulation.
Objective:
To investigate the association between retinal vessel characteristics and neurological functioning in children aged 4 to 5 years.
Design, Setting, And Participants:
In this cohort study, mother-child pairs were recruited at birth from February 10, 2010, to June 24, 2014, and renewed consent at their follow-up visit from December 10, 2014, to July 13, 2018. Participants were followed up longitudinally within the prospective Environmental Influence on Aging in Early Life birth cohort. A total of 251 children underwent assessment for this study. Data were analyzed from July 17 to October 30, 2019.
Main Outcomes And Measures:
Retinal vascular diameters, the central retinal arteriolar equivalent (CRAE), central retinal venular equivalent (CRVE), vessel tortuosity, and fractal dimensions were determined. Attention and psychomotor speed, visuospatial working memory, and short-term visual recognition memory were assessed by the Cambridge Neuropsychological Test Automated Battery, including the following tasks: Motor Screening (MOT), Big/Little Circle (BLC), Spatial Span (SSP), and Delayed Matching to Sample (DMS).
Results:
Among the 251 children included in the assessment (135 girls [53.8%]; mean [SD] age, 4.5 [0.4] years), for every 1-SD widening in CRVE, the children performed relatively 2.74% (95% CI, -0.12 to 5.49; P = .06) slower on the MOT test, had 1.76% (95% CI, -3.53% to -0.04%; P = .04) fewer correct DMS assessments in total, and made 2.94% (95% CI, 0.39 to 5.29; P = .02) more errors given a previous correct answer in the DMS task on multiple linear regression modeling. For every 1-SD widening in CRAE, the total percentage of errors and errors given previous correct answers in the DMS task increased 1.44% (95% CI, -3.25% to 0.29%; P = .09) and 2.30% (95% CI, -0.14% to 4.61%; P = .07), respectively. A 1-SD higher vessel tortuosity showed a 4.32% relative increase in latency in DMS task performance (95% CI, -0.48% to 9.12%; P = .07). Retinal vessel characteristics were not associated with BLC and SSP test outcomes.
Conclusions And Relevance:
These findings suggest that children's microvascular phenotypes are associated with short-term memory and that changes in the retinal microvasculature may reflect neurological development during early childhood.
