Cognitive and Attentional Function in Children with Hypoplastic Left Heart Syndrome: A Pilot Study

Area of Science:

• Pediatric Cardiology
• Neurodevelopmental Pediatrics
• Cognitive Psychology

Background:

• Improved survival rates for hypoplastic left heart syndrome (HLHS) have shifted focus to long-term neurodevelopmental outcomes.
• Previous research primarily assessed broad cognitive abilities in young children, leaving a gap in understanding specific cognitive functions in older youth with HLHS.

Purpose of the Study:

• To investigate specific cognitive functions and attention in youth aged 8 to 16 years with HLHS.
• To compare cognitive performance in HLHS youth to normative data.
• To explore potential correlations between cognitive deficits, attention problems, and age.

Main Methods:

• Pilot study involving 20 youth (ages 8-16) diagnosed with HLHS.
• Cognitive function assessed using the Wechsler Intelligence Scale for Children - Fifth Edition (WISC-V) and NIH Toolbox Cognition Battery (NTCB).
• Parental reports on behavior collected via the Child Behavior Checklist.

Main Results:

• HLHS youth demonstrated significantly lower scores than normative means across multiple WISC-V indices (Full Scale IQ, Verbal Comprehension, Visual Spatial, Working Memory, Processing Speed) and the NTCB Fluid Cognition Composite.
• Effect sizes for these cognitive deficits ranged from medium to large.
• Attention problems were significantly associated with poorer cognitive outcomes, and older age correlated with lower visual-spatial scores.

Conclusions:

• Youth with HLHS exhibit widespread and significant cognitive deficits, extending beyond broad measures.
• Attention difficulties represent a substantial challenge for this population.
• Comprehensive cognitive assessments are vital for identifying specific deficits to guide targeted interventions, with consideration for age and disease-related factors in future research.