Language brain responses and neurodevelopmental outcome in preschoolers with congenital heart disease: A fNIRS study
Sarah Provost1, Solène Fourdain1, Phetsamone Vannasing2
1Department of Psychology, Université de Montréal, Montréal, QC, Canada; Research Center, Sainte-Justine University Hospital Research Center, Montréal, QC, Canada.
Insights
Children with congenital heart disease (CHD) show reduced brain activity in language processing areas. This reduced temporal posterior activation is linked to lower neurodevelopmental outcomes in preschoolers.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Cognitive Science
Background:
- Congenital heart disease (CHD) survivors often experience neurodevelopmental disabilities, including language difficulties.
- Structural brain alterations are known in CHD, but functional brain activity during language processing remains understudied.
- Early identification of neurodevelopmental vulnerabilities in children with CHD is crucial.
Purpose of the Study:
- To characterize brain responses during a passive story-listening task in 3-year-old children with CHD.
- To investigate the relationship between functional brain patterns and neurodevelopmental outcomes in this population.
- To identify potential brain markers for cognitive development in children with CHD.
Main Methods:
- Functional near-infrared spectroscopy (fNIRS) was used to assess hemodynamic changes during a story-listening task.
- Neurodevelopmental outcomes were evaluated using the Wechsler Preschool and Primary Scale of Intelligence - 4th Edition (WPPSI-IV).
- The study included 19 children with CHD and 23 healthy controls.
Main Results:
- Children with CHD exhibited significantly lower scores on multiple WPPSI-IV indices, including Verbal Comprehension Index (VCI) and General Ability Index (GAI).
- Healthy controls showed robust hemodynamic responses in temporal and temporal posterior regions during story listening.
- Children with CHD displayed reduced activation in temporal posterior regions, which correlated with lower neurodevelopmental outcomes.
Conclusions:
- This study reveals diminished functional brain responses in preschoolers with CHD during receptive language tasks.
- Reduced temporal posterior activation may serve as a potential brain marker for cognitive development in children with CHD.
- Findings support the feasibility of using brain functional measures to identify neurodevelopmental vulnerabilities in children with CHD.
Abstract:
Neurodevelopmental disabilities affect up to 50% of survivors of congenital heart disease (CHD). Language difficulties are frequently identified during preschool period and can lead to academic, social, behavioral, and emotional difficulties. Structural brain alterations are associated with poorer neurodevelopmental outcomes in patients with CHD during infancy, childhood, and adolescence. However, evidence is lacking about the functional brain activity in children with CHD and its relationship with neurodevelopment. This study therefore aimed to characterize brain responses during a passive story-listening task in 3-year-old children with CHD, and to investigate the relationship between functional brain patterns of language processing and neurodevelopmental outcomes. To do so, we assessed hemodynamic concentration changes, using functional near-infrared spectroscopy (fNIRS), and neurodevelopmental outcomes, using the Wechsler Preschool and Primary Scale of Intelligence - 4th Edition (WPPSI-IV), in children with CHD (n = 19) and healthy controls (n = 23). Compared to their healthy peers, children with CHD had significantly lower scores on the Verbal comprehension index (VCI), the Vocabulary acquisition index (VAI), the General ability index (GAI), and the Information and the Picture Naming subtests of the WPPSI-IV. During the passive story-listening task, healthy controls showed significant hemodynamic brain responses in the temporal and the temporal posterior regions, with stronger activation in the temporal posterior than in the temporal regions. In contrast, children with CHD showed reduced activation in the temporal posterior regions compared to controls, with no difference of activation between regions. Reduced brain responses in the temporal posterior regions were also correlated with lower neurodevelopmental outcomes in both groups. This is the first study that reveals reduced brain functional responses in preschoolers with CHD during a receptive language task. It also suggests that the temporal posterior activation could be a potential brain marker of cognitive development. These findings provide support for the feasibility of identifying brain correlates of neurodevelopmental vulnerabilities in children with CHD.
