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Assessing Executive Function in Pediatric Sleep-Disordered Breathing Using Functional Neuroimaging.

Nithya Navarathna^1,2, Sergio L Novi¹, Sophia Uddin¹

¹Department of Otorhinolaryngology-Head and Neck Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA.

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|July 17, 2025

Summary

This summary is machine-generated.

This study shows functional near-infrared spectroscopy (fNIRS) can assess brain activity in children with sleep-disordered breathing (SDB). Reduced prefrontal cortex activation in children with SDB correlates with symptom severity and executive dysfunction.

Keywords:

behavior executive function functional near‐infrared spectroscopy pediatric sleep‐disordered breathing prefrontal cortex

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Area of Science:

Pediatric Neurology
Neuroimaging
Sleep Medicine

Background:

Sleep-disordered breathing (SDB) affects 10% of children, linked to attention and executive function deficits.
Neural mechanisms of SDB's impact on cognition are poorly understood in school-aged children.
Functional magnetic resonance imaging (fMRI) is challenging for this age group due to motion artifacts.

Purpose of the Study:

To evaluate the feasibility of functional near-infrared spectroscopy (fNIRS) for assessing prefrontal cortex (PFC) activation in children with SDB.
To investigate the relationship between SDB symptom burden, executive function, and PFC activity.
To explore fNIRS as a child-friendly neuroimaging tool for pediatric SDB research.

Main Methods:

Prospective observational study involving 78 children (ages 5-11) with SDB.
fNIRS recorded PFC activity during a Go/No-Go task assessing response inhibition.
Pediatric Sleep Questionnaire and Behavior Rating Inventory of Executive Function (BRIEF) assessed SDB symptoms and executive function.

Main Results:

Greater SDB symptom burden correlated with reduced PFC activation (r = -0.31, P = .028 in left middle frontal gyrus).
Higher executive dysfunction scores were associated with lower PFC activation across multiple regions.
Left dorsolateral PFC activation moderated the SDB-Symptom-Executive Function relationship, indicating potential neural compensation.

Conclusions:

Task-based fNIRS is a feasible method for studying neural correlates of SDB in children.
SDB symptoms negatively impact PFC activation, potentially mediating behavioral effects.
fNIRS offers a practical approach for investigating brain function in pediatric SDB.