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

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.