Poster No:
2093
Submission Type:
Abstract Submission
Authors:
Asuka Toyofuku1,2,3, Melanie Ehrler1,2,4, Alenka Schmid1,2, Nadja Naef2, Oliver Kretschmar5, Beatrice Latal1,2,4, Ruth Tuura1,3
Institutions:
1Children's Research Centre, University Children's Hospital Zurich, Zurich, Switzerland, 2Child Development Centre, University Children's Hospital Zurich, Zurich, Switzerland, 3Centre for MR Research, University Children's Hospital Zurich, Zurich, Switzerland, 4University Research Priority Program (URPP), Adaptive Brain Circuits in Development and Learning (AdaBD), University of Zurich, Zurich, Switzerland, 5Pediatric Cardiology, Pediatric Heart Center, Department of Surgery, University Children's Hospital, Zurich, Switzerland
First Author:
Asuka Toyofuku
Children's Research Centre, University Children's Hospital Zurich|Child Development Centre, University Children's Hospital Zurich|Centre for MR Research, University Children's Hospital Zurich
Zurich, Switzerland|Zurich, Switzerland|Zurich, Switzerland
Co-Author(s):
Melanie Ehrler
Children's Research Centre, University Children's Hospital Zurich|Child Development Centre, University Children's Hospital Zurich|University Research Priority Program (URPP), Adaptive Brain Circuits in Development and Learning (AdaBD), University of Zurich
Zurich, Switzerland|Zurich, Switzerland|Zurich, Switzerland
Alenka Schmid
Children's Research Centre, University Children's Hospital Zurich|Child Development Centre, University Children's Hospital Zurich
Zurich, Switzerland|Zurich, Switzerland
Nadja Naef
Child Development Centre, University Children's Hospital Zurich
Zurich, Switzerland
Oliver Kretschmar
Pediatric Cardiology, Pediatric Heart Center, Department of Surgery, University Children's Hospital
Zurich, Switzerland
Beatrice Latal
Children's Research Centre, University Children's Hospital Zurich|Child Development Centre, University Children's Hospital Zurich|University Research Priority Program (URPP), Adaptive Brain Circuits in Development and Learning (AdaBD), University of Zurich
Zurich, Switzerland|Zurich, Switzerland|Zurich, Switzerland
Ruth Tuura
Children's Research Centre, University Children's Hospital Zurich|Centre for MR Research, University Children's Hospital Zurich
Zurich, Switzerland|Zurich, Switzerland
Introduction:
Heart Rate Variability (HRV) originates from the dynamic interplay between parasympathetic/sympathetic inputs to the heart, thus serving as an indicator of Autonomic Nervous System (ANS) regulation (Malik et al., 1996). Prior research has identified both positive and negative associations between HRV and brain morphology, including grey matter volume and cortical thickness, mainly in the cingulate cortex (Matusik et al., 2023). HRV is also linked with cognitive function, such that decreased HRV, marked by reduced autonomic balance, is related to poorer cognitive performance (Forte, Favieri and Casagrande, 2019). The connection between HRV and cognitive function could be explained by the common central autonomic network (CAN), which controls both the cardiac autonomic function and cognitive regulation (Thayer et al., 2009). However, previous literature mainly investigated healthy populations with a normal range of HRV. While the population with congenital heart disease (CHD) may show changes in HRV (Nederend et al., 2016), brain structure and cognitive function linked with the heart defect (Brossard-Racine and Panigrahy, 2023), the association between these variables in CHD remains unexplored. Thus, this study examines the brain volumetric and surface correlates of HRV and cognitive function in adolescents with CHD.
Methods:
58 adolescents with CHD who went through open-heart surgery during infancy and 86 healthy controls (52.7% males, 12.7±1.4 years) underwent neurodevelopmental testing and global executive function, and IQ were calculated. A cerebral MRI was performed on a 3T GE MR750 scanner. High-resolution T1-weighted images were acquired using a three-dimensional spoiled gradient echo pulse sequence (SPGR) with the following parameters: repetition time/echo time (TR/TE)=11/5ms; inversion time=600ms; flip angle=8°; reconstructed matrix=256×256; field of view (FOV)=26cm; 176contiguous axial slices, 1mm slice thickness. SPGR images were segmented with Freesurfer 7.1 using standard preprocessing and an extensive quality assessment protocol. Grey and white matter volume, cortical thickness, and surface area were calculated following surface deformation to identify the cortical pial and white matter surfaces. Photoplethysmograph recordings were obtained during the MRI. HRV was quantified as the number of temporal differences (>50ms) between successive heartbeats. The associations between brain measurements, HRV and cognitive function were analysed with multiple linear regression.
Results:
Adolescents with CHD showed lower HRV (p=0.004), cortical grey matter volume (p<0.001), cortical thickness (p=0.003), and pial surface area (p=0.004) than controls. HRV was positively associated with cortical grey volume (β=0.194, p=0.027) and with pial surface area (β=0.201, p=0.023) in the whole sample but not with cortical thickness (p=0.387). Positive correlations were found between IQ and cortical grey volume (β=0.436, p<0.001), pial surface area (β=0.453, p<0.001) and cortical thickness (β=0.167, p=0.033), as well as global executive function and those brain measurements. Furthermore, increased HRV was correlated with better global executive function (β=0.220, p=0.029) and higher IQ (β=0.229, p=0.017) in the whole sample and with higher IQ (β=0.388, p=0.032) in the CHD group. These associations were robust to confounders, including age, sex, and socioeconomic status.
Conclusions:
Our findings highlight the anatomical underpinnings for HRV and autonomic regulation in adolescents, in line with prior research. Our results also demonstrated the association between HRV and cognitive functions, with the CHD group mainly driving the correlation, indicating the brain morphological correlates of HRV and cognitive function. Importantly, adolescents with CHD exhibit vulnerability to poorer IQ and altered brain development in connection with reduced HRV and autonomic imbalance. Future studies should elucidate more detailed mechanisms of the brain-heart interaction in CHD.
Higher Cognitive Functions:
Executive Function, Cognitive Control and Decision Making 2
Modeling and Analysis Methods:
Segmentation and Parcellation
Neuroanatomy, Physiology, Metabolism and Neurotransmission:
Anatomy and Functional Systems 1
Keywords:
Cognition
Cortex
Morphometrics
PEDIATRIC
STRUCTURAL MRI
Other - heart rate variability (HRV)
1|2Indicates the priority used for review
Provide references using author date format
Brossard-Racine, M. and Panigrahy, A. (2023) ‘Structural Brain Alterations and Their Associations With Function in Children, Adolescents, and Young Adults With Congenital Heart Disease’, The Canadian journal of cardiology, 39(2), pp. 123–132.
Forte, G., Favieri, F. and Casagrande, M. (2019) ‘Heart Rate Variability and Cognitive Function: A Systematic Review’, Frontiers in neuroscience, 13, p. 710.
Malik, M. et al. (1996) ‘Heart rate variability: Standards of measurement, physiological interpretation, and clinical use’, European heart journal, 17(3), pp. 354–381.
Matusik, P.S. et al. (2023) ‘Neuroimaging Studies of the Neural Correlates of Heart Rate Variability: A Systematic Review’, Journal of clinical medicine research, 12(3). Available at: https://doi.org/10.3390/jcm12031016.
Nederend, I. et al. (2016) ‘Postnatal Cardiac Autonomic Nervous Control in Pediatric Congenital Heart Disease’, Journal of cardiovascular development and disease, 3(2). Available at: https://doi.org/10.3390/jcdd3020016.
Thayer, J.F. et al. (2009) ‘Heart rate variability, prefrontal neural function, and cognitive performance: the neurovisceral integration perspective on self-regulation, adaptation, and health’, Annals of behavioral medicine: a publication of the Society of Behavioral Medicine, 37(2), pp. 141–153.