Affiliation:
1. Centre for the Developing Brain School of Biomedical Engineering and Imaging Sciences King's College London London UK
2. Department of Forensic and Neurodevelopmental Sciences Institute of Psychiatry Psychology & Neuroscience King's College London London UK
3. Paediatric Cardiology Department Evelina London Children's Healthcare London UK
4. Department of Psychology University of Cambridge Cambridge UK
5. Department of Psychological Sciences Centre for Brain and Cognitive Development Birkbeck University of London London UK
6. Department of Child and Adolescent Psychiatry Institute of Psychiatry Psychology and Neuroscience King's College London London UK
Abstract
AbstractBackgroundCongenital Heart Disease (CHD) is the most common congenital abnormality. Survival rates are over 90%, however infants with CHD remain at high risk of attention and executive function impairments. These abilities are difficult to assess in toddlers because clinical assessments rely on language abilities which are commonly delayed in CHD. Our aim was to characterise visual attention in toddlers with CHD compared to controls and identify associations with parent‐rated effortful control.MethodsThirty toddlers with CHD (19 male, median (IQR) age at assessment 22.2 (22–23.1) months) and 66 controls from the developing human connectome project (36 male, age at assessment 22 (21.5–23.8) months) using eye‐tracking tasks designed to assess multiple components of visual attention. Analyses of co‐variance and regressions were used to identify differences between groups and relationships between gaze behaviours and parent‐rated effortful control.ResultsToddlers with CHD were less accurate when switching behaviours (set‐shifting) [median (IQR) 79%, (28–100)] compared to controls [100% (86–100), pFDR = 0.032], with worse accuracy associated with lower parent‐rated effortful control in CHD but not controls (interaction pFDR = 0.028). Reaction times were slower during selective [CHD 1243 ms (986–1786), controls 1065 ms (0851–1397), pFDR<0.001] and exogenous attention tasks [CHD 312 ms (279–358), control 289 (249–331), (pFDR = 0.032) and endogenous attention was less mature (prolonged looks at facial stimuli CHD 670 ms (518–885), control 500 ms (250–625), (pFDR = 0.006). These results were unrelated to differences in cognition or socioeconomic status. In contrast, the allocation of attentional resources was preserved in CHD.ConclusionsWe identified a profile of altered attention and early executive functioning development in CHD. Eye‐tracking may provide clinically feasible, early objective measures of attention and executive function development in CHD.
Funder
Action Medical Research
British Heart Foundation
FP7 Ideas: European Research Council
Medical Research Council