Author(s)
Nithya Navarathna, BS
Sergio L. Novi, PhD
Sabrina Nusraty, BS
Amal Isaiah, BS
Affiliation(s)
University of Maryland Medical Center
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to understand how functional near-infrared spectroscopy (fNIRS) can be used to assess the relationship between PFC activation and cognitive performance in children with sleep-disordered breathing.
Objectives: Sleep-disordered breathing (SDB) affects up to 10% of children and is associated with executive dysfunction and poor academic outcomes. This study examined the relationship between prefrontal cortex (PFC) activation measured by functional near-infrared spectroscopy (fNIRS) and cognitive performance in children evaluated for SDB.
Study Design: Two-center prospective observational study from January 2024 to July 2025.
Methods: We enrolled 210 children aged 5-11 years referred for clinical evaluation of SDB. During fNIRS measurement, participants completed a Go/No-Go task assessing response inhibition. Cognitive performance was measured using the NIH-Toolbox Cognition Battery, including domains of inhibitory control, language-based reasoning, crystallized cognition, and overall cognitive performance. Pearson correlations were computed between regional brain activation and standardized cognitive scores.
Results: Higher cognitive performance was associated with lower task-related PFC activation, suggesting greater neural efficiency. Inhibitory control correlated negatively with activation in the left superior frontal gyrus (r=–0.28, P<0.001) and positively with the right frontal gyrus (r=0.28, P=0.02). Similar spatial activation patterns were observed for crystallized cognition, indicating overlapping PFC organization for inhibitory control and language-based tasks. Significant correlations between PFC activation and cognitive performance were observed specifically for inhibitory control, oral reading recognition, crystallized cognition, and overall cognitive composite scores.
Conclusions: Children with SDB and stronger cognitive performance demonstrated reduced task related PFC activation, reflecting greater neural efficiency. These findings highlight fNIRS-derived neural efficiency as a potential biomarker of cognitive resilience in pediatric SDB and may inform targeted interventions for children at risk of cognitive impairment.