Association of Retinal Microvascular Characteristics With Short-term Memory Performance in Children Aged 4 to 5 Years
Association of Retinal Microvascular Characteristics With Short-term Memory Performance in Children Aged 4 to 5 Years
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DOI：
10.1001/jamanetworkopen.2020.11537
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发表时间：
2020-07-24
影响因子：
13.8
通讯作者：
Nawrot, Tim S.
中科院分区：
文献类型：
--
作者：
Luyten, Leen J.;Dockx, Yinthe;Nawrot, Tim S.
这项队列研究调查了4至5岁儿童视网膜血管特征和神经功能之间的关系。问题视网膜微血管特征是否反映了儿童早期的神经认知发育？结果在这项队列研究的251名4至5岁的儿童，视网膜小静脉增宽和血管迂曲度较高与短期视觉识别记忆的表现较低，通过延迟匹配样本任务的剑桥神经心理测试自动电池进行评估。意义这些协会之间的视网膜微血管特征和神经认知发展的幼儿提供了基本信息之间的关联的微血管和神经认知从生命早期forward.Importance神经认知功能的发展迅速，在幼儿期，并依赖于大脑结构和循环系统之间的内在合作。视网膜微血管系统可以看作是脑血管循环的镜像。目的探讨4 ~ 5岁儿童视网膜血管特征与神经功能的关系。在这项队列研究中，从2010年2月10日至2014年6月24日出生时招募了母婴对，并在2014年12月10日至2018年7月13日的随访访视中更新了同意书。参与者在前瞻性环境对早期生命出生队列中衰老的影响中进行纵向随访。共有251名儿童接受了这项研究的评估。数据分析时间为2019年7月17日至10月30日。主要结果和测量视网膜血管直径、视网膜中央小动脉当量（CRAE）、视网膜中央小静脉当量（CRVE）、血管迂曲度和分形维数。采用剑桥神经心理测验自动化成套测验对注意和心理速度、视觉空间工作记忆和短时视觉识别记忆进行评估，包括以下任务：运动筛选（MOT）、大/小圆圈（BLC）、空间广度（SSP）和延迟匹配样本（DMS）。结果纳入评估的251名儿童中，（135名女孩[53.8%];平均[SD]年龄为4.5 [0.4]岁），CRVE每增加1-SD，儿童的表现相对为2.74%（95% CI，-0.12至5.49; P = 0.06）在MOT检验中较慢，有1.76%（95% CI，-3.53%至-0.04%; P = 0.04）总体上正确的DMS评估较少，（95% CI，0.39至5.29; P = 0.02）在DMS任务中，在多元线性回归建模中，给出先前正确答案的错误更多。CRAE中每增加1-SD，DMS任务中错误和先前正确答案错误的总百分比分别增加1.44%（95%CI，-3.25%至0.29%; P = 0.09）和2.30%（95%CI，-0.14%至4.61%; P = 0.07）。血管迂曲度增加1-SD，显示DMS任务表现的潜伏期相对增加4.32%（95% CI，-0.48%至9.12%; P = 0.07）。视网膜血管特征与BLC和SSP测试结果无关。结论和相关性这些研究结果表明，儿童的微血管表型与短期记忆和视网膜微血管的变化可能反映在儿童早期的神经发育。
This cohort study investigates the association between retinal vessel characteristics and neurological functioning in children aged 4 to 5 years.Question Do retinal microvascular traits reflect neurocognitive development in early childhood? Findings In this cohort study of 251 children aged 4 to 5 years, retinal venular widening and a higher vessel tortuosity were associated with a lower performance of short-term visual recognition memory, assessed by means of the Delayed Matching to Sample task of the Cambridge Neuropsychological Test Automated Battery. Meaning These associations between retinal microvascular characteristics and neurocognitive development in young children provide fundamental information on the association between the microvasculature and neurocognition from early life onwards.Importance Neurocognitive functions develop rapidly in early childhood and depend on the intrinsic cooperation between cerebral structures and the circulatory system. The retinal microvasculature can be regarded as a mirror image of the cerebrovascular circulation. Objective To investigate the association between retinal vessel characteristics and neurological functioning in children aged 4 to 5 years. Design, Setting, and Participants In this cohort study, mother-child pairs were recruited at birth from February 10, 2010, to June 24, 2014, and renewed consent at their follow-up visit from December 10, 2014, to July 13, 2018. Participants were followed up longitudinally within the prospective Environmental Influence on Aging in Early Life birth cohort. A total of 251 children underwent assessment for this study. Data were analyzed from July 17 to October 30, 2019. Main Outcomes and Measures Retinal vascular diameters, the central retinal arteriolar equivalent (CRAE), central retinal venular equivalent (CRVE), vessel tortuosity, and fractal dimensions were determined. Attention and psychomotor speed, visuospatial working memory, and short-term visual recognition memory were assessed by the Cambridge Neuropsychological Test Automated Battery, including the following tasks: Motor Screening (MOT), Big/Little Circle (BLC), Spatial Span (SSP), and Delayed Matching to Sample (DMS). Results Among the 251 children included in the assessment (135 girls [53.8%]; mean [SD] age, 4.5 [0.4] years), for every 1-SD widening in CRVE, the children performed relatively 2.74% (95% CI, -0.12 to 5.49; P = .06) slower on the MOT test, had 1.76% (95% CI, -3.53% to -0.04%; P = .04) fewer correct DMS assessments in total, and made 2.94% (95% CI, 0.39 to 5.29; P = .02) more errors given a previous correct answer in the DMS task on multiple linear regression modeling. For every 1-SD widening in CRAE, the total percentage of errors and errors given previous correct answers in the DMS task increased 1.44% (95% CI, -3.25% to 0.29%; P = .09) and 2.30% (95% CI, -0.14% to 4.61%; P = .07), respectively. A 1-SD higher vessel tortuosity showed a 4.32% relative increase in latency in DMS task performance (95% CI, -0.48% to 9.12%; P = .07). Retinal vessel characteristics were not associated with BLC and SSP test outcomes. Conclusions and Relevance These findings suggest that children's microvascular phenotypes are associated with short-term memory and that changes in the retinal microvasculature may reflect neurological development during early childhood.