Neuroimaging Correlates of the NIH-Toolbox-Driven Cognitive Metrics in Children

Background: The National Institutes of Health (NIH) Toolbox Cognition Battery is increasingly being used as a standardized test to examine cognitive functioning in multicentric studies. This study examines the associations between the NIH Toolbox Cognition Battery composite scores with neuroimaging metrics using data from the Adolescent Brain Cognitive Development (ABCD) study to elucidate the neurobiological and neuroanatomical correlates of these cognitive scores.

Methods: Neuroimaging data from 5290 children (mean age 9.9 years) were analyzed, assessing the correlation of the composite scores with Diffusion Tensor Imaging (DTI), structural Magnetic Resonance Imaging (sMRI), and resting-state functional connectivity (rs-fMRI). Results were adjusted for age, sex, race/ethnicity, head size, body mass index (BMI), and parental income and education.

Results: Higher fluid cognition composite scores were linked to greater white matter (WM) microstructural integrity, lower cortical thickness, greater cortical surface area, and mixed associations with rs-fMRI. Conversely, crystallized cognition composite scores showed more complex associations, suggesting that higher scores correlated with lower WM microstructure integrity. Total cognition scores reflected patterns consistent with a combination of both fluid and crystallized cognition, but with diluted specific insights. Our findings highlight the complexity of the neuroimaging correlates of the NIH Toolbox composite scores.

Conclusions: The results suggest that fluid cognition composite scores may serve as a marker for cognitive functioning, emphasizing neuroimaging's clinical relevance in assessing cognitive performance in children. These insights can guide early interventions and personalized education strategies. Future ABCD follow-ups will further illuminate these associations into adolescence and adulthood.