Neonatal brain structure, cognitively stimulating parenting and behavioural outcomes in preschool children with congenital heart disease and controls

B Barat Gal-Er (Centre for the Developing Brain, Research Department of Early Life Imaging, School of Biomedical Engineering and Imaging Sciences, King’s College London) A Alexandra F. Bonthrone (Centre for the Developing Brain, Research Department of Early Life Imaging, School of Biomedical Engineering and Imaging Sciences, King’s College London) A Andrew T.M. Chew S Sian Wilson D Daniel Cromb (Centre for the Developing Brain, Research Department of Early Life Imaging, School of Biomedical Engineering and Imaging Sciences, King’s College London) A Alexia Egloff K Kuberan Pushparajah (Research Department of Cardiovascular Imaging, School of Biomedical Engineering & Imaging Sciences, King’s College London) J John Simpson (Department of Fetal and Paediatric Cardiology, Evelina London Children’s Hospital) M Mirthe E.M. van der Meijden M Mary A. Rutherford (Centre for the Developing Brain, Research Department of Early Life Imaging, School of Biomedical Engineering and Imaging Sciences, King’s College London) J Joseph V. Hajnal (Centre for the Developing Brain, Research Department of Early Life Imaging, School of Biomedical Engineering and Imaging Sciences, King’s College London) A A. David Edwards (Centre for the Developing Brain, Research Department of Early Life Imaging, School of Biomedical Engineering and Imaging Sciences, King’s College London) J Jonathan O’Muircheartaigh (Centre for the Developing Brain, Research Department of Early Life Imaging, School of Biomedical Engineering and Imaging Sciences, King’s College London) C Chiara Nosarti (Centre for the Developing Brain, Research Department of Early Life Imaging, School of Biomedical Engineering and Imaging Sciences, King’s College London) S Serena J. Counsell (Centre for the Developing Brain, Research Department of Early Life Imaging, School of Biomedical Engineering and Imaging Sciences, King’s College London)

Abstract

Abstract Children with congenital heart disease (CHD) are at increased risk of altered early brain development and neurodevelopmental impairments. Although environmental factors are known to influence neurodevelopmental outcomes, the interplay between neonatal brain structure and the home environment in shaping behavioural outcomes remains unclear. We investigated associations between neonatal structural covariance networks (SCNs), cognitively stimulating parenting, and behavioural outcomes at 4–6 years in 44 preschool children with CHD and 117 controls. Principal component analysis of 19 parent-reported questionnaires identified distinct components of childhood behaviour. Parents completed the cognitively stimulating parenting scale (CSPS) to assess cognitive stimulation at home. Forty SCNs were extracted from Jacobian determinants of neonatal T2-weighted MRI using independent component analysis. In children with CHD, anterior thalamus and cingulum morphometry was associated with empathy in childhood. Higher CSPS scores were associated with fewer neurodevelopmental difficulties in CHD, but not controls. In both groups, CSPS moderated the relationship between superior temporal gyrus morphometry and empathy while, in CHD only, CSPS moderated the relationship between inferior temporal gyrus morphometry and empathy. These findings identify early neurobiological and environmental determinants of behavioural outcomes in children with CHD and highlight the home environment as a modifiable factor in supporting neurodevelopment in this population.

Article Details

Volume / Issue Vol. 1, Issue 1
Published May 29, 2026
ISSN 2045-2322
Publisher Nature Portfolio

Journal Info

Scientific Reports

Nature Portfolio

ISSN: 2045-2322 Open Access Life Sciences

Authors (15)

B

Barat Gal-Er

Centre for the Developing Brain, Research Department of Early Life Imaging, School of Biomedical Engineering and Imaging Sciences, King’s College London

A

Alexandra F. Bonthrone

Centre for the Developing Brain, Research Department of Early Life Imaging, School of Biomedical Engineering and Imaging Sciences, King’s College London

A

Andrew T.M. Chew

S

Sian Wilson

D

Daniel Cromb

Centre for the Developing Brain, Research Department of Early Life Imaging, School of Biomedical Engineering and Imaging Sciences, King’s College London

A

Alexia Egloff

K

Kuberan Pushparajah

Research Department of Cardiovascular Imaging, School of Biomedical Engineering & Imaging Sciences, King’s College London

J

John Simpson

Department of Fetal and Paediatric Cardiology, Evelina London Children’s Hospital

M

Mirthe E.M. van der Meijden

M

Mary A. Rutherford

Centre for the Developing Brain, Research Department of Early Life Imaging, School of Biomedical Engineering and Imaging Sciences, King’s College London

J

Joseph V. Hajnal

Centre for the Developing Brain, Research Department of Early Life Imaging, School of Biomedical Engineering and Imaging Sciences, King’s College London

A

A. David Edwards

Centre for the Developing Brain, Research Department of Early Life Imaging, School of Biomedical Engineering and Imaging Sciences, King’s College London

J

Jonathan O’Muircheartaigh

Centre for the Developing Brain, Research Department of Early Life Imaging, School of Biomedical Engineering and Imaging Sciences, King’s College London

C

Chiara Nosarti

Centre for the Developing Brain, Research Department of Early Life Imaging, School of Biomedical Engineering and Imaging Sciences, King’s College London

S

Serena J. Counsell

Centre for the Developing Brain, Research Department of Early Life Imaging, School of Biomedical Engineering and Imaging Sciences, King’s College London