Socioeconomic Status, Cerebellar Structure, and Executive Functions in Children and Adolescents with Spina Bifida Myelomeningocele

Spina bifida myelomeningocele (SBM) is a congenital neurological defect associated with abnormal cerebellar structure and poorer executive functions (EFs) in children. This study investigated the impact of cerebellar volume on EFs in children with SBM and the potential moderating effect of socioeconomic status (SES). 25 typically developing (TD) children and 74 children with SBM underwent a structural MRI, which was used to measure the volumes of three cerebellar regions: the anterior lobe, posterior lobe, and corpus medullare. A parent-report questionnaire was administered which measured two major EF constructs: metacognition and behavioral regulation. We hypothesized that a larger posterior lobe and corpus medullare would predict greater EFs in both constructs, and that this prediction would be larger in children with SBM. We also hypothesized that, for children with SBM, this prediction would be larger in children with lower SES. Multivariate multiple regression analyses found that the combination of the EF constructs was predicted by group (trace=.122, p=.003) and age (trace=.114, p=.005), such that parents of younger children and children with SBM reported worse EFs. Specifically, group predicted metacognition (β=1.33, 95% CI: [40, 2.25], p=.005) and behavioral regulation at the trend level (β=.92, 95% CI: [-.07, 1.89], p=.07), and age predicted behavioral regulation (β=-.31, 95% CI: [-.51, -.10], p=.004). For children with SBM, age predicted the combination of the constructs (trace=.107, p=.03), and specifically predicted behavioral regulation (β=-.29, 95% CI: [-.55, -.03], p=.03). However, no cerebellum volume measurement significantly predicted either EF construct. The group x volume and group x SES interactions were also non-significant. Therefore, the question of the impact of cerebellar volume on EFs in SBM remains inconclusive.