Nasal nitric oxide (nNO) may be a proxy for NO or NO synthase (NOS) availability in the brain, while NO/NOS availability is likely related to metabolism and downstream to neurocognitive function. We tested this hypothesis using a mediation analysis with nNO the independent variable, regional CBF (rCBF) as measured by ASL the mediator, and neurocognitive outcome (NIH Toolbox) the dependent variable in a cohort of normal adolescents and adolescents with congenital heart disease. Anterior and posterior default mode network regions positively mediated all NIH Toolbox composite scores, especially crystallized cognition. Results indicate nNO may be a powerful biomarker for brain function and metabolism.
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