Brain-Wide Resting-State Functional Connectivity Partially Mediates Socioeconomic Disparities in Children's Cardiometabolic Health.

Background: Although some neural mechanisms underlying socioeconomic status (SES) disparities are known, the role of brain-wide resting-state functional connectivity in these effects remains less understood.

Aim: This study aims to identify brain-wide resting-state functional connectivity signatures that may mediate the effects of SES on body mass index (BMI) and blood pressure in children, using data from the Adolescent Brain Cognitive Development (ABCD) study.

Methods: Data were drawn from the ABCD study, a large, diverse cohort of children aged 9-10. Pre-processed resting-state functional MRI data were used, and factor analysis was conducted to extract a whole- brain connectivity factor. The first factor, capturing the greatest variance in brain-wide resting-state connectivity, was selected for further analysis in a structural equation model (SEM). This connectivity factor was tested as a potential mediator of the relationship between SES (measured by parental education, family income, and neighborhood characteristics) and two indicators of cardiometabolic health: BMI and systolic blood pressure.

Results: Factor analysis revealed a robust first factor that accounted for a significant proportion of variance in brain-wide resting-state functional connectivity. This factor was significantly associated with SES, indicating that children from lower SES backgrounds exhibited distinct connectivity patterns. Additionally, the factor was linked to both BMI and systolic blood pressure, suggesting its relevance to cardiometabolic health. Mediation analysis showed that this connectivity factor partially mediated the relationship between SES and both BMI and systolic blood pressure.

Conclusions: Brain-wide functional connectivity may be a mediator of SES effects on BMI and blood pressure in children. The first connectivity factor provides a promising neural signature linking SES with cardiometabolic risk. Comprehensive brain- wide approaches to functional connectivity may offer valuable insights into how social determinants of health shape neural and physical development in childhood.