Bilateral remote ischemic conditioning in children: A two-center, double-blind, randomized controlled trial in young children undergoing cardiac surgery.

Objective: The study objective was to determine whether adequately delivered bilateral remote ischemic preconditioning is cardioprotective in young children undergoing surgery for 2 common congenital heart defects with or without cyanosis. Methods: We performed a prospective, double-blind, randomized controlled trial at 2 centers in the United Kingdom. Children aged 3 to 36 months undergoing tetralogy of Fallot repair or ventricular septal defect closure were randomized 1:1 to receive bilateral preconditioning or sham intervention. Participants were followed up until hospital discharge or 30 days. The primary outcome was area under the curve for high-sensitivity troponin-T in the first 24 hours after surgery, analyzed by intention-to-treat. Right atrial biopsies were obtained in selected participants. Results: Between October 2016 and December 2020, 120 eligible children were randomized to receive bilateral preconditioning (n = 60) or sham intervention (n = 60). The primary outcome, area under the curve for high-sensitivity troponin-T, was higher in the preconditioning group (mean: 70.0 ± 50.9 µg/L/h, n = 56) than in controls (mean: 55.6 ± 30.1 µg/L/h, n = 58) (mean difference, 13.2 µg/L/h; 95% CI, 0.5-25.8; P = .04). Subgroup analyses did not show a differential treatment effect by oxygen saturations (pinteraction = .25), but there was evidence of a differential effect by underlying defect (pinteraction = .04). Secondary outcomes and myocardial metabolism, quantified in atrial biopsies, were not different between randomized groups. Conclusions: Bilateral remote ischemic preconditioning does not attenuate myocardial injury in children undergoing surgical repair for congenital heart defects, and there was evidence of potential harm in unstented tetralogy of Fallot. The routine use of remote ischemic preconditioning cannot be recommended for myocardial protection during pediatric cardiac surgery.

Is a sex difference in audio-visual temporal precision consistent across age groups? An update on Hernández et al. (2019).

Hernández et al. (2019) previously reported independent age and sex differences in temporal audio-visual integration in a large national cohort of older adults. Susceptibility to the sound induced flash illusion (SIFI) at long stimulus onset asynchronies (SOAs) increased with age and was stronger in older adult females than males. However, it is unclear if this sex difference is stable across age. We reanalyzed the data set used by Hernández et al. (2019) on SIFI performance from 3,479 older adults (Mage = 64.20 years, SD = 7.77, range = 50-93; 56% female) across three age groups (50-64, 65-74, and 75+ years), drawn from The Irish Longitudinal Study on Ageing. For the 70 ms SOA, females were less susceptible to the SIFI than males, irrespective of age. At longer SOAs (150 ms and 230 ms), females aged 50-64 years but not older were more susceptible to the SIFI than age-matched males. These findings extend those of Hernández et al. (2019) by indicating that age and sex can collectively influence the precision of multisensory integration exhibited by older adults. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Nutrition is associated with differences in multisensory integration in healthy older adults.

Diet can influence cognitive functioning in older adults and is a modifiable risk factor for cognitive decline. However, it is unknown if an association exists between diet and lower-level processes in the brain underpinning cognition, such as multisensory integration. We investigated whether temporal multisensory integration is associated with daily intake of fruit and vegetables (FV) or products high in fat/sugar/salt (FSS) in a large sample (N = 2,693) of older adults (mean age = 64.06 years, SD = 7.60; 56% female) from The Irish Longitudinal Study on Ageing (TILDA). Older adults completed a Food Frequency Questionnaire from which the total number of daily servings of FV and FSS items respectively was calculated. Older adults' susceptibility to the Sound Induced Flash Illusion (SIFI) measured the temporal precision of audio-visual integration, which included three audio-visual Stimulus Onset Asynchronies (SOAs): 70, 150 and 230 ms. Older adults who self-reported a higher daily consumption of FV were less susceptible to the SIFI at the longest versus shortest SOAs (i.e. increased temporal precision) compared to those reporting the lowest daily consumption (p = .013). In contrast, older adults reporting a higher daily consumption of FSS items were more susceptible to the SIFI at the longer versus shortest SOAs (i.e. reduced temporal precision) compared to those reporting the lowest daily consumption (p < .001). The temporal precision of multisensory integration is differentially associated with levels of daily consumption of FV versus products high in FSS, consistent with broader evidence that habitual diet is associated with brain health.

Distinct profiles of multisensory processing between professional goalkeepers and outfield football players.

In association football (soccer), the position of goalkeeper is the most specialised position in the sport and has the primary objective of stopping the opposing team from scoring. While previous studies have highlighted differences in physiological and match performance profiles between goalkeepers and outfield players1, surprisingly little research has focused on whether goalkeepers differ in terms of their perceptual-cognitive abilities. Given that goalkeepers use multiple sensory cues and are often required to make rapid decisions based on incomplete multisensory information to fulfil their role2, we hypothesised that professional goalkeepers would display enhanced multisensory temporal processing relative to their outfield counterparts. To test this hypothesis, we measured the temporal binding windows - the time window within which signals from the different senses are integrated into a single percept - of professional goalkeepers, professional outfield players, and a control group with no professional football experience using the sound-induced flash illusion3. Our results indicated a marked difference in multisensory processing between the three groups. Specifically, we found that the goalkeepers displayed a narrower temporal binding window relative to both outfielders and control participants, indicating more precise audiovisual timing estimation. However, this enhanced multisensory temporal processing was accompanied by a general reduction in crossmodal interactions relative to the other two groups that could be attributed to an a priori tendency to segregate sensory signals. We propose that these differences stem from the idiosyncratic nature of the goalkeeping position that puts a premium on the ability of goalkeepers to make quick decisions, often based on partial or incomplete sensory information.

Audio-visual integration is more precise in older adults with a high level of long-term physical activity.

It is well established that physical activity leads to numerous health, cognitive, and psychological benefits. However, to date, very few studies have investigated the impact of physical activity on multisensory perception, that is, the brain's capacity to integrate information across sensory modalities. Furthermore, it is unknown what level of long-term physical activity is associated with multisensory integration in adults. We explored the relationship between multisensory integration and a ten-year physical activity trajectory in 2,974 adults aged 50+ from The Irish Longitudinal Study on Ageing by measuring susceptibility to the Sound Induced Flash Illusion (SIFI) at multiple audio-visual temporal asynchronies. Physical activity was measured using the International Physical Activity Questionnaire (IPAQ-SF) at 2 years intervals over ten years. We used latent class trajectory modelling to identify latent growth classes of individuals following a similar trajectory of physical activity over time. We analysed the association of this trajectory with performance accuracy to the illusion trials of the SIFI task with generalized logistic mixed effects regression models, adjusted for several covariates. Results showed that more precise integration (i.e., lower SIFI susceptibility with larger temporal asynchronies) was associated with a higher level of sustained physical activity across ten years. Although the use of self-reported physical activity and a short version of the SIFI task limit our conclusions to some extent, nonetheless, the results suggest that sustained physical activity is associated with more precise multisensory integration, which in turn is linked to better balance and a lower risk of falling in older adults.

The temporal precision of audiovisual integration is associated with longitudinal fall incidents but not sensorimotor fall risk in older adults.

Sustained multisensory integration over long inter-stimulus time delays is typically found in older adults, particularly those with a history of falls. However, the extent to which the temporal precision of audio-visual integration is associated with longitudinal fall or fall risk trajectories is unknown. A large sample of older adults (N = 2319) were grouped into longitudinal trajectories of self-reported fall incidents (i.e., decrease, stable, or increase in number) and, separately, their performance on a standard, objective measure of fall risk, Timed Up and Go (TUG; stable, moderate decline, severe decline). Multisensory integration was measured once as susceptibility to the Sound-Induced Flash Illusion (SIFI) across three stimulus onset asynchronies (SOAs): 70 ms, 150 ms and 230 ms. Older adults with an increasing fall number showed a significantly different pattern of performance on the SIFI than non-fallers, depending on age: For adults with increasing incidents of falls, those aged 53-59 years showed a much smaller difference in illusion susceptibility at 70 ms versus 150 ms than those aged 70 + years. In contrast, non-fallers showed a more comparable difference between these SOA conditions across age groups. There was no association between TUG performance trajectories and SIFI susceptibility. These findings suggests that a fall event is associated with distinct temporal patterns of multisensory integration in ageing and have implications for our understanding of the mechanisms underpinning brain health in older age.

Susceptibility to the sound-induced flash illusion is associated with gait speed in a large sample of middle-aged and older adults.

BACKGROUND: Multisensory integration is the ability to appropriately merge information from different senses for the purpose of perceiving and acting in the environment. During walking, information from multiple senses must be integrated appropriately to coordinate effective movements. We tested the association between a well characterised multisensory task, the Sound-Induced Flash Illusion (SIFI), and gait speed in 3255 participants from The Irish Longitudinal Study on Ageing. High susceptibility to this illusion at longer stimulus onset asynchronies characterises older adults, and has been associated with cognitive and functional impairments, therefore it should be associated with slower gait speed. METHOD: Gait was measured under three conditions; usual pace, cognitive dual tasking, and maximal walking speed. A separate logistic mixed effects regression model was run for 1) gait at usual pace, 2) change in gait speed for the cognitive dual tasking relative to usual pace and 3) change in maximal walking speed relative to usual pace. In all cases a binary response indicating a correct/incorrect response to each SIFI trial was the dependent variable. The model controlled for covariates including age, sex, education, vision and hearing abilities, Body Mass Index, and cognitive function. RESULTS: Slower gait was associated with more illusions, particularly at longer temporal intervals between the flash-beep pair and the second beep, indicating that those who integrated incongruent sensory inputs over longer intervals, also walked slower. The relative changes in gait speed for cognitive dual tasking and maximal walking speed were also significantly associated with SIFI at longer SOAs. CONCLUSIONS: These findings support growing evidence that mobility, susceptibility to falling and balance control are associated with multisensory processing in ageing.

Can we measure individual differences in cognitive measures reliably via smartphones? A comparison of the flanker effect across device types and samples.

Research deployed via the internet and administered via smartphones could have access to more diverse samples than lab-based research. Diverse samples could have relatively high variation in their traits and so yield relatively reliable measurements of individual differences in these traits. Several cognitive tasks that originated from the experimental research tradition have been reported to yield relatively low reliabilities (Hedge et al., 2018) in samples with restricted variance (students). This issue could potentially be addressed by smartphone-mediated administration in diverse samples. We formulate several criteria to determine whether a cognitive task is suitable for individual differences research on commodity smartphones: no very brief or precise stimulus timing, relative response times (RTs), a maximum of two response options, and a small number of graphical stimuli. The flanker task meets these criteria. We compared the reliability of individual differences in the flanker effect across samples and devices in a preregistered study. We found no evidence that a more diverse sample yields higher reliabilities. We also found no evidence that commodity smartphones yield lower reliabilities than commodity laptops. Hence, diverse samples might not improve reliability above student samples, but smartphones may well measure individual differences with cognitive tasks reliably. Exploratively, we examined different reliability coefficients, split-half reliabilities, and the development of reliability estimates as a function of task length.

Perceptual training narrows the temporal binding window of audiovisual integration in both younger and older adults.

There is a growing body of evidence to suggest that multisensory processing changes with advancing age - usually in the form of an enlarged temporal binding window - with some studies linking these multisensory changes to negative clinical outcomes. Perceptual training regimes represent a promising means for enhancing the precision of multisensory integration in ageing; however, to date, the vast majority of studies examining the efficacy of multisensory perceptual learning have focused solely on healthy young adults. Here, we measured the temporal binding windows of younger and older participants before and after training on an audiovisual temporal discrimination task to assess (i) how perceptual training affected the shape of the temporal binding window and (ii) whether training effects were similar in both age groups. Our results replicated previous findings of an enlarged temporal binding window in older adults, as well as providing further evidence that both younger and older participants can improve the precision of their audiovisual timing estimation via perceptual training. We also show that this training protocol led to a narrowing of the temporal binding window associated with the sound-induced flash illusion in both age groups indicating a general refinement of audiovisual integration. However, while younger adults also displayed a general reduction in crossmodal interactions following training, this effect was not observed in the older adult group. Together, our results suggest that perceptual training narrows the temporal binding window of audiovisual integration in both younger and older adults but has less of an impact on prior expectations regarding the source of audiovisual signals in older adults.

The magnitude of the sound-induced flash illusion does not increase monotonically as a function of visual stimulus eccentricity.

The sound-induced flash illusion (SIFI) occurs when a rapidly presented visual stimulus is accompanied by two auditory stimuli, creating the illusory percept of two visual stimuli. While much research has focused on how the temporal proximity of the audiovisual stimuli impacts susceptibility to the illusion, comparatively less research has focused on the impact of spatial manipulations. Here, we aimed to assess whether manipulating the eccentricity of visual flash stimuli altered the properties of the temporal binding window associated with the SIFI. Twenty participants were required to report whether they perceived one or two flashes that were concurrently presented with one or two beeps. Visual stimuli were presented at one of four different retinal eccentricities (2.5, 5, 7.5, or 10 degrees below fixation) and audiovisual stimuli were separated by one of eight stimulus-onset asynchronies. In keeping with previous findings, increasing stimulus-onset asynchrony between the auditory and visual stimuli led to a marked decrease in susceptibility to the illusion allowing us to estimate the width and amplitude of the temporal binding window. However, varying the eccentricity of the visual stimulus had no effect on either the width or the peak amplitude of the temporal binding window, with a similar pattern of results observed for both the "fission" and "fusion" variants of the illusion. Thus, spatial manipulations of the audiovisual stimuli used to elicit the SIFI appear to have a weaker effect on the integration of sensory signals than temporal manipulations, a finding which has implications for neuroanatomical models of multisensory integration.

Self-Reported Sensory Decline in Older Adults Is Longitudinally Associated With Both Modality-General and Modality-Specific Factors.

Background and Objectives: Self-reported sensory data provide important insight into an individual's perception of sensory ability. It remains unclear what factors predict longitudinal change in self-reported sensory ability across multiple modalities during healthy aging. This study examined these associations in a cohort of older adults for vision, hearing, taste, and smell. Research Design and Methods: Data on self-report sensory ability were drawn from 5,065 participants of The Irish Longitudinal Study on Ageing (mean age at baseline = 61.6, SD = 9.5, range 32-93 years; 59% female; resident in the Republic of Ireland) across 6 waves of data collection (2009-2021). Covariates included demographics, lifestyle factors, and measures of sensory, physical, mental, and cognitive health. Independent discrete survival analyses were performed for each sensory modality. Results: A transition to self-reported fair/poor hearing was most prevalent (21% of the sample), followed by fair/poor vision (19%), smell (11%), and taste (6%). Participants who self-reported fair/poor function in one sensory modality were likely to report fair/poor ability in another sensory modality, although not for all pairings. Only self-rated fair/poor health was associated with increased odds of self-reported fair/poor ability across all sensory modalities. Age was associated with increased odds of self-reported fair/poor hearing, smell, and taste, as was current smoker status (vision, smell, and taste). Several other sensory (e.g., eye disease, hearing aid use) and nonsensory covariates (e.g., education, depression) were associated with the odds of self-reported fair/poor ability in one or two sensory modalities only. Discussion and Implications: Over time, older adults perceive associations in fair/poor ability for multiple sensory modalities, albeit somewhat inconsistently. Both modality-general and modality-specific factors are associated with a transition from normal to fair/poor sensory ability. These results suggest the need for more routine testing of multiple senses with increasing age.

Sleep duration, sleep problems, and perceived stress are associated with hippocampal subfield volumes in later life: findings from The Irish Longitudinal Study on Ageing.

STUDY OBJECTIVES: This study examines the cross-sectional and 2-year follow-up relationships between sleep and stress and total hippocampal volume and hippocampal subfield volumes among older adults. METHODS: Four hundred seventeen adults (aged 68.8 ± 7.3; 54% women) from the Irish Longitudinal Study on Ageing completed an interview, a questionnaire, and multiparametric brain magnetic resonance imaging. The relationships between self-reported sleep duration, sleep problems, perceived stress, and total hippocampal volume were examined by using ordinary least squares regressions. Linear mixed-effects models were used to investigate the relationships between sleep duration, sleep problems, perceived stress, changes in these measures over 2-years, and hippocampal subfield volumes. RESULTS: No cross-sectional and follow-up associations between sleep and total hippocampal volume and between stress and total hippocampal volume were found. By contrast, Long sleep (≥9-10 h/night) was associated with smaller volumes of molecular layer, hippocampal tail, presubiculum, and subiculum. The co-occurrence of Short sleep (≤6 h) and perceived stress was associated with smaller cornu ammonis 1, molecular layer, subiculum, and tail. Sleep problems independently and in conjunction with higher stress, and increase in sleep problems over 2 years were associated with smaller volumes of these same subfields. CONCLUSION: Our study highlights the importance of concurrently assessing suboptimal sleep and stress for phenotyping individuals at risk of hippocampal subfield atrophy.

OSARI, an Open-Source Anticipated Response Inhibition Task.

The stop-signal paradigm has become ubiquitous in investigations of inhibitory control. Tasks inspired by the paradigm, referred to as stop-signal tasks, require participants to make responses on go trials and to inhibit those responses when presented with a stop-signal on stop trials. Currently, the most popular version of the stop-signal task is the 'choice-reaction' variant, where participants make choice responses, but must inhibit those responses when presented with a stop-signal. An alternative to the choice-reaction variant of the stop-signal task is the 'anticipated response inhibition' task. In anticipated response inhibition tasks, participants are required to make a planned response that coincides with a predictably timed event (such as lifting a finger from a computer key to stop a filling bar at a predefined target). Anticipated response inhibition tasks have some advantages over the more traditional choice-reaction stop-signal tasks and are becoming increasingly popular. However, currently, there are no openly available versions of the anticipated response inhibition task, limiting potential uptake. Here, we present an open-source, free, and ready-to-use version of the anticipated response inhibition task, which we refer to as the OSARI (the Open-Source Anticipated Response Inhibition) task.

Urban and rural environments differentially shape multisensory perception in ageing.

Recent studies suggest that the lived environment can affect cognition across the lifespan. We examined, in a large cohort of older adults (n = 3447), whether susceptibility to a multisensory illusion, the Sound-Induced Flash Illusion (SIFI), was influenced by the reported urbanity of current and childhood (at age 14 years) residence. If urban environments help to shape healthy perceptual function, we predicted reduced SIFI susceptibility in urban dwellers. Participants reporting urban, compared with rural, childhood residence were less susceptible to SIFI at longer Stimulus-Onset Asynchronies (SOAs). Those currently residing in urban environments were more susceptible to SIFI at longer SOAs, particularly if they scored low on general cognitive function. These findings held even when controlling for a several covariates, such as age, sex, education, social participation and cognitive ability. Exposure to urban environments in childhood may influence individual differences in perception and offer a multisensory perceptual benefit in older age.

Multisensory integration precision is associated with better cognitive performance over time in older adults: A large-scale exploratory study.

Age-related sensory decline impacts cognitive performance and exposes individuals to a greater risk of cognitive decline. Integration across the senses also changes with age, yet the link between multisensory perception and cognitive ageing is poorly understood. We explored the relationship between multisensory integration and cognitive function in 2875 adults aged 50 + from The Irish Longitudinal Study on Ageing. Multisensory integration was assessed at several audio-visual temporal asynchronies using the Sound Induced Flash Illusion (SIFI). More precise integration (i.e. less illusion susceptibility with larger temporal asynchronies) was cross-sectionally associated with faster Choice Response Times and Colour Trail Task performance, and fewer errors on the Sustained Attention to Response Task. We then used k-means clustering to identify groups with different 10-year cognitive trajectories on measures available longitudinally; delayed recall, immediate recall and verbal fluency. Across measures, groups with consistently higher performance trajectories had more precise multisensory integration. These findings support broad links between multisensory integration and several cognitive measures, including processing speed, attention and memory, rather than association with any specific subdomain.

The development of visuotactile congruency effects for sequences of events.

Sensitivity to the temporal coherence of visual and tactile signals increases perceptual reliability and is evident during infancy. However, it is not clear how, or whether, bidirectional visuotactile interactions change across childhood. Furthermore, no study has explored whether viewing a body modulates how children perceive visuotactile sequences of events. Here, children aged 5-7 years (n = 19), 8 and 9 years (n = 21), and 10-12 years (n = 24) and adults (n = 20) discriminated the number of target events (one or two) in a task-relevant modality (touch or vision) and ignored distractors (one or two) in the opposing modality. While participants performed the task, an image of either a hand or an object was presented. Children aged 5-7 years and 8 and 9 years showed larger crossmodal interference from visual distractors when discriminating tactile targets than the converse. Across age groups, this was strongest when two visual distractors were presented with one tactile target, implying a "fission-like" crossmodal effect (perceiving one event as two events). There was no influence of visual context (viewing a hand or non-hand image) on visuotactile interactions for any age group. Our results suggest robust interference from discontinuous visual information on tactile discrimination of sequences of events during early and middle childhood. These findings are discussed with respect to age-related changes in sensory dominance, selective attention, and multisensory processing.

Gray matter volume in the right angular gyrus is associated with differential patterns of multisensory integration with aging.

Multisensory perception might provide an important marker of brain function in aging. However, the cortical structures supporting multisensory perception in aging are poorly understood. In this study, we compared regional gray matter volume in a group of middle-aged (n = 101; 49-64 years) and older (n = 116; 71-87 years) adults from The Irish Longitudinal Study on Aging using voxel-based morphometry. Participants completed a measure of multisensory integration, the sound-induced flash illusion, and were grouped as per their illusion susceptibility. A significant interaction was observed in the right angular gyrus; in the middle-aged group, larger gray matter volume corresponded to stronger illusion perception while in older adults larger gray matter corresponded to less illusion susceptibility. This interaction remained significant even when controlling for a range of demographic, sensory, cognitive, and health variables. These findings show that multisensory integration is associated with specific structural differences in the aging brain and highlight the angular gyrus as a possible "cross-modal hub" associated with age-related change in multisensory perception.

The effect of eye disease, cataract surgery and hearing aid use on multisensory integration in ageing.

Sensory impairment is common in ageing, as are approaches to treat it. However, the impact of age-related sensory impairment upon multisensory perception remains unexplored, despite the multisensory nature of our environment. Here, we used data from The Irish Longitudinal Study of Ageing (TILDA) to investigate whether common, age-related eye diseases (cataracts, glaucoma and Age-Related Macular Degeneration, ARMD) and clinical intervention to improve sensory function (cataract removal and hearing aids) influence multisensory integration in older adults. Integration was measured using the Sound-Induced Flash Illusion (SIFI), and the extent to which identifying two flashes was improved by accompanying auditory information ("visual gain"). Visual gain was not influenced by eye disease or treatment. For the SIFI, participants self-reporting cataracts, ARMD or glaucoma were as susceptible as healthy controls, even when controlling for age, sex, cognition, self-reported vision/hearing and visual acuity. In a second analysis using retinal photographs, glaucoma and ARMD (hard drusen) did not influence susceptibility relative to controls. However, participants with soft drusen ARMD were more susceptible to the illusion at long Stimulus-Onset Asynchronies (SOAs) compared with controls. Following this, we identified groups reporting bilateral cataract removal or hearing aid acquisition >4 years and <2 years prior to assessment, enabling comparison of longer- and shorter-term effects of interventions. Cataract removal groups did not differ from controls. Longer-term hearing aid users were less susceptible to the SIFI at short SOAs compared with controls. Our findings suggest that multisensory integration in ageing might be specifically influenced by ARMD (soft drusen) and hearing aid use.

What you see is what you hear: Twenty years of research using the Sound-Induced Flash Illusion.

In the Sound-Induced Flash Illusion (SIFI) sound dramatically alters visual perception, as presenting a single flash with two beeps results in the perception of two flashes. In this comprehensive review, we synthesise 20 years of research using the SIFI, from over 100 studies. We discuss the neural and computational principles governing this illusion and examine the influence of perceptual experience, development, ageing and clinical conditions. Convergent findings show that the SIFI results from optimal integration and probabilistic inference and directly reflects crossmodal interactions in the temporal domain. Its neural basis lies in early modulation of visual cortex by auditory and multisensory regions. The SIFI shows increasingly strong potential as an efficient tool for measuring multisensory processing. Greater harmonisation across studies is now required to maximise this potential. We therefore propose considerations for researchers relating to choice of stimulus parameters and signpost directions for future research.

Impaired orthostatic heart rate recovery is associated with smaller thalamic volume: Results from The Irish Longitudinal Study on Aging (TILDA).

The thalamus is a central hub of the autonomic network and thalamic volume has been associated with high-risk phenotypes for sudden cardiac death. Heart rate response to physiological stressors (e.g., standing) and the associated recovery patterns provide reliable indicators of both autonomic function and cardiovascular risk. Here we examine if thalamic volume may be a risk marker for impaired heart rate recovery in response to orthostatic challenge. The Irish Longitudinal Study on Aging involves a nationally representative sample of older individuals aged ≥50 years. Multimodal brain magnetic resonance imaging and orthostatic heart rate recovery were available for a cross-sectional sample of 430 participants. Multivariable regression and linear mixed-effects models were adjusted for head size, age, sex, education, body mass index, blood pressure, history of cardiovascular diseases and events, cardiovascular medication, diabetes mellitus, smoking, alcohol intake, timed up-and-go (a measure of physical frailty), physical exercise and depression. Smaller thalamic volume was associated with slower heart rate recovery (-1.4 bpm per 1 cm3 thalamic volume, 95% CI -2.01 to -0.82; p < .001). In multivariable analysis, participants with smaller thalamic volumes had a mean heart rate recovery -2.7 bpm slower than participants with larger thalamic volumes (95% CI -3.89 to -1.61; p < .001). Covariates associated with smaller thalamic volume included age, history of diabetes, and heavy alcohol consumption. Thalamic volume may be an indicator of the structural integrity of the central autonomic network. It may be a clinical biomarker for stratification of individuals at risk of autonomic dysfunction, cardiovascular events, and sudden cardiac death.