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单缝颅缝早闭婴儿的神经发育:术前与病例匹配对照的比较。

Neurodevelopment of infants with single-suture craniosynostosis: presurgery comparisons with case-matched controls.

作者信息

Speltz Matthew L, Kapp-Simon Kathy, Collett Brent, Keich Yona, Gaither Rebecca, Cradock Mary M, Buono Lauren, Cunningham Michael L

机构信息

Seattle, Wash.; Chicago and Westchester, Ill.; St. Louis, Mo.; and Atlanta, Ga. From the Departments of Psychiatry and Behavioral Sciences, Epidemiology, and Pediatrics, University of Washington; Outpatient Child Psychiatry Department and Children's Craniofacial Center, Children's Hospital and Regional Medical Center; Department of Clinical Surgery, Northwestern University; Cleft Lip and Palate Institute; Department of Psychology, St. Louis Children's Hospital; and Department of Neuropsychology, Children's Health Care of Atlanta.

出版信息

Plast Reconstr Surg. 2007 May;119(6):1874-1881. doi: 10.1097/01.prs.0000259184.88265.3f.

Abstract

BACKGROUND

The hypothesized association between single-suture craniosynostosis and neurodevelopment remains unclear, given the methodologic limitations of previous studies, most notably the absence of control groups.

METHODS

Standardized measures were used to assess the neurodevelopment of 125 matched case-control pairs shortly after cases were first diagnosed with isolated fusions of the sagittal, metopic, lambdoid, or right or left coronal sutures. Participants varied in age from 2 to 24 months.

RESULTS

Cases had significantly lower mean standardized scores than controls on measures of cognitive ability and motor functioning (p < 0.02). These differences were unaffected by the location of synostosis, age of diagnosis, infant sex, and maternal IQ. Measures of early language functions revealed no group differences.

CONCLUSIONS

Before cranioplasty, single-suture craniosynostosis is associated with modest but reliable neurodevelopmental delays that cannot be attributed to maternal intelligence and family sociodemographic variables. Follow-up of this sample will determine the predictive significance of these delays. In the meantime, routine neurodevelopmental screening of infants with isolated craniosynostosis is recommended.

摘要

背景

鉴于既往研究存在方法学局限性,尤其是缺乏对照组,单缝颅缝早闭与神经发育之间的假设关联仍不明确。

方法

在病例首次被诊断为矢状缝、额缝、人字缝或右或左冠状缝孤立融合后不久,采用标准化测量方法对125对匹配的病例对照进行神经发育评估。参与者年龄在2至24个月之间。

结果

在认知能力和运动功能测量方面,病例的平均标准化得分显著低于对照组(p < 0.02)。这些差异不受颅缝早闭位置、诊断年龄、婴儿性别和母亲智商的影响。早期语言功能测量未显示组间差异。

结论

在颅骨成形术前,单缝颅缝早闭与适度但可靠的神经发育延迟相关,这不能归因于母亲智力和家庭社会人口统计学变量。对该样本的随访将确定这些延迟的预测意义。同时,建议对孤立性颅缝早闭婴儿进行常规神经发育筛查。

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