Cabrejo Raysa, Lacadie Cheryl, Brooks Eric, Beckett Joel, Sun Alexander, Yang Jenny, Chuang Carolyn, Eilbott Jeffrey, Duncan Charles, Steinbacher Derek, Alperovich Michael, Ventola Pamela, Pelphrey Kevin, Constable Todd, Persing John
Department of Surgery, Section of Plastic Surgery, Yale Medical School.
Department of Diagnostic Radiology, Yale University School of Medicine.
J Craniofac Surg. 2019 Mar/Apr;30(2):497-502. doi: 10.1097/SCS.0000000000005194.
The purpose of this study is to investigate further findings that corroborate similarities between corrected sagittal craniosynostosis and attention deficit hyperactivity disorder (ADHD). The aim is to further characterize the neurocognitive deficits seen in adolescents with corrected craniosynostosis by comparing it to established learning deficits such as ADHD.
A total of 30 functional magnetic resonance imaging (fMRI) of 10 sagittal nonsyndromic craniosynostosis (sNSC), 10 ADHD-combined, and 10 control adolescents were studied. The fMRI scans were analyzed utilizing Statistical Parametric Mapping (University College London, UK) and analyzed with BioImageSuite (Yale University, New Haven, CT).
The ADHD has lower connectivity to Brodmann area (BA) 11 (Montreal Neurological Institution [MNI]: -12,26,-21), BA20 (MNI: 62,-24,-25), and BA21 (MNI: 62,-32,-23) compared to sNSC and controls (P < 0.001). The sNSC has a unique visuospatial defect, compared to ADHD, created by decreased connectivity to BA31 (MNI: -3,-68,37), BA7 (MNI: -4,-68,41), BA19 (MNI: 0,-83,31), visual association cortex (MNI: -4,-78,22), and primary visual cortex (MNI: 7,-74,21) (P < 0.001).
Patients born with sNSC have different neural connections than children born with ADHD. Patients born with sNSC have decreased connections in areas of visual processing and increased connections in areas of attention and auditory processing than patients with ADHD. Therefore, children with sagittal craniosynsotosis may have learning difficulties that, similar, yet different from ADHD.
本研究旨在进一步探究能证实矫正型矢状缝早闭与注意力缺陷多动障碍(ADHD)之间相似性的其他发现。目的是通过将矫正型矢状缝早闭青少年中出现的神经认知缺陷与ADHD等已确定的学习缺陷进行比较,进一步描述这些缺陷的特征。
对10例矢状缝非综合征性颅缝早闭(sNSC)青少年、10例ADHD混合型青少年和10例对照青少年进行了总共30次功能磁共振成像(fMRI)研究。利用统计参数映射(英国伦敦大学学院)对fMRI扫描进行分析,并使用生物图像套件(美国康涅狄格州纽黑文市耶鲁大学)进行分析。
与sNSC和对照组相比,ADHD与布罗德曼区(BA)11(蒙特利尔神经病学研究所[MNI]:-12,26,-21)、BA20(MNI:62,-24,-25)和BA21(MNI:62,-32,-23)的连接性较低(P<0.001)。与ADHD相比,sNSC存在独特的视觉空间缺陷,这是由于与BA31(MNI:-3,-68,37)、BA7(MNI:-4,-68,41)、BA19(MNI:0,-83,31)、视觉联合皮层(MNI:-4,-78,22)和初级视觉皮层(MNI:7,-74,21)的连接性降低所致(P<0.001)。
出生时患有sNSC的患者与出生时患有ADHD的儿童具有不同的神经连接。与ADHD患者相比,出生时患有sNSC的患者在视觉处理区域的连接减少,而在注意力和听觉处理区域的连接增加。因此,矢状缝早闭儿童可能存在与ADHD相似但又不同的学习困难。