School of Psychology, University of Adelaide , Adelaide, South Australia, Australia.
The Australian Craniofacial Unit, Women's and Children's Hospital , North Adelaide, South Australia, Australia.
Child Neuropsychol. 2021 Feb;27(2):190-208. doi: 10.1080/09297049.2020.1817356. Epub 2020 Sep 8.
Children diagnosed with metopic synostosis (MS) commonly experience poor neuropsychological outcomes, with research suggesting that children whose MS is managed conservatively (without surgery) potentially having worse outcomes than their operated peers. However, studies of children whose MS was managed conservatively are scarce. This study therefore examined the cognitive, behavioral, and psychological functioning of children/adults with conservatively managed MS ( = 38) and compares their outcomes to individually matched healthy controls ( = 38) of the same age and sex (matched-pairs design) from the general community. Age-appropriate, validated assessments measuring general cognition, verbal and visuospatial ability, attention and working memory, executive functioning, behavior, depression, anxiety, and satisfaction with appearance were utilized. Group differences were estimated using linear regression for (a) the overall sample and (b) by broad developmental stages: 2&3 yrs; ≥6-≤17. Moderate to large negative effects ( = -0.38 to -1.30) were evident before controlling for socio-economic status (SES), with the MS group performing significantly worse on 8 out of the 10 cognitive domains (general cognition, visuospatial ability, working memory, information processing, executive functioning: semantic & initial letter verbal fluency, switching, inhibition+switching). However, only initial letter verbal fluency ( = -0.99) and switching ( = -1.19) remained significant after adjusting for SES. The MS group displayed more behavioral problems, although this was not significant. Depression, anxiety, and satisfaction with appearance did not differ between the groups. Regular monitoring of cognitive functioning, particularly executive functioning, should be undertaken for those with conservatively managed MS.
患有额缝早闭（MS）的儿童通常经历较差的神经心理结局，研究表明，接受保守治疗（不手术）的 MS 儿童比接受手术的同龄儿童可能有更差的结局。然而，关于接受保守治疗的 MS 儿童的研究很少。因此，本研究检查了接受保守治疗的 MS 儿童/成人（n = 38）的认知、行为和心理功能，并将他们的结果与来自普通社区的同年龄和同性别（配对设计）的经个体匹配的健康对照组（n = 38）进行比较。使用了适合年龄的、经过验证的评估方法，测量一般认知、言语和视空间能力、注意力和工作记忆、执行功能、行为、抑郁、焦虑和对外观的满意度。使用线性回归估计了组间差异：（a）整体样本，（b）按广泛的发育阶段：2&3 岁；≥6-≤17 岁。在不考虑社会经济地位（SES）的情况下，MS 组的中度至较大负效应（=-0.38 至-1.30）明显，在 10 个认知领域中的 8 个领域（一般认知、视空间能力、工作记忆、信息处理、执行功能：语义和首字母言语流畅性、转换、抑制+转换）中表现明显更差。然而，只有在调整 SES 后，首字母言语流畅性（=-0.99）和转换（=-1.19）仍然显著。MS 组表现出更多的行为问题，但这并不显著。抑郁、焦虑和对外观的满意度在两组之间没有差异。对于接受保守治疗的 MS 患者，应定期监测认知功能，特别是执行功能。
