Section of Plastic Surgery, Department of Surgery, Yale School of Medicine.
Magnetic Resonance Research Center, Yale School of Medicine, New Haven, CT.
J Craniofac Surg. 2021 May 1;32(3):910-914. doi: 10.1097/SCS.0000000000007274.
Unicoronal synostosis (UCS) has been associated with reading, language, and social dysfunction. Limited brain function connectivity studies exist for UCS with none devoted to comparing outcomes by side of synostosis (left versus right-sided UCS).
Twelve patients with surgically treated UCS, 7 right-sided and 5 left-sided, were age matched to healthy controls. Resting state functional MRI was acquired in a 3T Siemens TIM Trio scanner (Erlangen, Germany). Data was collected with intrinsic connectivity distribution and seed-connectivity analysis using BioImage Suite (Yale School of Medicine). Region of interest analysis was performed based on Brodmann areas related to emotional, executive, language, motor, and visuo-spatial function. Significance was set at P < 0.05.
Compared to controls, all UCS patients demonstrated decreased connectivity in areas of the parietal and temporal cortices responsible for visuo-motor coordination and language function. Right UCS patients demonstrated decreased intrinsic connectivity in regions related to complex motor movement and proprioception relative to control subjects. Left UCS patients demonstrated decreased seed connectivity between regions of the parietal lobe and occipital lobe related to motor coordination, visual function, and language compared to right UCS patients.
Unicoronal synostosis had decreased functional connectivity in regions associated with memory, visual information processing, and motor function. Moreover, left-sided UCS had decreased connectivity in circuits for motor coordination and language when compared to right-sided UCS. This study provides data suggestive of long-term sequelae of UCS that varies by sidedness, which may be responsible for neurocognitive impairments found in previous cognitive analyses.
颅缝早闭(UCS)与阅读、语言和社交功能障碍有关。虽然有一些关于 UCS 的大脑功能连接性研究,但没有一项研究专门比较颅缝侧别(左侧与右侧 UCS)对结果的影响。
12 例接受手术治疗的 UCS 患者(7 例右侧,5 例左侧)与健康对照组进行年龄匹配。在 3T 西门子 TIM Trio 扫描仪(德国埃朗根)上采集静息态功能磁共振成像(rs-fMRI)数据。使用 BioImage Suite(耶鲁大学医学院)进行内在连通性分布和种子连通性分析。基于与情感、执行、语言、运动和视空间功能相关的布罗德曼区域进行感兴趣区分析。以 P < 0.05 为显著性标准。
与对照组相比,所有 UCS 患者的顶叶和颞叶皮质区域的连通性降低,这些区域负责视动协调和语言功能。与对照组相比,右侧 UCS 患者的复杂运动和本体感觉相关区域的内在连通性降低。与右侧 UCS 患者相比,左侧 UCS 患者的顶叶和枕叶之间与运动协调、视觉功能和语言相关的种子连通性降低。
UCS 患者与记忆、视觉信息处理和运动功能相关的区域功能连通性降低。此外,与右侧 UCS 相比,左侧 UCS 的运动协调和语言相关回路的连通性降低。本研究提供的数据提示 UCS 存在长期的继发病变,其侧别不同,这可能是先前认知分析中发现的神经认知障碍的原因。