Junn Alexandra, Dinis Jacob, Park Kitae E, Hauc Sacha, Yang Jenny F, Chuang Carolyn, Han Gloria, McPartland James C, Persing John A, Alperovich Michael
Section of Plastic and Reconstructive Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Conn.
Child Study Center, Yale University School of Medicine, New Haven, Conn.
Plast Reconstr Surg Glob Open. 2021 Oct 4;9(10):e3844. doi: 10.1097/GOX.0000000000003844. eCollection 2021 Oct.
Previous studies demonstrated impaired auditory processing in children with sagittal and metopic craniosynostosis before surgical correction. This study investigated whether worse presurgical neural response as assessed by event-related potentials (ERP) was predictive of poorer school-age neurocognition.
Preoperative infant ERP was recorded in 15 sagittal and 18 metopic patients. Mismatch negativity and P150 paradigms were derived from ERP recordings, as previously published. Of those, 13 sagittal and 13 metopic patients returned for neurocognitive evaluation 6 or more years later. ERP was correlated to neurocognitive outcomes using Spearman's correlations controlling for age. Two-tailed t-tests were used to evaluate the influence of age at the time of surgery (6 months) and morphologic severity on neurocognitive outcomes.
In the sagittal group, no significant correlations were found between preoperative mismatch negativity or P150 amplitudes and neurocognitive outcomes. Although no correlation was found between mismatch negativity and neurocognitive outcome in the metopic group, those with lower P150 amplitudes had higher scores in performance IQ (r = -0.877, P < 0.001) and full-scale IQ (r = -0.893, < 0.001). Morphologic severity and neurocognitive outcomes showed no relationship in the sagittal or metopic groups. Patients who received surgery at less than 6 months had higher full-scale IQ (109.69 versus 95.92, = 0.025), visuomotor integration (103.15 versus 90.46, = 0.041), and visual perception scores (105.69 versus 96.08, = 0.033).
Preoperative infant ERP does not correlate with school-age neurocognitive outcomes. Earlier age at the time of surgery was associated with improved neurocognitive outcomes.
先前的研究表明，矢状缝和额缝早闭患儿在手术矫正前存在听觉处理障碍。本研究调查了术前通过事件相关电位（ERP）评估的较差神经反应是否可预测学龄期神经认知功能较差。
对15例矢状缝早闭和18例额缝早闭患儿进行术前婴儿ERP记录。如先前发表的那样，从ERP记录中得出失配负波和P150范式。其中，13例矢状缝早闭和13例额缝早闭患儿在6年或更长时间后返回进行神经认知评估。使用控制年龄的Spearman相关性分析将ERP与神经认知结果相关联。采用双尾t检验评估手术时年龄（6个月）和形态学严重程度对神经认知结果的影响。
在矢状缝早闭组中，术前失配负波或P150波幅与神经认知结果之间未发现显著相关性。虽然在额缝早闭组中失配负波与神经认知结果之间未发现相关性，但P150波幅较低的患儿在操作智商（r = -0.877，P < 0.001）和全量表智商（r = -0.893，P < 0.001）方面得分较高。在矢状缝早闭或额缝早闭组中，形态学严重程度与神经认知结果之间均无关系。6个月前接受手术的患儿全量表智商（109.69对95.92，P = 0.025）、视觉运动整合能力（103.15对90.46，P = 0.041）和视觉感知得分（105.69对96.08，P = 0.033）更高。
术前婴儿ERP与学龄期神经认知结果无关。手术时年龄较小与神经认知结果改善相关。
